A survey of carboplatin desensitization therapy in Japan: A multicenter retrospective study

INTRODUCTION

Hypersensitivity reactions (HSRs) to chemotherapy are serious adverse events associated with cancer drug therapy and can occur with any antitumor drug. This study investigated the safety and efficacy of carboplatin desensitization therapy in Japan and established a method for treating carboplatin HSRs.

METHODS

Patients diagnosed with gynecological (ovarian, endometrial, or cervical) cancers who underwent carboplatin desensitization therapy between 2016 and 2020 at the Gynecologic Cancer Study Group of Japan Clinical Oncology Group were included. The carboplatin desensitization therapy at each institution and the implementation cases were registered in an online case report form.

RESULTS

This retrospective study enrolled 136 patients (ovarian, 108; endometrial, 17; and cervical cancer, 11). Pre-existing allergies were present in 37 (27.2%) patients, and 32 (23.5%) patients exhibited prodromal symptoms during treatment before HSR onset. Erythema was the most common symptom at HSR onset, affecting 93 (68.4%) patients, followed by itching in 72 (52.9%) patients and decreased oxygen saturation in 43 (31.6%) patients. Loss of consciousness occurred in three (2.2%) patients. The most common timing of HSR onset was during the first recurrence treatment (47%). The mean total carboplatin dose until HSR onset was 7331 (2620-18,282) mg, and the mean number of doses was 14 (4-63). Desensitization treatment was completed in 75% of cases, and breakthrough HSRs occurred in 25% (34/136). No deaths occurred in the study cohort. The risk factors for HSRs were not identified.

CONCLUSION

Although carboplatin desensitization therapy has high success rates in Japan, erythema and pruritus are important HSRs to consider.

A case of solitary lymph node recurrence 9 years after initial treatment for advanced premenopausal endometrioid endometrial cancer; clinical usefulness of hormonal replacement therapy

There is no consensus on the use of hormone replacement therapy (HRT) after treatment of advanced corpus cancer. We report a case of advanced corpus cancer at a young age, in which HRT was initiated 7 years after surgery, and regional lymph node recurrence was later detected. The patient was 35 years old at the time of initial treatment in X year, when she was diagnosed with stageIIIC2 corpus cancer and underwent a hysterectomy with bilateral salpingo-oophorectomy and a retroperitoneal lymphadenectomy. HRT was started at X + 7 years, and at X + 9 years, a 25 × 12-mm-sized mass was found in the hilum of the right kidney. A laparoscopic resection revealed regional lymph node recurrence of the corpus cancer. A retrospective study further revealed that a tumor measuring 12 × 3 mm was found at X + 3 years and grew to 18 × 7 mm in X + 6 years, just before the start of the HRT. We hypothesize that HRT did not induce tumor recurrence; instead, it allowed for long-term follow-up and early diagnosis.

A case of paraovarian tumor of borderline malignancy with decrease of apparent diffusion coefficient value and marked 18F-fluorodeoxyglucose accumulation

Para-ovarian cysts are occasionally encountered in clinical practice; however, malignant tumors derived from them are rare. Due to its rarity, the characteristic imaging findings of para-ovarian tumors with borderline malignancy (PTBM) are largely unknown. Herein, we report a case of PTBM, along with imaging findings. A 37-year-old woman came to our department with a suspected malignant adnexal tumor. Pelvic contrast-enhanced magnetic resonance imaging (MRI) revealed a solid part within the cystic tumor with a decrease in the apparent diffusion coefficient (ADC) value (1.16 × 10-3 mm2/s). We also performed Positron Emission Tomography-MRI and showed a strong accumulation of 18F-fluorodeoxyglucose (FDG) in the solid part (SUVmax = 14.8). In addition, the tumor appeared to develop independently of the ovary. Because tumor was derived from para-ovarian cyst, we suspected PTBM preoperatively and planned fertility sparing treatment. Pathological examination revealed a serous borderline tumor and PTBM was confirmed. PTBM can have unique imaging characteristics, including a low ADC value and high FDG accumulation. When a tumor appears to develop from para-ovarian cysts, borderline malignancy can be suspected, even if imaging findings suggest malignant potential.

A case of dedifferentiated carcinoma associated with grade 1 endometrioid carcinoma with prominent squamous differentiation at the lower uterine segment

Locally advanced cervical squamous cell carcinoma is a rare indication for surgery. In this report, we describe the case of a patient with presumed locally advanced cervical squamous cell carcinoma who underwent surgical treatment and was postoperatively diagnosed with endometrial cancer with prominent squamous differentiation. A 41-year-old woman presented with squamous cell carcinoma that was detected via Pap smear and confirmed by histological diagnosis of cervical biopsy. Magnetic resonance imaging showed a bulky cervical mass that spread to the lower uterine segment, vaginal wall, and rectum. The initial diagnosis was cervical cancer stage IVA. The patient underwent neoadjuvant chemotherapy followed by radical hysterectomy with combined rectal resection. Postoperative histopathology revealed a dedifferentiated carcinoma of the uterine corpus with prominent squamous differentiation. Immunohistochemistry of the surgical specimen showed loss of expression of mismatch repair proteins. The patient was informed of the possibility of Lynch syndrome and was recommended genetic counseling.

Nivolumab for malignant transformation of ovarian mature cystic teratoma

Mature cystic teratoma of the ovary (MCT) occasionally undergoes malignant transformation (MT) that is resistant to chemotherapy and has a poor prognosis. We experienced a case of clinically aggressive MCT-MT that invades surrounding organs and tissues. Although tumor was resected entirely, a rapid tumor recurrence occurred during postoperative chemotherapy (paclitaxel + ifosfamide + cisplatin). The results of comprehensive genomic profiling test performed early in the postoperative period showed a high tumor mutational burden of 23 mutations/Mb. Treatment with nivolumab monotherapy has promptly been initiated and has been very successful for more than one year.

Development of healthy lifestyle consciousness index for gynecological cancer patients

PURPOSE

Healthy lifestyle is related to quality of life (QOL) after cancer diagnosis and prognosis. However, there are few reports on patients conscious of healthy lifestyle and patients requiring medical providers' attention regarding healthy lifestyle. We aimed to develop a healthy lifestyle consciousness index (HLCI) for cancer patients and evaluated its validity in gynecological cancer patients.

METHODS

The HLCI was designed to assess degree of healthy lifestyle consciousness, including items regarding "diet," "exercise," "body weight," and "sleep." Exploratory factor analysis was performed for dimensionality of the scale; Cronbach's alpha was calculated to assess internal-consistency reliability. For criterion-based validity, we calculated proportions of stage III/IV gynecological malignancies in those with categorized HLCI scores based on tertiles. Concurrent validity was evaluated between HLCI and other quality of life (QOL) scales including European Organization for Research and Treatment of Cancer QLQ-C30 in limited patients.

RESULTS

HLCI comprised five 10-point items (0-45); higher values implied improved healthy lifestyle consciousness. Data from 108 gynecological malignancy patients at Kyoto University Hospital were analyzed. The mean age of subjects was 55.8 years; 36.1% of them had uterine corpus cancer; 34.3% were at stage III/IV of gynecological malignancy. The factor analysis revealed HLCI was unidimensional; the reliability based on Cronbach's alpha was satisfactory (0.88). The proportions of stage III/IV gynecological malignancies were 25.7%, 33.3%, and 44.4% in those with first (7-24 points), second (25-30 points), and third (31-46 points) tertiles of HLCI score, respectively. For patients with other QOL scales (n = 25), the mean scores of global health status of QLQ-C30 were 33.3, 50.0, and 83.3 for first, second, and third tertiles of HLCI score, respectively.

