Human papillomavirus modifies the prognostic significance of T stage and possibly N stage in tonsillar cancer

BACKGROUND

Despite the association with more advanced nodal stage, patients with human papillomavirus (HPV) positive oropharyngeal cancers have better outcomes. We examined whether the HPV can modify the effect of known prognostic factors in tonsillar cancer.

PATIENTS AND METHODS

A total of 489 patients from 10 centres were followed up for recurrence or death for a median of 3.2 years. Determinants of the rate of locoregional recurrence, death from tonsillar cancer and overall survival were modelled using Cox regression.

RESULTS

The prognostic value of T and N stages were modified by HPV as indicated by statistically significant interaction terms. After adjusting for age, gender and treatment, T stage appeared relevant only for HPV-positive cancers (where a higher T stage was associated with worse outcomes). There was some evidence that N stage was a more relevant prognostic factor for HPV-negative than -positive cancers. There was no evidence that the HPV modifies the effect of age, gender or grade on outcomes.

CONCLUSIONS

This study suggests that the prognostic significance of the conventional staging system in tonsillar cancer is modified by HPV.

Effect of stenting on patients with chronic internal carotid artery occlusion

AIM

Effects of carotid artery stenting (CAS) on patients with chronic internal carotid artery occlusion are unknown.

METHODS

This study included 21 patients who underwent successful CAS treatment and 41 patients who received optimal medical therapy. Modified Rankin Scale (mRS) and cardiocerebral vascular events were compared between CAS and medical therapy group.

RESULTS

The mRS in CAS group was lower than in control group during a 2-year follow up (P<0.05 or 0.01). The combined cerebrovascular events and mortality in study group was lower than in the control group (33.4% vs. 56.1%, P=0.045), but there was no statistically significant difference in the cerebrovascular event (28.6% vs. 46.3%, P=0.088) or mortality rate (4.8% vs. 9.8%, P=0.247) between the two groups. Cox regression analysis revealed that smoking (RR=3.189, 95% CI 1.020-9.968, P=0.046), diabetes (RR=2.717, 95% CI 1.113-6.631, P=0.028), and baseline National Institute of Health stroke scale (RR=2.984, 95% CI 1.049-8.485, P=0.040) were independent risk factors for major cerebrovascular events following CAS.

CONCLUSION

CAS was superior to drug therapy in achieving better functional outcomes in patients with chronic internal carotid artery occlusion. However, CAS was not associated with a statistically significant reduction in cerebrovascular events or mortality. Larger and randomized clinical trials are required to ascertain the long-term benefits of CAS in patients with chronic internal carotid artery occlusion.

Voltage-dependent amplification of synaptic inputs in respiratory motoneurones

The role of persistent inward currents (PICs) in cat respiratory motoneurones (phrenic inspiratory and thoracic expiratory) was investigated by studying the voltage-dependent amplification of central respiratory drive potentials (CRDPs), recorded intracellularly, with action potentials blocked with the local anaesthetic derivative, QX-314. Decerebrate unanaesthetized or barbiturate-anaesthetized preparations were used. In expiratory motoneurones, plateau potentials were observed in the decerebrates, but not under anaesthesia. For phrenic motoneurones, no plateau potentials were observed in either state (except in one motoneurone after the abolition of the respiratory drive by means of a medullary lesion), but all motoneurones showed voltage-dependent amplification of the CRDPs, over a wide range of membrane potentials, too wide to result mainly from PIC activation. The measurements of the amplification were restricted to the phase of excitation, thus excluding the inhibitory phase. Amplification was found to be greatest for the smallest CRDPs in the lowest resistance motoneurones and was reduced or abolished following intracellular injection of the NMDA channel blocker, MK-801. Plateau potentials were readily evoked in non-phrenic cervical motoneurones in the same (decerebrate) preparations. We conclude that the voltage-dependent amplification of synaptic excitation in phrenic motoneurones is mainly the result of NMDA channel modulation rather than the activation of Ca2+ channel mediated PICs, despite phrenic motoneurones being strongly immunohistochemically labelled for CaV1.3 channels. The differential PIC activation in different motoneurones, all of which are CaV1.3 positive, leads us to postulate that the descending modulation of PICs is more selective than has hitherto been believed.

