Sensitization to acid-hydrolyzed wheat protein by transdermal administration to BALB/c mice, and comparison with gluten

BACKGROUND

An increasing number of studies have shown that hydrolyzed wheat protein (HWP) can induce IgE-mediated hypersensitivity by skin contact and/or food ingestion. However, there has been no study of the sensitizing potential of HWP. In this study, the possibility of transdermal pathway for sensitization to acid-HWP (HWP1) was investigated using BALB/c mice, and compared with that of gluten.

METHODS

HWP1 or gluten (500 μg/mouse) was transdermally administered using patches. After three or four cycles of sensitization for 3 days/week, active systemic anaphylaxis (ASA) was induced by intraperitoneal injection of the antigen, and rectal temperatures, scores of anaphylactic responses, and plasma histamine levels were determined. Because HWP1 was included in facial soap in Japan, the effect of detergent on the sensitizing potential was also investigated.

RESULTS

Transdermal administration of HWP1 induced dose-dependent production of IgE and IgG1. After sensitization for 3 or 4 weeks, intraperitoneal injection of HWP1 caused ASA, leading to decreased rectal temperatures, increased anaphylaxis scores, and increased plasma histamine levels. In addition, splenocytes harvested after ASA produced IL-4, IL-5, and IL-10 by re-stimulation with HWP1. Transdermal exposure to gluten also induced IgE and IgG1 production, and intraperitoneal injection of gluten also induced ASA only in mice sensitized in the presence of sodium dodecyl sulfate.

CONCLUSIONS

Transdermal exposure to HWP1 is sufficient to activate key immune pathways necessary for sensitizing mice for immediate hypersensitivity reactions. This study shows that HWP has a sensitizing potential as well as gluten, whereas its allergenicity may be different from that of gluten.

DIFFERENCES IN RADIOGRAPHIC FINDINGS BETWEEN SCAPHOID FRACTURE PATTERNS

Scaphoid fracture patterns can be divided into volar and dorsal type using three-dimensional computed tomography. Ninety-nine patients underwent this examination plus radiography to determine how often fracture pattern was identifiable by radiography including proximal fragment ratio (PFR) measurement. Oblique radiographs obtained at 45° of pronation demonstrated a volar displacement in 28 of 37 volar type fractures in three-dimensional computed tomography (76%), while as oblique view with 45° of supination could identify the dorsal type in ten of 18 (56%). PFR showed a significant difference, with means of 0.59 for volar type and 0.43 for dorsal type. Using oblique views in the two rotational directions together with the PFR, the two fracture patterns could be differentiated in 35 of 43 fractures (81%). No differences were evident between the two fracture patterns with respect to prevalence of dorsal intercalated segment instability deformity.

RADIOGRAPHIC MORPHOLOGY OF THE ULNAR HEAD

Posteroanterior radiographs of 102 normal wrists were studied to determine the morphological characteristics of the ulnar head associated with the value of ulnar variance. Ulnar variance, ulnar styloid length, ulnar head diameter, ulnar seat inclination, and the distance of ulnar head peak to the distal radioulnar joint were measured together with the third metacarpal length as a reference of the size of the wrist. Moderate correlation was confirmed not only between ulnar variance and ulnar seat inclination but also between ulnar variance and the distance of the ulnar head peak. Furthermore, we found a statistically significant correlation between ulnar variance and ulnar head diameter. The results showed that whole ulnar head configurations are affected by ulnar variance although there are considerable variations.

Retardation in the Oxidation Rate of Nanocrystalline Silicon Quantum Dots

Using very-high-frequency (VHF) plasma decomposition of SiH4 and pulsed gas technique, we have successfully prepared nanocrystalline silicon (nc-Si) quantum dots having average diameter of 8 nm and dispersion of 1 nm. The role of natural oxide is very important. It controls the size of nc-Si dots. Of particular interest is that the oxidation of these dots can be self limited, due to the stress induced near Si/oxide interface, which would allow further reduction of size and improvement in dispersion. This paper deals with the systematic study of oxidation process of nc-Si dots. Nc-Si dots formed in an Ar plasma with SiH4 gas pulses are deposited onto a Pt mesh The dots are then oxidized at 750, 800 and 850°C from 20 minutes to 15 hours. The dimensions of the residual nc-Si and the grown oxide are measured directly from the TEM micrographs and analyzed. For comparison, field oxide is investigated using ellipsometry. Retardation in the oxidation rate of nc-Si is observed. The mechanism of the reduction of oxidation rate in nc-Si is discussed taking into account the effect of stress.