CONCLUSION

HLCI was successfully validated; thus, patients with advanced stages or higher QOL might have strong consciousness regarding healthy lifestyle. HLCI may be useful in precision care for improved lifestyles and QOL.

Abstract 5261: Development of a computational algorithm to detect fatigue of gynecologic cancer patients using lifelogs

The improvement of the quality of life (QOL) of gynecological cancer patients is a critical purpose in cancer treatment. At present, there is no other methodology to evaluate QOL other than patients reported outcomes using QOL questionnaires. Therefore, management of QOL is not performed clinically because there is no objective and easy method to evaluate QOL. In this study, we extracted the worst symptom of QOL in gynecological cancer patients and examined whether QOL can be evaluated by lifelogs objectively.

Lifelogs (diets, sleep duration, the number of steps, pulse rate, voice, and so on) and QOL questionnaires (EORTC-qlq-c30, PHQ9, and so on) were collected from 139 gynecological cancer patients at our hospital using mobile applications. Scales of symptoms and functions were calculated from EORTC-qlq-c30. Logistic regression analyses and calculation of feature impact in the predictive model depicting receiver operating characteristic (ROC) curve were performed to extract symptoms and functions that contributed most to global health status (GHS) indicating a general QOL status. Fatigue-related metabolites in patient serum were measured by ELISA. Correlations between each lifelog, fatigue scale, and fatigue-related metabolites were examined. A computational model to detect high fatigue scale status was developed using lifelogs.

The fatigue scale was the highest among all treatment periods. The fatigue scale, appetite loss scale, and physical functioning scale were symptoms that deteriorate QOL frequently in gynecologic cancer patients (odds ratio: 0.9708, 0.9797, and 1.0374, respectively; 95% CI: 0.9493 to 0.9927, 0.9677 to 0.9919, and 1.0155 to 1.0597, respectively). ROC curve indicated that an accurate prediction of GHS using scales of symptoms and functions (area under the curve, AUC: 0.85). From the scales of symptoms and functions, the fatigue scale showed the highest feature impact to predict GSH. Several lifelogs were significantly correlated with fatigue scores (p<0.05, r=-0.25 to -0.15 for each), and with the blood concentration of fatigue-related metabolites (p<0.05, r=-0.44 to -0.37 for each). A computational algorithm using the fatigue-related lifelogs was successful to detect high fatigue score status (AUC=0.79). We found that two cases with persistent high fatigue scores and a low fatigue-related lifelog during chemotherapy led to depression and depressive relapse.

In summary, fatigue is a significant problem contributing to the decline in QOL of gynecological cancer patients. Fatigue can be monitored and diagnosed using digital data using lifelogs. These findings lead to the development of future management strategies of QOL for cancer patients.

Citation Format: Ken Yamaguchi, Nozomi higashiyama, Akihiko Ueda, Shiro Takamatsu, Masayo Ukita, Mana Taki, Koji Yamanoi, Junzo Hamanishi, Masaki Mandai. Development of a computational algorithm to detect fatigue of gynecologic cancer patients using lifelogs [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5261.

Abstract 6109: Clonal relationship of B cells between tertiary lymphoid structures (TLSs) and tumor infiltrating lymphocytes (TILs) in advanced endometrial cancer

Objective: Tertiary lymphoid structures (TLSs) are known to be a marker of peripheral inflammation. While high densities of TLSs were reported to be associated with longer patient survival in several cancer types, there is no direct evidence where B cells in TLSs(TLBs) are derived from and whether these clones are consistent with tumor infiltrating B cells (TIBs), in endometrial cancer.

Methods: We analyzed the pathological distribution of TLSs and TIBs in human endometrial cancer samples using immunohistochemistry of a series of B cell markers and evaluated the relationship with patients’ clinical outcomes. Additionally, we micro-dissected six pairs of tumor nests and their neighbor TLSs and analyzed the clonal consistency between TLBs and TIBs using the sequencing of complementarity-determining region (CDR) of B cell receptor (BCR).

Results: In 104 patients with endometrial cancer, TLSs were detected in 81 patients (78%), and the absence of TLS was related to worse progression-free survival (PFS) (HR, 0.15, P <0.01). Among TLS-detected cases, the high number of TIBs was significantly associated with better PFS (P<0.05). BCR analyses in the six patients found that three patients with advanced stage had a unique B cell clones in common between TLBs and TIBs, while the other three patients with early stage did not have any common B cell clones. The frequency of common B cell clones in the former three patients were 10.3% (5250/51146 reads), 9.7% (1873/19369 reads) and 3.0% (1034/34618 reads).

Conclusion: TLSs and TIBs are associated with better prognosis in endometrial cancer. Common B cell clones were found in the advanced stage cases, suggesting that B cells may have gradually acquired immunospecificity in TLSs.

Citation Format: Haruka Suzuki, Junzo Hamanishi, Meng Qin, Masayo Ukita, Akihiko Ueda, Shunsuke Kawahara, Koji Yamanoi, Taito Miyamoto, Shiro Takamatsu, Mana Taki, Yoko Hosoe, Takashi Kobayashi, Ken Yamaguchi, Masaki Mandai. Clonal relationship of B cells between tertiary lymphoid structures (TLSs) and tumor infiltrating lymphocytes (TILs) in advanced endometrial cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 6109.

Safety of the cyclin dependent kinase 9 (CDK9) inhibitor FIT039 for cervical intraepithelial neoplasia (CIN) 1 or 2 in a phase I/II trial

3022

Background: Human papillomaviruses (HPVs) infect uterine cervical epithelial cells, leading to cervical intraepithelial neoplasia (CIN) and cervical cancer. However, there is no treatment for HPV infection in the uterine cervix prior to vaccination. We recently reported that cyclin dependent kinase 9 (CDK9) plays a critical role in viral RNA transcription of DNA viruses such as HPVs in host cells, and that FIT-039, a specific inhibitor of CDK9, suppresses the proliferation of several DNA viruses. Here, we evaluated the safety and antiviral effect of a FIT039-releasing vaginal tablet (FIT039CT) for CIN1 or 2 (CIN1/2). Methods: A multi-institutional, single-blind, placebo-controlled randomized phase I/II clinical trial involving 2 cohorts was designed to evaluate the safety of transvaginal FIT039CT for CIN1/2 as follows:. In the first cohort, 8 healthy women were randomized into FIT039CT (50mg/day or 100mg/day) or control group. In the second cohort, 14 women with a primary diagnosis of CIN1/2 were randomized into either FIT039CT (100mg/day) or control group. The primary endpoints were adverse events and plasma concentrations of FIT039. Results: 22 patients (8 volunteers, 11 CIN1 and 3 CIN2) were enrolled. There were no serious adverse events. Adverse events considered related to treatment were mild (vaginal discharge Grade 1: FIT039CT 16/17 women [94%] vs placebo 2/6 [33%]) and self-limiting in both cohorts. No patient discontinued this study due to adverse events. Maximum concentration (C max) and terminal elimination half-life (t 1/2) of serum FIT039 concentrations after single transvaginal treatment of FIT039CT were similar between the two doses as follows; C max (mean ± standard deviation) was 4.5 ± 0.5 ng/mL (50mg/day) and 4.4 ±1.4 ng/mL (100mg/day) at 6-7 hours; mean t1/2 was 14.8 ± 2.1 hours (50mg/day) and 12.1 ± 2.6 hours (100mg/day) hours. Conclusions: This study demonstrated the safety and validity of transvaginal FIT039CT once a day and may contribute to the development of an antiviral agent that can cure CIN1/2, and supports the design of the ongoing phase 2 clinical study. Clinical trial information: jRCT2051180201.

