Reduction malarplasty using an L-shaped osteotomy through intraoral and sideburns incisions

The slender, oval-shaped face is considered to be attractive in East Asia. To obtain the ideal contour of the midface, reduction malarplasty has been popularized in oriental countries in recent years. This report describes a surgical technique for reduction of the zygomatic body and arch. After labiobuccal vestibular incisions are made, the anterior zygomatic body and lateral orbital rim are exposed by subperiosteal dissection. Thereafter, an L-shaped osteotomy is performed. Two parallel horizontal osteotomies are made in the anterior part of the zygomatic body, and the middle bone segment is removed. The zygomatic arch root is fractured through a small sideburn incision just anterior to the articular tubercle. Finally, the freed zygomatic complex is medially repositioned and fixed with one or two bicortex screws. Operations on 32 patients demonstrated that this technique may be a sound method for malar complex reduction, with the advantages of simple manipulation, stable fixation, and less risk of a drooping face.

NF-κB mediates the induction of Fas receptor and Fas ligand by microcystin-LR in HepG2 cells

Microcystin-LR (MC-LR) is the most frequent and most toxic microcystin identified. This natural toxin has multiple features, including inhibitor of protein phosphatases 1 and 2A, inducer of oxidative stress, as well as, tumor initiator and promoter. One unique character of MC-LR is this chemical can accumulate into liver after contacting and lead to severe damage to hepatocytes, such as apoptosis. Fas receptor (Fas) and Fas ligand (FasL) system is a critical signaling system initiating apoptosis. In current study, we explored whether MC-LR could induce Fas and FasL expression in HepG2 cells, a well used in vitro model for the study of human hepatocytes. The data showed MC-LR induced Fas and FasL expression, at both mRNA and protein levels. We also found MC-LR induced apoptosis at the same incubation condition at which it induced Fas and FasL expression. The data also revealed MC-LR promoted nuclear translocation and activation of p65 subunit of NF-κB. By applying siRNA to knock down p65 in HepG2 cells, we successfully impaired the activation of NF-κB by MC-LR. In these p65 knockdown cells, we also observed significant reduction of MC-LR-induced Fas expression, FasL expression, and apoptosis. These findings demonstrate that the NF-κB mediates the induction of Fas and FasL as well as cellular apoptosis by MC-LR in HepG2 cells. The results bring important information for understanding how MC-LR induces apoptosis in hepatocytes.

Abstract P5-06-04: Nicastrin Reveals Gamma-Secretase Independent Function in Breast Cancer Cells and Can Be Targeted by a Blocking Monoclonal Antibody To Reduce Breast Cancer Cell Proliferation and Invasion

BACKGROUND: Nicastrin (NCT) is a structural and functional part of the gamma-secretase (GS) enzyme, implicated in tumorigenesis and resistance to treatment in multiple cancer types. However, its mechanism(s) of action and biological functions are poorly understood. We investigated functional and biological effects of inhibiting NCT in breast cancer (BC)cells by means of gene silencing and blocking antibodies, as well as the prognostic value of NCT expression in BC tissue. METHODS: NCT siRNA (Dahrmacon) was used at 40nM. A polyclonal antibody (pcAb) against NCT extracellular domain was developed at Biogenes (GE), and anti-NCT monoclonal antibodies (mAbs) at Genovac (GE). We tested the Abs for their ability to recognize endogenous NCT in BC cells by FACS and Western blot. Best Abs were tested in vitro, using a transwell cell invasion assay and proliferation assay. Anti-NCT Ab (Sigma, N1660) was used for immunohistochemistry (IHC) staining of BC tissues (n = 1050). Cases were scored as NCT negative (0), 1+, 2+ or 3+. Kaplan Meier analysis was used to investigate impact of NCT expression on survival. Illumina (Agilent) oligonucleotide arrays were used to investigate NCT siRNA effects on gene expression in BC cells. Both PcAb and mAbs recognized endogenous NCT in BC cells. In vitro, blocking NCT in MDA-MB231 BC cells with the PcAb, reduced cell proliferation in a dose dependent manner; by 50% and 70% at concentrations of 50μg/ml and 100μg/ml, respectively. mAbs reduced proliferation by 50% (clones 2H6 and 10C5) and 70% clone 10C11, (P<0.01). In transwell cell invasion assay, anti-NCT pcAb induced a dose dependent reduction of invasion, by 35% at the 5μg/ml, peaking at > 60% reduction at 50μg/ml (P<0.001). mAbs reduced cell invasion by 40-50% (clone 10C5 and 10C11) and by >65% (clone 2H6) (P<001). IHC data showed that NCT was highly expressed (2+, 3+) in 47.5% of BC tissues. High NCT expression correlated with worse overall survival (OS) in ERnegative patients (p=0.05). To elucidate the effects of NCT loss, compared to those induced by GSIs or silencing Notch receptors, we examined cDNA from MDA231 treated independently with NCT, Notch1, Notch2, Notch4 siRNAs and GSI MK-003, on Illumina expression arrays. Thirteen of the 18 genes maximally affected by GSI were similarly affected by NCT siRNA. NCT knockdown also affected 1745 other genes that by large were not affected by GSI or Notch knockdowns. This suggests that NCT has GS-and Notch-independent cellular functions and may have different biological properties as a therapeutic target than GS. Among NCT siRNA affected genes, some are tumor suppressors: CST4 increased 8 fold; pro-invasive genes like GNG11 decreased 4 fold; cell adhesion genes: CTGF increased 4.5 fold etc.

