Role of Diagnostic Laparoscopy During Pancreatic Cancer Surgery in the Modern Era

INTRODUCTION

Despite improvements in preoperative image resolution, approximately 10% of curative-intent resection attempts for pancreatic ductal adenocarcinoma are aborted at the time of operation. To avoid nontherapeutic laparotomy, many surgeons perform intraoperative diagnostic laparoscopy (DL) to identify radiographically occult metastatic disease. There are no consensus guidelines regarding DL in pancreatic cancer. The goal of this study is to investigate the efficacy of same-procedure DL at avoiding nontherapeutic laparotomy.

METHODS

A single-institution retrospective review was performed from 2016 to 2022, identifying 196 patients with pancreatic ductal adenocarcinoma who were taken to the operating room for open curative-intent resection. Patient demographic, tumor characteristic, treatment, and outcome data were abstracted. Univariate and multivariate Cox hazard ratio analysis was performed to investigate risk factors for overall survival and recurrence-free survival. Number needed to treat (NNT) was calculated to identify number of DLs necessary to avoid one nontherapeutic laparotomy.

RESULTS

Curative-intent resection was achieved in 161 (82.1%) patients. One hundred twenty six (64.0%) patients received DL prior to resection and DL identified metastatic disease in three (2.4%) patients with an NNT of 42. NNT of DL in a subgroup analysis performed on clinically high-risk patients (defined by preoperative or preneoadjuvant therapy carbohydrate antigen 19-9 > 500 U/mL) is 11. Receipt of DL did not prolong operative times in patients receiving pancreaticoduodenectomy when accounting for completed versus aborted resection.

CONCLUSIONS

Although intraoperative DL is a short procedure with minimal morbidity, these data demonstrate that same-procedure DL has potential efficacy in avoiding nontherapeutic laparotomy only in a subgroup of clinically high-risk patients. Focus should remain on optimizing preoperative patient selection and further investigating novel diagnostic markers predictive of occult metastatic disease.

Peritoneal Metastases After Intraductal Papillary Mucinous Neoplasm Resection: How Common are They?

INTRODUCTION

Peritoneal metastases (PMs) following resection of pancreatic intraductal papillary mucinous neoplasms (IPMNs) are rare. Consequently, prevalence, risk factors, and prognosis are not well known. We reviewed our institution's experience and published literature to further characterize the scope of this phenomenon.

METHODS

All pancreatectomy cases (556 patients) performed at a tertiary care center between 2010 and 2020 were reviewed to identify IPMN diagnoses. Patients with adenocarcinoma not arising from IPMN, or a history of other malignancies were excluded.

RESULTS

Seventy-eight patients underwent pancreatectomy with IPMN on final pathology at our institution; 51 met inclusion criteria. Of these, there were five cases of PMs (4:1 females:males). Four had invasive carcinoma arising from IPMN and one had high-grade dysplasia at the index operation. Female sex and invasive histology were significantly associated with PM (P < 0.05). PM rates by sex were 3% (95% confidence interval [CI]: 0.5-15) in males and 22% (95% CI: 9-45) in females. Rates by histology were 2.9% (95% CI: 0.5-15) for noninvasive IPMN, and 23.5% (95% CI: 9.5-47) for invasive carcinoma arising from IPMN. Median interval from surgery to PMs was 7 mo (range: 3-13).

CONCLUSIONS

PMs following IPMN resection are rare but may be more common in patients with invasive histology. Although rare, PMs can arise in patients with noninvasive IPMNs. Further studies on pathophysiology and risk factors of PM following IPMN resection are needed and may reinforce adherence to guidelines recommending long-term surveillance.

Management of Gastric Adenocarcinoma for General Surgeons

Gastric cancer is one of the most common cancers in the world, despite declining incidence of the disease in the United States. Because of the rare occurrence of the disease in the United States, there is significant treatment variance in use of diagnostic modalities, neoadjuvant/adjuvant therapies, and surgical techniques. The survival of patients with gastric cancer in the United States is significantly lower than those of Asian countries where the diagnosis is made at an earlier stage and uniform high-quality treatment is delivered. This article reviews pearls and pitfalls of multidisciplinary management of the gastric adenocarcinoma for best outcomes.

The effect of femoral bone tunnel configuration on tendon-bone healing in an anterior cruciate ligament reconstruction: An animal study

Objectives

To compare the effect of femoral bone tunnel configuration on tendon-bone healing in an anterior cruciate ligament (ACL) reconstruction animal model.

Methods

Anterior cruciate ligament reconstruction using the plantaris tendon as graft material was performed on both knees of 24 rabbits (48 knees) to mimic ACL reconstruction by two different suspensory fixation devices for graft fixation. For the adjustable fixation device model (Socket group; group S), a 5 mm deep socket was created in the lateral femoral condyle (LFC) of the right knee. For the fixed-loop model (Tunnel group; group T), a femoral tunnel penetrating the LFC was created in the left knee. Animals were sacrificed at four and eight weeks after surgery for histological evaluation and biomechanical testing.

Results

Histologically, both groups showed a mixture of direct and indirect healing patterns at four weeks, whereas only indirect healing patterns were observed in both groups at eight weeks. No significant histological differences were seen between the two groups at four and eight weeks in the roof zone (four weeks, S: mean 4.8 sd 1.7, T: mean 4.5 sd 0.5, p = 0.14; eight weeks, S: mean 5.8 sd 0.8, T: mean 4.8 sd 1.8, p = 0.88, Mann-Whitney U test) or side zone (four weeks, S: mean 5.0 sd 1.2, T: mean 4.8 sd 0.4, p = 0.43; eight weeks, S: mean 5.3 sd 0.8,T: mean 5.5 sd 0.8, p = 0.61, Mann-Whitney U test) . Similarly, no significant difference was seen in the maximum failure load between group S and group T at four (15.6 sd 9.0N and 13.1 sd 5.6N) or eight weeks (12.6 sd 3.6N and 17.1 sd 6.4N, respectively).

Conclusion

Regardless of bone tunnel configuration, tendon-bone healing after ACL reconstruction primarily occurred through indirect healing. No significant histological or mechanical differences were observed between adjustable and fixed-loop femoral cortical suspension methods.

Cite this article: Y. Sato, R. Akagi, Y. Akatsu, Y. Matsuura, S. Takahashi, S. Yamaguchi, T. Enomoto, R. Nakagawa, H. Hoshi, T. Sasaki, S. Kimura, Y. Ogawa, A. Sadamasu, S. Ohtori, T. Sasho. The effect of femoral bone tunnel configuration on tendon-bone healing in an anterior cruciate ligament reconstruction: An animal study. Bone Joint Res 2018;7:327–335. DOI: 10.1302/2046-3758.75.BJR-2017-0238.R2.

