[Magnetic resonance imaging findings and differential diagnosis of renal epithelioid angiomyolipoma comparing with renal no-epithelioid angiomyolipoma]

Objective: To investigate whether MRI findings can differentiate renal epithelioid angiomyolipoma (EAML) from renal no-epithelioid (typical) angiomyolipoma. Methods: A total of 44 patients were collected from General Hospital of PLA.These cases were obtained from January 2009 to June 2015.To retrospectively analyze these mainly MRI findings among 12 cases of EAML (age from 27 to 61 years, male 2 cases, female 10 cases, mean age was 46.7 years); 32 cases of renal no-epithelioid AML (age from 34 to 70 years old, male 9 cases, female 23 cases, mean age was 53.4 years old) as case control study. MRI findings included gender, T(2)WI, the signal on gross fat, pseudocapsle, necrosis or cystic degeneration, DWI, hemorrhage and the peak in three phases of dynamic enhancement.All data were analyzed statistically using SPSS version 19.0 (IBM, Armonk, NY, USA). χ(2) test and a single order chart were used to analyze the enumeration data. Results: Comparing with renal no-epithelioid angiomyolipoma, minimal fat, necrosis or cystic degeneration and hemorrhage were statistical significance. P values were 0.002, 0.007, 0.025, respectively.Gender, solid components of tumors on T(2)WI, the signal of DWI, pesudocapsule and the peak of enhancement had no statistical significance. P values were 0.863, 0.053, 0.479, 0.460, respectively. Conclusion: Comparing with renal no-epithelioid AML, necrosis or cystic degeneration and hemorrhage with minimal fat are characteristic MRI findings of EAML.

Abstract P5-16-08: Applications of rib sparing technique in internal mammary vessels exposure of abdominal free flap breast reconstructions

Background:

Internal mammary vessels (IMVs) are widely used recipient vessels in abdominal free flaps breast reconstructions. Exposure of IMVs usually needs to resect a segment of costal cartilage or rib during the operations. The rib sparing technique is an alternative method with less damage. This study aims to analysis the applicability and advantages of rib sparing technique of IMVs exposure in breast reconstruction.

Methods:

medical records of 215 patients who underwent abdominal free flap reconstruction from November 2006 to December 2017 were analyzed. The factors influencing the choice of vessels and rib sparing were analyzed. The outcomes of rib sparing were assessed. Intercostal space (ICS) width and other related data were measured by the preoperative thin slice chest computed tomography (CT) scan images.

Results:

Among all 215 patients with 218 flaps, 172 flaps used IMVs as the recipient vessels while 13 used thoracodorsalvessels and 33 used subscapular vessels. The proportion of IMVs as recipient vessels showed a rising trend in general and remained over 90% for the last three years in our center. Patients with immediate reconstruction (p=0.005) and axillary lymph nodes dissection(ALND) (p<0.001) were less likely to use IMVs, both in univariate and multivariate logistic regression analysis. Patients' BMI and radiotherapy history showed no statistically significant differences between the IMVs group and the other vessels group (p=0.338 and 0.811). The rib sparing rate in IMVs exposure increased yearly and exceeded 40% in 2013, now it maintained more than 60% during the recent 3 years. Additionally, among the patients who received rib sparing IMVs exposure in 2017, the mean ICS width was relatively smaller than that in 2013 (2.54cm V.S 2.93cm, p=0.124). Compared with rib resection group, patients with rib sparing were higher (163.57 ± 4.44 cm vs. 161.83 ± 4.30 cm, p=0.047) and with a wider ICS (2.65 ± 0.54 cm vs. 2.25± 0.38 cm, p<0.01), while the depth from the surface of the pectoralis major muscle to the IMVs and distance between the parasternal line and IMVs had no difference between the two groups. Rib sparing group has a shorter surgery and hospitalization time, as well as a lower severe complication rate, but the differences were not statistically significant (p= 0.120, 0.450 and 0.296).