CXCL13-producing CD4+ T cells accumulate in early phase of tertiary lymphoid structures in ovarian cancer

Tertiary lymphoid structures (TLS) are transient ectopic lymphoid aggregates whose formation might be caused by chronic inflammation states, such as cancer. However, how TLS are induced in the tumor microenvironment (TME) and how they affect patient survival are not well understood. We investigated TLS distribution in relation to tumor infiltrating lymphocytes (TILs) and related gene expression in high-grade serous ovarian cancer (HGSC) specimens. CXCL13 gene expression correlated with TLS presence and the infiltration of T cells and B cells, and it was a favorable prognostic factor for patients with HGSC. Coexistence of CD8⁺ T cells and B cell lineages in the TME significantly improved the prognosis of HGSC and was correlated with the presence of TLS. CXCL13 expression was predominantly coincident with CD4⁺ T cells in TLS and CD8⁺ T cells in TILs, and it shifted from CD4⁺ T cells to CD21⁺ follicular DCs as TLS matured. In a mouse ovarian cancer model, recombinant CXCL13 induced TLS and enhanced survival by the infiltration of CD8⁺ T cells. These results suggest that TLS formation was associated with CXCL13-producing CD4⁺ T cells and that TLS facilitated the coordinated antitumor response of cellular and humoral immunity in ovarian cancer.

Immunosuppressive tumor microenvironment in Uterine Serous Carcinoma via CCL7 signal with myeloid-derived suppressor cells

Serous carcinoma of the uterus (USC) is a pathological subtype of high-grade endometrial cancers, with no effective treatment for advanced cases. Since such refractory tumors frequently harbor anti-tumor immune tolerance, many immunotherapies have been investigated for various malignant tumors using immuno-competent animal models mimicking their local immunities. In this study, we established an orthotopic mouse model of high-grade endometrial cancer and evaluated the local tumor immunity to explore the efficacy of immunotherapies against USC. A multivariate analysis of 62 human USC cases revealed that the tumor infiltrating cell status, few CD8+ cells and abundant myeloid-derived suppressor cells (MDSCs), was an independent prognostic factor (p<0.005). A murine endometrial cancer cell (mECC) was obtained from C57BL/6 mice via endometrium-specific deletion of Pten and Tp53, and another high-grade cell (HPmECC) was established by further overexpressing Myc in mECCs. HPmECCs exhibited higher capacities of migration and anchorage-independent proliferation than mECCs (p<0.01, p<0.0001), and when both types of cells were inoculated into the uterus of C57BL/6 mice, the prognosis of mice bearing HPmECC-derived tumors was significantly poorer (p<0.001). Histopathological analysis of HPmECC orthotopic tumors showed serous carcinoma-like features with prominent tumor infiltration of MDSCs (p<0.05), and anti Gr-1 antibody treatment significantly prolonged the prognosis of HPmECC-derived tumor-bearing mice (p<0.05). High CCL7 expression was observed in human USC and HPmECC, and MDSCs migration was promoted in a CCL7 concentration-dependent manner. These results indicate that anti-tumor immunity is suppressed in USC due to increased number of tumor-infiltrating MDSCs via CCL signal.

B7-H3 Suppresses Antitumor Immunity via the CCL2-CCR2-M2 Macrophage Axis and Contributes to Ovarian Cancer Progression

New approaches beyond PD-1/PD-L1 inhibition are required to target the immunologically diverse tumor microenvironment (TME) in high-grade serous ovarian cancer (HGSOC). In this study, we explored the immunosuppressive effect of B7-H3 (CD276) via the CCL2-CCR2-M2 macrophage axis and its potential as a therapeutic target. Transcriptome analysis revealed that B7-H3 is highly expressed in PD-L1-low, nonimmunoreactive HGSOC tumors, and its expression negatively correlated with an IFNγ signature, which reflects the tumor immune reactivity. In syngeneic mouse models, B7-H3 (Cd276) knockout (KO) in tumor cells, but not in stromal cells, suppressed tumor progression, with a reduced number of M2 macrophages and an increased number of IFNγ⁺CD8⁺ T cells. CCL2 expression was downregulated in the B7-H3 KO tumor cell lines. Inhibition of the CCL2-CCR2 axis partly negated the effects of B7-H3 suppression on M2 macrophage migration and differentiation, and tumor progression. In patients with HGSOC, B7-H3 expression positively correlated with CCL2 expression and M2 macrophage abundance, and patients with B7-H3-high tumors had fewer tumoral IFNγ⁺CD8⁺ T cells and poorer prognosis than patients with B7-H3-low tumors. Thus, B7-H3 expression in tumor cells contributes to CCL2-CCR2-M2 macrophage axis-mediated immunosuppression and tumor progression. These findings provide new insights into the immunologic TME and could aid the development of new therapeutic approaches against the unfavorable HGSOC phenotype.

Abstract 2746: CD276 in tumor cells contributes to the M2 macrophage-rich immunosuppressive tumor microenvironment via upregulating the CCL2-CCR2 axis in ovarian cancer

[Objective] Increased infiltration of CD8+ T cells and decreased infiltration of M2 macrophages are favorable prognostic factors in high-grade serous ovarian cancer (HGSOC). CD276 (B7H3) is a transmembrane co-inhibitory protein belonging to the B7 family. CD276 expression is suppressed in CD8+ T cell-rich, PD-L1-high immune reactive tumors. This suggests that CD276 plays immunosuppressive roles in addition to acting as a molecular brake for countering the T cell activation. In this study, we aimed to elucidate the role of CD276 in HGSOC microenvironment toward M2 macrophages. [Methods] CD276 expression was evaluated in HGSOC clinical cases (n=62) by immunohistochemistry tests. The correlation between survival and the presence of tumor-infiltrating immune cells, including M2 macrophages, was assessed. CD276 knockout murine ovarian cancer cell lines (HM1 and ID8) were established and used for experiments. [Results] In HGSOC patients, higher CD276 expression associated with poor prognosis (p&lt;0.001). CD276 expression positively correlated with the number of CD206+ M2 macrophages (Pearson's r=0.29, p=0.02), but not with that of CD8+ T cells. Although CD276 knockout did not affect in vitro proliferation of HM1 and ID8 cell lines, CD276 knockout tumors were less progressive than control tumors in immunocompetent mouse models (p&lt;0.001). Lower infiltration of CCR2+/CD206+ M2 macrophages and higher infiltration of IFN-γ+ CD8+ T cells was observed in the knockout tumors (p&lt;0.001 and P=0.02, respectively). The difference in progression between CD276 knockout tumors and control tumors was negated when tumor cells were inoculated into immunodeficient nude mice. RNA sequencing and protein analyses revealed decreased levels of CCL2, the ligand of CCR2, in CD276 knockout cells and tumors. In vitro, monocyte chemotaxis was reduced by CD276 knockout cells' supernatant (p&lt;0.001), and the difference was partially negated with CCR2 antagonist pretreatment. Furthermore, CCR2 blocking in vivo reduced tumor-infiltrating M2 macrophages and tumor volume in the CD276 control (p=0.048 and p=0.02, respectively), but not in the CD276 knockout group, suggesting that CCL2-CCR2 axis-induced M2 macrophages partially contribute to CD276-mediated tumor progression. [Conclusion] CD276 contributes to an unfavorable immunosuppressive tumor microenvironment driven by M2 macrophages via the CCL2-CCR2 axis in HGSOC.