Effects of islet neogenesis-associated protein pentadecapeptide on cell mass and insulin secretion of pancreatic β-cells

OBJECTIVE

To explore the effects of islet neogenesis- associated protein pentadecapeptide (INGAP-PP) on proliferation and secretion function of β-cells.

METHODS

Islets of adult Sprague Dawley rats were isolated by collagenase digestion and treated with 10 μg/ml INGAP-PP, after 12, 24, 48 h, glucose-stimulated insulin secretion (GSIS) and acridine orange/pro pidium iodide (AO/PI) staining were used to detect the secretion function and cell viability. The INS-1 cells were treated with 0, 1, 10, 25, 50, 100, 250, and 500 μg/ml INGAP-PP for 24 or 48 h, MTT cell proliferation assay was adopted to survey the dose-response relationship between INGAP-PP and cell proliferation. The mRNA expression of roliferating cell nuclear antigen (PCNA), Cyclin D1, Cdk4, P27, p38MAPK, and JNK in INS-1 cells were examined by RT-PCR, and the protein expression of PCNA was examined by Western blot. The statistical significance was determined by Student's t-test or one-way analysis of variance.

RESULTS

The insulin secreted by islets and the cell viability were increased by INGAP-PP. MTT indicated a dose-response relationship between INGAP-PP and quantity of INS-1 cells, and treatment for 48 h had a stronger effect on cell proliferation than the 24 h. INGAP-PP up-regulated the mRNA expression of PCNA, Cyclin D1, Cdk4 and downregulated P27, p38MAPK, and JNK. Moreover, the protein expression of PCNA was up-regulated by 45% after INGAPPP exposure for 48 h.

CONCLUSIONS

INGAP-PP increased the insulin secretion, enhanced the proliferation and might reduce apop tosis of β-cells. The mechanism may contribute to the changed expression of some genes related to cell cycle.

Transcriptional response to GAA deficiency (Pompe disease) in infantile-onset patients

Pompe disease is a genetic disorder resulting from a deficiency of lysosomal acid alpha-glucosidase (GAA) that manifests as a clinical spectrum with regard to symptom severity and rate of progression. In this study, we used microarrays to examine gene expression from the muscle of two cohorts of infantile-onset Pompe patients to identify transcriptional differences that may contribute to the disease phenotype. We found strong similarities among the gene expression profiles generated from biceps and quadriceps, and identified a number of signaling pathways altered in both cohorts. We also found that infantile-onset Pompe patient muscle had a gene expression pattern characteristic of immature or regenerating muscle, and exhibited many transcriptional markers of inflammation, despite having few overt signs of inflammatory infiltrate. Further, we identified genes exhibiting correlation between expression at baseline and response to therapy. This combined dataset can serve as a foundation for biological discovery and biomarker development to improve the treatment of Pompe disease.

First Report of Fusarium proliferatum Causing Fruit Rot of Winter Jujube (Zizyphus jujuba) in Storage in China

