Ambient heat exposure after the rainy season is associated with an increased risk of Stroke

Funding Acknowledgements

Type of funding sources: None.

Background

Stroke is a major global health issue and Climate change is the biggest and most urgent challenges. The Asia and Pacific region have been more vulnerable to climate change and extreme heat exposure than other regions of the world. Despite the growing concern for heat waves, few studies have investigated heat exposure and the risk of Stroke in the elderly considering effect of Asian meteorological factors.

Purpose

We aimed to examine the association between heat exposure and the risk of Stroke in the elderly and to evaluate possible effect-measure modifications by the rainy season, which is a characteristic climatic occurrence in East Asia.

Methods

Our study was designed as a time-stratified case-crossover. The study included 3367 residents in the city, Japan, aged 65 years or older who were dispatched to emergency hospitals between 2012 and 2019 for the onset of Stroke during and a few months after the rainy seasons (Picture 1). We examined the association between temperature and Stroke onset during and a few months after the rainy seasons with conditional logistic analysis adjusted for relative humidity, barometric pressure, and particulate matter less than 2.5 µm in diameter (pm 2.5). Furthermore, we examined analyses on effect-measure modification where is the exposure of a 1°C increase in temperature and potential effect modifier as stratified during and after the rainy seasons.

Results

Heat exposure during one month after the rainy season was associated with Stroke risk; the adjusted odds ratio (OR) for a 1°C increase in temperature was 1.34 (95% confidence interval [CI]: 1.29-1.39). In stratified type of the stroke, Hemorrhagic stroke (OR: 1.37, 95% CI: 1.24-1.51), Ischemic stroke (OR: 1.37, 95% CI: 1.24-1.53), and Transient ischemic attack (OR: 1.43, 95%CI: 1.23-1.68) were significantly associated with heat exposure during one month after the rainy season respectively (Picture 2). In the results of analyses on effect modification, one month after the rainy season group was highest than other groups when reference was during the rainy seasons (OR: 1.34, 95% CI: 1.3-1.39, P<0.001 [Measure of effect modification on additive scale]).

Conclusions

The present study suggests that heat exposure increases the risk of Stroke onset during the month after the end of the rainy season in the elderly. We propose that public health measures, such as maintenance designed high-insulated housing and improved air conditioning control, be implemented in the Asia and Pacific region to address heat exposure during one month after the rainy season, which can affect the incidence of stroke in the elderly.

Heat exposure after the rainy season is associated with an increased risk of cardiovascular emergency

Funding Acknowledgements

Type of funding sources: None.

Background

Climate change and global warming are some of the biggest issues in our society. Despite the growing concern for heat waves, while some previous studies have examined the effects of heat on CVD by focusing on maximum or mean daily temperature or long heat exposure periods, few studies have investigated the hourly effects of heat exposure and the risk of cardiovascular diseases (CVDs) in the elderly.

Purpose

We aimed to examine the association between heat exposure and the risk of CVD in the elderly and to evaluate possible effect-measure modifications by the rainy season in East Asia.

Methods

Our study was designed as a time-stratified case-crossover. The study included 6527 residents in Japan, aged 65 years or older who were dispatched to emergency hospitals between 2012 and 2019 for the onset of CVD during and a few months after the rainy seasons. We examined the association between temperature and CVD onset for each year and for hourly intervals (lag) before the emergency call during the most relevant months.

Results

Heat exposure during one month after the rainy season was associated with CVD risk; the odds ratio (OR) for a 1°C increase in temperature was 1.34 (95% confidence interval [CI]: 1.29–1.39). By hourly time interval (lag) before the emergency call during the month after the end of the rainy season, 0-6 hour before the case event (lag 0–6) were associated with CVD risk, particularly for lag 0–1 (OR: 1.33, 95% CI: 1.28–1.39). For longer periods, the highest risk was at lag 0-23 (OR: 1.40, 95% CI: 1.34-1.46) (Picture).

Conclusions

The present study suggests that heat exposure increases the risk of CVD onset during the month after the end of the rainy season in the elderly. Hourly exposure in less than one day to heat rise obtained from the temporal resolution may triggers CVD onset.

Association of the extent of myocardial ischemia with outcomes in patients with suspected coronary artery disease in Japan: a cohort study

Background

There is an ongoing controversy regarding the necessity of single-photon emission computed tomography (SPECT) for patients with ischemic heart diseases after the publication of the results of the ISCHEMIA trial.

Purpose

We aimed to evaluate the association of the extent of myocardial ischemia with outcomes in patients with suspected coronary artery disease in Japan.

Methods

From the data of 2780 patients with stable angina who were enrolled prospectively between January 2006 and March 2008 in Japan and had undergone physician-referred non-invasive imaging tests, 1205 patients managed with SPECT were stratified by 10% myocardial ischemia. Major adverse cardiac events (MACEs), including death, myocardial infarction, hospitalization for heart failure, and late revascularization, were followed-up for 1 year.

Results

Patients with ≥10% myocardial ischemia (n=173) were older than patients with <10% myocardial ischemia (n=1032) and had a significantly higher 1-year cumulative incidence of MACEs (9.1% vs. 1.2%, P<0.0001). After adjusting for confounders, the risk of ≥10% myocardial ischemia relative to <10% myocardial ischemia for MACEs remained significant (adjusted hazard ratio [95% confidence interval], 2.40 [1.09–5.26], P=0.029).

Conclusion

The presence of ≥10% myocardial ischemia was significantly associated with the 1-year risk for MACEs in Japanese patients with suspected coronary artery disease.

Funding Acknowledgement

Type of funding sources: None. Study flowchartOutcomes

Aneuploid rescue precedes X-chromosome inactivation and increases the incidence of its skewness by reducing the size of the embryonic progenitor cell pool

STUDY QUESTION

Do monosomy rescue (MR) and trisomy rescue (TR) in preimplantation human embryos affect other developmental processes, such as X-chromosome inactivation (XCI)?