Conclusion:

IMVs were used more frequently as the recipient vessels in abdominal free flap breast reconstructions, especially when axillary operation was not carried out at the same time. Rib sparing technique had the potential to decrease surgery time and hospitalization days, as well as the severe complications rate. It could be used in most of patients received free flap reconstruction when IMVs were used, particularly in higher patients and patients with a wider ICS. Preoperative slice chest CT scan can be used to measure the ICS width to provide suggestions for dealing with the ribs.

Citation Format: Zhang Q, Xiao Q, Guo R, Wu J, Gu Y, Xiu B. Applications of rib sparing technique in internal mammary vessels exposure of abdominal free flap breast reconstructions [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-16-08.

Abstract P6-05-01: A novel cleaved cytoplasmic lncRNA LacRNA interacts with PHB2 and suppresses breast cancer metastasis via repressing MYC targets

Long noncoding RNAs (lncRNAs) have been implicated in breast cancer metastases through largely unknown mechanisms. In this study, we used microarray analysis to compare lncRNAs expression levels between matched pairs of breast lymph node metastatic tissues and primary tumors. We discovered that lncRNA LINC00478 was substantially downregulated in the metastatic tumor samples. Interestingly, we found that LINC00478 could be cleaved by RNase to simultaneously generates the mature 5' ends of cytoplasmic RNA and 3' ends of nuclear RNA by polyadenylation. We named 5' ends 791-nt RNA as LacRNA (LINC00478-assciated cytoplasmic RNA). Over expression of full-length LINC00478 and LacRNA, but not LINC00478 3' RNA, significantly inhibited breast cancer proliferation, invasion and metastasis in vitro and in vivo.We used CRISPR-dCas9 complex to mediate efficient transcriptional activation of LacRNA at endogenous genomic loci followed by RNA-seq analyses. Gene set enrichment analysis (GSEA) showed that the MYC pathway/targets were prominent gene sets negatively enriched in LacRNA-activated cells. Further study revealed that LacRNA exerted its tumor suppressive activity by directly binding with prohibitin2(PHB2) to enhance its protein stability, which promoted PHB2 competing with MYC for transcriptionally suppressing the MYC target genes (e.g., CDC20, CDC45, CCNA2 and MAD2L1). Mechanistically, LacRNA inhibits breast cancer invasion and metastasis by interacting with PHB2 through LacRNA's 1-300nt region. In addition, taking advantage of CRISPR system to knock-out and activate the expression of LacRNA, as well as rescue experiment, we uncovered the positive correlation between LacRNA and PHB2 and their role in suppressing MYC target genes and cancer metastasis. At the same time, LacRNA can attenuated the MYC induced activation of MYC targets through binding with PHB2, indicating that LacRNA plays a central role in the suppression of MYC target genes. We further explored the role of LacRNA in inhibiting lung metastasis by implanting LacRNA-activated LM2 cells into the mammary fat pads of NOD-SCID mice. Luciferase imaging and histological analysis were used to detect lung metastasis and found that LacRNA significantly suppressed lung metastasis. Immunohistochemistry were used to detect the expression of PHB2 and MYC targets in both orthotopic tumors and lung metastasis and verified their correlation in vivo. Extensive analyses of clinical data indicated that LacRNA level was substantially downregulated in metastases tumors accompanied by enrichment of MYC targets. The robustness value of LacRNA expression was further verified in two independent patient cohorts, including 530 invasive breast cancer tumors in Fudan University Shanghai Cancer Center (FUSCC) and 819 breast patients' data from TCGA. High LacRNA expression level had a significantly better clinical outcome in both cohorts and represented an independent prognostic predictor for DFS (HR=0.48, P=0.006, multivariate analysis) and OS (HR=0.32, P=0.009, multivariate analysis) in FUSCC cohort. Collectively, LacRNA functions as a tumor suppressor lncRNA that inhibits breast cancer invasion-metastasis cascade.

Citation Format: Guo R, Su Y-H, Xue J-y, Si J, Chi Y-y, Wu J. A novel cleaved cytoplasmic lncRNA LacRNA interacts with PHB2 and suppresses breast cancer metastasis via repressing MYC targets [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-05-01.