Winter jujube, Zizyphus jujuba Mill., is a Chinese crop with fruit that has an extremely high nutritional value (4). In early November 2010, a severe fruit rot affecting ~20% of 1,000 kg of winter jujube fruit was observed in a storehouse in Zhengzhou, Henan province, China. The same fruit rot symptoms were found in two supermarkets in Zhengzhou in late November 2010 in ~10% of 100 kg of fruit in one supermarket and 25% of 50 kg of fruit in the other. Symptoms first appeared as small, round, pale yellow brown lesions on the fruits, 1 to 3 mm in diameter, then developed into 5- to 10-mm, sunken, brown spots, each with a pale brown margin. Three Fusarium isolates (DZF001 to DZF003) showing similar morphological characteristics were isolated from three specimens (collected from one storehouse and two supermarkets) by surface sterilizing small pieces of necrotic fruit tissue for 1 min in 2% NaOCl, washing the tissue pieces three times with sterile distilled water, and plating the pieces on potato dextrose agar (PDA). Fungal colonies for each isolate were white to light pink, and the adaxial side of each culture was pale yellow. Macroconidia were produced in pale orange sporodochia and were slender, relatively straight, three to five septa, 29.0 to 55.2 × 2.5 to 4.0 μm, with a curved apical cell and a poorly developed basal cell. Microconidia were produced in chains or false heads on synthetic nutrient-poor agar, clavate with a planar base, aseptate, and 4.5 to 8.0 × 2.5 to 3.5 μm. Conidiophores terminated in verticils of two to three phialides or monophialides. Chlamydospores were absent. The cultural and morphological characteristics were similar to those of Fusarium proliferatum (1,2). The identity of the three fungal isolates was confirmed to be F. proliferatum by DNA sequencing of the internal transcribed spacer (ITS) rDNA region (GenBank Accession Nos. JN889713 to JN889715), which were 99 to 100% homologous to those of other F. proliferatum isolates (GU066714, HQ113948, and GU363955); and the elongation factor 1-alpha (EF-1a) gene (JN889713 to JN889715), which was 99% homologous to those of other F. proliferatum isolates (FJ538244, FJ895277, and GQ848536) (3). Pathogenicity tests were conducted on 20 winter jujube fruits using a mycelial plug harvested from the periphery of a 7-day-old colony of strain DZF001, and placed on the surface of the fruit after the inoculated area of the fruit had been surface sterilized with 75% ethanol for 2 min; an equal number of fresh winter jujube fruits treated with non-colonized plugs of PDA served as the control treatment. Each jujube fruit was pricked three times with an insect needle to create three holes close together before inoculation with an agar plug. Each fruit was then enclosed in a clear plastic box with a cup of sterile distilled water to maintain high relative humidity, and held at 25°C. Symptoms similar to those originally observed on the naturally infected fruit were observed 3 days after inoculation, and the same fungus was reisolated from each of the symptomatic fruits; control fruits remained asymptomatic and no fungus was isolated from the control fruit. Koch's postulates were repeated three times with the same results. To our knowledge, this is the first report of F. proliferatum causing rot of winter jujube fruit in China. References: (1) K. Chehri et al. Saudi J. Biol. Sci. 18:341, 2011. (2) J. F. Leslie and B. A. Summerell. The Fusarium Laboratory Manual, Blackwell Publishing, 2006. (3) H. T. Phan. Studies Mycol. 50:261, 2004. (4) J. Sheng et al. Acta Hort. 620:203, 2003.

First Report of Bipolaris peregianensis Causing Leaf Spot of Cynodon dactylon in China

Cynodon dactylon is widely cultivated as a sod crop in warm climates worldwide. In early September 2009, heavy leaf spot infection was observed on C. dactylon from Zhengzhou, Henan, China. Early symptoms appeared as small, elliptical, pale brown lesions on the leaves. Lesions later expanded to 5 to 10 mm long and 1 to 2 mm wide, becoming brown to dark brown. A fungus was consistently isolated from leaf spots on potato dextrose agar (PDA), but with poor sporulation. Morphological characteristics were observed from single-conidium cultures on tap water agar + wheat straw (TWA+W) after 5 to 7 days. Conidiophores were light to medium brown, cylindrical, solitary or clustered, unbranched, usually with basal cells enlarged, and 94.5 to 147.0 × 4.0 to 9.0 μm. Conidia were fusoid, strongly curved, end cells broadly hemiellipsoidal, brown, 58.5 to 84.5 × 13.5 to 18.5 μm, with 6 to 10 septa. These morphological characteristics are similar to those of Bipolaris peregianensis (2). The identity of our fungus was confirmed to be B. peregianensis by DNA sequencing of the internal transcribed spacer (ITS) region (GenBank Accession No. JQ316121), which was 99% homologous to those of other B. peregianensis isolates (= Cochliobolus peregianensis; Accession Nos AF071328 and AF158111) (1). Koch's postulates were performed with the leaves of three pots of C. dactylon. Leaves were sprayed with 1 × 10⁵ conidia/ml of B. peregianensis; an equal number of leaves in the pots of the same plant sprayed with sterile distilled water served as the control. All test plants were covered with plastic bags for 24 h to maintain high relative humidity at 23 to 25°C. After 7 days, more than 50% of inoculated leaves showed symptoms identical to those observed in natural condition, whereas controls remained symptom free. Reisolation of the fungus from lesions on inoculated leaves confirmed that the causal agent was B. peregianensis. To our knowledge, this is the first report of leaf spots caused by B. peregianensis on C. dactylon in China. The disease cycle and the control strategies in the regions are being further studied. References: (1) M. L. Berbee et al. Mycologia 91:964, 1999. (2) A. Sivanesan. Mycol. Pap. 158:1, 1987.

