Molecular detection of three shrimp viruses and genetic variation of white spot syndrome virus in Hainan Province, China, in 2007

Abstract White spot syndrome virus (WSSV), Taura syndrome virus (TSV) and infectious hypodermal and haematopoietic necrosis virus (IHHNV) have been responsible for major pandemics affecting the shrimp farming industry. Shrimp samples were collected from eight farms in Hainan Province, China, during 2007 and analysed by polymerase chain reaction (PCR) or reverse transcriptase PCR methods to determine the prevalence of these viruses. From the eight sampling locations, only samples from one farm did not show any indication of infection with WSSV, TSV or IHHNV, while samples from one additional farm exhibited evidence of infection with TSV only. Surprisingly, evidence of co-infection with TSV and IHHNV was found among samples at two farms while evidence of co-infection with all three viruses (WSSV, TSV and IHHNV) was detected among shrimp samples at four farms. To further elucidate the molecular characteristics of WSSV in China, we further analysed genomic features of WSSV isolates based on the ORF23/24 variable region. From these data, we identified two novel WSSV strains which contain nucleotide deletions of 5657 and 11093 bp, respectively, when compared with the largest WSSV-TW isolate.

The validity of cause of death coding within the Surveillance, Epidemiology, and End Results (SEER) Registry

6544

Background: Disease-specific survival (DSS) analysis within large cancer registries is more informative than other methods of survival analysis but requires accurate information regarding the cause of death (COD). The purpose of this study was to evaluate the validity of the COD code for patients diagnosed with colon cancer and the extent to which it varies with regard to age, sex, and race within SEER. Methods: Patients with colon adenocarcinoma were identified from SEER (ver. 2008) from 1988 to 1998 to have at least 7 years of follow-up. Relative survival (RS) was calculated matching for age, sex, and the year of diagnosis using U.S. life-tables. Colon cancer cause of death was then assigned using SEER COD recode for colon and rectal death (21040–50). The number of observed and expected deaths by year was calculated to estimate deaths attributable to colon cancer. The ratio of this number to the recorded cause of death was defined as the validity of the COD code in SEER. Results: 86,641 patients were identified. Relative survival declined during the first 7 years of observation but then leveled indicating a minimum number of deaths subsequently attributable to colon cancer. At year 7 the observed number of deaths for the SEER cohort was 49,104; the expected number of deaths using life tables was 17,173. The difference (31,931) is theoretically attributable to colon cancer. Within the SEER cohort, 30,227 deaths were coded colorectal cancer deaths, an estimated validity of 94.6%. Stratified results demonstrated validity was sensitive to race but not age or gender (table). Conclusions: Cause of death coding for colon cancer in SEER is highly valid, suggesting that the use of DSS for colon cancer is appropriate.

[Table: see text]

No significant financial relationships to disclose.

Statistical optimization of process parameters on biohydrogen production from glucose by Clostridium sp. Fanp2

Statistically based experimental designs were applied to optimizing process parameters for hydrogen production from glucose by Clostridium sp. Fanp2 which was isolated from effluent sludge of anaerobic hydrogen-producing bioreactor. The important factors influencing hydrogen production, which identified by initial screening method of Plackett-Burman, were glucose, phosphate buffer and vitamin solution. The path of steepest ascent was undertaken to approach the optimal region of the three significant factors. Box-Behnken design and response surface analysis were adopted to further investigate the mutual interaction between the variables and identify optimal values that bring maximum hydrogen production. Experimental results showed that glucose, vitamin solution and phosphate buffer concentration all had an individual significant influence on the specific hydrogen production potential (Ps). Simultaneously, glucose and vitamin solution, glucose and phosphate buffer were interdependent. The optimal conditions for the maximal Ps were: glucose 23.75 g/l, phosphate buffer 0.159 M and vitamin solution 13.3 ml/l. Using this statistical optimization method, the hydrogen production from glucose was increased from 2248.5 to 4165.9 ml H2/l.