Radiotherapy, including sentinel lymph node, to superficial cancer of esophagus

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Background: It is known that esophageal cancer frequently causes lymph node metastasis. Even if relatively early stage of esophageal cancer, reaching muscularis mucosae (T1a-MM: Japanese Classification of Esophageal Cancer) causes subclinical node metastasis to about 10%. So when radiation therapy (RT) is administered to these patients, field of irradiation should include the areas where subclinical node metastasis may exist. But the wider field of irradiation is, the more likely adeverse event is to occur. In this study, we examined utility of RT based on sentinel lymph node (SLN) theory.

Methods: Before irradiation, Tc-99m tin colloid solution was endoscopically injected to the submucosal layer around the primary tumor and lymphoscintigraphy was examined to detect SLNs. And the irradiation field was planned as SLN regions were included. Patients with esophageal squamous cell carcinomas (ESCC) that reach cT1a-MM or cT1b and patients with ESCC who had underwent endoscopic resection and pathologically diagnosed pT1a-MM or pT1b were eligible if they had clinically no lymph node metastasis, no distant metastasis and no advanced cancer in other site. Between April 2001 and December 2009, 17 of these patients were received RT based on SLN theory. We retrospectively examined them.

Results: Characteristics of the 17 pts were: median age; 67 (58-82), male/female; 15/2, T1a-MM/T1b-SM1/T1b-SM2; 4/2/11, definitive RT/adjuvant RT; 10/7, RT alone/concurrent chemoradiotherapy; 1/16. Average dose of irradiation was 57.0 ± 6.4Gy. Median follow-up is 81.4 months (7.9-127.2). Ten pts with definitive RT gained complete remission. Two minor local relapses of the primary tumors were observed. They underwent salvage endoscopic resection and survive without other relapse. There was no treatment related death. Grade 3 or 4 late toxicity was not observed.

No significant financial relationships to disclose.

Availability of sentinel node as predictive index of lymph node metastases to early-stage gastric cancer surgery

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Background: Recently, the less invasive surgery for the early gastric cancer attract considerable attention, in particular, sentinel node navigation surgery (SNNS) is expected to be a new strategy. We analyzed the feasibility of sentinel node (SN) biopsy and its accuracy in predicting the lymph node status in patients with early gastric cancer.

Methods: Between 1999 and 2009, we have performed the gastrectomy with SN biopsy during an operation in over 500 cases. We focused attention on 115 patients with cT1N0, less or equal 40 mm in size, and isolated gastric cancer and they had undergone the individualized minimizing gastrectomy. Proximal, pylorus-preserving gastrectomy and wedge resections were performed in 51, 54 and 10 patients, respectively. We used a dual procedure with dye- and gamma probe-guided techniques for SN mapping and resected SN and non-SN as was conventionally done for the safety.

Results: Subjects were 85 males and 30 females with a mean age of 63.4 years. 53 patients had undergone laparoscopy-assisted gastrectomy. The mean number of SNs was 4.3/case. Of the four patients were SN positive and false-negative was found in one case. The sensitivity of detecting metastases was 80.0% (4/5) and the accuracy was 99.1% (114/115). One case had a recurrence in the liver and no cases without SN metastasis were confirmed any recurrences and metastases.

Conclusions: This study showed the diagnostic accuracy of metastasis based on SN was very high, and the minimized resection and lymphadenectomy could be performed safely.

No significant financial relationships to disclose.

Validation study of sentinel lymph node mapping using radio- and dye-guided methods in gastric cancer: 431 cases at a single institution

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Background: Some papers have reported that sentinel lymph node (SLN) concept can be applied in patients with early gastric cancer, in particular clinically T1N0M0 or T2N0M0 with a tumor diameter of 4cm or less. Little is, however, available on the SLN study with the other criteria than listed above. The aim of the present work was to investigate the accuracy of the SLN biopsy of gastric cancer with various stages and evaluate the indication for SLN navigated gastrectomy.

Methods: A total of 431 consecutive patients were diagnosed with operable gastric cancer during the period April 1999 through December 2007. Reasons for inclusion were, in principle, T1N0M0 or T2N0M0 gastric cancer. However, several patients diagnosed preoperatively with T3N0M0, T2N1M0, remnant gastric cancer, multiple gastric cancers and additional treatment after endoscopic therapy were also enrolled in this study according to their request. All patients underwent a radical gastrectomy with SLN mapping with an informed consent. The SLNs were identified using both radio-guided and dye-guided method.