SUMMARY ANSWER

Aneuploid rescue precedes XCI and increases the incidence of XCI skewness by reducing the size of the embryonic progenitor cell pools.

WHAT IS KNOWN ALREADY

More than half of preimplantation human embryos harbor aneuploid cells, some of which can be spontaneously corrected through MR or TR. XCI in females is an indispensable process, which is predicted to start at the early-blastocyst phase.

STUDY DESIGN, SIZE, DURATION

We examined the frequency of XCI skewness in young females who carried full uniparental disomy (UPD) resulting from MR or TR/gamete complementation (GC). The results were statistically analyzed using a theoretical model in which XCI involves various numbers of embryonic progenitor cells.

PARTICIPANTS/MATERIALS, SETTING, METHODS

We studied 39 children and young adults ascertained by imprinting disorders. XCI ratios were determined by DNA methylation analysis of a polymorphic locus in the androgen receptor gene. We used Bayesian approach to assess the probability of the occurrence of extreme XCI skewness in the MR and TR/GC groups using a theoretical model of 1-12 cell pools.

MAIN RESULTS AND THE ROLE OF CHANCE

A total of 12 of 39 individuals (31%) showed skewed XCI. Extreme skewness was observed in 3 of 15 MR cases (20%) and 1 of 24 TR/GC cases (4.2%). Statistical analysis indicated that XCI in the MR group was likely to have occurred when the blastocyst contained three or four euploid embryonic progenitor cells. The estimated size of the embryonic progenitor cell pools was approximately one-third or one-fourth of the predicted size of normal embryos. The TR/GC group likely had a larger pool size at the onset of XCI, although the results remained inconclusive.

LIMITATIONS, REASONS FOR CAUTION

This is an observational study and needs to be validated by experimental analyses.

WIDER IMPLICATIONS OF THE FINDINGS

This study provides evidence that the onset of XCI is determined by an intrinsic clock, irrespectively of the number of embryonic progenitor cells. Our findings can also be applied to individuals without UPD or imprinting disorders. This study provides a clue to understand chromosomal and cellular dynamics in the first few days of human development, their effects on XCI skewing and the possible implications for the expression of X-linked diseases in females.

STUDY FUNDING/COMPETING INTEREST(S)

This study was supported by the Grants-in-aid for Scientific Research on Innovative Areas (17H06428) and for Scientific Research (B) (17H03616) from Japan Society for the Promotion of Science (JSPS), and grants from Japan Agency for Medical Research and Development (AMED) (18ek0109266h0002 and 18ek0109278h0002), National Center for Child Health and Development and Takeda Science Foundation. The authors declare no conflict of interest.

TRIAL REGISTRATION NUMBER

Not applicable.

Excellent performance of aromatic polyguanamines induced by multiple hydrogen bondable tetraazacalix[2]arene[2]-triazine ring in their main chain

A series of poly(guanamine) (c-PG)s containing tetraazacalix[2]arene[2]-triazine (mPDA₂CyC₂) were successfully prepared by solution polycondensation of mPDA₂CyC₂ with various aromatic diamines in an aprotic organic solvent with a lithium chloride additive (5 wt%) at 150 °C for 6 hours. The number-average molecular weights (M_n)s of these c-PG polymers reached up to 31 500, with a relatively broad molecular weight distribution (M_w/M_n) of 5.3. They showed good solubility in aprotic organic solvents, such as N-methylpyrrolidone and N,N-dimethylacetamide at a concentration of 2 mg mL⁻¹. The glass transition temperatures (T_g) of the c-PG polymers were in the range 359 °C–392 °C, approximately 160 °C higher than those of counterpart polymers (i.e., with no aza-calixarene-based PG (l-PG)). The coefficients of thermal expansion (CTEs) of the c-PG polymers were 29.7–48.1 ppm K⁻¹ (at 100 °C–150 °C), much lower than those of l-PG samples, i.e., 59.1–85.1 ppm K⁻¹. Transparent and almost colorless c-PG films were successfully prepared by a solution casting method, showing maximum tensile strength (σ_S), modulus (E_γ), and elongation at break (E_b) values of 151 MPa, 6.3 GPa, and 4.4%, respectively, for the c-PG polymer from mPDA₂CyC₂ and 4,4′-oxydianiline monomers. The corresponding l-PG film exhibited σ_S, E_γ, and E_b values of just 76 MPa, 5.4 GPa, and 1.6%, respectively. These outstanding thermal and mechanical properties of the c-PG polymers can be attributed to their multiple hydrogen bonding interaction between mPDA₂CyC₂ residues in the polymer backbone. This interaction was identified by infrared spectroscopy measurements at the broad absorption band around 3000–3400 cm⁻¹.

Poly(guanamine)s containing tetraazacalix[2]arene[2]triazine ring within the polymer main-chain show outstanding thermal and mechanical properties arisen from the multiple-hydrogen bond.

In situ Raman monitoring of dielectric-heating-enhanced freeze-drying under different electromagnetic wave frequencies

We studied the effect of dielectric heating on the enhancement of freeze-drying by electromagnetic waves (EMWs) under different frequencies: 2.45 GHz microwaves (MWs), and 27 and 200 MHz radio frequencies (RFs). The irradiation with RFs, particularly at 27 MHz, reduced the duration of freeze-drying by 67%. We further analysed the water structure by in situ Raman spectroscopy during freeze-drying under EMWs. The phase transition from ice to water occurred soon after starting irradiation by MWs at 2.45 GHz, while the ice phase was almost maintained at an RF of 27 MHz.

We studied the effect of dielectric heating on the enhancement of freeze-drying by electromagnetic waves (EMWs) under different frequencies: 2.45 GHz microwaves (MWs), and 27 and 200 MHz radio frequencies (RFs).

Abstract P6-02-09: Diagnostic performance of dedicated breast PET for the prediction of pathological response after neoadjuvant chemotherapy

Background: Neoadjuvant chemotherapy (NAC) is a standard treatment for operable breast cancer. However, imaging methods for evaluating treatment response have not been established. Previous studies reported that ring-type dedicated breast positron emission tomography (DbPET) detected residual tumors following NAC more accurately than whole-body PET/CT. This study assessed DbPET parameters for predicting pathological complete response (pCR) in patients with breast cancer.