Outcome analysis for melanoma patients undergoing deep pelvic lymph node dissection

8514

Background: The benefits of deep pelvic lymph node dissection (DLND) for node-positive melanoma patients continue to be debated. The objective of our analysis was to assess factors associated with metastatic disease to deep pelvic nodes and examine survival outcomes following DLND. Methods: We retrospectively reviewed the records of 804 patients undergoing lymph node dissection (1990-2001). 97 patients underwent a superficial inguinofemoral lymph node dissection along with a DLND for indications which included: suspicious radiologic imaging (n= 31), documented superficial disease and concern for deep involvement (n = 57), and in-transit disease undergoing limb perfusion (n=9). Logistic regression was performed to identify factors associated with the metastatic tumor spread to deep nodes. Associations between clinicopathologic factors and disease-specific survival (DSS) were estimated using the Cox proportional hazards model. Results: Fifty-four patients (56%) had metastatic disease (median 2 positive lymph nodes, range 1–12) within their deep pelvis. With a median follow-up of 7.5 years, the 5-year DSS was 42% for patients with positive deep pelvic nodes and 52% for those with negative deep pelvic nodes (p = 0.07). When the number of metastatic deep nodes was stratified, the 5-year DSS for patients with 1 positive node, 2–3 positive nodes, and >3 positive nodes was 49%, 48%, and 27%, respectively (p = 0.04). Age ≥ 50 years (odds ratio [OR] = 3.5, p = 0.03), increasing number of positive superficial nodes (OR = 2.1, p < 0.001), and suspicious findings on pelvic CT images (OR = 11.9, p < 0.001) were associated with metastatic deep nodes. In the multivariate analysis, the number of positive deep nodes (hazard ratio [HR] = 1.1, p = 0.03), male gender (HR = 1.9, p = 0.03), and extra-capsular nodal extension of tumor (HR = 2.7, p < 0.001) were identified as adverse prognostic factors for DSS. Conclusions: Survival outcomes in patients with melanoma metastatic to ≤ 3 deep pelvic lymph nodes are comparable to those in patients without deep nodal involvement. These favorable outcomes support an aggressive surgical approach (i.e., DLND) in patients ≥ 50 years, with multiple positive superficial nodes, and suspicious CT findings.

No significant financial relationships to disclose.

The relationship among nephrin, podocin, CD2AP, and alpha-actinin might not be a true 'interaction' in podocyte

The abnormality of a single podocyte molecule, caused by a single gene mutation, such as NPHS1, NPHS2, CD2AP, and ACTN4, can lead to the hereditary/congenital nephrotic syndromes (NS). Further studies suggested that more than one podocyte molecule were together involved in acquired or experimental NS. However, we do not know much on the relationship among these podocyte molecules, and the molecular response induced by the change of each podocyte protein to the remaining ones. We respectively knockdown the nephrin, podocin, CD2AP, or alpha-actinin-4 mRNA by using reconstructed RNA interference vector--psiRNA-hH1GFPzeo in mouse podocyte clone. The molecular behavior or response was revealed by the quantitative expression both at mRNA and protein levels with RT-PCR and Western blot, and by the molecular distribution detected with confocal microscopy. With nephrin knockdown, only CD2AP increased, whereas podocin showed no change. Contrarily, with podocin or CD2AP knockdown, nephrin decreased, while CD2AP or podocin increased. Nephrin, podocin, or CD2AP knockdown did not change the expression of alpha-actinin-4, whereas alpha-actinin-4 knockdown begetted the reduction of nephrin, and the increment of podocin and CD2AP. The redistributions of nephrin, podocin, and CD2AP were revealed around a predominant nuclear staining compared with the membrane surface staining in the control podocytes. Our data imply that the response between the four podocyte molecules is very complicated and evidently different. There is not always an interaction between podocyte molecules. The normal localization of podocyte molecules would depend on their normal expression quantity and the molecular reactions between them.

Initial biopsy procedure for breast cancer diagnosis influences number of surgical procedures and cost of care