SU-E-T-10: Monte Carlo Study of the Dose Enhancement Factor (DEF) for Gold Nano-Particle (GNP) on the Cellular Level

PURPOSE

In megavoltage external beam radiotherapy, in vivo cell experiments suggest GNP could be used as a radiosensitizer by having radiation dose enhancement factor (DEF) significantly larger than 1. However, Monte Carlo (MC) simulations published in the literature failed to give prove, in which most of them only simulated the interactions between the radiation beams and a single GNP. In this study, we built a multi-GNPs model considering possible spatial arrangements of GNPs relative to a cell to calculate the DEFs of GNPs.

METHODS

Geant4 MC code with G4DNA physics model which can trace electrons down to eV level was used. Two types of geometry models representing different GNP-cell binding were created with each GNP modeled individually: (1) shell model with GNPs randomly and sparsely distributed in a shell in water mimicking when the GNPs were binding to the cell membrane, and (2) sphere model with GNPs randomly and sparsely distributed in a sphere in water mimicking when GNPs were floating inside the cytoplasm. Photon and electron spectrum at 5 cm in depth in water from a Varian 6MV beam was used as the radiation source. Dose to water inside the shell or the sphere representing cytoplasm were scored and compared to situations without GNPs to calculate the DEF. We also looked into the variation of DEFs due to different GNP sizes and concentrations.

RESULTS

A 35 um water cubic were successfully built in Geant4 with spatial resolution of 100 nm. Preliminary results shown under 200 keV electron irradiation, 100 nm GNPs in the shell model shown increased dose to cell at the beam entrance (DEF = 1.08).

CONCLUSIONS

The computation is undergoing for different GNP sizes and concentrations. Meaningful results are expected on the completion of this study.

Identification of a specific scar marker for detection of Tilletia foetida (Wall) Liro pathogen of wheat

Common bunt is one of the most important destructive diseases of wheat worldwide and is a domestic quarantined disease in China. However, a rapid and efficient method to identify the corresponding pathogens is currently limited. The objective of the present study was to develop a diagnostic molecular marker specific towards Tilletia foetida (Wall) Liro, a causal agent of the bunt disease. One specific DNA fragment for T. foetida (286 bp in length) was amplified using an Amplified Fragment Length Polymorphism (AFLP) assay and, this fragment was cloned and sequenced. One pair of specific primers (SC(286-1)/SC(286-2)), which was designed according to the sequence, could specifically amplify the corresponding fragment in all of the T. foetida isolates employed from both the People's Republic of China and United States, whereas this fragment could not be amplified by the other fungal species tested. Therefore, a specific Sequence Characterized Amplified Region (SCAR) marker was developed. This SCAR marker could distinguish T. foetida from related pathogenic fungi efficiently and could be used for the early diagnosis of the common bunt of wheat in the field, and provide an efficient way for disease surveillance and disease forecasting in cereal crop.