Abstract P3-13-09: Increased mortality with repeat lumpectomy alone after ipsilateral breast tumor recurrence: A propensity-adjusted, population-based SEER analysis

Background: The benefit of repeat lumpectomy for ipsilateral breast tumor recurrence (IBTR) after breast conserving surgery (BCS) is currently inconclusive. This issue has become even more important as small and isolated recurrent tumors were frequently diagnosed.

Methods: IBTR patients with definitive surgery were identified in the Surveillance, Epidemiology, and End Results registry between 1973 and 2013. The effect of different IBTR surgeries on overall and cancer-specific mortality was assessed using risk-adjusted Cox proportional hazard regression modeling and stratified propensity score matching analysis (PSMA).

Results: Based on the selection criteria, 5098 patients were recruited. Of those, 4048 (79.4%) women underwent mastectomy and 1050 (20.1%) underwent repeat lumpectomy after IBTR. Patients who received repeat lumpectomy had lower grade (23.7% vs 15% for well-differentiated) and smaller recurrent tumor (47% vs 36.2% for ≤ 1 cm) but earlier recurrence (23.9% vs 11.2% for interval times < 48 months) than those who underwent mastectomy. A minority of each group (24.7% of those undergoing repeat lumpectomy and 3% of the mastectomy group) underwent RT after surgery. In multivariable Cox regression analysis, repeat lumpectomy was associated with increased overall mortality (Hazard ratio (HR) = 1.58, 95% CI = 1.353 to 1.844, P < 0.001) and cancer-specific mortality (HR = 1.721, 95% CI = 1.345 to 2.202, P< 0.001). Similar HRs were derived from the PSMA cohort. However, we found no significant difference in overall mortality for women who underwent repeat lumpectomy followed by RT compared with that for those who underwent mastectomy (P= 0.411). Moreover, IBTR patients with small tumors (≤ 1 cm) who underwent repeat lumpectomy with RT rather than without had similar overall and cancer-specific survival rates to those who underwent mastectomy (P= 0.189 and P= 0.604, respectively).

Conclusions: Our investigation suggests that compared with mastectomy, repeat lumpectomy for IBTR is associated with higher overall and cancer-specific mortality under real-world observational conditions. Furthermore, repeat lumpectomy with RT is equivalent to mastectomy with respect to overall mortality and may influence treatment decision making for patients with small IBTR.

Citation Format: Su Y, Guo R, Xue J, Chi Y, Wu J. Increased mortality with repeat lumpectomy alone after ipsilateral breast tumor recurrence: A propensity-adjusted, population-based SEER analysis [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-13-09.

[Investigation of hearing loss and speech recognition ability of the elderly and analysis of its high risk factors]

Objective: To investigate the hearing loss and speech disorders in the elderly, to analyze the risk factors of the elderly deafness, as well as to provide reference for the clinical research of the elderly deafness. Methods: From March 2016 to March 2018, 913 elderly people, who were tested for hearing and speech disorders, were examined by a unified questionnaire to investigate the demographic data of the subjects and the related factors of deafness, and the hearing and speech recognition tests were carried out. According to the hearing loss, the hearing impaired group was divided into the hearing impaired group (500, 1 000, 2 000 and 4 000 Hz, the average hearing threshold>25 dBHL) and the non hearing impaired group (the average hearing threshold of the four frequencies ≤25 dBHL), and then the single factor analysis and the unconditional Logistic regression analysis were used. Finally, the risk factors of senile deafness were analyzed. Results: Of the 913 elderly subjects in the survey, 389 (42.61%, 389/913) had no hearing impaired, 345 (37.79%, 345/913) were mild hearing impaired, and 149 (16.32%, 149/913) had moderate hearing loss. Twenty-six patients were severe hearing loss (2.85%, 26/913); 4 patients had severe hearing loss (0.44%, 4/913). Among the 524 hearing-impaired elderly, there were 244 speech-recognition disorders (46.56%, 244/524), of whom 106 were mild hearing-impaired, accounting for 30.72% (106/345), 108 were moderate hearing loss, accounting for 72.48% (108/149), 26 were severe hearing loss, accounting for 100% (26/26), and 4 were the profound hearing loss, accounting for 100% (4/4). Statistical analysis showed that the age, job status, history of hypertension, history of hyperglycemia, and smoking history were independent risk factors for senile hearing loss (P<0.05). Conclusions: High incidences of hearing and speech recognition obstacle are found in health examination for the elderly patients. Noise exposure, age, history of hypertension, high blood sugar, and smoking history are high-risk factors for senile deafness, therefore, prevention and rehabilitation programs are urgent to be developed.