CONCLUSIONS: NCT is overexpressed in 47.5% of BC cases where it infers adverse OS in the ER-vecohort of patients. Anti-NCT mAbs recognize endogenous NCT in BC cells and reduce BC cell proliferation and invasion. Silencing NCT in invasive BC cells induces extensive gene expression changes that only partially overlap with those caused by GSIs or Notch siRNAs. We conclude that NCT has GS-independent functions in BC cells and that an anti-NCT mAb may be a promising therapeutic approach for invasive BC.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-06-04.

Regulation of pancreatic islet gene expression in mouse islets by pregnancy

Pancreatic β cells adapt to pregnancy-induced insulin resistance by unclear mechanisms. This study sought to identify genes involved in β cell adaptation during pregnancy. To examine changes in global RNA expression during pregnancy, murine islets were isolated at a time point of increased β cell proliferation (E13.5), and RNA levels were determined by two different assays (global gene expression array and G-protein-coupled receptor (GPCR) array). Follow-up studies confirmed the findings for select genes. Differential expression of 110 genes was identified and follow-up studies confirmed the changes in select genes at both the RNA and protein level. Surfactant protein D (SP-D) mRNA and protein levels exhibited large increases, which were confirmed in murine islets. Cytokine-induced expression of SP-D in islets was also demonstrated, suggesting a possible role as an anti-inflammatory molecule. Complementing these studies, an expression array was performed to define pregnancy-induced changes in expression of GPCRs that are known to impact islet cell function and proliferation. This assay, the results of which were confirmed using real-time reverse transcription-PCR assays, demonstrated that free fatty acid receptor 2 and cholecystokinin receptor A mRNA levels were increased at E13.5. This study has identified multiple novel targets that may be important for the adaptation of islets to pregnancy.

Systemic treatment with strontium ranelate promotes tibial fracture healing in ovariectomized rats

Systemic treatment with strontium ranelate (SR) was performed on ovariectomized (OVX) rats with fractured tibiae. Callus quality was assessed by radiographic, histological, micro-computerized tomography, and biomechanical examinations at 4 and 8 weeks after fracture. Results revealed that systemic applied SR promoted osteoporotic fracture healing.

INTRODUCTION

Several studies have demonstrated the dual effect of SR on osteoporotic and undisturbed bone. However, reports of their effect on osteoporotic fracture healing are limited. This study was designed to investigate the effects of SR on bone regeneration in OVX rats with fractured tibiae.

METHODS

Three months after being OVX, female Sprague-Dawley rats accepted bilateral osteotomy on proximal tibiae fixed with intramedullary wires and were divided into two groups: OVX and OVX + SR (625 mg/kg/day). Callus quality was evaluated at 4 and 8 weeks postfracture.