A National-Level Validation of the New American Joint Committee on Cancer 8th Edition Subclassification of Stage IIA and B Anal Squamous Cell Cancer

INTRODUCTION

The 8th edition of the American Joint Committee on Cancer (AJCC) updated the staging system of anal squamous cell cancer (ASCC) by subdividing stage II into A (T2N0M0) and B (T3N0M0) based on a secondary analysis of the RTOG 98-11 trial. We aimed to validate this new subclassification utilizing two nationally representative databases.

MATERIALS

The National Cancer Database (NCDB) [2004-2014] and the Surveillance, Epidemiology, and End Results (SEER) database [1988-2013] were queried to identify patients with stage II ASCC.

RESULTS

A total of 6651 and 2579 stage IIA (2-5 cm) and 1777 and 641 stage IIB (> 5 cm) patients were identified in the NCDB and SEER databases, respectively. Compared with stage IIB patients, stage IIA patients within the NCDB were more often females with fewer comorbidities. No significant differences were observed between age, race, receipt of chemotherapy and radiation, and mean radiation dose. Demographic, clinical, and pathologic characteristics were comparable between patients in both datasets. The 5-year OS was 72% and 69% for stage IIA versus 57% and 50% for stage IIB in the NCDB and SEER databases, respectively (p < 0.001). After adjustment for available demographic and clinical confounders, stage IIB was significantly associated with worse survival in both cohorts (hazard ratio 1.58 and 2.01, both p < 0.001).

CONCLUSION

This study validates the new AJCC subclassification of stage II anal cancer into A and B based on size (2-5 cm vs. > 5 cm) in the general ASCC population. AJCC stage IIB patients represent a higher risk category that should be targeted with more aggressive/novel therapies.

Biodistribution of N-lsopropyl-p-lodoamphetamine in the Rat Brain

The biodistribution of N-isopropyl-p-iodoamphetamine (IMP) was studied in the rat brain.131 l-labelled IMP was injected intravenously in awake animals. Activities in the brain of Sprague-Dawley rats were 2.68–3.22 (% dose/g) in the cortex and 0.59–0.66 (% dose/g) in the white matter at 1 min p. i. Activities in the cortex were slightly increased at 60 min p. i., while activities in the white matter increased markedly at 60 min and 6 h p. i. Therefore, the cerebral cortex-to-white matter ratio decreased from 5 to 1 within 60 min after injection. Autoradiograms of the rat brain at 1–10 min p. i. showed high contrasts. Activities were high in the cortex and low in the white matter, but homogeneous at 60 min – 6 h. IMP seems to be a useful agent for cerebral perfusion imaging in the early phase after injection. Knowledge of biodistribution of this agent is considered to be indispensable for the interpretation of images.

SS-MIX: A Ministry Project to Promote Standardized Healthcare Information Exchange

Objectives: To promote healthcare information exchange between providers and to allow hospital information systems (HIS) export information in standardized format (HL7 and DICOM) in an environment of widespread legacy systems, which only can export data in proprietary format.

Methods: Through the Shizuoka prefecture EMR project in 2004–2005, followed by the ministry’s SS-MIX project, many software products have been provided, which consist of 1) a standardized storage to receive HL7 v2.5 mes sages of patient demographics, prescription orders, laboratory results, and diagnostic disease in ICD-10, 2) a referral letter creation system, 3) a formatted document creation system, 4) a progress note/nursing record system, and 5) an archive/viewer to incorporate incoming healthcare data CD and allow users to view on HIS terminal. Meanwhile, other useful applications have been produced, such as adverse event reporting and clinical information retrieval. To achieve the above-mentioned objectives, these software products were created and propagated, because users can use these software products, provided that their HIS can export the above information to the standardized storage in HL7 v2.5 format.

Results: In 20 hospitals of Japan, the standardized storage has been installed and some applications have been used. As major HIS vendors are shipping HIS with HL7 export function since 2007, HIS of 594 hospitals in Japan became capable of exporting data in HL7 v2.5 format (as of March 2010).

Conclusions: In high CPOE installation rate (85% in 400+ bed hospitals), though most of them only capable of exporting data in proprietary format, prefecture and ministry projects were effective to promote healthcare information exchange between providers. The standardized storage became an infrastructure for many useful applications, and many hospitals started using them. Ministry designation of proposed healthcare standards was effective so as to allow vendors to conform their products, and users to install them.

The effect of systemic administration of G-CSF on a full-thickness cartilage defect in a rabbit model MSC proliferation as presumed mechanism: G-CSF for cartilage repair

Objectives

The aim of this study was to investigate the effect of granulocyte-colony stimulating factor (G-CSF) on mesenchymal stem cell (MSC) proliferation in vitro and to determine whether pre-microfracture systemic administration of G-CSF (a bone marrow stimulant) could improve the quality of repaired tissue of a full-thickness cartilage defect in a rabbit model.

Methods

MSCs from rabbits were cultured in a control medium and medium with G-CSF (low-dose: 4 μg, high-dose: 40 μg). At one, three, and five days after culturing, cells were counted. Differential potential of cultured cells were examined by stimulating them with a osteogenic, adipogenic and chondrogenic medium.

A total of 30 rabbits were divided into three groups. The low-dose group (n = 10) received 10 μg/kg of G-CSF daily, the high-dose group (n = 10) received 50 μg/kg daily by subcutaneous injection for three days prior to creating cartilage defects. The control group (n = 10) was administered saline for three days. At 48 hours after the first injection, a 5.2 mm diameter cylindrical osteochondral defect was created in the femoral trochlea. At four and 12 weeks post-operatively, repaired tissue was evaluated macroscopically and microscopically.

Results

The cell count in the low-dose G-CSF medium was significantly higher than that in the control medium. The differentiation potential of MSCs was preserved after culturing them with G-CSF.

Macroscopically, defects were filled and surfaces were smoother in the G-CSF groups than in the control group at four weeks. At 12 weeks, the quality of repaired cartilage improved further, and defects were almost completely filled in all groups. Microscopically, at four weeks, defects were partially filled with hyaline-like cartilage in the G-CSF groups. At 12 weeks, defects were repaired with hyaline-like cartilage in all groups.

Conclusions

G-CSF promoted proliferation of MSCs in vitro. The systemic administration of G-CSF promoted the repair of damaged cartilage possibly through increasing the number of MSCs in a rabbit model.

Cite this article: T. Sasaki, R. Akagi, Y. Akatsu, T. Fukawa, H. Hoshi, Y. Yamamoto, T. Enomoto, Y. Sato, R. Nakagawa, K. Takahashi, S. Yamaguchi, T. Sasho. The effect of systemic administration of G-CSF on a full-thickness cartilage defect in a rabbit model MSC proliferation as presumed mechanism: G-CSF for cartilage repair. Bone Joint Res 2017;6:123–131. DOI: 10.1302/2046-3758.63.BJR-2016-0083.