Prevalence and risk factors of diabetic retinopathy in Chongqing pre-diabetes patients

PURPOSE

To investigate the prevalence of diabetic retinopathy (DR) and relative risk factors among Chongqing pre-diabetes patients.

METHODS

A total of 750 participants were recruited in this cross-sectional study. All participants underwent a complete physical examination and an oral glucose-tolerance test. In all, 110 of the 125 newly diagnosed pre-diabetics and their healthy spouses as controls were examined with fluorescence fundus angiographies, and their blood with biochemical analyses. All the pre-diabetics with DR (23 subjects), 23 normal controls and 23 pre-diabetics without DR were compared for serum concentrations of regulated upon activation, normal T-expressed and secreted (RANTES). Student's t-test was used to compare continuous variables, and χ (2) test and analysis of variance to compare proportions among groups. Multiple logistic regression models were used to determine the risk factors for DR in pre-diabetics.

RESULTS

In all, 20.91% of the 110 pre-diabetics showed mild non-proliferative DR (NPDR). There was a statistically significant difference in serum concentrations of RANTES between pre-diabetics with and without DR (P<0.01), and also between pre-diabetics with DR and normal controls (P<0.01). However, age, body mass index, waist-hip ratio, triacylglycerol (TG), total cholesterol (TC), high-density lipoprotein-C, low-density lipoprotein-C, blood urea nitrogen, blood creatinine, and urine albumin excretion rate seemed to have no reliable relationship with DR in pre-diabetics (P>0.05).

CONCLUSION

The prevalence of DR in Chongqing pre-diabetes patients in the study was about 20.91% and only mild NPDR was found. It seems that RANTES is one possible risk factor associated with DR in pre-diabetics, not age, TG and TC, and others.

Electroacupuncture inhibition of hyperalgesia in an inflammatory pain rat model: involvement of distinct spinal serotonin and norepinephrine receptor subtypes

BACKGROUND

Although acupuncture analgesia is well documented, its mechanisms have not been thoroughly clarified. We previously showed that electroacupuncture (EA) activates supraspinal serotonin- and norepinephrine-containing neurones that project to the spinal cord. This study investigates the involvement of spinal alpha(2)-adrenoceptors (α2-ARs) and 5-hydroxytryptamine (serotonin) receptors (5-HTRs) in EA effects on an inflammatory pain rat model.

METHODS

Inflammatory hyperalgesia was induced by injecting complete Freund's adjuvant (CFA, 0.08 ml) into the plantar surface of one hind paw and assessed by paw withdrawal latency (PWL) to a noxious thermal stimulus. The selective α2a-AR antagonist BRL-44408, α2b-AR antagonist imiloxan hydrochloride, 5-HT2B receptor (5-HT2BR) antagonist SB204741, 5-HT3R antagonist LY278584, or 5-HT1AR antagonists NAN-190 hydrobromide, or WAY-100635 were intrathecally administered 20 min before EA or sham EA, which was given 2 h post-CFA at acupoint GB30.

RESULTS

EA significantly increased PWL compared with sham [7.20 (0.46) vs 5.20 (0.43) s]. Pretreatment with α2a-AR [5.35 (0.45) s] or 5-HT1AR [5.22 (0.38) s] antagonists blocked EA-produced anti-hyperalgesia; α2b-AR, 5-HT2BR, and 5-HT3R antagonist pretreatment did not. Sham plus these antagonists did not significantly change PWL compared with sham plus vehicle, indicating that the antagonists had little effect on PWL. Immunohistochemical staining demonstrated that α2a-ARs are on primary afferents and 5-HT1ARs are localized in N-methyl-d-aspartic acid (NMDA) subunit NR1-containing neurones in the spinal dorsal horn.

CONCLUSIONS

The data show that α2a-ARs and 5-HT1ARs are involved in the EA inhibition of inflammatory pain and that the NMDA receptors are involved in EA action.

