Separating the chaff from the grain (Tularemia)

A case of ulcero-glandular tularemia is presented. Discussion is based on the differential diagnosis of a patient presenting with cutaneous lesions, regional lymphadenopathy and fever.

Metabolic effects of bariatric surgery in type 2 diabetic patients with body mass index < 35 kg/m2

AIM

The aim of this meta-analysis is to assess the metabolic effects of bariatric surgery in type 2 diabetes mellitus (T2DM) patients with body mass index (BMI) < 35 kg/m(2) .

METHODS

We performed an electronic literature search of published articles to identify relevant evidence since inception to June 2011. Primary outcome measures were metabolic improvement and resolution diabetes after bariatric surgery. The weighted mean difference (WMD) and its 95% confidence interval (CI) were calculated from the raw data extracted from the original literature. The software Review Manager (version 4.3.1) was applied for meta-analysis.

RESULTS

Thirteen trials involving 357 patients were included in the meta-analysis. The follow-up interval ranged from 6 months to 18 years. According to WMD calculation, bariatric surgery led to 5.18 kg/m(2) of BMI lowering (95% CI, 3.79-6.57, p < 0.00001), 4.8 mmol/l of fasting plasma glucose (FPG) decrement (95% CI, 3.88-5.71 mmol/l, p < 0.00001), 2.59% of HbA1c decreasing (95% CI, 2.12-3.07%, p < 0.00001), 56.67 mg/dl of triglyceride decrement (95% CI 11.53-101.82, p = 0.01) and 48.38 mg/dl of total cholesterol reduction (95% CI 21.08-75.68, p = 0.0005). Moreover, the procedures produced an increased high-density lipoprotein cholesterol by 5.37 mg/dl (95% CI -11.37-0.63, p = 0.08). However, this effect was not statistically significant. Overall, 80.0% of the patients achieved adequate glycaemic control (HbA1c < 7%) without antidiabetic medication. The surgeries produced a low incidence of major complications (3.2%) with no mortality.

CONCLUSIONS

Bariatric surgery is effectual and safe in the treatment of non-severely obese (BMI < 35 kg/m(2) ) T2DM patients. Moreover, the metabolic benefits acquired from the procedures can be long sustained after the surgery.

Metabolic effects of bariatric surgery in type 2 diabetic patients with body mass index < 35 kg/m2

AIM

The aim of this meta-analysis is to assess the metabolic effects of bariatric surgery in type 2 diabetes mellitus (T2DM) patients with body mass index (BMI) < 35 kg/m(2) .

METHODS

We performed an electronic literature search of published articles to identify relevant evidence since inception to June 2011. Primary outcome measures were metabolic improvement and resolution diabetes after bariatric surgery. The weighted mean difference (WMD) and its 95% confidence interval (CI) were calculated from the raw data extracted from the original literature. The software Review Manager (version 4.3.1) was applied for meta-analysis.

RESULTS

Thirteen trials involving 357 patients were included in the meta-analysis. The follow-up interval ranged from 6 months to 18 years. According to WMD calculation, bariatric surgery led to 5.18 kg/m(2) of BMI lowering (95% CI, 3.79-6.57, p < 0.00001), 4.8 mmol/l of fasting plasma glucose (FPG) decrement (95% CI, 3.88-5.71 mmol/l, p < 0.00001), 2.59% of HbA1c decreasing (95% CI, 2.12-3.07%, p < 0.00001), 56.67 mg/dl of triglyceride decrement (95% CI 11.53-101.82, p = 0.01) and 48.38 mg/dl of total cholesterol reduction (95% CI 21.08-75.68, p = 0.0005). Moreover, the procedures produced an increased high-density lipoprotein cholesterol by 5.37 mg/dl (95% CI -11.37-0.63, p = 0.08). However, this effect was not statistically significant. Overall, 80.0% of the patients achieved adequate glycaemic control (HbA1c < 7%) without antidiabetic medication. The surgeries produced a low incidence of major complications (3.2%) with no mortality.

CONCLUSIONS

Bariatric surgery is effectual and safe in the treatment of non-severely obese (BMI < 35 kg/m(2) ) T2DM patients. Moreover, the metabolic benefits acquired from the procedures can be long sustained after the surgery.

P5-01-13: High Levels of Nuclear Heat Shock Factor 1 (HSF1) Are Associated with Poor Prognosis in Breast Cancer: Results from the Nurses' Health Study

Purpose: Heat shock factor 1 (HSF1) is the master transcriptional regulator of the cellular response to heat and a wide variety of other stressors. We previously reported that HSF1 promotes the survival and proliferation of malignant cells. At this time, however, the clinical and prognostic significance of HSF1 in cancer is unknown.