Citation Format: Taito Miyamoto, Ryusuke Murakami, Masayo Ukita, Mana Taki, Koji Yamanoi, Kaoru Abiko, Ken Yamaguchi, Junzo Hamanishi, Takashi Kobayashi, Masaki Mandai. CD276 in tumor cells contributes to the M2 macrophage-rich immunosuppressive tumor microenvironment via upregulating the CCL2-CCR2 axis in ovarian cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 2746.

Abstract 2005: ZDHHC7 contributes to ferroptosis resistance through YAP localization in ovarian clear cell carcinoma

[Objective] Ovarian clear cell carcinoma (CCC) shows unique clinical features including an association with benign endometriosis which contains iron-rich fluid, and poor prognosis because of resistance to chemotherapy. Therefore, elucidating the basic mechanism as well as new treatment strategy of ovarian CCC is urgently needed. Recently, ferroptosis, which is characterized by the iron-dependent accumulation of lipid ROS, was reported to affect the malignant behaviors. Also, some reports showed ferroptosis regulation by Hippo signaling. ZDHHC7 is reported as the molecule regulating yes-associated protein (YAP), a key molecule of Hippo signature and is one of the ovarian CCC gene signature which we previously identified. We explored the impact of ferroptosis in ovarian CCC by investigating YAP localization.[Methods] We performed immunohistochemistry (IHC) of malondialdehyde (MDA; a marker of lipid reactive oxygen species, ROS) and 8-Oxo-2'-deoxyguanosine (8-OHdG, a marker of oxidative stress DNA damage) to analyze the status of lipid ROS with ovarian cancer patients. We also performed IHC of YAP and ZDHHC7 to evaluate them in clinical status. We calculated IC50 values of erastin (ferroptosis inducer) with seventeen ovarian cancer cell lines. Functional annotation clustering of microarray expression data was performed using Metascape. ZDHHC7 knockdown and YAP-5SA mutant, or YAP-activated form of ovarian CCC cell lines were generated and applied for in vitro assays.[Results] IHC analysis indicated higher MDA expression (p=0.0354) and 8-OHdG (p&lt;0.0001) in CCC compared to high-grade serous carcinoma (HGSC), suggesting higher lipid ROS as well as oxidative stress status in ovarian CCC. IC50 values of erastin were significantly higher in CCC than in other types of ovarian cancer (p&lt;0.01). Categorical analysis revealed that genes related to Hippo signaling were enriched in erastin-resistant cell lines. IHC analyses indicated low nuclear expression of YAP and high expression of ZDHHC7 in CCC samples (p=0.0010). The cases with low expression of nuclear YAP showed significantly poorer prognosis compared to high expression cases (p=0.0075) in ovarian CCC. YAP-5SA mutant (YAP-active-mutant) CCC cells showed higher sensitivity to erastin and ML210 (ferroptosis inducer) than control in ovarian CCC cell lines. ZDHHC7 knockdown of CCC cells induced nuclear localization of YAP and showed decreased IC50 values of erastin and ML210 compared to control cells.[Conclusion] Although lipid ROS is accumulated in ovarian CCC, ovarian CCC showed ferroptosis resistance through YAP localization regulated by ZDHHC7.

Citation Format: Yoko Furutake, Ken Yamaguchi, Masayo Ukita, Mana Taki, Koji Yamanoi, Junzo Hamanishi, Takashi Kobayashi, Masaki Mandai. ZDHHC7 contributes to ferroptosis resistance through YAP localization in ovarian clear cell carcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 2005.

Tumor Immune Microenvironment during Epithelial-Mesenchymal Transition

Epithelial-mesenchymal transition (EMT) has been shown to play a critical role in tumor development from initiation to metastasis. EMT could be regarded as a continuum, with intermediate hybrid epithelial and mesenchymal phenotypes having high plasticity. Classical EMT is characterized by the phenotype change of epithelial cells to cells with mesenchymal properties, but EMT is also associated with multiple other molecular processes, including tumor immune evasion. Some previous studies have shown that EMT is associated with the cell number of immunosuppressive cells, such as myeloid-derived suppressor cells, and the expression of immune checkpoints, such as programmed cell death-ligand 1, in several cancer types. At the molecular level, EMT transcriptional factors, including Snail, Zeb1, and Twist1, produce or attract immunosuppressive cells or promote the expression of immunosuppressive checkpoint molecules via chemokine production, leading to a tumor immunosuppressive microenvironment. In turn, immunosuppressive factors induce EMT in tumor cells. This feedback loop between EMT and immunosuppression promotes tumor progression. For therapy directly targeting EMT has been challenging, the elucidation of the interactive regulation of EMT and immunosuppression is desirable for developing new therapeutic approaches in cancer. The combination of immune checkpoint inhibitors and immunotherapy targeting immunosuppressive cells could be a promising therapy for EMT.

Anti-VEGF therapy resistance in ovarian cancer is caused by GM-CSF-induced myeloid-derived suppressor cell recruitment

BACKGROUND

The mechanism of resistance development to anti-VEGF therapy in ovarian cancer is unclear. We focused on the changes in tumour immunity post anti-VEGF therapy.

METHODS

The frequencies of immune cell populations and hypoxic conditions in the resistant murine tumours and clinical samples were examined. The expression profiles of both the proteins and genes in the resistant tumours were analysed. The impact of granulocyte-monocyte colony-stimulating factor (GM-CSF) expression on myeloid-derived suppressor cell (MDSC) function in the resistant tumours was evaluated.

RESULTS

We found a marked increase and reduction in the number of Gr-1 + MDSCs and CD8 + lymphocytes in the resistant tumour, and the MDSCs preferentially infiltrated the hypoxic region. Protein array analysis showed upregulation of GM-CSF post anti-VEGF therapy. GM-CSF promoted migration and differentiation of MDSCs, which inhibited the CD8 + lymphocyte proliferation. Anti-GM-CSF therapy improved the anti-VEGF therapy efficacy, which reduced the infiltrating MDSCs and increased CD8 + lymphocytes. In immunohistochemical analysis of clinical samples, GM-CSF expression and MDSC infiltration was enhanced in the bevacizumab-resistant case.