Hidden osteophyte formation on plain X-ray is the predictive factor for development of knee osteoarthritis after 48 months--data from the Osteoarthritis Initiative

OBJECTIVE

To examine whether the detection of osteophytes anywhere in the knee could serve as a pre-radiographic biomarker for osteoarthritis (OA) development.

METHODS

Baseline magnetic resonance imaging (MRIs) of 132 participants in the Osteoarthritis Initiative (OAI) were studied. Based on radiographs, 66 knees were assessed as osteoarthritis-free (no-osteoarthritis [NOA], or Kellgren/Lawrence [K/L] severity grade 0/1 both at baseline and 48 months), and another 66 knees were assessed as having radiographic OA changes (pre-radiographic osteoarthritis [PROA], or with K/L grade 0/1 at baseline and grade ≥ 2 at 48 months). Using baseline MRI data, we examined eight sites of osteophyte formation: the medial and lateral femoral condyle (MFC and LFC, respectively); medial and lateral tibial plateau (MTP and LTP, respectively); medial and lateral facets of the patellofemoral joint (PM and PL, respectively); tibial spine (TS); and femoral intercondylar notch (IC). Knee joint osteophyte size was assessed via the 8-point marginal osteophytes item of the whole-organ magnetic resonance imaging score (WORMS). The frequencies and distributions of osteophytes were compared between groups.

RESULTS

Mild-size osteophytes (defined as score ≥ 2) were observed more frequently at the MFC (P = 0.00278), MTP (P = 0.0046), TS (P = 0.0146), PM (P < 0.0001), PL (P = 0.0012), and IC (P < 0.0001) in PROA knees than in NOA knees. Moderate-size osteophytes (defined as score ≥ 4) were more frequently observed in PROA knees than in NOA knees only at the IC (P < 0.0001).

CONCLUSION

Knees with osteophyte formation at the IC, even those of K/L severity grade 0/1, are at risk for the development of radiographic OA by 48 months.

Preventive effects of hyaluronan from deterioration of gait parameters in surgically induced mice osteoarthritic knee model

OBJECTIVE

Osteoarthritis (OA) leads to pain and loss of function in affected joints. Gait disturbance results from these symptoms of OA, and gait analysis can be important to evaluate the progression of OA. The purpose of this study was to analyze gait pattern in a rodent model of OA and to assess the effects of intra-articular injection of hyaluronan (IAI-HA) by gait analysis, along with histological evaluation.

DESIGN

OA was induced by destabilization of the medial meniscus (DMM) of C57BL/6 mice. IAI-HA started 3 weeks after DMM surgery. Mice were allocated to three groups and were given either 800-kDa HA (800-HA), 6000-kDa HA (6000-HA) or saline. We compared these three groups with a sham group by gait analysis using CatWalk. Histological evaluation was performed to assess articular cartilage changes in the knee joints.

RESULTS

Mice injected with 800-HA or 6000-HA showed gait patterns similar to that of the sham mice, while the saline-injected group showed gait disturbances 12 and 16 weeks after DMM surgery. Histological changes in articular cartilage were similar among the 800-HA, 6000-HA and saline-treated groups, demonstrating OA progression throughout the experimental time points. Positive gait-related effects of IAI-HA might occur by its pain relieving effect and/or by preventing contracture.

CONCLUSION

IAI-HA prevented gait disturbances in the DMM model, but did not prevent histological changes associated with OA progression.

Cerebral cyst formation following stereotactic ablative irradiation for non-nasopharyngeal head and neck malignancies: imaging findings and relevant dosimetric parameters

OBJECTIVE

To describe the clinical characteristics, imaging findings and relevant dosimetric parameters of cases presenting with cerebral cyst formation (CCF) after single or oligo-fractionated stereotactic radiotherapy (SRT) for non-nasopharyngeal head and neck malignancies (HNMs).

METHODS

We identified four cases with the follow-up duration of 5.7-9.1 years from SRT. The irradiated sites included the middle ear in one case and the ethmoid sinus in three cases, two of the latter possessed brain invasion. The chronological changes in MR images and the dose-volume histogram of the adjacent brain tissue were evaluated.

RESULTS

CCF with or without multiple septi presented with a latency of 29-86 months (median, 45.5 months), which was preceded by either non-specific parenchymal enhancement or typical radiation necrosis. In three cases, CCF adjacent to the frontal base resultantly caused mass effect, and two of these three cases required surgical intervention at 38 and 54 months, respectively, after SRT for alleviation of symptoms. The relation of the irradiated brain volumes to the biological equivalent dose based on the linear-quadratic (LQ) and LQ-cubic models was represented as a threshold.

CONCLUSION

When contemplating SRT for HNM cases, caution should be exercised to the dose-volume relation-ship of the adjacent brain tissue, especially the frontal base, as well as other critical structures, and long-term vigilant follow-up is also mandatory.

ADVANCES IN KNOWLEDGE

CCF can occur as an unusual consequence of late brain injury with variable but mostly long latency following SRT for non-nasopharyngeal HNMs adjacent to the brain, even superficial parts that were previously irradiated via conventional radiotherapy.

Complications and survival associated with operative procedures in patients with unresectable pancreatic head adenocarcinoma

BACKGROUND

Unresectable tumors of the pancreatic head are encountered in up to 20% of patients taken for resection. The objective of this study was to evaluate the complications and outcome associated with palliative surgical procedures to help guide management decisions in these patients.

METHODS

Patients with pancreatic head adenocarcinoma taken to the operating room with curative intent who did not undergo pancreatectomy were evaluated.

RESULTS

From 1997 to 2013, 50 patients were explored and found be unresectable due to M1 disease (n = 27, 54.0%) or vascular invasion (n = 23, 46.0%). Among unresectable patients, 34 (68.0%) had a palliative procedure performed including double bypass (n = 13), biliary bypass (n = 7), gastrojejunostomy (n = 5), or cholecystectomy (n = 9). Complications occurred in 22 patients (44.0%), and patients who had a palliative operation had a longer hospital stay and more major complications. Overall survival was reduced in patients treated with a palliative operation.

CONCLUSIONS

Despite advancements in endoscopic palliation, operative bypasses are still commonplace in patients with unresectable pancreatic head cancer. In this study, patients treated with operative procedures had a high rate of complications without a notable improvement in outcome. These findings highlight the importance of identifying unresectable disease prior to surgery and support a selective approach to palliative operations.