Patients and Methods: Among patients with breast cancer who underwent surgery after NAC, 61 were examined using ring-type DbPET before and after NAC. The maximum standardized uptake values (SUVmax) and tumor-to-normal-tissue ratio (TNR) were calculated before and after NAC (pre-SUVmax, pre-TNR, post-SUVmax and post-TNR, respectively). Moreover, the reduction rates (ΔSUVmax and ΔTNR) were determined. pCR was defined as complete remission of breast cancer.

Results: The median patient age was 52 years. Forty patients (65.6%) were estrogen receptor (ER)-positive, whereas 25 patients (41.0%) were HER2-positive. Fifteen patients (24.6%) achieved pCR after NAC. The calculated values for the parameters of DbPET are summarized in Table 1. The most promising parameters for predicting pCR were ΔSUVmax (area under the curve [AUC]: 0.506) and post-TNR (AUC: 0.640). Although neither of these two parameters reflected the pathological response to NAC in patients with ER-positive disease, post-TNR showed the highest AUC (i.e., AUC: 0.750) for pCR in patients with ER-negative disease. The sensitivity and specificity of post-TNR in the ER-positive group were 85.7% and 39.4%, respectively. In the ER-negative group, these values were 100% and 58.3%, respectively [Table 2]

Table 1.Diagnostic performance of dedicated breast positron-emission tomography for the prediction of pathological complete response after neoadjuvant chemotherapyParameterspCR Median (IQR)Non-pCR Median (IQR)PAUC (95% CI)Pre-SUVmax14.8 (9.2–17.7)14.4 (10.7–19.8)0.6040.454 (0.285–0.624)Post-SUVmax1.8(1.5–2.1)2.0 (1.6–3.4)0.2370.603 (0.460–0.746)ΔSUVmax (%)87.32 (81.5–91.8)88.6(82.8–91.8)0.9540.506 (0.329–0.682)Pre-TNR8.0 (5.3–9.2)7.3(5.9–10.2)0.7570.472 (0.297–0.647)Post-TNR1.7(1.0–1.1)1.2 (1.0–2.4)0.0980.640 (0.506–0.774)ΔTNR (%)87.3 (78.3–89.1)79.8 (62.7–86.7)0.1130.638 (0.472–0.803)pCR, pathological complete response; IQR, interquartile range; AUC, area under the curve; CI, confidence interval, SUV, standardized uptake value; TNR, tumor-to-normal-tissue ratio.Table 2.Diagnostic accuracy of post-TNR according to estrogen receptor status Sensitivity (%)Specificity (%)Accuracy (%)PPV (%)NPV (%)ER-positive85.739.447.523.192.9ER-negative10058.375.061.5100TNR, tumor-to-normal-tissue ratio; ER, estrogen receptor; PPV, positive predictive value; NPV, negative predictive value

Conclusion: In DbPET, ΔSUVmax and post-TNR were shown to be promising parameters for predicting pathological response to NAC. Post-TNR provided the highest sensitivity for predicting pCR in patients with ER-negative breast cancer.

Citation Format: Suzuki E, Sasada S, Sueoka S, Masumoto N, Goda N, Kajitani K, Emi A, Haruta R, Kadoya T, Kataoka T, Okada M. Diagnostic performance of dedicated breast PET for the prediction of pathological response after neoadjuvant chemotherapy [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 P6-02-09.

Abstract P5-02-03: Evaluation of pathological malignancy grade and neoplastic progress of breast cancer using dedicated breast positron emission tomography

Background: Dedicated breast positron emission tomography (DbPET)provides detailed high resolution images of the breast and enables quantitative assessment using standard uptake values (SUVs). We aimed to determine whether DbPET can predict the pathological malignancy grade and neoplastic progress of breast cancer compared with whole body (WB) PET.

Methods: We investigated 196 consecutive patients with invasive breast cancerwho underwent concurrent Db- and WB-PET from January 2016 to March 2017. All Db- and WB-PET were quantified based on SUVs. We also investigated pathological features of breast cancer who had a ring-like uptake (RU) without central FDG accumulation on DbPET.

Results:

The associations between the SUVs for DB- and WB-PET and the pathological factors in breast cancerCharacteristicSUV WBPETDbPET Mean ± SDpMean ± SDpall3.6 ± 3.4 9.4±7.9 Tumor size    ≤2.0 cm2.2±1.6<0.0016.5±5.2<0.001>2.0 cm5.5±4.1 13.3±9.2 LN    Negative3.1±3.3<0.0018.4±7.8<0.001Positive4.9±3.2 11.8±7.7 NG    1 or 22.4±2.1<0.0016.6±5.9<0.00135.1±4.0 12.7±8.7 Ki67    < 201.8±1.1<0.0015.2±3.3<0.001≥ 204.4±3.7 11.4±8.6 ER    positive3.4±3.30.028.8±7.60.006negative5.2±3.6 13.5±8.6 HER-2    positive4.6±3.10.0911.8±7.60.04negative3.4±3.4 9.0±7.9 Sub type vs Lumnal A vs Lumnal ALuminal A1.8±1.1 5.2±3.3 Luminal B4.0±3.8<0.00110.1±8.5<0.001HER24.6±3.1<0.00111.8±7.6<0.001Triple negative5.3±3.8<0.00113.8±9.2<0.001

summarizes the association between SUVs for Db- and WB-PET and pathological factors inbreast cancer.SUVs on PET were significantly higher for the tumor size of >2.0 cm than for tumor size ≤2.0 cm (p<0.001), for LN-positive than for LN-negative (p<0.001), for NG3 than for NG1-NG2 (p<0.001), for higher Ki67 expression than for lower Ki67 expression (p<0.001), and for ER-negative than for ER-positive (WBPET, p=0.02; DbPET, p=0.006). SUVs were significantly lower for Luminal A than for Luminal B, HER2, and triple-negative cancer (p<0.001 for all three).SUVs for DbPET was significantly higher for HER2-positive than for HER2-negative (p=0.02).