CONCLUSIONS

The anti-VEGF therapy induces tumour hypoxia and GM-CSF expression, which recruits MDSCs and inhibits tumour immunity. Targeting the GM-CSF could help overcome the anti-VEGF therapy resistance in ovarian cancers.

Clonal composition of human ovarian cancer based on copy number analysis reveals a reciprocal relation with oncogenic mutation status

Intratumoral heterogeneity of cancer cells remains largely unexplored. Here we investigated the composition of ovarian cancer and its biological relevance. A whole-genome single nucleotide polymorphism array was applied to detect the clonal composition of 24 formalin-fixed, paraffin-embedded samples of human ovarian cancer. Genome-wide segmentation data consisting of the log2 ratio (log2R) and B allele frequency (BAF) were used to calculate an estimate of the clonal composition number (CC number) for each tumor. Somatic mutation profiles of cancer-related genes were also determined for the same 24 samples by next-generation sequencing. The CC number was estimated successfully for 23 of the 24 cancer samples. The mean ± SD value for the CC number was 1.7 ± 1.1 (range of 0-4). A somatic mutation in at least one gene was identified in 22 of the 24 ovarian cancer samples, with the mutations including those in the oncogenes KRAS (29.2%), PIK3CA (12.5%), BRAF (8.3%), FGFR2 (4.2%), and JAK2 (4.2%) as well as those in the tumor suppressor genes TP53 (54.2%), FBXW7 (8.3%), PTEN (4.2%), and RB1 (4.2%). Tumors with one or more oncogenic mutations had a significantly lower CC number than did those without such a mutation (1.0 ± 0.8 versus 2.3 ± 0.9, P = 0.0027), suggesting that cancers with driver oncogene mutations are less heterogeneous than those with other mutations. Our results thus reveal a reciprocal relation between oncogenic mutation status and clonal composition in ovarian cancer using the established method for the estimation of the CC number.

Practice patterns of adjuvant therapy for intermediate/high recurrence risk cervical cancer patients in Japan

Objective

Although radiation therapy (RT) and concurrent chemoradiotherapy (CCRT) are the global standards for adjuvant therapy treatment in cervical cancer, many Japanese institutions choose chemotherapy (CT) because of the low frequency of irreversible adverse events. In this study, we aimed to clarify the trends of adjuvant therapy for intermediate/high-risk cervical cancer after radical surgery in Japan.

Methods

A questionnaire survey was conducted by the Japanese Gynecologic Oncology Group to 186 authorized institutions active in the treatment of gynecologic cancer.

Results

Responses were obtained from 129 facilities. Adjuvant RT/CCRT and intensity-modulated RT were performed in 98 (76%) and 23 (18%) institutions, respectively. On the other hand, CT was chosen as an alternative in 93 institutions (72%). The most common regimen of CT, which was used in 66 institutions (51%), was a combination of cisplatin/carboplatin with paclitaxel. CT was considered an appropriate alternative option to RT/CCRT in patients with risk factors such as bulky tumors, lymph node metastasis, lymphovascular invasion, parametrial invasion, and stromal invasion. The risk of severe adverse events was considered to be lower for CT than for RT/CCRT in 109 institutions (84%).

Conclusion

This survey revealed a variety of policies regarding adjuvant therapy among institutions. A clinical study to assess the efficacy or non-inferiority of adjuvant CT is warranted.

Long-term survival in metastatic malignant struma ovarii treated with oral chemotherapy: A case report

Malignant struma ovarii is a rare type of ovarian tumor. Metastasis from malignant struma ovarii is rare and has only been documented in 5–6% of cases. The natural history and optimal treatment strategy for malignant struma ovarii remains controversial due to its rarity. The current report presents the case of a 45-year-old female who presented with a tumor of the rib bone. Following resection, the postoperative diagnosis was a metastasizing thyroid carcinoma. No abnormality was detected in the thyroid gland, however, computed tomography revealed a tumor in the left ovary. The patient underwent a left salpingo-oophorectomy and a wedge resection of the right ovary. The postoperative diagnosis was determined as a mature cystic teratoma with malignant struma ovarii (thyroid type, follicular carcinoma) of the left ovary and mature cystic teratoma of the right ovary. Four years subsequent to the initial diagnosis, multiple lung metastases were detected. The following chemotherapies were administered sequentially and intermittently: Tegafur-uracil, paclitaxel/carboplatin and oral etoposide. During this period, the metastatic lesions extended into the bone and progressed slowly. The patient continues to survive with the disease and 24 years have passed since the initial diagnosis, 20 years following the diagnosis of multiple lung metastates. The present report describes a rare case of malignant struma ovarii in which surgical resection and pathological examination of a metastatic rib tumor resulted in the identification of the primary ovarian lesion. The clinical behavior of malignant struma ovarii does not necessarily indicate a histological malignancy, therefore, prediction of future metastasis is difficult and the optimal treatment strategy for malignant struma ovarii is controversial. The present case indicates that the long-term use of oral anticancer agents may facilitate the maintenance of tumor dormancy.

Advanced papillary serous carcinoma of the uterine cervix: a case with a remarkable response to paclitaxel and carboplatin combination chemotherapy

Papillary serous carcinoma of the uterine cervix (PSCC) is a very rare, recently described variant of cervical adenocarcinoma. This review, describes a case of stage IV PSCC whose main tumor existed in the uterine cervix and invaded one third of the inferior part of the anterior and posterior vaginal walls. Furthermore, it had metastasized from the para-aortic lymph nodes to bilateral neck lymph nodes. Immnoreactivity for CA125 was positive, whereas the staining for p53 and WT-1 were negative in both the original tumor and the metastatic lymph nodes. Six cycles of paclitaxel and carboplatin combination chemotherapy were administered and the PSCC dramatically decreased in size. The main tumor of the uterine cervix showed a complete response by magnetic resonance imaging (MRI), and on rebiopsy, more than 95% of the tumor cells in the cervix had microscopically disapperared. This is the first report of PSCC in which combination chemotherapy was used and showed a remarkable response.

Isolated levocardia: prenatal diagnosis and management

Isolated levocardia (IL) is a rare condition of situs anomaly in which there is a normal left-sided heart (levocardia) with dextro position of the abdominal viscera. IL has been reported in children and adults with complex cardiac defects, whereas there are only few published reports regarding the prenatal diagnosis of IL. We report two prenatal cases of IL diagnosed by ultrasonography and magnetic resonance imaging (MRI). In both cases, fetal cardiac function remained within the normal range throughout pregnancy, and no treatment for the heart was required after birth. For the dextro position of abdominal viscera, one case was followed without any surgical procedure, but the other case required prophylactic operation due to malrotation of the small intestine. Although the prognosis of IL largely depends on the severity of associated cardiac anomaly, future bowel obstruction caused by intestinal malrotation may also be life-threatening. In this respect, prenatal diagnosis of IL is important, even when there is no associated cardiac structural anomaly. If IL is suspected in routine fetal ultrasonography, MRI may be recommended to obtain more detailed information on the anatomy of abdominal viscerae, and careful observation for bowel problems is required, especially after oral nutrition is started.