P450 in wild animals as a biomarker of environmental impact

The impact of environmental pollution on selected animals was tested by monitoring the hepatic content of cytochromes P450 and their enzyme activities or by calculating TEQ values from the concentration of pollutants in the body. Fish-eating Stellars Sea Eagles, Haliaeetus pelagicus, found dead in the northern part of Hokkaido island accumulated high levels of PCBs and DDT and metabolites. The TEQ values calculated from the PCB concentration in the eagles were high enough to cause a significant toxic effect in other birds living in the same environment. Some of these birds were also contaminated with high concentrations of lead. Spotted seals, Phoca largha, captured along the coast-line of Hokkaido accumulated PCBs in their fat at about 100 million times the concentrations in the surface sea water. The levels of expressions of hepatic microsomal CYP 1A1and related enzyme activities in these seals showed good correlation to the levels of PCBs accumulated in the fat. The fresh water crabs, Eriocheir japonicus, were captured from three different rivers with various degrees of pollution. The P450 content and the related enzyme activities showed good correlation to TEQ values obtained from the concentrations of PCBs and PCDDs in the crabs from the rivers. The wild rodents, Clethrionomys rufocanus, were captured from urban, agricultural, and forest areas in Hokkaido. Those from the forest area had the lowest CYP content and related enzyme activities, comparable to those in laboratory-raised animals. Those from the urban areas, presumably contaminated with PAHs from fuel combustion, showed increased CYP 1A1 content and related enzyme activities. Those from the agricultural areas showed increased levels of CYP 1A1, 2B, 2E1. Rats treated with some of the agrochemicals used in the area resulted in a similar pattern of induction. It is concluded that P450 can be a useful biomarker for assessing the environmental impact of chemical pollutants on wild animals.

Bovine oviductal epithelial cells: their cell culture and applications in studies for reproductive biology

Epithelial cells of the mammalian oviduct play an important role in reproductive and developmental events that occur there. Oviductal epithelial cells from several mammalian species can be isolated and cultured in serum or serum-free medium in vitro and cell culture of bovine oviductal epithelial cells (BOEC) has been described by many investigators. Cultured BOEC show a wide variety of secretory activities and these secretory factors may influence early embryonic development or sperm function. Monolayer cultures of BOEC have been widely used for in vitro co-culture of bovine preimplantation embryos. The use of BOEC co-culture systems has improved embryonic development in nearly all the studies conducted. In addition, interaction of bovine spermatozoa with BOEC, in a similar manner to that observed for spermatozoa in vivo, induced specific changes in sperm capacitation and consequently improved the fertilizing capacity of bovine spermatozoa in vitro. Thus co-culture systems with BOEC may not only offer an excellent model for studying the mechanisms of capacitation and acrosome reaction of bovine spermatozoa but also provide a useful tool for the improvement of embryo development in vitro.

A serum-free culture system for efficient in vitro production of bovine blastocysts with improved viability after freezing and thawing

The aim of this study was to evaluate whether two completely serum-free media (IVMD101 and IVD101) could improve the yield and quality of bovine blastocysts from in vitro matured and fertilized oocytes. The media were evaluated in the presence (IVMD101) or absence (IVD101) of bovine cumulus/granulosa cell (BCGC) cocultures. The proportion of embryos developing to the blastocyst stage in IVMD101 medium with BCGC cocultures (36.5%) and IVD101 medium without BCGC cocultures (37.1%) was significantly higher than in serum-supplemented medium (TCM199 + 5% calf serum) with BCGC cocultures (25.1%). Furthermore, the mean cell numbers per blastocyst on Day 7 developed in IVMD101 medium (179.5 cells) and IVD101 medium (177.1 cells) were greater than in the serum-supplemented medium (145.7 cells). The survival rates of blastocysts derived in IVMD101 medium (73.3%) and IVD101 medium (60.0%) based on hatching after 72 h of post-thaw culture were superior to that of blastocysts derived in the serum-supplemented medium (48.1%). Under microscopic observation, bovine blastocysts derived in the serum-supplemented medium showed abundant lipid droplets, largely into the trophectoderm cells. This morphological difference may partly explain the sensitivity of serum-derived embryos after freezing and thawing. In conclusion, these new serum-free culture media are useful, not only to study the mechanisms of early embryogenesis, but also for mass production of good quality embryos for embryo transfer, cloning and transgenesis.

Aldosterone-to-renin ratio as a predictor of stroke under conditions of high sodium intake: the Ohasama study

BACKGROUND

Aldosterone is thought to have deleterious effects on the cardiovascular system. The aldosterone-to-renin ratio (ARR) is more reproducible than aldosterone levels alone and could be an index for inappropriate aldosterone secretion or activity. We previously reported the apparent relation between ARR and hypertension in subjects with high sodium intake. This prospective study investigated the risk of ARR for a first stroke in a general population stratified by sodium intake.

METHODS

We obtained plasma renin activity (PRA) and plasma aldosterone concentrations (PAC) for 883 participants aged ≥ 35 years not receiving antihypertensive treatment in the general population of Ohasama (mean age: 59.0 ± 11.3 years; 65.6% women).

RESULTS

Over a mean of 10.9 follow-up years, 45 strokes occurred. The median PRA, PAC, and ARR were 1.2 ng/ml/h, 6.4 ng/dl, and 5.3 ng/dl per ng/ml/h, respectively. Using Cox regression, we computed hazard ratios adjusted for sex, age, body mass index (BMI), and systolic blood pressure. No association between logARR and stroke was observed in subjects overall. However, in subjects with high sodium intake (≥ median of 4,058 mg/day (salt equivalent, 10.5 g/day)), each 1 s.d. increase in logARR was associated with an increased hazard ratio for stroke (hazard ratio: 1.49, P = 0.04). No significant association was observed in subjects with low sodium intake (P = 0.7). When we repeated all the analyses using logPRA or logPAC, no significant associations were found.

CONCLUSION

These results suggest that high ARR, that is, relative aldosterone excess, is a predictor for stroke under conditions of high sodium intake.

Automated segmentation of recuts abdominis muscle using shape model in X-ray CT images

Our purpose in this study is to segment the rectus abdominis muscle region in X-ray CT images, and we propose a novel recognition method based on the shape model. In this method, three steps are included in the segmentation process. The first is to generate a shape model for the rectus abdominis muscle. The second is to recognize anatomical feature points corresponding to the origin and insertion of the muscle, and the third is to segment the rectus abdominis muscles based on the shape model. We generated the shape model from 20 CT cases and tested the model to recognize the muscle in 20 other CT cases. The average values for the Jaccard similarity coefficient (JSC) and true segmentation coefficient (TSC) were 0.841 and 0.863, respectively. The results suggest the validity of the model-based segmentation for the rectus abdominis muscle.

Consideration of optimal isodose surface selection for target coverage in micro-multileaf collimator-based stereotactic radiotherapy for large cystic brain metastases: comparison of 90%, 80% and 70% isodose surface-based planning

OBJECTIVE

This study aims to compare dynamic conformal arc (DCA) plans based on different-percentage isodose surfaces (IDSs), normalised to 100% at the isocentre, for target coverage (TC; dose prescription) in stereotactic radiotherapy for large cystic brain metastases.

