Health IT in Asia-Pacific region

APAMI 2009 was held in Hiroshima, Japan, on November 22-24, 2009. This issue includes two selected papers recommended by the programming committee co-chairs. They are "Lessons Learned from Data Mining of WHO Mortality Database" and "Survey on Medical Records and EHR in Asia-Pacific Region - Languages, Purposes, IDs and Regulations". The theme of APAMI 2009 was "What are the medical records for?" A Hiroshima episode; Medical Records at Dr. Ban's Clinic, 9 km from the Epicenter of A-Bomb, is included, which lets us think of the fundamental purpose of medical records.

Abstract P1-01-16: Evaluation of Sentinel Node Biopsy Using a Combined Dye and Fluorescence Method for Breast Cancer

Background: Sentinel lymph node (SLN) dissection is now widely accepted for staging the axilla in patients with breast cancer. At present, several methods are used to detect SLN. A combination of blue dye and radioactive colloid has been described previously as a superior method for detecting SLN in breast cancer patients. However, use of radioactive colloids is not generally available for various reasons in Japan. SLN detection guided by indocyanine green (ICG) fluorescence could emerge as a new method for SLN biopsy. The aim of this study was to evaluate sentinel node biopsy using a combined dye and fluorescence method for breast cancer.

Methods: Fifty-eight patients with clinically node-negative breast cancer were examined between April 2008 and March 2009 at Yokohama City University Hospital. Intradermal injections of 20 mg/5 ml of indigo carmine and 0.5 mg/0.1 ml of ICG were made into the upper-lateral region of the periareolar area. Subcutaneus lymphatic channels draining from the areola to the axilla were visible under fluorescence within a few minutes. SLNs were then dissected under direct vision supported by fluorescence navigation. Palpable lymph nodes were also dissected. All SLNs were histologically evaluated by 2-mm serial section and staining with hematoxylin and eosin. Patients with positive SLNs underwent axillary lymph node dissection (ALND), while patients with negative SLN did not.

Results: SLNs were identified in 58 patients (100%). ICG fluorescence imaging was compared with indigo carmine dye, and SLNs were identified in 57 and 52 patients, respectively (detection rate: ICG, 98.3%; dye, 89.7%). The mean number of excised SLNs was 2.72. Mean numbers of lymph nodes showing fluorescence and blue stain from injected dye were 2.31 and 1.41, respectively. Eight of 58 patients (13.8%) had metastases detected in the SLN, so ALND were subsequently performed. Five of these cases were without metastases at non-SLN that were dissected. One patient showed metastasis in a SLN that was positive for fluorescence, but negative for blue dye. Among all cases, 1 patient (1.7%) showed an SLN without fluorescence or blue staining, and this case was detected by palpation only.

Conclusion: Combined use of dye and fluorescence method identified SLNs effectively.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-01-16.

Abstract P6-11-13: Phase I Study of Combined S-1 Plus Weekly Paclitaxel Therapy in Patients with Metastatic Breast Cancer

Introduction: S-1, a novel anticancer compound, contains tegafur, a prodrug of fluorouracil (FU), 5-chloro-2.4-dihydroxypyridine, which prevents FU degradation, and potassium oxonate, which prevents drug-induced diarrhea, has a broad spectrum of activity against gastric, colorectal, head & neck, and breast cancers. While combined S-1 with cisplatin or paclitaxel (PAC) therapy is feasible and highly active against gastrointestinal cancer, the feasibility in breast cancer patients has not yet been clarified. We conducted a phase I study of combined S-1 plus weekly PAC therapy (S-1/PAC) to determine the maximum tolerated dose (MTD), recommended dose (RD) and dose-limiting toxicities (DLT) in patients (pts) with HER2-negative, taxane-naïve metastatic breast cancer (MBC).

Methods: S-1 was administered orally from day 1 through day 14 and PAC was administered intravenously on days 1, 8 and 15 of each 28-day cycle. Since S-1 is prescribed at the dose of 80mg/m2 in monotherapy, the primary dose levels (level 1) were set at 65 and 70mg/m2, respectively. The final dose (level 3) was set at 80mg/m2 for each drugs. DLT was defined over 2 cycles.