Enhancement of oxygen transfer efficiency in diffused aeration systems using liquid-film-forming apparatus

Surface transfer and bubble transfer both contribute significantly to oxygen transfer in a diffused aeration system. In the present study, liquid-film-forming apparatus is successfully developed on a laboratory scale to improve considerably the surface transfer via the unique liquid film transfer technique. The experimental results show that the volumetric mass transfer coefficient for liquid-film-forming apparatus alone is found to be as much as 5.3 times higher than that for water surface and that the total volumetric mass transfer coefficient for liquid film aeration system increases by 37 % in comparison with conventional aeration system. Additionally, by tuning finely the structural parameters of the liquid-film-forming apparatus, it can also lead to high dissolved oxygen water with the dissolved oxygen percent saturation greater than 90 %. More importantly, this result is accomplished by simply offering a single-pass aeration at the depth as shallow as 26 cm. As a result, the objective of economical energy consumption in diffused aeration systems can be realized by lowering the aeration depth without sacrificing the aeration efficiency.

Improvement of oxygen transfer efficiency in aerated ponds using liquid-film-assisted approach

In aerated ponds, oxygen is generally supplied through either diffused or mechanical aeration means. Surface transfer and bubble transfer both contribute significantly to oxygen transfer in a diffused aeration system. In the present study, a liquid-film-forming apparatus (LFFA) is successfully developed on a laboratory scale to improve considerably the surface transfer via the unique liquid film transfer technique. The experimental results show that the volumetric mass transfer coefficient for LFFA alone is found to be as much as 5.3 times higher than that for water surface and that the total volumetric mass transfer coefficient for the liquid film aeration system increases by 37% in comparison with a conventional aeration system. Additionally, by tuning finely the structural parameters of the LFFA, it can also lead to high dissolved oxygen (DO) water with the DO percent saturation greater than 90%. More importantly, this result is accomplished by simply offering a single-pass aeration at a depth as shallow as 26 cm. As a result, the objective of economical energy consumption in aerated ponds can be realized by lowering the aeration depth without sacrificing the aeration efficiency. It is noteworthy that the data presented in this study are acquired either numerically or experimentally.

Resource recovery from excess sludge by subcritical water combined with magnesium ammonium phosphate process

The amount of excess sludge produced in municipal wastewater treatment plants in Japan is increasing every year as the urban population increases. Phosphorus in excess sludge could be a potential phosphorus resource since at present, phosphate rock is being exhausted all over the world. Every year, Japan imports large quantities of phosphorus from abroad but much is discharged as excess sludge. Therefore, the solubilization process, one method of recovering phosphorus from sludge, could be a promising solution. In this study, a subcritical water process, a new technology that solubilizes sludge under subcritical conditions, was applied before the phosphorus in sludge was recovered with the magnesium ammonium phosphate (MAP) process. As a result, the solubilization rate of excess sludge achieved approximately 80% and about 94-97% of the phosphorus could be recovered.

Screening Thermotolerant White-Rot Fungi for Decolorization of Wastewaters

To select a thermotolerant fungal strain for decolorization of wastewaters, ligninolytic enzyme production (lignin peroxidase, manganese peroxidase [MnP], and laccase), decolorization, and removal of total phenol and chemical oxygen demand (COD) were detected. Thirty-eight fungal strains were studied for enzyme production at 35 and 43 degrees C on modified Kirk agar medium including 2,2'-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) and MnCl2. Thirteen strains grew on manganese-containing agar and provided green color on ABTS-containing agar plates under culture at 43 degrees C. Decolorization of wastewater from alcohol distillery (WAD) by these strains was compared under static culture at 43 degrees C, and Pycnoporus coccineus FPF 97091303 showed the highest potential. Thereafter, immobilized mycelia were compared with free mycelia for WAD decolorization under culture conditions of 43 degrees C and 100 rpm. The immobilized mycelia on polyurethane foam enhanced the ligninolytic enzyme production as well as total phenol and color removal. At about the same COD removal, MnP and laccase produced by immobilized mycelia were 2 and 19 times higher than by free mycelia; the simultaneous total phenol and color removal were 3.1 and 1.5 times higher than the latter. Moreover, decolorization of synthesis dye wastewater was carried out at 43 degrees C and 100 rpm. More than 80% of 300 mg/L of reactive blue-5 was decolorized by the immobilized mycelia within 1 to 2 d for four cycles.

Study on the potential of farmland soils as non-point sources of nitrogen and phosphorus in Japan

The amounts of N and P accumulated in farmland soils of 50 cm depth were equivalent to the amount of chemical fertilizer supplied for 50-70 years. The values of N/P of surface soils in farmlands were 1.0-4.3, lower than expected. The median diameter of soil particles in run-off waters was generally less than 10 microm. The mean values of particulate fractions over 1 microm and over 0.22 microm were 19% for N, 27% for P, and 39% for N, 64% for P respectively. Fine particles of soil containing concentrated phosphorus should be carefully monitored as potential sources related to eutrophication.

On-site treatment of turbid river water using chitosan, a natural organic polymer coagulant

Chitosan, acetylate of chitin, is a biodegradable cationic polymer. The objective of this study is to assess the applicability of chitosan as an on-site treatment agent of turbid water caused by river construction works and other diffused pollutions. The results of jar-tests indicate that floc of chitosan is much larger than that of aluminium sulfate, and turbidity treated by chitosan under moving water conditions is much lower than that of aluminium sulfate. Chitosan is applied to Imou River in Yamaguchi prefecture, where river construction work is going on. St.1 is located just below the construction work, St.2 is located about 250 m downstream from St.1, and St.3 is located about 350 m downstream from St.2. Initial turbidity of each station is 1,100, 937 and 313 NTU, respectively. By applying chitosan at St.1, turbidity of each station is drastically reduced to 1,100, 12 and 0 NTU. Chitosan could be helpful to reduce problems caused by turbidity in rivers.

Recycling mineral nutrients to farmland via compost application

Increased cultivation of farmland has resulted in nutrient deficiency and consequently fertility degradation of soils. This research examined the application of composted wastes in terms of the feasibility and effectiveness of recycling plant essential minerals. Minerals in composts (derived from sewage sludge, livestock excrement, and municipal solid wastes, respectively) and in amended soils were observed. Ca/Mg ratios in amended soils and the effect of compost applications (mineral nutrients and heavy metals) on plant uptake were also studied. Results showed that composts, especially those made from sewage sludge and livestock excrement, were richer in mineral nutrients but also contained more heavy metals than untreated soil. The increase in some elements and plant-growth-essential Ca/Mg ratios were found in amended farmlands, implying that compost applications have made up for the nutrient deficiency and have adjusted chemical conditions of the soil. The soil contamination from heavy metals was noticeable. However, some results showed that the large existence of mineral nutrients and heavy metals in soils has caused no significant increase in the plant uptake of elements. The controlled composting process and farmland uses are believed necessary for reducing the heavy metal accumulation in agricultural plants.

Decolorization of alcohol distillery wastewater by thermotolerant white-rot fungi

To detect thermotolerant fungus strain for decolorization of alcohol distillery wastewater (WAD), 38 fungus strains were studied. Ability of ligninolytic enzyme production was examined at 35 and 43 degrees C on agar media containing 2,2'-azino-bis (3-ethylbenzothiazoline-6-sulphonic acid) and MnCl2. At 43 degrees C, four of Pycnoporus coccineus strains showed their higher potential for WAD decolorization both on agar media and in liquid media. Immobilized mycelia on polyurethane foam removed total phenol about threefold higher than free mycelia did in shaking condition at 43 degrees C. Moreover, color removed by immobilized mycelia nearly 50% higher than free mycelia did.