METHODS

The DCA plans were generated for 15 targets (5 spherical models and 10 metastatic brain lesions) based on 90%, 80% and 70% IDSs for dose prescription to attain ≥99% TC values using the Novalis Tx platform. These plans were optimised mainly by leaf margin and/or collimator angle adjustment, while similar arc arrangements were used.

RESULTS

TC values were equivalent among the three plans. Conformity index values were similar between the 80% and 70% plans, while they were worse in the 90% plans. Mean doses (D(mean)) of the interior 3 mm rind structure were highest in the 70% plans, followed by the 80% plans and lowest in the 90% plans. D(mean) of the exterior 3 mm rind structure and the ratio of 50%/100% isodose volumes (Paddick's gradient index values) were highest in the 90% plans, followed by 80% and lowest in the 70% plans.

CONCLUSIONS

These results suggest that the 70% IDS plans might be beneficial for both tumour control and reducing toxicity to surrounding normal tissue if appropriate dose conformity and precise treatment set-up are ensured. The 90% IDS plans are unfavourable in view of inferior dose gradient outside the target and should be limited to cases in which the target dose homogeneity is given the highest priority.

The relation between various conformity indices and the influence of the target coverage difference in prescription isodose surface on these values in intracranial stereotactic radiosurgery

OBJECTIVE

The purpose of this study was to describe the relation between various frequently used conformity indices (CIs) and to examine the influence of the target coverage (TC) difference in prescription isodose surface (IDS) on these CI values in dynamic conformal arc (DCA) plans.

METHOD

73 plans for simple-shaped brain metastases that were previously characterised for dose distribution with regard to the effect of the target volume (TV) and the depth from the skin surface were reviewed. Three different-definition CI values for each TV were calculated at the 80% IDS, and at D99, D95, D90 and D85, considering the interplanner variability in the TC values for the prescription IDS.

RESULTS

The CI used as the Radiation Therapy Oncology Group criterion showed nearly perfect values at D90. The CI defined in the BrainSCAN (BrainLAB AG, Feldkirchen, Germany) treatment planning system (CI(BS)) denoted lower (superior) values as the TC of the reference IDS decreased. Nakamura's CI (NCI) had lower variability but demonstrated lower (superior) values at D95. NCI showed the most stringent (higher) values at an 80% IDS, but the differences between the plans were less distinct with NCI.

CONCLUSION

The TC difference in IDS chosen for dose prescription or evaluation significantly led to CI value variability in a definition-dependent manner, even when NCI was applied. Definition of the reference IDS at a specific TC value according to clinical situation would reduce the CI value variability to a minimum and would make the CI(BS) sufficient for the objective metric with a perfect value of 1.

Characterisation of dose distribution in linear accelerator-based intracranial stereotactic radiosurgery with the dynamic conformal arc technique: consideration of the optimal method for dose prescription and evaluation

OBJECTIVES

The purpose of this study was to characterise dose distribution in linear accelerator-based intracranial stereotactic radiosurgery using the dynamic conformal arc technique, and to validate the pertinence of dose prescription to the specific percentage isodose surface (IDS).

METHODS

73 plans for brain metastases were reviewed and replanned with a uniform method for target definition and treatment planning.

RESULTS

In all cases except 1 the dose prescription to the 80% IDS satisfied the criteria of the standardised prescription IDS as previously proposed. However, both of the planning target volume (PTV) coverage values for the 80% and 90% IDSs and the PTV D99 and D95 (IDS receiving at least 99% or 95% of the PTV) were inconsistent and significantly increased as a function of the PTV size. The 80% IDS for a PTV of more than 5 cm(3) achieved adequate PTV coverage without a leaf margin. The dose conformity for 80% IDS gradually worsened as the PTV increased, whereas that for the PTV D99 or D95 improved as a function of the PTV size. The addition of a leaf margin attained 100% PTV coverage for 80% IDS, while leading to a poorer dose conformity.

CONCLUSION

The dose prescription to the specific percentage IDS does not necessarily guarantee consistent target coverage, D99 and D95, and desirable dose conformity in proportion to the target volume. The dose prescription and evaluation at the specific target coverage would therefore be preferable as an objective method in order to report the "marginal dose" and to clearly compare the planning parameters with those from other modalities.

Serum magnesium, ambulatory blood pressure, and carotid artery alteration: the Ohasama study

BACKGROUND

To investigate the associations of 24-h ambulatory blood pressure (ABP) and serum magnesium level (sMg) with risk of carotid artery alteration in a general population.

METHODS

sMg and ABP, monitored every 30 min, were measured in 728 subjects (mean age, 67 years) from the Japanese general population. The extent of carotid artery alteration was evaluated according to mean common carotid intima-media thickness (IMT) and the presence of focal carotid plaque. To determine the association of sMg and carotid artery alteration, analysis of covariance (ANCOVA) (for adjusted mean IMT) or multiple logistic regression analysis (for odds ratio (OR) for the presence of carotid plaques) was used.

RESULTS

Lower sMg was significantly associated with mean IMT (P = 0.004) and risk of ≥2 carotid plaques (P = 0.03) after adjusting for possible confounding factors, including 24-h ABP (systolic), creatinine clearance (Ccr) (estimated using the Cockcroft-Gault equation), and serum minerals (sodium, potassium, calcium, and inorganic phosphorus). Even when 24-h ABP values were within normal range (<130/80 mm Hg), lower sMg levels (<2.2 mg/dl) were significantly associated with mean IMT (P = 0.007) and risk of ≥2 carotid plaques (OR, 2.14; 95% confidence interval, 1.18-3.85; P = 0.01).

CONCLUSIONS

Both 24-h ABP and lower sMg were closely and independently associated with risk of carotid artery alteration. Further investigations are needed to examine the relationship between sMg levels and the incidence of cardiovascular disease.

Automated recognition of the psoas major muscles on X-ray CT images

The purpose of this study is to recognize the psoas major muscle on X-ray CT images. For this purpose, we propose a novel recognition method. The recognition process in this method involves three steps: the generation of a shape model for the psoas major muscle, recognition of anatomical points such as the origin and insertion, and the recognition of the psoas major muscles by the use of the shape model. We generated the shape model using 20 CT cases and tested the model for recognition in 20 other CT cases. The average Jaccard similarity coefficient (JSC) and reproducibility rate were 0.704 and 0.783, respectively. Experimental results indicate that our method was effective for a 2-D cross-sectional area (CSA) analysis.