Patients and methods: Breast cancer samples from 1,841 participants in the Nurses’ Health Study (NHS) were scored for levels of nuclear HSF1. Associations of HSF1 status with clinical parameters and survival outcomes were investigated by Kaplan-Meier analysis and Cox proportional hazard models. The associations were further delineated by Kaplan-Meier analysis using publicly available mRNA expression data.

Results: Nuclear HSF1 levels were elevated in ∼80% of in situ and invasive breast carcinomas. In invasive carcinomas, HSF1 expression was associated with high histologic grade, larger tumor size, and nodal involvement at diagnosis (P&lt;0.0001). Overall, in multivariate analysis, high-HSF1 levels were associated with increased breast cancer-specific mortality (HR, 1.62; 95% CI, 1.21−2.17). This association was seen in the ER-positive population (HR, 2.10; 95% CI, 1.25−2.47), even in early-stage lymph node negative cases (HR, 1.98; 95% CI, 1.17−3.33). In public expression profiling data, high-HSF1 mRNA levels were also associated with an increase in ER-positive breast cancer-specific mortality.

Conclusions: Increased HSF1 is associated with reduced survival in breast cancer. The findings indicate that HSF1 should be evaluated prospectively as an independent prognostic indicator in ER-positive breast cancer and that HSF1 may provide a useful therapeutic target.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-01-13.

P4-02-12: Plasma Estradiol Levels and Degree of Estrogen Receptor Positivity by Image Analysis in a Large Cohort of Breast Cancer Cases: Results from the Nurses' Health Study

Background

Breast cancer risk is strongly associated with endogenous reproductive hormones. There is also good evidence to suggest that endogenous estradiol levels are more strongly associated with the development of estrogen receptor (ER) positive breast cancers than with ER negative cancers. However, the degree of ER positivity in those cancers that develop is not yet established. Therefore, we sought to evaluate the proportion and intensity of tumor cells demonstrating ER positivity using image analysis in a large cohort of breast cancers for which we also had plasma estradiol levels.

Design: Tissue microarray (TMA) sections of breast cancers from women enrolled in the Nurses’ Health Study were immunostained for ER (1D5, Dako Corporation, Carpinteria, CA). Slides were then scanned using the ScanScope slide scanning system (Aperio Technologies Inc., Vista, CA) and ER staining was assessed for both intensity and percent of nuclei staining positively using a specific algorithm, Nuclear v9, which evaluates nuclear size, intensity, roundness, curvature, compactness, and elongation. Plasma samples were collected prior to the date of diagnosis for all women in the study and estradiol levels were determined by radioimmunoassay following extraction and celite column chromatography.

Result: Image analysis data for ER was available for 691 breast cancers. The mean percent of tumor cell positivity was approximately uniformly distributed, with a mean of 44.5%, (median=41.3%, max=99.6%). The proportion of tumor cells staining for ER from the TMA cores was positively associated with patient age (p&lt;0.0001), and postmenopausal status (p=0.008), while inversely associated with tumor grade (p&lt;0.0001). Among women with image analysis data for ER, plasma estradiol data were also available for 320 postmenopausal women. Estrogen receptor positivity (by proportion or intensity) did not vary according to plasma estradiol levels (p=0.17).

Exercise improved rat metabolism by raising PPAR-α

Based on the importance of exercise and crucial role of liver in metabolism, the aim of this study was to determine whether the expression of peroxisome proliferator-activated receptor (PPAR)-α, γ and adiponectin receptor 2 in OLETF rat liver were altered in conjunction with improved metabolism with exercise training. OLETF rats were randomly assigned to 2 groups: sedentary control group (n=26), and long-term exercise-trained group (n=26). Full data were available on 32 OLETF rats (16 for each group). Adiponectin, glucose, insulin, triglyceride and cholesterol were assessed. Livers were taken to determine the expression of PPAR-α, γ and adiponectin receptor 2. Compared with sedentary control group, fasting glucose (9.38 ± 2.99 mmol/L vs. 7.32 ± 1.76 mmol/L, P<0.05), triglyceride (1.73 ± 0.34 mmol/L vs. 0.89 ± 0.12 mmol/L, P<0.05) and cholesterol (4.41 ± 0.75 mmol/L vs. 2.13 ± 0.32 mmol/L, P<0.05) were substantially reduced after exercise, which significantly correlated with increased PPAR-α (P<0.05) in liver. The expression of PPAR-α upstream and target genes, including hepatocyte nuclear factor-4 (HNF4), carnitine palmitoyl transferase 1 (CPT-1), catalase (CAT) and ATPbinding cassette transporter A1 (ABCA1) also increased significantly. Therefore, our findings suggest that increased PPAR-α expression in OLETF rats liver is a contributory factor to the exercise-related improvements in whole-body metabolism.