Compost stability assessment using a secondary metabolite: geosmin

Composting is a process involved not only in transformation of organic matter (OM), but also for transition of the microbial community. Microorganisms can directly provide important information on the stages and characteristics of composting. This paper was aimed at characterizing compost stability by a microbial secondary metabolite, geosmin, which is a volatile compound presenting an earthy smell. Since secondary metabolite production is dependent on the nutrient state of microorganisms, its production in association with physical and chemical parameters was monitored in the laboratory-scale and plant-scale composting processes. The results showed that the peaked geosmin liberation was consistent with stable state of composting indicated by the ambient temperature achieved, a slightly alkaline product and steady states of dissolved organic carbon (DOC), N and P contents and OM degradation in the laboratory-scale experiment. It was also in accordance with the stability identified by the facilities and CO2 respiration rate in the plant-scale composting. In addition, the production of geosmin was correlated with the C/N ratio for the solid sample. These results demonstrated that geosmin levels could be used as an index for the compost stability assessment in different composting processes with various organic solid wastes.

Distributions of iron, manganese, copper and zinc in various composts and amended soils

A detailed observation was conducted on Fe, Mn, Cu and Zn in the composts derived from seafood processing by-product, garbage, swine manure and sewage sludge, respectively, as well as in amended farmlands. All elements were at lower levels of total contents but a higher percentage of water-soluble and exchangeable forms in composted seafood processing by-product and composted garbage than in composted swine manure and composted sewage sludge. Total contents increased in the order: composted seafood processing by-product approximately composted garbage < composted swine manure < composted sewage sludge. The applications of composted seafood processing by-product and composted garbage have neither caused Fe, Mn, Cu and Zn accumulation nor changed their distribution in soils; while the application of composted swine manure has largely increased Cu and Zn contents in soils, mainly in organic matter-bound form, and that of composted sewage sludge increased Mn, Cu and Zn in soils mainly in carbonate-bond and Fe-Mn oxides-bound ones. Fe is an exception, its total contents in soils decreased with the applications of composts except for composted garbage. Also, the rainfall and irrigation were another two main factors that affected available elements in soils.

Modeling prediction of membrane bioreactor process with the concept of soluble microbial product

The existence of soluble microbial products (SMP) produced by microbial cultures involved in biological wastewater treatment process has been widely investigated. This paper aims to establish an available mathematical model by incorporating the SMP concept into the Activated Sludge Model (ASM) No. 3. Prediction of sewage treatment performance in membrane bioreactor process under intermittent aerobic condition by model simulation was presented, and the results provided a more comprehensive image for this process. It was found that SMP could not be ignored and it contributed about 15% of total COD in the reactor under HRT = 12 hr and SRT = 10 days condition. The model also provided reasonable simulation results for nitrogen, biomass concentration, and other treatment behaviors. Furthermore, the treatment performance can be predicted under various operating conditions by this proposed model.

Monitoring of shallow sea environment by using snapping shrimps

We examine the validity of pulse count of snapping shrimps for sea environmental monitoring. Snapping shrimps, which make a peculiar pulse sound, are found everywhere in the world. Pulse count can be achieved merely by recording their sounds for a few minutes by using a hydrophone without special biological knowledge. From field surveys and laboratory experiments, we found that the pulse count depends on water temperature when sea environment is normal, and it falls due to the occurrence of oxygen-deficient water. The results show that this method can be a useful index of the effect of water pollution on benthic animals in fixed-point observation.

Present state of food and feed cycle and accompanying issues around Japan

Nitrogen (N) and phosphorus (P) cycles of food and feed, and the regulation systems for industrial wastewater are studied. The rate of domestic supply of food in Japan is 41% in 1970, 32% in 1990, and 29% in 1998 for N and 33%, 29%, and 28% for P, excluding grass feed. Among 3 countries, Japan, USA and Thailand, Japan is in the most difficult state to recycle food wastes to farmland. Comparing the estimated load of wastewater from food processing industries with the estimated load according to the budget study for N and P cycles, the tentative criteria of wastewater of food processing for P seem to be loose, and denitrification might be considered in every stage of N cycles. New regulation of industrial wastewater recently proposed in Japan may induce the chance for environmental business to remove N and P.

Effect of enforced aeration on in-vessel food waste composting

A laboratory composting was conducted to determine the effect of the continuously enforced aeration on the composting performance. The mixture of dog food, excess sludge, and woodchip was used as raw composting materials. The temperature changes in the decomposition process, and pH, weight loss, ash, and extract composition from the final product after 17 days composting were investigated. The results demonstrated that flow rate of enforced aeration indeed influenced the composting performance. Composting under 0.05-0.1 1 min(-1) condition seemed better than that under 0.2-0.41 min(-1) condition. Higher flow rate of air not only cooled the composting mixture significantly, further adversely affected temperature rise, but also evaporated moisture mostly. Thermophilic composting can occur under 0.05-0.11 min(-1) air flow rate condition, while composting in cases of 0.2-0.4 l min(-1) air flow rate mainly resulted in a mesophilic process. Microbial activity was considered to be significantly inhibited at 0.4 1 min(-1) air flow rate condition based on the analyses of total organic carbon and volatile fatty acids from water extraction of composting products.

A model for membrane bioreactor process based on the concept of formation and degradation of soluble microbial products

A mathematical model of soluble microbial products (SMPs) formation-degradation was established based on the activated sludge model no. 1 and was applied to the membrane bioreactor process with high concentration of activated sludge under intermittent aerobic operational condition. The simulation results were in good agreement with the experimental data which indicated that the coefficients used in the model could successfully describe the treatment performance. The most advantage of this modified model over the conventional one was that the significant importance of SMP existence was demonstrated and the model provided an reasonable comprehension for SMP concept. The present study demonstrated that SMPs contributed most to the organic matter in the effluent, and the results coincided well with the observations of many other researchers.

A pilot-scale study of tertiary treatment of Jizhuangzi wastewater treatment plant by continuous preozonation-microflocculation-filtration process

A pilot-scale study of tertiary wastewater treatment of the JIZHUANGZI Municipal Wastewater Treatment Plant was carried out by preozonation, coagulation and direct filtration process with the aim of producing wastewater suitable for reuse. The proposed treatment scheme could produce a filtered water with lower turbidity, COD(Cr) and colour at lower ozone and coagulant dosages. Ozone was added into the mixing tank with coagulant simultaneously and postozonation was not cost effective. With the increase of ozone dosage, better COD(Cr) and colour removals were observed especially at the ozone dosage between 0.7-1.0 mg l(-1). Similarly, increasing ferric sulphate dosage resulted in better removals of turbidity, COD(Cr) and colour in the filtered water. In contrast, increasing polymer T-80 dosage seemed to improve colour removal rather than turbidity and COD(Cr). To achieve removal efficiency of 70% for turbidity, 45% for COD(Cr) and over 60% for colour, the optimum dosages of ozone, ferric sulphate and polymer T-80 should be 0.7-1.0 mg l(-1), 10.0-12.5 mg l(-1) and 0.7-1.0 mg l(-1), respectively.