Results: Ten MBC pts were enrolled in the study. No DLTs were documented. Although grade 1 or 2 adverse events were seen in all pts, no cases of febrile neutropenia or Gr 4 neutropenia were observed. Of the 8 evaluable pts, 3 pts achieved partial response and 4 pts had stable disease.

Conclusion: Based on the results of this study, RD was determined to be 80mg/m2 for either drugs. We conclude that S-1/PAC was well-tolerated and highly active against HER2-negative MBC.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P6-11-13.

[Experience with surgical resections of metachronous liver and bilateral pulmonary metastases from gastric cancer]

A 75-year-old female patient underwent distal gastrectomy with lymph node dissection for gastric cancer. Six months later, computed tomography (CT) and magnetic resonance imaging (MRI) revealed liver metastasis and radio frequency ablation (RFA) was performed. Ten months later, she underwent a partial hepatectomy for recurrent hepatic metastasis. Then, pulmonary nodules were revealed 1 year later, and segmentectomy (S4 + S5) for left pulmonary metastasis and wedge resection for right middle lobe pulmonary metastasis were sequentially performed after 9 months and 10 months observation by CT, respectively. Two years have passed since the last surgery, and the patient has survived more than 5 years since initial gastrectomy.

High resolution, low hν photoelectron spectroscopy with the use of a microwave excited rare gas lamp and ionic crystal filters

The need for not only bulk sensitive but also extremely high resolution photoelectron spectroscopy for studying detailed electronic structures of strongly correlated electron systems is growing rapidly. Moreover, easy access to such a capability in one's own laboratory is desirable. Demonstrated here is the performance of a microwave excited rare gas (Xe, Kr, and Ar) lamp combined with ionic crystal filters (sapphire, CaF(2), and LiF), which can supply three strong lines near the photon energy of hnyu hν=8.4, 10.0, and 11.6 eV, with the hν resolution of better than 600 μeV for photoelectron spectroscopy. Its performance is demonstrated on some materials by means of both angle-integrated and angle-resolved measurements.

Mapping of susceptibility locus for endometriosis within the HLA region using microsatellite markers in Japanese women

Endometriosis is a female disorder characterized by the presence of uterine endometrial tissue in ectopic loci. Previous studies reported a higher prevalence of particular human leukocyte antigen (HLA) in endometriosis. In order to confirm the association between endometriosis and the HLA region, 15 polymorphic microsatellite markers distributed in the HLA class II to class III region were subjected to association analysis by polymerase chain reaction (PCR)-based DNA typing of 89 patients and 136 healthy controls. Statistical analysis of the allelic frequency at each microsatellite locus showed that there were no statistically significant differences in the allele frequency distributions between the cases and controls. This finding suggests that the etiology of endometriosis does not involve the HLA class II genomic region and a portion of class III genomic region in the Japanese population.

Multilayer white light-emitting organic electroluminescent device

Organic electroluminescent devices are light-emitting diodes in which the active materials consist entirely of organic materials. Here, the fabrication of a white light-emitting organic electroluminescent device made from vacuum-deposited organic thin films is reported. In this device, three emitter layers with different carrier transport properties, each emitting blue, green, or red light, are used to generate white light. Bright white light, over 2000 candelas per square meter, nearly as bright as a fluorescent lamp, was successfully obtained at low drive voltages such as 15 to 16 volts. The applications of such a device include paper-thin light sources, which are particularly useful for places that require lightweight illumination devices, such as in aircraft and space shuttles. Other uses are a backlight for liquid crystal display as well as full color displays, achieved by combining the emitters with micropatterned color filters.