Lasing at K Points of a Honeycomb Plasmonic Lattice

We study lasing at the high-symmetry points of the Brillouin zone in a honeycomb plasmonic lattice. We use symmetry arguments to define singlet and doublet modes at the K points of the reciprocal space. We experimentally demonstrate lasing at the K points that is based on plasmonic lattice modes and two-dimensional feedback. By comparing polarization properties to T-matrix simulations, we identify the lasing mode as one of the singlets with an energy minimum at the K point enabling feedback. Our results offer prospects for studies of topological lasing in radiatively coupled systems.

Risk factors for cardiac rupture complicating myocardial infarction: a PRISMA meta-analysis and systematic review

Cardiac rupture (CR) is a complication of acute myocardial infarction (AMI) that is associated with a high mortality rate. This study aimed to identify the risk factors for CR in patients with AMI. Medline, Cochrane, EMBASE, and Google Scholar databases were searched for relevant literature published through September 16, 2018. Eligible studies included patients with AMI and compared factors between patients with and without CR. Sixteen studies were identified and included in the meta-analysis. Results revealed that female gender (pooled OR=2.72, 95% CI 2.04 to 3.63, p<0.001), older age (pooled difference in means=6.91, 95% CI 4.20 to 9.62, p<0.001), infarction at left anterior descending coronary artery (LAD) (pooled OR=1.85, 95% CI 1.03 to 3.32, p=0.039), and anterior wall infarction (pooled OR=1.87, 95% CI 1.30 to 2.68, p=0.001) were associated with increased risk of CR, whereas history of MI, smoking, and multivessel disease were associated with reduced risk of CR. Patients treated with primary percutaneous coronary intervention (PCI) had reduced risk of CR, while patients who had received any thrombolysis had increased risk of CR. In conclusion, results of systematic review and meta-analysis of existing literature suggest that risk factors for CR in patients with AMI include female gender, older age, new-onset MI, non-smoking status, LAD infarction, anterior wall infarction, and single-vessel disease. Furthermore, treatment with primary PCI may help reduce the risk for CR, while thrombolysis might increase the risk for CR.

Wettability of pear leaves from three regions characterized at different stages after flowering using the OWRK method

BACKGROUND

A better understanding of leaf surface wettability is critical to improve the adhesion of liquid pesticides. Leaf surface wettability is dependent on the property of the liquid as well as the physical and chemical properties of the leaf, which vary with climate and growth stage. The aim of this study was to characterize the wettability of pear leaves from three different climatic regions at different stages after flowering.

RESULTS

The contact angles of different test liquids were measured on both adaxial and abaxial pear leaf surfaces and the Owens-Wendt-Rabel-Kaelble (OWRK) method was used to calculate surface free energy (SFE) and its polar and non-polar components. The results demonstrated that the SFE of both the adaxial and abaxial surface of the pear leaf, and the proportion of polar component, increased with increasing time after flowering. At early growth stages, pear leaves were highly hydrophobic, similar to a polytetrafluoroethylene surface, whereas at later growth stages, pear leaves were hydrophobic, more similar to a polymethylmethacrylate surface. Also, the SFE differed with climatic region. Factors influencing these changes are discussed.

CONCLUSION

Changes in contact angles and SFE correlated with the change of the leaf surface wettability. Leaves became easier to wet (higher SFE), with an overall increasing polar component to the surface, with increasing age after flowering. As expected, changes in wettability were found in pear leaves at different stages after flowering and in different regions (P < 0.05). Pear leaves from Yuanping were easier to wet than leaves from Yuci and Linyi, and adaxial surfaces were easier to wet than abaxial surfaces. These results provide beneficial information for the application of agrochemicals for improved wetting and spreading behavior. © 2018 Society of Chemical Industry.