RESULTS

Compared with OVX group, SR treatment significantly increased bone formation, BMD, biomechanical strength, and improved microstructural properties of the callus. The ultimate load was increased by 211.0% and 61.4% (p<0.01), and the total bone volume of callus by 74.8% and 79.3% (p<0.01) at 4 and 8 weeks postfracture, respectively. SR treatment also promoted healing progress with increased osteogenesis at 4 weeks; more mature and tightly arranged woven or lamellar bone at 8 weeks across the fracture gap in histological analysis.

CONCLUSION

This study suggests that systemic treatment with strontium ranelate could promote tibial fracture healing in OVX rats.

Relationship between response to risperidone, plasma concentrations of risperidone and CYP3A4 polymorphisms in schizophrenia patients

In this study, we examined the relationships between plasma concentrations of risperidone and 9-hydroxyrisperidone and polymorphisms of CYP3A4. All 130 schizophrenia patients (45 men, 85 women, age 15-60 years) who met DSM-IV criteria were given risperidone for 8 weeks. Clinical efficacy was determined using the Positive and Negative Syndrome Scale (PANSS). CYP3A4*1G was found to be associated with the change in total PANSS scores (Kruskal-Wallis test, P = 0.021), which was not significant on adjusting for multiple testing. Our study has, for the first time, conducted a genetic association study of the CYP3A4 gene with risperidone response. Further studies on larger groups and on the effects of the longer term risperidone treatment are needed to confirm these results.

Association of nuclear factor κB expression with a poor outcome in nasopharyngeal carcinoma

The aim of this study was to determine the relationship between nuclear factor κB and the prognosis of patients with nasopharyngeal carcinoma. We used immunohistochemical studies to examine nuclear factor κB expression in 42 patients with nasopharyngeal carcinoma. The results showed that tumors positive for nuclear factor κB were associated with an increased relapse potential, poor disease-free survival, and reduced overall survival in nasopharyngeal carcinoma. Our study indicates that nuclear factor κB could be an independent molecular marker for predicting poor prognosis among patients with nasopharyngeal carcinoma. Understanding the biology of nuclear factor κB-mediated pathways may lead to the development of novel therapeutic strategies for nasopharyngeal carcinoma.

Calcium Signaling Promotes Targeted Recycling of the Lateral Border Recycling Compartment (LBRC) During Diapedesis (140.1)

Leukocyte transendothelial migration (diapedesis, TEM) is a crucial step in both the innate and adaptive immune responses. We have shown that targeted recycling of membrane from a reticulum localized close to the endothelial cell (EC) lateral border (the lateral border recycling compartment, LBRC) surrounds the transmigrating leukocyte during TEM (Mamdouh, Z., et al 2003. Nature). Targeted recycling is required for TEM to proceed. However the mechanisms underlying recruitment of the LBRC are not entirely clear. An increase of cytosolic free calcium (Ca) in ECs and the resulting activation of Ca/Calmodulin-dependent myosin light chain kinase (MLCK) are crucial for diapedesis to occur. Here we address the role of Ca signaling in the process of targeted recycling. The cell permeant Ca chelator BAPTA-AM was loaded into ECs under conditions that blocked calcium flux in response to histamine, but did not impair cytoskeletal or junctional integrity. Under these conditions, blocking of cytosolic free Ca flux in ECs abolished targeted recycling of the LBRC, as well as leukocyte transendothelial migration to the same extent (&gt; 80%). Furthermore, blockade of MLCK with ML7 (1uM) also blocked targeted recycling and TEM by &gt; 80%. This study demonstrates that Ca signaling is upstream of LBRC targeted recycling, and MLCK activation (presumably by Ca/Calmodulin dependent mechanism) is required for targeted recruitment of the LBRC.

Clinical study of mini-nutritional assessment for older Chinese inpatients

BACKGROUND

Malnutrition is a common problem in older patients. Early detection of malnutrition is an important task in clinical practice. The MNA has become an extensively used tool to evaluate nutritional status in European countries and the United States.