Tick infestation and spotted-fever group Rickettsia in shelter dogs, California, 2009

In response to an outbreak of Rocky Mountain spotted fever (RMSF) in Baja California in early 2009, dogs at two shelters in neighbouring Imperial County, California, were evaluated for ectoparasites. Brown dog ticks (Rhipicephalus sanguineus), a recognized vector for RMSF, were found on 35 (30%) of 116 dogs but all ticks tested negative for Rickettsia rickettsii by PCR.

The New Unified International Diabetes Federation/American Heart Association/National Heart, Lung, and Blood Institute Metabolic Syndrome definition: does it correlate better with C-reactive protein in Chinese patients diagnosed with type 2 diabetes?

This study evaluated the association between high-sensitivity C-reactive protein (hsCRP) and metabolic syndrome, defined by the definition proposed by the International Diabetes Federation (IDF), American Heart Association (AHA) and National Heart, Lung, and Blood Institute (NHLBI) versus the older IDF definition, in 506 Chinese patients with type 2 diabetes. Anthropometric and biochemical parameters were compared and analysed using multivariate linear regression models. Serum hsCRP was higher in patients with metabolic syndrome compared with those without metabolic syndrome for both definitions and increased as the number of components of metabolic syndrome increased (after adjusting for age, gender and smoking). Patients with metabolic syndrome according to the IDF/AHA/NHLBI but not the IDF definition had significantly higher hsCRP levels than those not meeting either definition and similar hsCRP levels to those meeting both definitions. Serum hsCRP levels were significantly associated with metabolic syndrome according to the IDF definition after adjusting for age, gender and smoking. Adding metabolic syndrome status according to the IDF/AHA/NHLBI definition significantly increased the fit of the multivariate linear regression model. The new IDF/AHA/NHLBI definition of metabolic syndrome may have a stronger relationship with serum hsCRP than the IDF definition.

Glucose metabolism-related protein 1 (GMRP1) regulates pancreatic beta cell proliferation and apoptosis via activation of Akt signalling pathway in rats and mice

AIMS/HYPOTHESIS

We attempted to elucidate the impacts on and possible mechanisms by which glucose metabolism-related protein 1 (GMRP1) affects beta cell survival.

METHODS

Adenovirus-mediated GMRP1 overproduction and siRNA-mediated knockdown were performed in INS-1E cells and rat islets, after which cell proliferation or apoptosis were determined, and phosphorylation of Akt and BCL2-associated agonist of cell death (BAD) investigated. INS-1E cells and rat islets were cultured at 5.6 (low) or 25 mmol/l (high) glucose for 24 or 48 h, and cell proliferation or apoptosis and GMRP1 levels were investigated. INS-1E cells were treated for 24 h with 0, 10, 50 and 100 nmol/l insulin, and GMRP1 levels were determined. After INS-1E cells were transfected with siRNA for 72 h, high glucose-induced cell proliferation and insulin-stimulated Akt phosphorylation were investigated. Glucose-infused rat models were established and beta cell proliferation and mass were evaluated. Levels of GMRP1, and phosphorylation of Akt and BAD were determined in glucose-infused islets. The GMRP1-mediated Akt pathway was also investigated in db/db mice.

RESULTS

Overproduction of GMRP1 promoted beta cell proliferation via increased phosphorylation of Akt. Knockdown of Gmrp1 (also known as Btbd10) reduced phosphorylation of Akt with enhanced beta cell apoptosis. High glucose increased GMRP1 levels and cell proliferation in INS-1E cells and islet cells. Knockdown of Gmrp1 decreased high glucose-induced cell proliferation and insulin-stimulated Akt phosphorylation. Increased GMRP1 levels were involved in the enhancement of beta cell proliferation and mass in glucose-infused islets. Decreased GMRP1 levels may participate in beta cell apoptosis of db/db mice.

CONCLUSIONS/INTERPRETATION

GMRP1 regulates pancreatic beta cell proliferation and apoptosis via activation of Akt signalling pathway.