Diffusion model of intergroup selection, with special reference to evolution of an altruistic character

Assume a diploid species consisting of an infinite number of competing demes, each having N(e) reproducing members and in which mating is at random. Then consider a locus at which a pair of alleles A and A' are segregating, where A' is the "altruistic allele," which has selective disadvantage s' relative to A with respect to individual selection, but which is beneficial for a deme in competition with other demes; namely, a deme having A' with frequency x has the advantage c(x - x) relative to the average deme, where c is a positive constant and x is the average of x over the species. Let varphi = varphi(x;t) be the distribution function of x among demes in the species at time t. Then, we have partial differentialvarphi/ partial differentialt = L(varphi) + c(x - x)varphi, where L is the Kolmogorov forward differential operator commonly used in population genetics [i.e., L = (1/2) ( partial differential(2)/ partial differentialx(2))V(deltax) - ( partial differential/ partial differentialx)M(deltax)], and M(deltax) and V(deltax) stand for the mean and variance of the change in x per generation within demes. As to migration, assume Wright's island model and denote by m the migration rate per deme per generation. By investigating the steady state, in which mutation, migration, random drift, and intra- and interdeme selection balance each other, it is shown that the index D = c/m - 4N(e)s' serves as a good indicator for predicting which of the two forces (i.e., group selection or individual selection) prevails; if D > 0, the altruistic allele predominates, but if D < 0, it becomes rare and cannot be established in the species.

Genetic variability and effective population size when local extinction and recolonization of subpopulations are frequent

If a population (species) consists of n haploid lines (subpopulations) which reproduce asexually and each of which is subject to random extinction and subsequent replacement, it is shown that, at equilibrium in which mutational production of new alleles and their random extinction balance each other, the genetic diversity (1 minus the sum of squares of allelic frequencies) is given by 2N(e)v/(1 + 2N(e)v), where [Formula: see text] in which N is the harmonic mean of the population size per line, n is the number of lines (assumed to be large), lambda is the rate of line extinction, and v is the mutation rate (assuming the infinite neutral allele model). In a diploid population (species) consisting of n colonies, if migration takes place between colonies at the rate m (the island model) in addition to extinction and recolonization of colonies, it is shown that effective population size is [Formula: see text] If the rate of colony extinction (lambda) is much larger than the migration rate of individuals, the effective population size is greatly reduced compared with the case in which no colony extinctions occur (in which case N(e) = nN). The stepping-stone type of recolonization scheme is also considered. Bearing of these results on the interpretation of the level of genetic variability at the enzyme level observed in natural populations is discussed from the standpoint of the neutral mutation-random drift hypothesis.

Purification, primary structure, and homology relationships of a chloroplast ribosomal protein

A chloroplast ribosomal protein that showed immunological homology to Escherichia coli ribosomal protein L12 was purified from spinach (Spinacia oleracea) leaves and its primary structure was determined by manual micro Edman degradation. The protein is composed of 130 amino acid residues and has M(r) 13,576. It shows structural features characteristic of the L12 proteins of eubacterial 70S ribosomes (e.g., identical amino acid residues in about 50% of the sequence) but no apparent homology to the L12-type proteins of eukaryotic cytoplasmic 80S ribosomes. The homology to eubacterial proteins is highest in the COOH-terminal region (70%) and low in the NH(2)-terminal region (<20%).

Genetic variability maintained in a finite population under mutation and autocorrelated random fluctuation of selection intensity

By using the diffusion equation method, the level of genetic variability maintained under mutation pressure in a finite population is investigated, assuming autocorrelated random fluctuation of selection intensity. An appropriate mathematical model was formulated to treat the change of gene frequencies, incorporating mutation pressure and fluctuating selection. Extensive Monte Carlo simulation experiments were also performed to supplement the theoretical treatments. Excellent agreement between the two results suggests the validity of the present diffusion model for the autocorrelated selection. One of the most important findings from the simulation studies is that mutations and random sampling drift largely determine the level of genetic variability, and that the presence of autocorrelated selection can significantly lower genetic variability only when its strength, as measured by the cumulative variance of selection intensity, is larger than about 10(3) times the mutation rate. It is pointed out that the effects of both mutations and random sampling drift have to be incorporated in order to assess the role of various factors for the maintenance of genetic variability in natural populations.