Automated measurement of bone-mineral-density (BMD) values of vertebral bones based on X-ray torso CT images

Bone is one of the most important anatomical structures in humans and osteoporosis is one of the major public health concerns in the world. Osteoporosis is a main target disease of bone, which can be detected by medical image techniques. The purpose of this study is to develop a fully automated computer scheme to measure bone-mineral-density (BMD) values for vertebral trabecular bones. This scheme will aid osteoporosis diagnosis performed using computer tomography (CT) images. This scheme includes the following processing steps: segmentation of the bone region, recognition of the skeletal structures and measurement of the BMD value in vertebral trabecular bone of each vertebral body. The proposed scheme was applied to 20 X-ray torso CT cases to measure the BMD values for vertebral trabecular bones. The experimental results show that the mean and standard deviation of the difference between the BMD values measured by using the proposed method and those measured using a manual segmentation method were 6.93 mg/cm(3) and 6.82 mg/cm(3) respectively. The accuracy of the proposed scheme satisfied the requirement for a computer-aided system used in osteoporosis diagnosis.

309 PRODUCTION OF CATTLE BY NUCLEAR TRANSFER FROM CELLS IN WHICH A GENE IS DISRUPTED

Gene-targeted animals provide a powerful model to examine gene functionality. In this study, we examined the effect of gene targeting of donor cells for nuclear transfer (NT) on the pregnancy rate and on viability of the offspring after embryo transfer. Gene-targeted (tg; targeting of both alleles of the gene encoding bovine prion protein) or non-manipulated (control) bovine fetal fibroblasts were used for NT. A promoterless positive selection vector (pPrP5.2) containing an internal ribosome entry site-antibiotic resistance gene (neo) cassette and loxP sequences was used to disrupt the bovine prion protein gene. The cells (tg) in which homologous recombination was occurred were used for NT. The tg and control cells were cultured in DMEM with 10% FCS and were prepared in the early G1 phase to our previous report (Urakawa M et al. 2004 Theriogenology 62, 714–728). Each donor cell was inserted into an enucleated in vitro-matured (19 h) oocyte. Cell fusion (DC, 200 V mm–1, 10 μs) and activation (DC, 100 V mm–1 , 60 μs) were done in 0.3 m mannitol solution. The NT embryos were then activated with 5 μm Ca-ionophore and 10 μg of mL–1 cycloheximide and were cultured with bovine oviduct epithelial cells in CR1aa with 5% CS. The blastocyst rates were judged at 6 days after NT. The blastocysts were non-surgically transferred to recipient heifers. The recipients were monitored daily for heat behavior, examined by ultrasound at Day 30 and 60, and then observed monthly to confirm pregnancy. The offspring born in the tg group were confirmed by PCR to be transgenic. Statically significance was tested using a chi-square test or t-test. Developmental rate to the blastocyst stage, pregnancy rate at Day 30 and 60, and calving rate did not differ significantly between tg and the control group (Table 1). Gestation length (tg; 290.0 ± 2.2 days v. control; 290.5 ± 3.9 days) and birth weight (tg; 39.6 ± 8.0 kg v. control; 40.2 ± 4.1 kg) were not significantly different. These results indicate that gene targeting of donor cells used for NT does not significantly affect the development of embryos, pregnancy rate, or the viability of the offspring. Table 1.Development of NT embryos with tg or control cells

Optimal cutoff point of waist circumference and use of home blood pressure as a definition of metabolic syndrome: the Ohasama study

BACKGROUND

Self-measured blood pressure (BP) at home (HBP) has a stronger predictive power for cardiovascular mortality and morbidity than casual-screening BP (CBP). No studies have evaluated the clinical significance of self-measured HBP for diagnosing metabolic syndrome (MS). Eight scientific associations recently defined MS for the Japanese population. However, this definition remains controversial, especially with respect to the cutoff value of waist circumference (WC) being higher in women than in men.

METHODS

The: participants of this population-based survey were the 395 residents (> or =35 years of age) of Ohasama, a rural Japanese community. They measured HBP and underwent the oral glucose tolerance test between the years 2000 and 2006. We calculated the optimal cutoff values of WC required to diagnose MS, and examined the association of HBP with metabolic risk-factor clustering using multivariate analyses.

RESULTS

Receiver operation characteristic analysis indicated that the optimal WC cutoff values for identifying clusters of metabolic risk factors were 87 and 80 cm in men and women, respectively. Elevated HBP was significantly associated with the clustering of metabolic risk factors but CBP was not.

CONCLUSION

The appropriate WC cutoff value in the current MS criteria for Japanese women would be 80 cm. We suggest that HBP would be useful when considering a diagnosis of MS. The association between MS determined using HBP and the prognosis of cardiovascular diseases (CVDs) requires further investigation.

Association of microalbuminuria with brachial-ankle pulse wave velocity: the Ohasama study

BACKGROUND

Microalbuminuria is recognized as a marker of generalized vascular dysfunction. However, the associations between microalbuminuria and pulse wave velocity (PWV), carotid intima-media thickness (IMT), and ambulatory blood pressure (ABP), respectively, have not been investigated.

METHODS

Brachial-ankle PWV (baPWV), IMT, and ABP were determined in 328 individuals (mean age, 65.7 +/- 6.4 years) from the general population of Ohasama, a rural Japanese community. The participants were assigned to groups with microalbuminuria and with normoalbuminuria, and their characteristics were compared. We also examined the association between microalbuminuria and baPWV, IMT, and ABP, respectively, using multivariate analyses.

RESULTS

Seventy-nine participants (24%) with microalbuminuria had significantly higher baPWV (P < 0.001) and 24-h systolic BP (SBP) (P = 0.006) than those with normoalbuminuria, although 24-h pulse pressure and mean IMT did not significantly differ between the groups. Multiple logistic regression analyses showed that baPWV, but not 24-h ABP, was independently associated with microalbuminuria (P = 0.002) when adjusted for various confounding factors. After further adjustment for 24-h SBP, the association between baPWV and microalbuminuria remained significant (P = 0.012). The trend was significant even when daytime or nighttime SBP was used instead of 24-hour SBP in this model.

CONCLUSIONS

Microalbuminuria appears to be associated with baPWV more closely than with IMT and ABP, and its association with baPWV is independent of ABP and other cardiovascular risk factors.

Ossifying pleomorphic adenoma of the parotid gland: a case report and review

Pleomorphic adenoma is the most common parotid gland neoplasm and occasionally arises from the deep lobe of the parotid gland with extension into the parapharyngeal space. However, ossification of pleomorphic adenoma is rare, although chondroid and myxochondroid tissue formation is frequently seen histologically. We report an unusual case of ossifying pleomorphic adenoma arising from the deep lobe of the parotid gland in the parapharyngeal space.