Results: Detection rate of hot and/or blue node was 95.8% (413/431). The accuracy of metastatic status based on SLN was 97.6% (403/413). In six of 10 false-negative cases, some clinical backgrounds and problems were present; scirrhous gastric cancer, the tumor penetration of serosa, multiple lesions, remnant gastric cancer after partial resection and the technical issue of tracer injection. Nine of these 10 false-negative cases had the metastatic lymph nodes within only the sentinel basins. Specifically, in the group of clinically T1N0M0 untreated gastric cancer with a tumor diameter of 4 cm or less, there were only 3 false- negative cases. In addition, all the metastatic lymph nodes of the 3 cases located within the sentinel basins.

Conclusions: Our study suggested that SLN concept for untreated early gastric cancer could be validated. The sentinel basin dissection might be used to advantage to improve curativity for gastric cancer.

No significant financial relationships to disclose.

Abstract P3-14-13: Necessity of Confirming the Biological Marker of Distant Metastatic Lesion for Breast Cancer Patients

Background

The systemic management of metastatic breast cancer patients is usually based on biological marker of the primary tumor. However, characteristics of hormone status or HER2 over expression may change with metastatic site due to long term treatment for metastatic cancer with endocrine therapy, chemotherapy or biologic agents. The first purpose of this study was to investigate the concordance in HER2 over expression between primary tumor and distant metastases. The second purpose was to evaluate the efficacy of biologic agents for the patients with positive changes in HER2 status.

Material and methods One hundred forty-one patients had biopsy or operation of their metastatic site from 2000 to December 2009 at the Chiba Cancer Center Hospital. Specimen of operation or biopsies of suspected metastatic site were obtained from breast cancer patients. Specimen were analyzed pathologically to confirm metastatic disease and secondly to evaluate

HER2 by immunohistochemistry or FISH.

Results

Specimen of metastatic site were 67 local lesion (breast or lymph node), 27 brain, 16 liver, 12 bone and 5 others organs (stomach, intestine, ovary or uterus. Negative, positive or no change in HER2 status was observed in 4%, 6%, and 90% respectively. Positive changes of HER2 in metastatic site were 3(4%) local lesion, 3(11%) brain, 1 (7%) lung, 0(0%) liver, 2(17%) bone, and 0(0%) others, respectively. Three patients with positive change in HER2 status of metastatic site were treated to trastuzumab. Two of 3 patients with HER2 positive change were assessed to responded to trastuzumab-based treatment schedules.

Conclusions This study demonstrates the presence of substantial discordance in HER2 overexpression between primary tumor and metastases site.Metastatic tissue confirmation might be considered in patients with suspicious metastatic recurrence or resistance trastuzumab treatment.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-14-13.

Abstract P1-01-24: Is the Dye Method Alone Useful for Sentinel Lymph Node Biopsy in Early-Stage Breast Cancer? Prospective Analysis of 1081 Patients after SLN Biopsy

Introduction: Sentinel lymph node biopsy (SLNB) for breast cancer has been established. The objective of this study was to investigate factors which elevate the identification rate employing the dye method (DYm) alone.

Subjects: The subjects were 1,081 cN0 breast cancer patients who underwent preoperative cytology of the axillary lymph nodes at our facility between May 2001 and April 2010.

Methods: In the morning of the operation day, 0.3 ml of technetium phytate was subcutaneously injected immediately above the tumor, and 5 ml of indigocarmine was subcutaneously injected into the para-areolar region on the axillary side immediately before surgery, attempting to identify sentinel lymph nodes (SLN) using the combination method. The rates of identification employing the DYm and RI method (Rim) and false-negative rates were calculated. Regarding SLN in which the highest count was detected by the RIm as the first SLN (fSLN), consistency with that detected using the DYm was investigated.

Results: The mean numbers of SLN identified by the DYm and RIm were 1.36 and 1.90, respectively, showing that significantly more lesions were identified employing the RIm (P<0.05). The identification rates employing the dye, RI, and both methods were 88.7, 98.7, and 99.3%, respectively, and the consistency of fSLN between the DYm and RIm was 78.1%. SLN metastasis detected using the RIm could not be identified employing the dye method in 20 cases. The age, tumor size, and BMI were investigated in these 20 cases, and a significant difference was noted in the tumor size. Conclusion: The identification rate employing the DYm alone was lower than that employing the RIm. The consistency of fSLN between the two methods was 78.1%. Although the RIm may have biopsied excess lymph nodes (LN), its use may be important to complement the DYm. Dye does not readily enter metastatic LN because of the presence of tumor plugs. The application of preoperative axillary LN cytology to cases with large tumors to exclude metastasis-positive cases may elevate the SLN identification rate employing the DYm.

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