High TPMT enzyme activity does not explain drug resistance due to preferential 6-methylmercaptopurine production in patients on thiopurine treatment

BACKGROUND

Up to 20% of patients on thiopurine therapy fail to achieve adequate drug response. Many of these patients preferentially produce the toxic 6-methylmercaptopurine metabolites (6-MMP) rather than the active 6-thioguanine nucleotides (6-TGN) resulting in a high 6-MMP/6-TGN ratio (>20) and increased risk of hepatotoxicity.

AIM

To determine the prevalence of preferential 6-MMP producers and define the relationships between 6-TGN, 6-MMP and thiopurine methyltransferase (TPMT).

METHODS

The database of 6-TGN, 6-MMP and TPMT measurements from patients throughout New Zealand was used to calculate patients' 6-MMP/6-TGN ratios and identify those with high (>20) or normal ratio (≤20).The TPMT enzyme activity was compared amongst the groups.

RESULTS

Of 1879 patients with TPMT, 6-TGN and 6-MMP results, 349 (19%) had a 6-MMP/6-TGN ratio >20. The mean TPMT enzyme activity was slightly lower for those with a 6-MMP/6-TGN ratio ≤20 vs. >20, which achieved statistical significance (12.2 vs. 13.2; P < 0.001). However, the distributions of TPMT enzyme activity were similar, with 97% of TPMT results falling between 5.0 and 17.6 IU/mL for both groups. In all, 17% of those with 6-MMP/6-TGN ratio ≤20 were intermediate TPMT metabolisers (TPMT 5.0-9.2 IU/mL) vs. 7% in those with a ratio >20.

CONCLUSIONS

In this patient population with measured 6-MMP/6-TGN ratios, 19% of patients were preferential 6-MMP producers. The results show that high TPMT enzyme activity is not the major reason for preferential 6-MMP production in most patients with a high metabolite ratio. This suggests that there are one or more important alternative mechanisms for preferentially producing 6-MMP.

First Report of the Lesion Nematode, Pratylenchus agilis, Parasitizing Wheat in China

Wheat (Triticum aestivum L.) fields in Zhengzhou, Henan Province that exhibited reduced height and number of tillers were surveyed in 2008, and samples were collected for analyses. Fifteen of thirty-five samples contained a nematode suspected of causing small, brown lesions in roots. Both lateral roots and root hairs were reduced in infected plants. Nematode presence was associated with enlarging lesions and necrotic roots. We also observed lesion nematode infestation in samples with no symptoms in the roots. During the growing season, wheat yield increased by 14% with nematocide treatments in Zhengzhou suburb fields. The morphological and molecular analyses of the nematodes isolated from soil samples established the identity of the species as the lesion nematode, Pratylenchus agilis (2,3). Morphological characteristics that were used for identification included female body, lip annules, tail terminus, number of lines in the lateral field, stylet knobs, stylet length, and vulva location in relation to body length. Females were cylindrical, measured 452 to 811 μm long, and contained two lip annules, a smooth tail terminus, four lateral lines, a vulva at 72.64 to 79.97%, a stylet of 16.20 to 17.55 μm, basal esophageal lobes elongated less than twice the body width, and stylet knobs rounded posteriorly. Males were rare and the spermatheca was empty. Molecular analysis was conducted by amplifying the internal transcribed spacer (ITS) regions ITS1 and 2. Sequence of ITS regions from this population (GenBank Accession No. JQ039330) showed highest sequence homology to P. agilis isolate PagKL5 (GenBank Accession No. FJ71289.1) with the identity of 90%. High variability at species level has been found for Pratylenchus species (1). On the basis of the morphological traits and molecular analyses, the nematodes were identified as P. agilis. To our knowledge, this is the first report of P. agilis parasitizing wheat. References: (1) F. De Luca et al. Eur. J. Plant Pathol. 130:415, 2011. (2) A. M. Golden et al. Plant Dis. Rep. 62:430, 1978. (3) R. V. Rebois et al. J. Nematol. 18:392, 1986.