The association between SUVs for breast cancer with and without RU on DbPETCharacteristicRU(-), nRU(+), npall17323 Tumor size   ≤2.0 cm1095<0.001>2.0 cm6418 LN   Negative1299<0.001Positive4414 NG   1 or 210070.0237316 Ki67   < 206130.03≥ 2011220 ER   positive152190.49negative214 HER-2   positive2620.38negative14721 Sub type  vs Lumnal ALuminal A493 Luminal B84150.02HER22620.81Triple negative1430.04

summarizes the association between SUVs for breast cancer with and without RU on DbPET. SUVs for breast cancer with RU on DbPET were significantly higher for the tumor size of >2.0 cm than for tumor size ≤2.0 cm, for LN -positive than for LN-negative (p<0.001), for NG3 than for NG1-2 (p=0.02), and for higher Ki67 expression than for lowerKi67 expression (p=0.03). SUVs were significantly lower for Luminal A than for Luminal B (p=0.02) and triple-negative cancer (p=0.04).

Conclusions: SUVs for DbPET were equal or superiorto WBPET in predicting the pathological malignancy grade and neoplastic progress in tumors. Furthermore, the presence of RU on DbPET can provide excellent predictive value for high-grade malignancy and might help to determine appropriate therapeutic strategies.

Citation Format: Masumoto N, Kadoya T, Nishina M, Kimura Y, Suzuki E, Sueoka S, Goda N, Sasada S, Kajitani K, Emi A, Haruta R, Kataoka T, Okada M. Evaluation of pathological malignancy grade and neoplastic progress of breast cancer using dedicated breast positron emission tomography [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-02-03.

Abstract PD2-07: Real-time navigation for sentinel lymph node biopsy in breast cancer patients using projection mapping with indocyanine green fluorescence

Background)

Sentinel lymph node (SLN) biopsy using indocyanine green fluorescence (fICG) method showed equal or better identification rate compared with blue dye or radioisotope (RI) method. In the fICG method, lymphatic vessels which drain into the SLNs can be seen through skin or subcutaneous tissue using near infrared camera (Photodynamic Eye®: PDE), and we can easily find the SLNs. However, whenever we observe the fluorescence images, we have to hold the PDE, turn off the operating light, and look at a monitor because fluorescence images cannot be seen directly. Medical imaging projection system (MIPS) is a new device which detects fluorescent emission from the organ and projects their images on the location of the fluorescence emission (Panasonic Connected Solutions Company, Japan). Projected images can be adjusted following the body movement or deformation of the organ. Therefore, MIPS could provide an option for real-time navigation for the SLN biopsy. The aim of this study was to evaluate the clinical utility of the MIPS.

Patients and methods)

Patients with clinically node-negative primary breast cancer underwent the fICG SLN biopsy using MIPS. Primary endpoint was identification rate of the fICG method using MIPS. At first, the study was conducted as an interventional study because the MIPS was the unapproved medical device. After approval of the MIPS, this study was conducted as an observational study. The study protocol was approved by the institutional review board at Kyoto University Hospital. All patients provided informed consent to participate in this study.

Results)

Between March 2016 and May 2017, 39 patients (40 procedures) underwent the fICG method SLN biopsy using MIPS. The median age was 55 years (range 32–74 years), and the median body mass index was 20.4 kg/m2 (range 17.7–27.7 kg/m2). About half had tumor stage T1 (58%) and 8 (20.0%) had DCIS. 8 procedures (20%) were performed after preoperative systemic therapy (PST). As MIPS itself can illuminate the operating field, SLN biopsy using MIPS was successfully performed without operating light in all procedures. At least one SLN was detected using MIPS for all procedures and the identification rate was 100% (95% CI: 91–100%). Median number of SLNs detected by MIPS was 3 (range 1–9) for all procedures, and 3 (range 2–8) for procedures after PST. Two pathologically positive SLNs and one SLN which included isolated tumor cells were detected by MIPS. In 25 procedures, RI was also used. 62 of 97 SLNs detected by MIPS (64%) were also detected by RI. However, no SLNs were detected only by RI.

Conclusions)

Although we still may not be able to avoid RI method because 25/40 (62.5%) procedures required the combined use of RI method, the fICG methods SLN biopsy using MIPS, which showed comparable identification rate of SLN with the conventional methods, could be useful tool with a view of allowing us to perform a real-time navigation surgery.

Acknowledgements)

This study was supported by Acceleration Transformative research for Medical innovation, Japan Agency for Medical Research and Development (AMED).

Citation Format: Takada M, Takeuchi M, Suzuki E, Sato F, Matsumoto Y, Torii M, Sakita-Kawaguchi N, Nakayama Y, Okuda T, Nishino H, Seo S, Hatano E, Toi M. Real-time navigation for sentinel lymph node biopsy in breast cancer patients using projection mapping with indocyanine green fluorescence [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD2-07.

Abstract P6-03-08: Detection ability of dedicated breast positron emission tomography for small-sized breast cancer

Background: Whole body (WB) 18F-fluorodeoxyglucose positron emission tomography (PET) has a relatively poor spatial resolution (>1 cm), which limits the capability to detect small lesions. Therefore, small-sized breast cancers (≤1 cm) may not be visible on WBPET. To overcome these limitations, dedicated breast PET (DbPET) has been developed to improve spatial resolution. DbPET enables detailed high-resolution images within the breast. We aimed to determine whether DbPET can detect small-sized breast cancer compared to WBPET.

Methods: We investigated 203 consecutive patients (217 tumors) (T1–3, N0–3a, M0) with breast cancer who underwent concurrent DbPET and WBPET between January 2016 and March 2017. All DbPET and WBPET images were semi-quantified based on standard uptake values. The diagnostic performance of each scanner was assessed in DbPET and WBPET. Tumors were classified based on pathological classification as follows: Tis, ductal carcinoma in situ (DCIS); T1a, ≤0.5 cm; T1b, 0.5–1 cm; and T1c, 1–2 cm; T2, 2–5 cm; T3, >5 cm. The sensitivities of DbPET and WBPET were compared in each size group.