Average time until fixation of a mutant allele in a finite population under continued mutation pressure: Studies by analytical, numerical, and pseudo-sampling methods

We consider a single locus, and denote by A the wild-type allele and by A' the mutant allele that is produced irreversibly in each generation from A at the rate v. Let 1 + s, 1 + h, and 1 be, respectively, the relative fitnesses of mutant homozygote A'A', mutant heterozygote A'A, and wild-type homozygote AA. Then, it is shown, on the basis of the diffusion equation method, that the average time until fixation of the mutant allele (A') in a randomly mating population of effective size N(e), given that the initial frequency is p, is [Formula: see text] in which B(x) = (S/2)x(2) + Hx(1 - x), S = 4N(e)s, H = 4N(e)h, and V = 4N(e)v. Of particular interest are the cases in which the mutant allele is deleterious (s = -s', s' > 0). Three cases are considered; the mutant is: (i) completely dominant s = h = -s', (ii) completely recessive s = -s', h = 0, and (iii) semidominant s = -s', h = -s'/2, in which s' is the selection coefficient against the mutant homozygote. It is shown that the average time until fixation is shorter when the deleterious mutant allele is dominant than when it is recessive if 4N(e)v is larger than 1. On the other hand, the situation is reversed if 4N(e)v is smaller than 1. It is also shown that for a mutant allele for which N(e)s' > 10, it takes such a long time until fixation that we can practically ignore the occurrence of random fixation of a deleterious allele under continued mutation pressure. To supplement the analytical treatment, extensive simulation experiments were performed by using a device called the pseudo-sampling variable, which can enormously accelerate the process of simulation by a computer. This method simulates the diffusion process itself rather than the binominal sampling process (in population genetics the diffusion model is usually regarded as an approximation of the discrete binomial sampling process).

Model of effectively neutral mutations in which selective constraint is incorporated

Based on the idea that selective neutrality is the limit when the selective disadvantage becomes indefinitely small, a model of neutral (and nearly neutral) mutations is proposed that assumes that the selection coefficient (s') against the mutant at various sites within a cistron (gene) follows a Gamma distribution; f(s') = alpha(beta)e(-alphas')s'(beta-1)/Gamma(beta), in which alpha = beta/ s' and s' is the mean selection coefficient against the mutants ( s' > 0; 1 [unk] beta > 0). The mutation rate for alleles whose selection coefficients s' lie in the range between 0 and 1/(2N(e)), in which N(e) is the effective population size, is termed the effectively neutral mutation rate (denoted by v(e)). Using the model of "infinite sites" in population genetics, formulas are derived giving the average heterozygosity ( h(e)) and evolutionary rate per generation (k(g)) in terms of mutant substitutions. It is shown that, with parameter values such as beta = 0.5 and s' = 0.001, the average heterozygosity increases much more slowly as N(e) increases, compared with the case in which a constant fraction of mutations are neutral. Furthermore, the rate of evolution per year (k(1)) becomes constant among various organisms, if the generation span (g) in years is inversely proportional to radicalN(e) among them and if the mutation rate per generation is constant. Also, it is shown that we have roughly k(g) = v(e). The situation becomes quite different if slightly advantageous mutations occur at a constant rate independent of environmental conditions. In this case, the evolutionary rate can become enormously higher in a species with a very large population size than in a species with a small population size, contrary to the observed pattern of evolution at the molecular level.

Efficiency of truncation selection

Truncation selection is known to be the most efficient form of directional selection. When this is modified so that the fitness increases linearly over a range of one or two standard deviations of the value of the selected character, the efficiency is reduced, but not greatly. When truncation selection is compared to a system in which fitness is strictly proportional to the character value, the relative efficiency of truncation selection is given by f(c)/sigma, in which f(c) is the ordinate of the frequency distribution at the truncation point and sigma is the standard deviation of the character. It is shown, for mutations affecting viability in Drosophila, that truncation selection or reasonable departures therefrom can reduce the mutation load greatly. This may be one way to reconcile the very high mutation rate of such genes with a small mutation load. The truncation model with directional selection is appropriate for this situation because of the approximate additivity of these mutations. On the other hand, it is doubtful that this simple model can be applied to all genes affecting fitness, for which there are intermediate optima and antagonistic selection among components with negative correlations. Whether nature ranks and truncates, or approximates this behavior, is an empirical question, yet to be answered.