598

Background: Excisional biopsy (ExB) and percutaneous needle biopsy (PB) are both accurate methods for diagnosing breast cancer. However, comprehensive breast cancer staging requires surgical assessment of the primary tumor and regional nodes. This study was designed to examine surgical and financial implications for breast cancer patients undergoing either ExB or PB. Methods: We evaluated 2,459 women with invasive breast cancer enrolled in a comprehensive database from 2000 to 2005. Clinical and treatment factors were compared for patients who had ExB versus PB. Total costs, facility fees (operating rooms, radiology suites, and pathology processing), and professional fees were estimated. A multivariate logistic regression was performed to determine factors associated with biopsy type. Results: PB was utilized in 1817 (74%) patients and ExB in 642 (26%). Of ExB patients, 86% were performed prior to referral. Patients undergoing ExB required a greater number of surgical procedures for margin control and lymph node assessment compared to PB (median 2.0 vs. 1.0, respectively). ExB exacted a cost increase 1.7 times that of PB, with a difference of >$3400 at our institution. After adjusting for age, tumor size and year of diagnosis, ExB was significantly associated with an increased number of surgical procedures required for definitive treatment compared to PB (OR = 166.7, p < 0.001). Conclusions: Excisional biopsy for breast cancer diagnosis results in an increased need for return trips to the operating room and higher cost of care. Percutaneous biopsy should be considered as the preferred approach in the diagnosis of breast cancer.

No significant financial relationships to disclose.

Lymphedema is common among post-operative cancer survivors

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Background: Lymphedema (LE) is associated with the surgical treatment of a number of tumors and is a serious long-term condition with significant medical, economic, and quality of life consequences. Early detection and management are critical to preventing LE progression and complications. We examined the literature to ascertain the incidence and identify factors associated with an increased postoperative risk for LE. Methods: We systematically reviewed the oncology literature (1972–2005) to identify studies that examined postoperative LE. Data pertaining to the type of malignancy, the surgical procedure performed, the criteria used to define LE, and the median follow-up time were extracted. The incidence of LE was summarized using weighted averages. Results: We identified a total of 122 reports of postoperative LE (N = 24,095 patients), which were broken down by cancer type as follows: breast cancer (n = 45), melanoma (n = 31), gynecologic (GYN) malignancies (n = 30), genitourinary (GU) malignancies (prostate n = 6, penile n = 6, bladder n = 2), and sarcoma (n = 2). When only prospective studies (n = 74, 61%) were considered, the incidence of LE following axillary node dissection (AND) in patients with breast cancer was 19% compared with 8% following AND for melanoma. The incidence of lower extremity LE following inguinofemoral and/or pelvic lymph node dissection for melanoma was 30% compared with 24%, 14%, and 20% for GYN malignancies, GU malignancies and sarcomas. The relative risk of postoperative lower extremity LE increased two-fold in patients who received radiation therapy. Methods of measuring LE included extremity circumference (n = 17 studies) with various defined thresholds (>1 cm [n = 8], >2 cm [n = 7], and >3 cm [n = 2]). Fourteen studies used volume measurements, while the remainder used an ad hoc clinical grading method. The lowest incidence of LE was seen in studies with the shortest follow-up. Conclusions: LE is a common condition resulting from the surgical treatment of a number of different malignancies. To enhance the quality of postoperative care in cancer survivors, objective LE measurement and symptom assessment should be part of standard practice during both early and long-term follow-up.

No significant financial relationships to disclose.

Routine use of sentinel lymph node surgery in patients undergoing prophylactic mastectomy: A decision analysis model

607

Background: Patients with invasive carcinoma identified following prophylactic mastectomy (PM) require axillary lymph node dissection (ALND) for nodal staging as standard surgical treatment. Since most patients will be node negative, sentinel lymph node (SLN) surgery has been advocated to avoid the sequelae of unnecessary axillary surgery. However, since SLN surgery is not without complications and the incidence of invasive cancer in PM is extremely low, we sought to compare surgical strategies using a decision analysis model in order to define the true risks and benefits of routine SLN surgery versus standard surgical treatment (ALND). Methods: Model estimates were derived by systematic review of the literature. The outcomes examined were: (1) the number of SLN procedures that would need to be performed to avoid one ALND in a pathologically node negative patient; and (2) the probability of long-term axillary complications with each strategy. Occult breast cancer was defined as invasive cancer in the PM specimen and/or SLN metastases. Results: The following weighted averages were used to inform the model: i) incidence of invasive cancer in PM of 1%, ii) incidence of nodal disease of 25% in the presence of invasive breast cancer and 1% in the absence of invasive cancer in the breast, and iii) incidence of complications after ALND of 30% and after SLN surgery of 6%. Routine use of SLN surgery doubled the sensitivity for detection of carcinoma compared to ALND. However, 133 SLN procedures were required to avoid one ALND in a node negative PM patient. Additionally, the probability of complications per breast cancer detected was 10-fold greater with the SLN strategy. When the risk of breast cancer was projected at 10%, 13 SLN procedures were required to avoid one negative ALND and the complication rate per cancer detected was 2-fold greater in the SLN arm. Conclusions: The benefit of adding SLN surgery in patients undergoing PM depends on the probability of detecting invasive cancer. Routine SLN surgery in PM is not warranted given the large number of procedures required to benefit one patient and the complications associated with performing SLN surgery in all patients. However, the SLN strategy may be appropriate for subgroups of patients at higher risk of occult carcinoma.