120 EFFECTS OF BOVINE PLASMA LIPOPROTEINS ON ACCUMULATION OF CYTOPLASMIC LIPID DROPLETS AND MITOCHONDRIAL MORPHOLOGY IN BOVINE EMBRYOS

The excessive accumulation of cytoplasmic lipid droplets (LD) may affect the embryo quality such as the sensitivity of embryos to chilling and freezing. Previous studies demonstrated that the presence of serum in embryo culture medium caused the abnormal accumulation of cytoplasmic LD. However, the mechanism and source of cytoplasmic LD accumulation in bovine embryos cultured in serum-containing medium is unclear. In this study, the effects of bovine plasma lipoproteins (BPL) on the accumulation of cytoplasmic LD were investigated in bovine embryos. Bovine oocytes were matured in IVMD101 serum-free medium and inseminated in BO-based medium. After insemination, embryos were cultured in IVMD101 supplemented BPL (Sigma) at various concentrations (60, 150, 300, 600 μg mL–1) or 5% calf serum (CS) in a humidified atmosphere of 5% CO2 in air at 38.5°C. The embryos of 2-, 8-cell, morula, and blastocyst stages were used for experiments. Embryos were fixed and stained with Sudan black B (SBB) for histochemical evaluation. Some embryos were prepared for transmission electron microscopy. The effect of media supplemented with BPL on in vitro development of bovine embryos is shown in Table 1. The proportion of embryos developing to morula and blastocyst stages decreased with increased levels of BPL (Table 1). Histochemical examinations demonstrated that embryos cultured in BPLcontaining media had numerous lipid droplets in their cytoplasm as observed in the embryos developed in CS-supplemented medium. The increase in number of LD was dose-dependent. Electron microscopic observations demonstrated that large LD were abundant in the cytoplasm of morulae and blastocysts cultured in medium supplemented with BPL (300 μg mL–1). Many elongated mitochondria were found in embryos developed in IVMD101 medium at the morula and blastocyst stages, whereas many of the mitochondria in the morulae and blastocysts developed in IVMD101 medium supplemented with BPL or CS were of an immature form such as spherical or ovoid shape. These results indicate that bovine embryos cultured in BPL-containing media abnormally accumulated LD in their cytoplasm, suggesting that the BPL directly affects the accumulation of cytoplasmic LD. Furthermore, the excessive accumulation of cytoplasmic LD in embryos may affect the mitochondrial development of bovine embryos. Table 1. Effects of BPL on in vitro development of IVM/IVF bovine embryos This work was parially supported by Grant-in-Aid for Scientific Research (17380164), on Priority Areas ‘Lifesurveyor’(19021006) from the Ministry of Education, Culture, Sports, Science and Technology of Japan, Special Coordination Funds for Promoting Science and Technology of Japan, and the Japan Livestock Technology Association.

Regional and Cyclic Variations in the Ultrastructural Features of Secretory Cells in the Oviductal Epithelium of the Chinese Meishan Pig

The Chinese Meishan pig is prolific breed and it is considered that this pig has a capacity with higher rates of embryonic survival. The oviductal secretory cells may affect the embryonic development and survival. The aim of the present study was to investigate the ultrastructural features of secretory cells in the various regions of the Chinese Meishan pig oviduct during the follicular and luteal phases of the oestrous cycle. In the ampullar secretory cells, numerous secretory granules with moderately electron-dense matrices were present in the supranuclear cytoplasm and exocytosis of secretory granules was observed. The number of secretory granules was dramatically reduced in the ampullar secretory cells in the luteal phase. During the follicular phase in the fimbrial epithelium, the secretory cells contained rough endoplasmic reticulum and Golgi apparatus, but most cells had few small granules. In the luteal phase, the secretory cells in the ampullar and fimbrial epithelia extended beyond the luminal border of the ciliated cells. In the isthmus, many granules were present in the cytoplasm of secretory cells throughout the oestrous cycle, but the number of secretory granules was reduced in the luteal phase. The cytomorphometric data revealed that the height of ciliated cells decreased substantially in the fimbriae and ampulla at the luteal phase, while that of non-ciliated cells was less affected. These results suggest that the drastic reduction of cell height of ciliated cells cause the extrusion of most secretory cells beyond the ciliated cells in the fimbriae and ampulla during the luteal phase. In summary, our ultrastructural observations of Chinese Meishan pig oviduct revealed marked cyclic changes in the ultrastructural features of secretory cells. In particular, the ultrastructural features and the numbers of secretory granules were distinctive for each particular segment. These findings should provide insight into the regional and cellular differences in functions of secretory cells of the Chinese Meishan pig oviduct.

Nodule detection in 3D chest CT images using 2nd order autocorrelation features

We have developed a new recognition approach using 2nd order autocorrelation and multi-regression analysis to detect a small (<7mm in diameter) lung nodules in chest 3D CT images. By combining our previous detection method of the template matching based on genetic algorithm, the detection performance was 94% true-positive rate at 2.05 false-positive marks per case using leave-one- out study.

Preliminary Study for Automated Recognition of Anatomical Structure from Torso CT images

The anatomical human structure recognition is very important and necessary during the development of computer-aided diagnosis (CAD) system. In this paper, we propose an image processing scheme that can recognize the general structure of human torso by identifying the human torso region from CT images automatically and separating it into 7 parts: skin, subcutaneous fat, muscle, bone, diaphragm, thoracic cavity and abdominal cavity based on CT number distribution and spatial relations between different organ and tissue regions. We applied this scheme to 313 patient cases of torso CT images and confirmed its usefulness from the preliminary experiment.

94 PRODUCTION OF AN α1,3-GALACTOSYLTRANSFERASE GENE KNOCKOUT CALF USING A SINGLE TARGETING VECTOR AND REJUVENATED CELL LINES