Results: Table 1 shows the detection rate of breast cancer in WBPET and DbPET

The detection rate of breast cancer in WB- and Db-PET DbPETWBPETpTumor sizeDetection (-) n(%)Detection (+) n(%)Detection (-) n(%)Detection (+) n(%) Tis6(14.6)35(85.4)18(43.9)23(56.1)0.0030T1a2(8)23(92)7(28)18(72)0.0594T1b2(6.5)29(93.5)10(32.3)21(67.7)0.0077T1c5(8.2)56(91.8)11(18)50(82)0.1038T20(0)57(100)1(1.8)56(98.2)0.2375T30(0)2(100)0(0)2(100)-total15(6.9)202(93.1)47(21.7)170(78.3)<0.0001

. The overall detection rate in DBPET [93.1% (202/217)] was significantly higher than that of WBPET [78.3% (170/217)] (P < 0.001). For smaller tumors, DbPET was more sensitive than WBPET: Tis (85.4% vs. 56.1%), T1a (92% vs. 72%), T1b (93.5% vs. 67.7%), T1c (91.8% vs. 82%), T2 (100% vs. 98.2%), and T3 (100% vs. 100%). The sensitivity of DbPET was significantly higher than that of WBPET in Tis (P = 0.003) and T1b (P = 0.008) and tended to be higher than that of WBPET in T1a (P = 0.059). Conversely, no significant differences were observed in T1c (P = 0.103) and T2 (P = 0.238).

Conclusion: The imaging sensitivity of DbPET was higher than that of WBPET. DbPET showed significant sensitivity in DCIS and tumors ≤1 cm, which is a weak point for WBPET. DbPET may serve as a new diagnostic modality to detect small-sized breast cancer.

Citation Format: Sueoka S, Masumoto N, Nishina M, Kimura Y, Suzuki E, Goda N, Sasada S, Kajitani K, Emi A, Haruta R, Kadoya T, Kataoka T, Okada M. Detection ability of dedicated breast positron emission tomography for small-sized breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-03-08.

Endocrine disrupting chemicals, 4-nonylphenol, bisphenol A and butyl benzyl phthalate, impair metabolism of estradiol in male and female rats as assessed by levels of 15α-hydroxyestrogens and catechol estrogens in urine

Bisphenol A (BPA), 4-nonylphenol (NP) and butyl benzyl phthalate (BBP), termed endocrine-disrupting chemicals, are known to mimic estrogen activity. The effects of these chemicals on 17β-estradiol (E₂ ) metabolism in vivo in rats were examined. Male and female rats were given NP (250 mg kg^-1  day^-1 ), BPA (250 μg kg^-1  day^-1 ) or BBP (500 mg kg^-1  day^-1 ) by gavage for 14 days, followed by a single intraperitoneal injection of E₂ (5 mg kg^-1 ) on the final day. The urinary excretion over 72 hours of 2-hydroxyestrone 1-N-acetylcysteine thioether, 2-hydroxyestrone 4-N-acetylcysteine thioether, 4-hydroxyestrone 2-N-acetylcysteine thioether, 2-hydroxy-17β-estradiol (2-OHE₂ ), 2-hydroxyestrone (2-OHE₁ ), 4-hydroxy-17β-estradiol, 4-hydroxyestrone, 15α-hydroxyestriol (E₄ ), 15α-hydroxy-17β-estradiol and 15α-hydroxyestrone was measured. Increases in urinary excretion of 2-OHE₁ and decreases in E₄ were observed in males treated with NP or BBP. Decreases in urinary excretion of 2-OHE₂ and E₄ were observed in males treated with BPA. Decreases in urinary excretion of 2-OHE₁ and 2-OHE₂ were observed in females treated with BBP. Normalized liver and weights were increased in both sexes treated with NP or BBP. Histologic observations revealed marked changes in the distal tubules and collecting ducts in the kidneys of rats exposed to NP and BBP, and hypertrophy in the hepatocytes of the centrilobular zone of the liver. No BPA-related effects on organ weight and on liver or kidney histopathology were found. These results suggest that the 14 day oral dosing of NP and BBP disrupted E₂ metabolism, resulting from marked morphological and functional alterations in the liver and kidneys. In addition, BPA could induce metabolic and endocrine disruption.

Effect of the combined use of enamel matrix derivative and atelocollagen sponge scaffold on osteoblastic differentiation of mouse induced pluripotent stem cells in vitro

BACKGROUND AND OBJECTIVE

Induced pluripotent stem cells (iPSCs) are a candidate cell source in periodontal regenerative therapy. Enamel matrix derivative (EMD) has been shown to regenerate periodontal tissues, and atelocollagen sponge (ACS) is considered a suitable scaffold or carrier for growth factors. This study aimed to investigate the effect of combined use of EMD and an ACS scaffold on cell behaviors and differentiation of mouse iPSCs (miPSCs) in vitro.

MATERIAL AND METHODS

Following embryonic body formation from miPSCs, dissociated cells (miPS-EB-derived cells) were seeded onto ACS with or without EMD, and cultured in osteoblast differentiation medium. Scanning electron microscopy and histological analyses were used to assess cell morphology and infiltration within the ACS. Cell viability (metabolism) was determined using an MTS assay, and expression of mRNA of osteoblastic differentiation markers was assessed by quantitative RT -PCR. Alkaline phosphatase (ALP) staining intensity and activity were evaluated. Mineralization was assessed by von Kossa staining, and calcium content was quantitated using the methylxylenol blue method.