No significant financial relationships to disclose.

Meta-analysis of sentinel lymph node biopsy after preoperative chemotherapy in patients with breast cancer

BACKGROUND

Women with breast cancer are more frequently being treated with preoperative neoadjuvant chemotherapy. The reliability of sentinel lymph node biopsy (SLNB) following chemotherapy has not been determined. This was a meta-analysis of studies that examined the results of SLNB after preoperative chemotherapy.

METHODS

Included articles had to meet two criteria. First, patients had to have had operable breast cancer and to have undergone SLNB after preoperative chemotherapy and, second, patients had to have undergone subsequent axillary lymph node dissection. Meta-analyses were performed in which Bayesian hierarchical models were created to estimate the identification rate (IR) and sensitivity of SLNB in this setting.

RESULTS

Twenty-one studies were identified that included a total of 1273 patients. The IRs reported ranged from 72 to 100 per cent, with a pooled estimate of 90 per cent. The sensitivity of SLNB ranged from 67 to 100 per cent, with a pooled estimate of 88 (95 per cent confidence interval 85 to 90) per cent. Meta-analyses performed using Bayesian modelling resulted in (posterior) estimates for IR and sensitivity of 91 (95 per cent credible interval 88 to 94) and 88 (95 per cent credible interval 84 to 91) per cent respectively.

CONCLUSION

SLNB is a reliable tool for planning treatment after preoperative chemotherapy.

Family-based association studies of the TCP1 gene and schizophrenia in the Chinese Han population

A previous case-control study by Yang et al. indicated that the TCP1 gene in 6q25 was associated with schizophrenia in the Han population. To replicate this result, we selected eight SNPs (rs2273828, rs3818298, rs1547094, rs1547093, rs2295898, rs2295899, rs4832, rs15982) spanning the whole gene and performed a family-based study using 325 trios samples. Our transmission disequilibrium test showed neither allele nor haplotype association with schizophrenia, and suggests that the TCP1 locus is not associated with schizophrenia in the Chinese population. Since 6q25 has consistently been found to be a susceptible region for schizophrenia, we suggest that other genes within this region should be the focus of attention.

Development and aging of N-methyl-D-aspartate receptor expression in the prefrontal/frontal cortex of mice

The present study was designed to determine whether the changes that occur during aging in the expression of the N-methyl-D-aspartate (NMDA) receptor and two NMDA receptor subunits, zeta1 and epsilon2, are a continuation of developmental processes and whether protein and mRNA expression patterns of the subunits are similar across the lifespan. The prefrontal/frontal cortex of C57BL/6 mice of eight different ages (7-8, 13-15, 30-32, 49-53, and 70-72 days and 4.5, 11, and 25 months of age) were used to examine NMDA-displaceable [(3)H]glutamate binding and mRNA in tissue sections and mRNA and protein from homogenates. The lateral prefrontal/frontal cortex of C57BL/6 mice showed more significant declines in density of agonist binding to NMDA receptors during both development and aging than the medial cortex. Changes in mRNA expression for the epsilon2 subunit across the lifespan appeared to be related to the changes in NMDA receptor binding in the lateral cortex, even though the protein expression of the epsilon2 subunit did not show the same pattern of expression as the mRNA during development. The changes in epsilon2 subunit mRNA expression during adult aging may be a continuation of developmental processes, but there was also evidence that expression levels plateaued during early adulthood. The developmental expression of the zeta1subunit in the prefrontal/frontal cortex was influenced by gender and there was no significant effect of adult aging on either the protein or mRNA expression of this subunit. Determining how the expression of the NMDA receptor and its subunits change throughout the lifespan can help us to better understand the processes affecting the receptor during aging. These results should be useful for designing interventions into the aging process to repair or prevent changes in the NMDA receptor and its associated functions, such as learning and memory.