The entire nucleotide sequences of two distinct TT virus (TTV) isolates (TJN01 and TJN02) remotely related to the original TTV isolates

TT virus (TTV) has a wide range of sequence divergence by which it is classified into at least 16 genotypes. A TTV isolate of genotype 12 (TJNO1) and another of genotype 13 (TJN02) were sequenced in the entire genome, and compared with the reported TTV isolates. TJN01 and TJN02 had genomic lengths of 3787 and 3794 nucleotides (nt), respectively, which were shorter by 66 and 59 nt than the prototype TTV isolate of genotype 1 (TA278). TJN01 and TJN02 shared the nucleotide sequence with TA278 merely in 53.9% and 55.2%, respectively. They possessed two major open reading frames (ORFs) and the noncoding region with a GC-rich region forming stem-loop structures, which are characteristic of TTV. However, their amino acid sequences in ORF1 were similar to that of TA278 in only 35.4 and 34.0%, respectively; TJN01 was 45.4% similar to TJN02. Comparison with TTV isolates of the same genotype identified hypervariable regions in ORF1 of TJN01 and TJN02, as in the prototype TTV of genotype 1. However, quasispecies were barely observed in them. Furthermore, sequences of hypervariable regions scarcely changed during 2-5.5 years in both TJN01 and TJN02. These results indicate that TTV of genotypes 12 and 13 are much different from the prototype TTV of genotype 1.

Circular double-stranded forms of TT virus DNA in the liver

TT virus (TTV) is an unenveloped, circular, and single-stranded DNA virus commonly infecting human beings worldwide. TTV DNAs in paired serum and liver tissues from three viremic individuals were separated by gel electrophoresis and characterized biophysically. TTV DNAs in sera migrated in sizes ranging from 2.0 to 2.5 kb. TTV DNAs in liver tissues, however, migrated at 2.0 to 2.5 kb as well as at 3.5 to 6.1 kb. Both faster- and slower-migrating forms of TTV DNAs in the liver were found to be circular and of the full genomic length of 3.8 kb. TTV DNAs migrating at 2.0 to 2.5 kb, from either serum or liver tissues, were sensitive to S1 nuclease but resistant to restriction endonucleases, and therefore, they were single-stranded. By contrast, TTV DNAs in liver tissues that migrated at 3.5 to 6.1 kb were resistant to S1 nuclease. They migrated at 3.7 to 4.0 kb after digestion with EcoRI, which suggests that they represent circular, double-stranded replicative intermediates of TTV. When TTV DNAs were subjected to strand-specific primer extension and then amplified by PCR with internal primers, those in serum were found to be minus-stranded DNAs while those in liver tissues were found to be a mixture of plus- and minus-stranded DNAs. These results suggest that TTV replicates in the liver via a circular double-stranded DNA.

Significance of egg-jelly substances in the internal fertilization of the newt, Cynops pyrrhogaster

Japanese newt, Cynops pyrrhogaster, undergoes internal fertilization as do most urodeles. In this study, we focused on the roles of egg-jelly in fertilization of C. pyrrhogaster and characterized the substances associated with those roles. When dry sperm were directly inseminated onto the egg, normal fertilization occurred without the presence of water. Egg-jelly extract (JE) prepared with Steinberg's salt solution contained the activity for the initiation of sperm motility. A substance of about 50 kDa in JE was significant for this activity; an inactive form of the substance probably exists in JE. Strong activity to induce acrosome reaction was detected in JE. It was inhibited by the treatment of JE with WGA, suggesting that carbohydrate in JE may be important for the induction of the acrosome reaction. This study suggests that two significant processes of fertilization are regulated by substances in the egg-jelly of the newt, C. pyrrhogaster.

Fact-finding survey of actual garbage discharged from dormitory and its biological anaerobic-aerobic treatment

The objective of this study is to find a possibility of complete treatment of garbage and resource recovery (production of methane from available utility of carbon resource in garbage) by biological treatment process. As the first step, a fact-finding survey of actual garbage discharged from the dormitory of the Ube National College of Technology (equivalent to 300 population) was carried out. Second, the combined biological anaerobic-aerobic treatment, i.e. combination of upflow anaerobic sludge blanket (UASB) process and aerobic membrane bioreactor (AMB) process, was applied to the garbage treatment. The applicability and efficiency of this system were investigated in this study. The survey results showed that the composition and quantity of garbage from a student dormitory changed slightly during a week due to the change of the menu, however, they remained almost unchanged during the entire experimental period. The experimental results showed high biodegradability of the garbage, and demonstrated its suitability for methane production. The soluble nitrogen removal was high: over 97%. No excess sludge was wasted from the system. A high treatment efficiency of simultaneous organic carbon and nitrogen was obtained. The possibility of complete treatment of garbage with this process has been positively demonstrated by this study.

Quasispecies of TT virus (TTV) with sequence divergence in hypervariable regions of the capsid protein in chronic TTV infection

Three hypervariable regions were identified in a central portion of open reading frame 1 of TT virus DNA, which codes for a putative capsid protein of 770 amino acids. TT virus circulates as quasispecies, with many amino acid substitutions in hypervariable regions, to evade immune surveillance of the hosts and to establish a persistent infection.

A novel unenveloped DNA virus (TT virus) associated with acute and chronic non-A to G hepatitis

In 1997, a novel DNA virus was isolated from the serum of a patient with posttransfusion hepatitis of unknown etiology in Japan, and it was named TT virus (TTV) after the initials of the index patient. TTV is a nonenveloped, single-stranded and circular DNA virus, and its entire sequence of approximately 3.9 kb has been determined. For being a DNA virus, TTV has a wide range of sequence divergence, allowing the classification into at least 16 genotypes separated by a sequence difference of >30% from one another. The nucleotide sequence of the noncoding region of the TTV genome is conserved, whereas that of the coding region is highly variable. TTV strains with extremely high sequence divergence are common in the same individuals, thereby indicating a mixed infection of TTV strains of different genotypes. An association is found between hepatitis of unknown etiology and the TTV genotypes which are detectable by PCR with primers deduced from the N22 region (genotype 1) in the open reading frame 1 encoding the capsid protein. It would be important to select the primers for specific detection of the TTV genotypes associated with clinical diseases, to further evaluate the capacity of TTV to induce acute and chronic liver disease as well as extrahepatic manifestations.

Effect of interferon on a nonenveloped DNA virus (TT virus) associated with acute and chronic hepatitis of unknown etiology

An unenveloped DNA virus named TT virus (TTV) has been reported in association with acute and chronic hepatitis of unknown etiology. The effect of interferon on TTV was evaluated in the patients with chronic hepatitis C who were coinfected with TTV. TTV DNA was determined by a polymerase chain reaction with heminested primers in the 96 patients with chronic hepatitis C who received interferon-alpha (516 million units in 26 weeks) and followed for 24 months thereafter. TTV DNA was detected in 31 (32%) patients before therapy. TTV DNA became undetectable during interferon therapy and remained absent in 14 (45% of the 31 patients) through 24 months thereafter. The four patients with pretreatment TTV DNA titer > or =10(3)/ml did not respond. These results indicate that TTV is sensitive to interferon, and the response would be inversely correlated with pretreatment viral titers.