Avian malaria parasites share congeneric mosquito vectors

Assessing parasite specificity to vector is crucial to understanding the emergence of vector-borne diseases and the evolution of parasite diversity. Avian malaria parasites have a cosmopolitan distribution and broad avian host range, which together predict they are vector generalists, but little is known about parasite-vector associations in the wild. We tested this prediction by asking if 5 different mosquito species, known to feed on birds and abundant in the northeastern United States, were naturally infected in the field with identical avian Plasmodium spp. lineages. Mosquitoes were not pooled but rather analyzed individually, and, possibly as a result, lineage diversity was higher than reported in previous avian malaria vector studies. Plasmodium spp. lineages were rare in Aedes canadensis and absent in Aedes aurifer and Culiseta melanura. We sequenced a standard Plasmodium cytochrome b marker from Culex pipiens pipiens, Culex restuans, and Ae. canadensis. Most Plasmodium clades were shared by Cx. pipiens and Cx. restuans. In addition, 4 individual lineages were shared by both mosquito species, including the most common lineage. One Plasmodium clade, however, was only found in Cx. restuans. We therefore found limited support for our prediction that avian Plasmodium spp. vector breadth accompanies host breadth. The association of both Culex species with most Plasmodium clades, and the presence of a single parasite lineage in 3 mosquito species representing 2 genera, suggests that avian Plasmodium species are not tightly coevolved with vector species.

Enhancement of caffeine-induced locomotor hyperactivity produced by the combination with L-arginine or taurine in mice: Possible involvement of nitric oxide

Combinations of caffeine with L-arginine or with taurine can enhance the effect of caffeine, but the mechanisms remain elusive. This study was designed to test the hypothesis that stimulant effects of central nervous system nitric oxide (NO) may explain the beneficial effect of caffeine on combinations with amino acid, L-arginine or taurine. Caffeine increased the spontaneous locomotor activity dose-dependently (2-10 mg/kg) in mice. The locomotor activity induced by caffeine at a dose of 2 mg/kg was enhanced by combined administration of L-arginine at a dose of 600 mg/kg, or taurine at a dose of 400 mg/kg, respectively. For both combinations, enhancement was significantly inhibited by pretreatment with N-nitro-L-arginine methyl ester (L-NAME) at a dose of 40 mg/kg. These results suggest that the enhancement induced by combining caffeine with amino acid might be regulated at least in part by NO in the central nervous system.

Juxtacellular labeling of tonically active neurons and phasically active neurons in the rat striatum

Tonically active neurons (TANs) and phasically active neurons (PANs) are widely believed to be the cholinergic interneurons and GABAergic projection neurons, respectively, in the striatum based on in vivo intracellular recordings coupled with morphological examinations of anesthetized rats, and on histochemical, electrophysiological, and labeling studies of in vitro slice preparations. TANs of alert behaving animals exhibit prolonged pause responses to behaviorally significant events. PANs, on the other hand, are mostly inactive when subjects are quiet and not performing any actions, but exhibit burst discharges in response to external stimuli and/or voluntary actions. Several other types of interneurons have also been identified in the striatum, such as parvalbumin-containing GABAergic interneurons (fast-spiking cells), somatostatin-containing interneurons, and calretinin-containing interneurons. To identify the neurochemical and morphological characteristics of TANs and PANs in a more direct manner, we conducted juxtacellular labeling, combining electrophysiology with immunohistochemistry and morphology in anesthetized rats. All of the juxtacellularly labeled TANs (n=3) among those recorded (n=10) were ChAT-positive and had large cell somata with aspiny dendrites. Thus, although our observations are based on a limited number of neurons, our findings provide the most convincing evidence to date that TANs in the striatum are cholinergic neurons. We also found that the majority of PANs are GABA-immunoreactive (46 of 48 tested) and approximately two-thirds had spiny dendrites (30 of 48 tested), indicating that the majority are medium-sized, spiny, GABAergic projection neurons, consistent with general beliefs. Conversely, the remaining one-third of PANs had aspiny dendrites (n=18), indicating that they were interneurons. Therefore, the present study reveals that TANs are cholinergic neurons and that the majority of PANs are medium-sized, spiny, GABAergic projection neurons, while a smaller number are GABAergic interneurons.