Gene targeting in large animals has the potential to be useful in agriculture. In this study, we examined whether an �1,3-galactosyltransferase-gene knockout (null) calf could be produced using a single targeting vector for disruption of both alleles and a rejuvenation of cell line by production of cloned fetuses. A promoter-less positive selection vector (pGT-22) containing an IRES (internal ribosome entry site)-antibiotic resistance gene(neo) cassette and loxP sequences was used to disrupt the bovine �1,3-galactosyltransferase (�1,3-GT) gene. In gene-targeting (GT), Japanese Black fetal fibroblasts were transfected with pGT-22, and were selected with 0.4 mg mL-1 G418. G418-resistant cells were monitored by PCR and Southern blot analysis. After PCR selection, a portion of the PCR-positive colonies were infected with the adenovirus AxCANCre, which transiently expresses Cre recombinase in the infected cells, to excise the antibiotic-resistance gene cassette (IRES/lacZ-neo) from the targeted allele. The targeted cells in which homologous recombination occurred were used for somatic cell nuclear transfer (SCNT). The cell cycle synchronization of donor cells in the early G1 phase and SCNT were performed according to the established procedure in our laboratory (Urakawa et al. 2004 Theriogenology 62, 714–728). As a result, in the first GT, one PCR-Southern blot-positive clone (0.26%, in 380 G418-resistant colony) was used for SCNT. Of 35 pulsed SCNT embryos, 4 (11.4%) developed to the blastocyst stage and 3 blastocysts were nonsurgically transferred to a recipient heifer; one fetus was recovered on Day 41. The cell line (�1,3-GT+/-) was established and was transfected with pGT-22 in the second GT. As a result, 8 PCR-Southern blot-positive clones (1.6%, in 508 G418-resistant colony) were recovered. The 2nd GT and the following SCNT were accomplished by the same methods used in the 1st GT and SCNT procedure. Of 36 pulsed SCNT embryos, 7 (19.4%) developed to the blastocyst stage and 3 blastocysts were nonsurgically transferred to a recipient heifer; one fetus was recovered on Day 41. The cell line (�1,3-GT-/-) was established, and was used for SCNT to obtain the �1,3-GT homozygous knockout offspring. Finally, 52 of 148 pulsed SCNT embryos (35.1%) developed to the blastocyst stage and 6 cloned embryos were transferred into 3 recipient heifers. A single knockout female offspring with normal morphology in all organs was born (Day 287) but died about one hour after birth. In this study, we established both heterozygous and homozygous �1,3-GT knockout cell lines from primary fetal fibroblasts and produced an �1,3-GT knockout offspring using a single targeting vector and rejuvenated cell lines.

359 THE EFFICIENT MAINTENANCE OF OXYGEN CONSUMPTION BY PORCINE OOCYTES RELATES TO THE HIGH COMPETENCE OF OOCYTE MATURATION

We succeeded in noninvasively and quantitatively determining the oxygen consumption rate of single bovine oocytes and embryos by scanning electrochemical microscopy (SECM). Results from our earlier studies with bovine embryos established a positive relationship between oxygen consumption and embryo quality by using SECM (Abe et al. 2004 J. Mamm. Ova Res. 21, 22–30). However, the oxygen consumption of porcine oocytes and the relationship between oxygen consumption and oocytes quality were still unclear. The aims of this study were: (1) to assess the oxygen consumption of single porcine cumulus–oocyte complexes (COCs) and oocytes; and (2) to examine the change of oxygen consumption of oocytes during IVM. The COCs collected from 2–5 mm follicles of a porcine ovary were classified into four grades according to morphological criteria (A, compact multilayered cumulus; B, 3 to 5 layers of compact cumulus; C, less than 3 layers of cumulus, including small areas of denuded zonae pellucidae; and D, completely or mostly denuded). Oxygen consumption of these COCs was measured using by the SECM system (HV-403; Research Institute for Functional Peptides, Yamagata, Japan). After the measurement, cumulus cells were removed from COCs mechanically, and oxygen consumption of the oocytes was evaluated. The COCs were cultured in TCM-199 supplemented with 10% porcine follicular fluid and 10 IU mL-1 eCG. After IVM, oxygen consumption and ATP content of the oocytes were determined. ATP content was measured using a commercial assay kit (Promega K.K. Japan, Chuo-Ku, Tokyo, Japan) based on the luciferin-luciferase reaction. Moreover, distribution of active mitochondria in the oocytes during IVM was investigated using MitoTracker Orange staining (Invitrogen Japan K.K., Tokyo, Japan). The rates of oxygen consumption and oocyte maturation of higher-graded COCs and oocytes tended to be higher. In matured oocytes with a first polar body, oxygen consumption (F × 10-14 mol s-1) was maintained at a high level during IVM (GV oocytes: 0.60 ± 0.03; matured oocytes: 0.57 ± 0.01). ATP content (pmol/oocyte) of matured oocytes was significantly increased by IVM culture (GV oocytes: 1.16 ± 0.11; matured oocytes: 2.06 ± 0.06). On the other hand, in non-matured oocytes without a first polar body, oxygen consumption (0.31 ± 0.04) and ATP content (1.51 ± 0.21) were significantly lower than in matured oocytes. The mitochondrial distribution pattern of the oocytes during IVM was changed into an aggregated type (mitochondria distributed to the inner region of the cytoplasm with aggregation of larger fluorescent areas) from a peripheral type (mitochondria evenly distributed to the periphery of the cytoplasm) through a semi-peripheral type (mitochondria distributed to the periphery of the cytoplasm with small spots of fluorescence intensity). However, most of non-matured oocytes showed a semi-peripheral type. These results demonstrated that the oocytes with high oxygen consumption and ATP levels showed higher competence of oocyte maturation. Furthermore, these findings suggest that mitochondrial reorganization may be partly related to the oxygen consumption and consequently the quality of porcine oocytes.

175 DETECTION OF LIPID GRANULES ON IVF BLASTOCYSTS MATURED IN APO-TRANSFERRIN IN KOREAN NATIVE COWS (HANWOO)

Apo-transferrin (apo-Tf) is found in mammalian sera and plays a role as an anti-oxidant in media. The objective was to investigate the effects of apo-Tf on in vitro maturation and development and to examine the characteristics of blastocysts derived from IVF production in the presence of apo-Tf in Korean native cows (Hanwoo). Ovaries were collected from a slaughterhouse and cumulus–oocyte complexes (COCs) were taken from 2–6-mm antral follicles. The collected COCs were washed 3 times with 0.1 M PVA-TCM-199 and matured in 10 �g mL-1 apo-Tf with TCM-199 at 39�C, 5% CO2, 95% air for 24 h. Matured COCs were fertilized with frozen–thawed Korean native cattle semen treated with BO medium containing 5 mM caffeine and 1 �g mL-1 heparin for 8 h, and developed to the blastocyst stage in 5% FBS, 0.3% BSA in TCM-199, and IVMD (IFP, Japan). To detect the lipid granules, blastocysts were fixed with 10% formalin-PBS for 2 h and then 50% ethanol for 2 min. Staining of blastocysts was performed with 1% Sudan Black B in 70% ethanol for 2 min. IVM and IVF were replicated 3 times. The results of blastocyst formation were analyzed by chi-squared test. The maturation rate was 92.6% at Met II in 10 �g mL-1 apo-Tf. The blastocyst formation was 22.5%, 38.4%, and 34.8% in 5% FBS (control), 0.3% BSA in TCM-199 (P &lt; 0.05), and IVMD (P &lt; 0.05), respectively. The lipid granules in blastocysts from the 5% FBS-TCM-199 group were larger than those in the 0.3% BSA-TCM-199 and IVMD groups. The results suggest that apo-Tf is an important factor for in vitro maturation and that FBS in culture medium affects lipid granule formation on bovine blastocysts derived from in vitro fertilization.