Combined Structural and Optical Assessment of CVD Grown 3C-SiC/Si

A combined structural and optical assessment of cubic (3C-) SiC thin films grown on Si (100) substrates by chemical vapor epitaxy (CVD) is presented. The CVD growth was performed at both atmospheric and low (100 Torr) pressure, using a vertical reactor. The CVD-grown 3C-SiC films with different growth time were characterized by X-ray diffraction, Raman scattering and Fourier transform infrared (FTIR) spectroscopy to be single crystalline with a high degree of crystal perfection. The film thickness was determined from FTIR spectra. Variations of X-ray, FTIR and Raman spectra with different growth conditions and film thicknesses are studied comparatively. Related problems are discussed.

Transcription specificity of the class Ib genes SLA-6, SLA-7 and SLA-8 of the swine major histocompatibility complex and comparison with class Ia genes

Our aim was to analyse the transcription levels of the three non-classical class Ib genes SLA-6, SLA-7 and SLA-8 of the swine major histocompatibility complex in various tissues and conditions and to compare them to the transcription levels of classical class Ia genes. Twenty-five adult tissues from two pig breeds, pig renal PK15 cells infected with the Pseudorabies virus, and peripheral blood mononuclear cells (PBMCs) stimulated by lipopolysaccharide or a mixture of phorbol myristate acetate and ionomycin were included in our study. Relative transcription was quantified by quantitative real-time PCR. On average, in adult tissues and PBMCs and compared to SLA-6, the transcription level of SLA-Ia genes was 100-1000 times higher, the level of SLA-8 was 10-20 times higher, and that of SLA-7 was five times higher. Thus, SLA-8 is the most transcribed SLA-Ib gene, followed by the SLA-7 and SLA-6 genes. The highest transcription levels of SLA-Ib transcripts were found in the lymphoid organs, followed by the lung and the digestive tract. The tissue variability of expression levels was widest for the SLA-6 gene, with a 1:32 ratio between the lowest and highest levels in contrast to a 1:12 ratio for the SLA-7 and SLA-8 genes and a 1:16 ratio for the SLA-Ia genes. During PK-15 infection and PBMC stimulation, SLA-Ia and SLA-8 genes were downregulated, whereas SLA-6 and SLA-7 were upregulated, downregulated or not significantly modified. Our overall results confirm the tissue-wide transcription of the three SLA-Ib genes and suggest that they have complementary roles.

A novel screening method of cellulase-producing bacteria

Cellulase is the key to utilize the renewable and abundant cellulose resource, cellulase-producing microorganism is an important source of cellulase. The traditional screening method of cellulase-producing microorganism is low efficacy and not macroscopic. The screening method in this study was based on the interactive culture character between cellulase-producing bacteria and Phytophthora parasitica var. nicotianae on plates, the results indicated that the inhibition zone and cellulase activity of bacterial strains are conformity on the whole, so the screening method is very quickly and apparent.

Gender-Dependent Penetrance of Small Heterodimer Partner (SHP) Gene Deficiency in Overweight/Obese Chinese Pedigrees

Mutations of the small heterodimer partner ( SHP) gene have been associated with mild obesity in Japanese subjects. This study was designed to investigate whether there was a similar association in 772 Chinese adults. A total of 272 subjects were normal weight, 423 were overweight and 77 were obese. Four non-synonymous mutations (R34X, H53fsdel10, G171A, G189E) were identified in 10 out of the 500 overweight/obese subjects, but were not seen in the normal weight controls (prevalence 2.00% versus 0.00%, respectively). The relatives of proband carriers, including 25 carriers and 33 non-carriers from three generations, were also screened for 10 multigenerational non-consanguineous pedigrees. A gender-dependent penetrance effect was observed in the pedigrees. Furthermore, the frequency of SHP gene mutations was significantly higher in those with type 2 diabetes compared with the non-diabetics (61.5% versus 28.1%, respectively). These data provide evidence of a gender-dependent effect on penetrance for SHP deficiency and suggest that SHP mutations increase susceptibility to type 2 diabetes.