RESULTS

By 24 hours after seeding, miPS-EB-derived cells in both the EMD and control groups had attached to and infiltrated the ACS scaffold. Scanning electron microscopy images revealed that by day 14, many cytoplasmic protrusions and extracellular deposits, suggestive of calcified matrix, were present in the EMD group. There was a time-dependent increase in cell viability up to day 3, but no difference between groups was observed at any time point. The levels expressed of ALP and osterix genes were significantly higher in the EMD group than in the control group. Expression of runt-related transcription factor 2 was increased in the EMD group compared with the control group on day 7. EMD upregulated the expression of bone sialoprotein and osteopontin on day 14, whereas expression of osteocalcin was lower at all time points. The staining intensity and activity of ALP were higher in the EMD group than in the control group. Mineralization levels and calcium contents were significantly higher in the EMD group throughout the observation period.

CONCLUSION

These data suggest that combining ACS with EMD increases levels of osteoblastic differentiation and mineralization in miPS-EB-derived cells, compared with ACS used alone.

Determination of urinary 15α-hydroxyestrogen levels via immunoaffinity extraction

15α-Hydroxyestrogens (15α-OHEs) are metabolites of the female hormone estradiol. In this study, to discover physiological markers that can be utilized for monitoring fetal conditions and estrogen-induced cancers, we established a method for quantifying 15α-OHEs in rat urine via immunoaffinity column extraction and HPLC-electrochemical detection, and detected 15α-OHEs in urine obtained male rats treated with estradiol. Notably, the standard curves for quantification obtained using the column were linear over a range of 0.5-50ng 15α-OHEs. The accuracy of the analytical method with cleanup was 97-109% for the three kinds of 15α-OHEs examined, and the intra-assay precision of the measured values had a coefficient of variation of ≤20.6%. Therefore, the theoretical limit of quantification was 0.5ng. However, the actual measured values obtained from the urine of male rats indicated that the detection limits were 0.425, 0.103, and 0.047ng for estetrol, 15α-hydroxyestradiol, and 15α-hydroxyestrone, respectively. Our newly established method for measuring 15α-OHE concentrations in urine could facilitate characterization of the in vivo metabolic profile of 15α-OHEs in mammals under various physiological conditions, which could comprise clinical markers for monitoring human fetal health conditions in mammals.

Catastrophic cellular events leading to complex chromosomal rearrangements in the germline

Although complex chromosomal rearrangements were thought to reflect the accumulation of DNA damage over time, recent studies have shown that such rearrangements frequently arise from 'all-at-once' catastrophic cellular events. These events, designated chromothripsis, chromoanasynthesis, and chromoanagenesis, were first documented in the cancer genome and subsequently observed in the germline. These events likely result from micronucleus-mediated chromosomal shattering and subsequent random reassembly of DNA fragments, although several other mechanisms have also been proposed. Typically, only one or a few chromosomes of paternal origin are affected per event. These events can produce intrachromosomal deletions, duplications, inversions, and translocations, as well as interchromosomal translocations. Germline complex rearrangements of autosomes often result in developmental delay and dysmorphic features, whereas X chromosomal rearrangements are usually associated with relatively mild clinical manifestations. The concept of these catastrophic events provides novel insights into the etiology of human genomic disorders. This review introduces the molecular characteristics and phenotypic outcomes of catastrophic cellular events in the germline.

MR angiography for the evaluation of non-systemic vasculitic neuropathy: A case report

Peripheral neuropathy due to vasculitis without any complications of vasculitis in other organs was first reported in 1987. This condition was termed non-systemic vasculitic neuropathy (NSVN). Although vasculitis is believed to develop in small arteries and arterioles in this disease, the level of vascular involvement has not been fully established. We present a case of NSVN followed up by MR angiography, which was thought to be useful to assess the level as well as the state of vascular lesions in this condition.

Abstract P4-04-22: Upregulation of the interleukin 17/granulocyte-colony stimulating factor/fibroblast growth factor axis in breast cancer and its negative association with treatment outcome

Background

Interleukin (IL) 17 is secreted by T helper 17 cells and tumor cells. It may induce the proliferation of mesenchymal stem cells (MSCs) in the tumor microenvironment directly and/or via fibroblast growth factor (FGF) and granulocyte-colony stimulating factor (G-CSF) production by tumor-associated macrophages. MSCs play various roles in tumor development and progression, by mediating tumor cell migration, promoting angiogenesis, regulating immune responses, and inducing anti-cancer drug resistance. Therefore, in this study, we examined the association of the IL17/FGF/G-CSF axis with both breast cancer development and response to chemotherapy.

Methods

Eighty-nine breast cancer patients (34% with luminal, 45% with HER2, and 21% with triple-negative breast cancer) and 55 healthy volunteers were analyzed. Serum IL17, basic FGF, and G-CSF levels were measured using a Luminex system. The primary objective was to evaluate the difference in IL17 serum levels between breast cancer patients and healthy volunteers. Secondary objectives were to determine the correlation of IL17 levels with the basic FGF and G-CSF levels, pathological complete response (pCR) (if neoadjuvant therapy was administered), and disease-free survival (DFS) in breast cancer patients. Statistical analyses were performed using the Mann-Whitney, chi-squared, and log-rank tests.

Results

Serum levels of IL17 (median, 91.9 vs. 40.3 pg/ml, p<0.0001), basic FGF (median, 63.9 vs. 3.15 pg/ml, p<0.0001), and G-CSF (median, 61.0 vs. 29.4 pg/ml, p<0.0001) were significantly higher in breast cancer patients than in healthy volunteers. IL17 levels were strongly correlated with basic FGF (r=0.86, p<0.0001) and G-CSF (r=0.73, p<0.0001) levels. Among 64 patients who received neoadjuvant therapy, those with low IL17 levels (<91.9 pg/ml) achieved a significantly higher pCR rate than those with high IL17 levels (≥91.9 pg/ml) (56.0% vs. 25.6%, p=0.014). In addition, the DFS at a median follow-up of 35.7 months was significantly higher in patients with low IL17 levels (p=0.0190).

Conclusion

The IL17/FGF/G-CSF axis was upregulated in breast cancer patients and the levels of these markers were inversely correlated with pCR and prognosis. These results may provide novel insight into the role of IL17 in tumor development and have important implications in the development of IL17 as a target in the treatment of breast tumors.