Identification of autoantigens specific for systemic lupus erythematosus with central nervous system involvement

Using proteomic analysis, we identified candidate autoantigens specific for central nervous system (CNS) involvement in systemic lupus erythematosus (SLE). Proteins, extracted from cultured human neuroblastoma cells, were separated both by SDS-PAGE (1-DE) and two-dimensional electrophoresis (2-DE), and transferred to membranes. Western blot analysis was performed using serum samples from 30 SLE patients with CNS involvement (CNS-Lupus) and from 30 SLE patients without CNS involvement (non-CNS-SLE). The detected autoantigens were identified using MALDI-TOF/TOF MS. On the 1-DE Western blot, we detected 32 antigenic bands in the serum samples from the CNS-Lupus patients. Among them, four bands were detected significantly more frequently in the CNS-Lupus patients than in the non-CNS-SLE patients. Three bands were detected in four or more of the CNS-Lupus patients but in only one or none of the non-CNS-SLE patients. We thus selected these seven bands for the next investigations. Next, we detected protein spots corresponding to the selected seven bands by 2-DE Western blot and identified four proteins. They are peroxiredoxin-4, ubiquitin carboxyl-terminal hydrolase isozyme L1, splicing factor arginine/serine-rich 3, and histone H2A type 1. These four candidate autoantigens for the anti-neuronal cell antibodies would be a useful marker for CNS-Lupus.

[Improved cardiac function after inhalation of nitric oxide and tricuspid annuloplasty in dilated cardiomyopathy patient on left ventricular assist system]

A 17-year-old man with severe cardiac failure due to dilated cardiomyopathy was treated by medication. As he did not improve, he had indication for transplantation of the heart and was put on a ventricular assist system as a bridge until he could be transplanted. He also had severe tricuspid regurgitation and tricuspid annuloplasty was performed. Inhalation of nitric oxide was used to decrease pulmonary vascular resistance. Although cerebral infarction was present postoperatively, he is waiting for transplant without paralysis. The ventricular assist system proved to be useful therapy for serious cardiac failure due to terminal dilated cardiomyopathy.

[Thoracoscopic surgery combined with a supraclavicular approach for removing left superior mediastinal neurogenic tumor]

The patient was a 41-year-old female and had been pointed out an abnormal shadow at the left lung apex on the chest X-ray film. Chest computed tomography (CT) scan and magnetic resonance imaging (MRI) revealed a left upper mediastinal mass at the Th1 to Th2 level, measuring 30 mm in size, which was suspected to be a neurogenic tumor. Surgical removal of the tumor using thoracoscopic procedure through 3 chest ports combined with a supraclavicular approach was successfully performed. She was discharged from the hospital on the 7th postoperative day. A pathological examination revealed the tumor to be benign neurilemmoma.

Evaluation of sympathetic vasoconstrictor response following nociceptive stimulation of latent myofascial trigger points in humans

AIM

Myofascial trigger points (MTrPs) are a major cause of musculoskeletal pain. It has been reported that stimulation of a latent MTrP increases motor activity and facilitates muscle pain via activation of the sympathetic nervous system. However, the magnitude of the sympathetic vasoconstrictor response following stimulation of MTrP has not been studied in healthy volunteers. The aims of this study were to (1) evaluate the magnitude of the vasoconstrictor response following a nociceptive stimulation (intramuscular glutamate) of MTrPs and a breath-hold manoeuvre (activation of sympathetic outflow) and (2) assess whether the vasoconstrictor response can be further modulated by combining a nociceptive stimulation of MTrPs and breath-hold.