Oxidative Stress and Apoptosis of Human Brain Microvascular Endothelial Cells Induced by Free Fatty Acids

Damage to endothelial cells is a key event in the pathogenesis of atherosclerosis and vascular disease. This study aimed to determine whether free fatty acids (FFAs) induced oxidative stress and apoptosis in human brain microvascular endothelial cells (HBMVECs) in vitro and, if so, which signalling pathway mediated these effects. After culture in different concentrations of FFAs for 24-72 h, cell viability/proliferation was determined using a cell counting kit, apoptosis was detected by measuring caspase-3 activity and by using annexin V-conjugated fluorescein isothiocyanate/propidium iodide staining, and oxidative stress was evaluated by measuring the levels of reactive oxygen species (ROS) and mitochondrial membrane potential (MMP). The HBMVECs exposed to FFAs showed significantly decreased cell proliferation, increased apoptosis and ROS levels, and decreased MMP. In conclusion, the results showed that high levels of FFAs induced oxidative stress, which damaged HBMVECs and resulted in apoptosis.

Effect of 14-3-3 tau protein on differentiation in BeWo choriocarcinoma cells

This study aimed to investigate the location and function of tau isoform of 14-3-3 proteins in human trophoblast. 14-3-3 tau was localized in human cytotrophoblast cells, but not in syncytiotrophoblast cells in both first trimester and term placenta by immunochemistry stain. Forskolin-induced cell fusion (BeWo cells) confirmed that 14-3-3 tau was decreased during trophoblast differentiation. Forskolin-induced differentiation was stimulated by small-interfering (si) RNA induced down-regulation of 14-3-3 tau, contrarily, it was suppressed by plasmid induced upregulation of 14-3-3 tau in BeWo cells. When BeWo cells were treated with 14-3-3 tau siRNA, an increase in protein concentration of cell cycle inhibitor p27kip1 and a decrease in protein concentration of proliferating cell nuclear antigen, as well as activation of the extracellular signal-regulated kinase (ERK) pathway, were also noticed. These findings suggest that 14-3-3 tau might be mediated trophoblast differentiation through cell cycle regulation.

The Association of Dysglycaemia and Cardiovascular Disease in Patients with Metabolic Syndrome

The objective of this study was to investigate the relationship between increased prevalence of cardiovascular disease and glucose regulation status in Chinese patients with metabolic syndrome (MetS). All patients underwent an oral glucose tolerance test (2-h post-load plasma glucose) to determine their glucose regulation status and had their brachial–ankle pulse wave velocity (baPWV) measured. Of the 590 patients included in the study, 115 (19.5%) had normal glucose tolerance, 114 (19.3%) had impaired fasting glucose (IFG) alone, 38 (6.4%) had impaired glucose tolerance (IGT) alone, 197 (33.4%) had diabetes mellitus and 126 (21.4%) had combined glucose intolerance (CGI; IFG plus IGT). Patients with diabetes mellitus had a significantly higher baPWV compared with all other groups and patients with CGI had a significantly higher baPWW compared with patients with IFG. Dysglycaemia was common in patients with MetS. An increased prevalence of cardiovascular disease in patients with MetS was related to their glucose regulation status.

A common variant in MTNR1B, encoding melatonin receptor 1B, is associated with type 2 diabetes and fasting plasma glucose in Han Chinese individuals

AIMS/HYPOTHESIS

Recently, three groups independently reported that variation in MTNR1B, the gene encoding melatonin receptor 1B, was associated with an increased risk of type 2 diabetes, increased fasting plasma glucose and impaired insulin secretion in populations of European ancestry. In the present study, we investigated whether a single MTNR1B polymorphism was associated with type 2 diabetes in Han Chinese individuals, to elucidate whether this is a cross-populational effect.

METHODS

The MTNR1B variant rs10830963 was genotyped in 1,165 type 2 diabetic patients and 1,105 normoglycaemic control individuals of southern Han Chinese ancestry who were residents of the metropolitan area of Shanghai. The risk of developing type 2 diabetes was calculated using a logistic regression model adjusted for age, sex and BMI. A possible association with fasting plasma glucose was analysed in the normoglycaemic control individuals using a multiple linear regression analysis with adjustments for age, sex and BMI.

RESULTS

The genetic variant rs10830963 was associated with an increased risk of type 2 diabetes in our Han Chinese cohort (OR 1.16, 95% CI 1.03-1.31, p = 0.015). As previously described, the risk variant was also associated with increased fasting plasma glucose, showing an increase of 0.068 mmol/l (95% CI 0.036-0.100, p = 4 x 10(-5)) per risk allele.

CONCLUSIONS/INTERPRETATION

A common variant in the MTNR1B gene is associated with an increased risk of type 2 diabetes and increased fasting plasma glucose in Han Chinese, suggesting an important role for this polymorphism in populations of different ethnic and environmental backgrounds.