Citation Format: Kawaguchi K, Suzuki E, Yamamoto Y, Saito K, Toi M. Upregulation of the interleukin 17/granulocyte-colony stimulating factor/fibroblast growth factor axis in breast cancer and its negative association with treatment outcome. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-04-22.

Synthesis of highly refractive and highly fluorescent rigid cyanuryl polyimines with polycyclic aromatic hydrocarbon pendants

A series of rigid cyanuryl polyimines, polyguanamines (PGs) bearing polycyclic aromatic hydrocarbon pendants were successfully synthesized from 2-substituted 4,6-dichloro-1,3,5-triazine and aromatic diamine monomers.

Specific electronic absorptions of alternate layered nanostructures of two metal oxides synthesized via a thiol–ene click reaction

Absorption properties of alternate stacked structures of niobate and tungstate nanosheets were continuously altered by a change of the interlayer distance.

Physiological responses in Alpine skiers during on-snow training simulation in the cold

This study examined the physiological responses to cold stimulus during intermittent high-intensity exercise simulating on-snow alpine ski training. 7 male alpine skiers performed intermittent high-intensity exercises composed of 4 bouts of cycling exercise at 140% VO 2max intensity for 30 s with 10-min rests on a cycle ergometer in cold (1°C) and control (22°C) conditions. The subjects wore racing suits, middle layers and half pants designed for alpine skiers. Rectal temperature and mean skin temperature were lower in the cold condition than in the control condition (36.8 ± 0.5 vs. 37.1 ± 0.1°C and 28.4 ± 0.6 vs. 33.3 ± 0.6°C, respectively). Oxygen consumption during rests and the last 2 bouts of exercise was higher in the cold condition than in the control condition. Although plasma noradrenaline and serum triglyceride were higher in the cold condition than in the control condition, plasma glucose, adrenaline and serum glycerol were lower. Serum free fatty acid and plasma lactate concentrations did not differ significantly between the 2 conditions. These results indicate that a cold stimulus affects body temperature and energy metabolism and may lead to a decrease in exercise capacity in alpine skiers during on-snow training.

IL-17 eliminates therapeutic effects of oral tolerance in murine airway allergic inflammation

BACKGROUND

Oral tolerance is a classically used strategy for antigen-specific systemic immunotherapy. However, the roles of IL-17 in modification of oral tolerance are not yet understood.

OBJECTIVE

To define the effects of IL-17 on the modification of oral tolerance, the effects of transfer of Th17 cells, administration of IL-17 or anti-IL-17 antibody (αIL-17Ab) to a murine allergic airway inflammation model were investigated.

METHODS

Mice sensitized to and challenged with OVA, received OVA feeding, followed by OVA challenges. Transfer of Th17 cells, administration of IL-17 or αIL-17Ab were executed during OVA feeding. Airway hyperresponsiveness (AHR), airway inflammation, Th2 cytokine response and lung pathology were assessed.

RESULTS

Administration of IL-17 as well as transfer of Th17 cells aggravated AHR and airway allergic inflammation as compared with the findings in mice subjected to OVA feeding alone, whereas administration of αIL-17Ab ameliorated AHR and airway eosinophilia. The effects of Th17 transfer were presumably attributable to augmentation of endogenous IL-6 production in gut. The number of Foxp3-positive regulatory T (Treg) cells in lungs and Payer's patches was increased in the OVA fed mice, whereas the number of these cells was decreased in the mice subjected to OVA feeding + Th17 cell transfer. Neutralization of IL-6 by monoclonal antibody in the mice subjected to OVA feeding + transfer of Th17 cells restored the effects of oral tolerance.

CONCLUSIONS AND CLINICAL RELEVANCE

These data suggest that IL-17 may inhibit the induction of tolerance to antigen through, at least in part augmenting IL-6 production, thereby suppressing the expansion of Treg cells.

Establishing apoptosis resistant cell lines for improving protein productivity of cell culture

The authors established apoptosis resistant COS-1, myeloma, hybridoma, and Friend leukemia cell lines by genetically engineering cells, aiming at more efficient protein production by cell culture. COS-1 cells, which are most widely used for eukariotic gene expression, were transfected with human bcl-2 gene. Both bcl-2 and mock transfected COS-1 cells were cultured at low (0.2%) serum concentration for 9 days. The final viable cell number of the bcl-2 transfected cells was ninefold of that of the mock transfectants. Both bcl-2 and mock transfectants were further transfected with the vector pcDNA-λ containing SV40 ori and immunoglobulin λ gene for transiently expressing λ protein. The bcl-2 expressing COS-1 cells produced more λ protein than the mock transfected COS-1 cells after 4 days posttransfection.Mouse myeloma p3-X63-Ag.8.653 cells, which are widely used as the partner for preparing hybridoma, and hybridoma 2E3 cells were transfected with human bcl-2 gene. Both bcl-2 transfected myeloma and hybridoma survived longer than the corresponding original cells in batch culture. The bcl-2 transfected 2E3 cells survived 2 to 4 four days longer in culture, producing 1.5- to 4-fold amount of antibody in comparison with the mock transfectants.Coexpression of bag-1 with bcl-2 improved survival of hybridoma 2E3 cells more than bcl-2 expression alone. The bag-1 and bcl-2 coexpressing cells produced more IgG than the the cells expressing bcl-2 alone.Apoptosis of Friend murine erythroleukemia(F-MEL) cells was suppressed with antisense c-jun expression. The antisense c-jun expressing cells survived 16 days at non-growth state.