OBJECTIVE

We evaluated the Mini-Nutritional Assessment (MNA) test and the short-form MNA (MNA-SF) test as screening tools for malnutrition in older Chinese inpatients and focused on finding an optimal cutoff point for MNA total score and MNA-SF score.

DESIGN

One hundred eighty-four older Chinese inpatients were enrolled in this study from July to August 2006. Nutritional assessment included MNA, anthropometric measurements, and biochemical markers.

RESULTS

According to the original cutoff point of the full MNA, 19.6% of those assessed were malnourished, 53.2% were at risk of malnutrition and 27.2% were well nourished. Correlations were found between MNA, MNA-SF and body mass index, triceps skinfold thickness, serum albumin, lymphocyte count, hemoglobin, lymphocyte ratio. With the most proper cutoff point lower than 19 indicating malnutrition, when using serum albumin (< 35.0 g/L) as the indicator, the sensitivity and specificity of the MNA total score were 0.6286 and 0.7466; when using BMI (< 18.5 kg/m2) as the indicator, the sensitivity and specificity were 0.8636 and 0.7469. The incidence rate of malnutrition was 32.6%. The most proper cutoff point of MNA-SF was lower than 12.

CONCLUSION

The MNA and MNA-SF were useful tools to identify older Chinese inpatients with malnutrition. However, the cutoff point of the MNA should be modulated for this population.

Sapap3 and pathological grooming in humans: Results from the OCD collaborative genetics study

SAP90/PSD95-associated protein (SAPAP) family proteins are post-synaptic density (PSD) components that interact with other proteins to form a key scaffolding complex at excitatory (glutamatergic) synapses. A recent study found that mice with a deletion of the Sapap3 gene groomed themselves excessively, exhibited increased anxiety-like behaviors, and had cortico-striatal synaptic defects, all of which were preventable with lentiviral-mediated expression of Sapap3 in the striatum; the behavioral abnormalities were also reversible with fluoxetine. In the current study, we sought to determine whether variation within the human Sapap3 gene was associated with grooming disorders (GDs: pathologic nail biting, pathologic skin picking, and/or trichotillomania) and/or obsessive-compulsive disorder (OCD) in 383 families thoroughly phenotyped for OCD genetic studies. We conducted family-based association analyses using the FBAT and GenAssoc statistical packages. Thirty-two percent of the 1,618 participants met criteria for a GD, and 65% met criteria for OCD. Four of six SNPs were nominally associated (P < 0.05) with at least one GD (genotypic relative risks: 1.6-3.3), and all three haplotypes were nominally associated with at least one GD (permuted P < 0.05). None of the SNPs or haplotypes were significantly associated with OCD itself. We conclude that Sapap3 is a promising functional candidate gene for human GDs, though further work is necessary to confirm this preliminary evidence of association.

Analysis of 10 independent samples provides evidence for association between schizophrenia and a SNP flanking fibroblast growth factor receptor 2

We and others have previously reported linkage to schizophrenia on chromosome 10q25-q26 but, to date, a susceptibility gene in the region has not been identified. We examined data from 3606 single-nucleotide polymorphisms (SNPs) mapping to 10q25-q26 that had been typed in a genome-wide association study (GWAS) of schizophrenia (479 UK cases/2937 controls). SNPs with P<0.01 (n=40) were genotyped in an additional 163 UK cases and those markers that remained nominally significant at P<0.01 (n=22) were genotyped in replication samples from Ireland, Germany and Bulgaria consisting of a total of 1664 cases with schizophrenia and 3541 controls. Only one SNP, rs17101921, was nominally significant after meta-analyses across the replication samples and this was genotyped in an additional six samples from the United States/Australia, Germany, China, Japan, Israel and Sweden (n=5142 cases/6561 controls). Across all replication samples, the allele at rs17101921 that was associated in the GWAS showed evidence for association independent of the original data (OR 1.17 (95% CI 1.06-1.29), P=0.0009). The SNP maps 85 kb from the nearest gene encoding fibroblast growth factor receptor 2 (FGFR2) making this a potential susceptibility gene for schizophrenia.