METHODS

Fourteen healthy subjects were recruited in this study. This study consisted of four sessions (normal breath group as control, breath-hold group, glutamate MTrP injection group and glutamate MTrP injection + breath-hold group). Skin blood flow and skin temperature in both forearms were measured with laser Doppler flowmetry and infrared thermography, respectively, in each session (before the treatment, during the treatment and after the treatment).

RESULTS

Glutamate injection into MTrPs decreased skin temperature and blood flow in the peripheral area. The magnitudes of the reduction were comparable to those induced by the breath-hold manoeuvre, which has been used to induce sympathetic vasoconstrictor response.

CONCLUSION

The combination of glutamate injection into latent MTrPs together with the breath-hold manoeuvre did not result in further decrease in skin temperature and blood flow, indicating that sympathetic vasoconstrictor activity is fully activated by nociceptive stimulation of MTrPs.

Regenerating gene 1α (REG 1α) expression and new treatment strategies in early non-small cell lung cancer

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Background: Regenerating gene (REG) I was originally isolated as an endogenous growth factor from pancreatic islet β cells. REG Iα protein is suggested to be involved in carcinogenesis in various gastroenterologic tissues. In the present study, to elucidate roles for REG Iα in non-small cell lung cancer (NSCLC), we investigated REG Iα expression in NSCLCs, focusing especially on its relationship with prognosis. Methods: We enrolled 70 NSCLCs (adenocarcinoma (AC)(n=48) and squamous cell carcinoma (SCC)(n=22)) who received surgery at Nara Medical University Hospital. Total RNA was extracted from each tumor tissue and corresponding normal lung tissue (NL)(n=70), cDNA was then reverse-transcribed from total RNA, and quantitative real-time reverse transcriptase-polymerase chain reaction was then carried out. The expression level of REG Iα in each sample was normalized with respect to that of β-actin, and the cutoff level was set at average+3SD expression of the 70 NLs. We also examined the relationship between REG 1α expression in the tumor tissue and the prognosis. Results: Six (12.5%) of the 48 ACs and 5 (22.7%) of the 22 SCCs were positive for REG Iα gene, and which is higher than that of NLs (2 of 70: 2.9%). After median follow-up of 26.2 months, 12 patients died due to disease progression. The survival rate among the REG 1α positive patients was significantly worse than among the REG 1α negative patients in ACs (P<0.05), and not significantly but worse in SCCs (P=0.07). In case of stage I, none of REG 1α negative patient died in both ACs and SCCs compared with 4 patients died of positive patients (AC:2, SCC:2), and also the survival rate among the REG 1α positive patients was significantly worse than among the negative patients in ACs (P<0.01) and SCCs (P<0.05). Disease free survival of REG 1α positive patients was also worse than negative patients in ACs (P<0.05) and SCCs (P=0.16). Conclusions: REG Iα expression in NSCLCs may be the risk factor for poor prognosis, and we anticipate that it will enable us to provide more appropriate and individualized treatment to patients of early NSCLC.

No significant financial relationships to disclose.

Genetic variation in a population of the wild quail Coturnix coturnix japonica

To investigate genetic variation and to compare it with those of domestic quail populations, enzymatic and non-enzymatic proteins in a wild quail population were examined electrophoretically. The wild quail population had a genetic variability considerably lower than those of domestic populations. The average heterozygosity estimated for 22 loci was 0.090 in the wild quail population.

Phosphoglucomutase electrophoretic patterns of the loach Cobitis biwae

Phosphoglucomutase of two groups of the loach Cobitis biwae, a fresh-water teleost, was examined by starch gel electrophoresis. Some of the fishes had six-banded electrophoretic patterns not observed in other loach species (e.g. Misgurnus anguillicaudatus and Cobitis delicata). The complexity of the pattern is explainable by an assumption that the loaches are tetraploid fishes. The result suggests that a diploid-tetraploid relationship exists within the species Cobitis biwae.