Reinforcing apoptosis-resistance of COS and myeloma cells by transfecting with bcl-2 gene

COS, myeloma and HeLa cells, which are commonly used for protein production by cell culture, were transfected with human bcl-2 gene encoded on the shuttle vector BCMGS. Expression of human bcl-2 improved survival of cells remarkably, mildly, or negligibly for COS, myeloma, and HeLa, respectively. Four clones were obtained from the human bcl-2 expressing cell population of COS cells. They expressed human bcl-2 almost at the same level. The viable cell numbers were 6, 2.5, 2.5, and 0.8 times as many for the clones #8, #5, #6, and #7, respectively, as for the control COS cells, when they were cultured at low (0.2%) serum concentration for 9 days. The bcl-2 overexpressing COS cells showed morphology different from that of the control COS cells in serum limited condition. When transfected with mouse lambda protein gene carried by an SV40-derived vector, clone #8 of the bcl-2 transfected COS cells continued the transient expression of lambda protein longer than the control COS cells.

Co-expression of bcl-2 and bag-1, apoptosis suppressing genes, prolonged viable culture period of hybridoma and enhanced antibody production

Human bcl-2 and bag-1 DNA were introduced into mouse hybridoma 2E3- O cells and expressed. The expression of bcl-2 in BCMGneo-bcl2 transfectants was confirmed by ELISA and that of bag-1 in pZeo-bag1 was confirmed by western blotting. In batch cultures, the over-expression of bcl-2 prolonged the culture period by 2 days and co-expression of bcl-2 and bag-1 prolonged the culture period by 3 days. The delayed increase in the dead cell number in culture of the bcl-2 and bag-1 cotransfectant indicated the additional antiapoptosis effect of bcl-2 and bag-1 cotransfection in comparison with the bcl-2 only transfection. The bcl-2 transfectants (2E3O-Bcl2) produced antibody twofold per batch culture in comparison with 2E3-O cells transfected with BCMGSneo (2E3O-Mock). Enhancement of this MoAb production was due to the improved survival of the cells and was not due to stimulation of antibody production rate per cell by Bcl-2 expression. And the bcl-2 and bag-1 co-transfectant (2E3O-Bcl2-BAG1) produced antibody approximately fourfold of 2E3O-Mock per batch culture. Enhancement of this MoAb production was due to the improved survival of the cells and was partly due to stimulation of MoAb production rate per cell in the non-growing phase by the cotransfection. The method to engineer hybridoma cells genetically with bcl-2 and bag-1 for increasing viability and productivity would be widely applied for improving antibody productivity of hybridoma cultures.

Overexpression of bcl-2, apoptosis suppressing gene: Prolonged viable culture period of hybridoma and enhanced antibody production

Human bcl-2 DNA was introduced into mouse hybridoma 2E3 cells and expressed at a high level by using BCMGSneo vector, which reportedly amplifies as multiple copies in the cells independently of their chromosomes. The high expression of bcl-2 in BCMGSneo-bcl-2 transfectants was confirmed by western blotting. In batch cultures, the overexpression of bcl-2 raised the maximum viable cell density by 45%, delayed the initiation of apoptosis by 2 days, and prolonged the viable culture period by 4 days. The delayed initiation of apoptosis was detected by emergence of the ladder pattern on DNA electrophoresis and increase of the dead cell number. The bcl-2 transfectants produced lgG(1) fourfold per batch culture in comparison with 2E3 cells transfected with BCMGSneo but not with bcl-2: a little less than twofold due to the improved survival of the cells and more than twofold due to the enhanced lgG(1) production rate per cell of the bcl-2 transfectants. The method to engineer hybridoma cells genetically with bcl-2 using BCMGSneo vector for increasing viability and productivity would be widely applied for improving antibody productivity of hybridoma cultures. (c) 1995 John Wiley & Sons, Inc.

Characterization and fed-batch culture of hybridoma overexpressing apoptosis suppressing gene bcl-2

Mouse hybridoma 2E3 transfected with human bcl-2 gene survived longer with increasing expression level of bcl-2 when cultured in DME medium supplemented with 9% serum. One of the transfectants, 2E3BCMGbcl-2, overexpressed bcl-2 and could maintain viable cell density higher than the initial density for more than four days at a low 0.5% serum concentration. In comparison a mock transfectant 2E3BCMG remained viable for only one day. However, both hybridomas died out within a day in serum-free medium. These results suggested that bcl-2 needed a small amount of some serum components to suppress apoptosis of the hybridoma. Overexpression of bcl-2 also suppressed apoptosis of the hybridoma induced by glutamine deprivation. When hybridoma 2E3BCMGbcl-2 was inoculated in DME medium supplemented with 9% serum and cultured for 10 d with additional 2% serum feed at day 4 of the culture, viable cell density increased 2-fold and antibody produced 3-fold, in comparison with mock transfected 2E3 cultured in the same manner. The mock transfectant with additional feed of serum at day 4 of the culture showed no difference in viable cell density and antibody production. These results suggested that the mock transfectant committed to apoptosis before day 4 of the culture and the additional serum at day 4 could not reverse the commitment.

Enhancement of radiosensitivity by a unique novel NF-κB inhibitor, DHMEQ, in prostate cancer

Background:

Inducible activation of nuclear factor (NF)-κB is one of the principal mechanisms through which resistant prostate cancer cells are protected from radiotherapy. We hypothesised that inactivation of inducible NF-κB with a novel NF-κB inhibitor, DHMEQ, would increase the therapeutic effects of radiotherapy.

Methods:

PC-3 and LNCaP cells were exposed to irradiation and/or DHMEQ. Cell viability, cell cycle analysis, western blotting assay, and NF-κB activity were measured. The antitumour effect of irradiation combined with DHMEQ in vivo was also assessed.

Results:

The combination of DHMEQ with irradiation resulted in cell growth inhibition and G2/M arrest relative to treatment with irradiation alone. Inducible NF-κB activity by irradiation was inhibited by DHMEQ treatment. The expression of p53 and p21 in LNCaP, and of 14-3-3σ in PC-3 cells, was increased in the combination treatment. In the in vivo study, 64 days after the start of treatment, tumour size was 85.1%, 77.1%, and 64.7% smaller in the combination treatment group than that of the untreated control, DHMEQ-treated alone, and irradiation alone groups, respectively.

Conclusion:

Blockade of NF-κB activity induced by radiation with DHMEQ could overcome radio-resistant responses and may become a new therapeutic modality for treating prostate cancer.