FERMT1 mediates epithelial-mesenchymal transition to promote colon cancer metastasis via modulation of β-catenin transcriptional activity

We previously demonstrated that fermitin family member 1 (FERMT1) was significantly overexpressed in colon cancer (CC) and associated with poor metastasis-free survival. This study aimed to investigate the precise role of FERMT1 in CC metastasis and the mechanism by which FERMT1 is involved in the epithelial-mesenchymal transition (EMT). Correlations between FERMT1 and EMT markers (E-cadherin, Slug, N-cadherin and β-catenin) were examined via immunohistochemistry in a cohort of CC tissues and adjacent normal colon mucosae. A series of in vitro and in vivo assays were performed to elucidate the function of FERMT1 in CC metastasis and underlying mechanisms. The upregulated expression of FERMT1 in CC tissues correlated positively with that of Slug, N-cadherin and β-catenin, but correlated inversely with E-cadherin expression. Altered FERMT1 expression led to marked changes in the proliferation, migration, invasion and EMT markers of CC cells both in vitro and in vivo. Investigations of underlying mechanisms found that FERMT1 interacted directly with β-catenin and activated the Wnt/β-catenin signaling pathway by decreasing the phosphorylation level of β-catenin, enhancing β-catenin nuclear translocation and increasing the transcriptional activity of β-catenin/TCF/LEF. Activation of the Wnt/β-catenin pathway by CHIR99021 reversed the effect of FERMT1 knockdown, whereas inhibition of the Wnt/β-catenin pathway by XAV939 impaired the effect of FERMT1 overexpression on EMT and cell motility. In conclusion, findings of this study suggest that FERMT1 activates the β-catenin transcriptional activity to promote EMT in CC metastasis.

Treatment of osteonecrosis of the femoral head with hBMP-2-gene-modified tissue-engineered bone in goats

The efficacy of β-tricalcium phosphate (β-TCP) loaded with bone morphogenetic protein-2 (BMP-2)-gene-modified bone-marrow mesenchymal stem cells (BMSCs) was evaluated for the repair of experimentally-induced osteonecrosis of the femoral head in goats.

Bilateral early-stage osteonecrosis was induced in adult goats three weeks after ligation of the lateral and medial circumflex arteries and delivery of liquid nitrogen into the femoral head. After core decompression, porous β-TCP loaded with BMP-2 gene- or β-galactosidase (gal)-gene-transduced BMSCs was implanted into the left and right femoral heads, respectively. At 16 weeks after implantation, there was collapse of the femoral head in the untreated group but not in the BMP-2 or β-gal groups. The femoral heads in the BMP-2 group had a normal density and surface, while those in the β-gal group presented with a low density and an irregular surface. Histologically, new bone and fibrous tissue were formed in the macropores of the β-TCP. Sixteen weeks after implantation, lamellar bone had formed in the BMP-2 group, but there were some empty cavities and residual fibrous tissue in the β-gal group. The new bone volume in the BMP-2 group was significantly higher than that in the β-gal group. The maximum compressive strength and Young’s modulus of the repaired tissue in the BMP-2 group were similar to those of normal bone and significantly higher than those in the β-gal group.

Our findings indicate that porous β-TCP loaded with BMP-2-gene-transduced BMSCs are capable of repairing early-stage, experimentally-induced osteonecrosis of the femoral head and of restoring its mechanical function.

Side-to-side variation in normal femoral morphology: 3D CT analysis of 122 femurs

BACKGROUND

The contralateral femur is often used as reference for reconstruction in unilateral hip joint pathology. The objective of this study was to quantify the side-to-side variation in proximal femur. We hypothesized that significant side-to-side differences exist between left and right femur with implications for preoperative planning and leg length discrepancy following hip arthroplasty.

MATERIALS AND METHODS

CT-based 3D femoral models were reconstructed for 122 paired femurs in 61 young healthy subjects (46.9±6.8 years) with no history of hip pathology. Side-to-side differences of several femoral morphologic parameters, including femoral head diameter, femoral anteversion, horizontal offset and femoral head center location, were compared and correlated with demographic factors using multiple linear regression.

RESULTS

Significant side-to-side differences (P<0.01) were found in femoral anteversion (4.3±3.8°; range: 0.2° to 17.3°), horizontal offset (2.5±2.1mm; range: 0.1 to 10.3mm), and femoral head center location (7.1±3.8mm; range: 0.5 to 19.4mm). The difference in femoral anteversion was strongly correlated with the difference in neck diameter (R(2)=0.79), whereas the difference in horizontal femoral offset was highly correlated with the head diameter difference (R(2)=0.72). Femoral head center difference was correlated with the femoral anteversion, horizontal offset and neck-shaft-angle difference (R(2)=0.82).

DISCUSSION

Relying on the anatomic landmarks of the contralateral femur during hip arthroplasty may not necessarily result in restoration of native anatomy and leg-length. Knowledge of the baseline side-to-side asymmetry could provide a range of error that would be tolerable following hip reconstruction.

LEVEL OF EVIDENCE

Level IV.

TYPE OF STUDY

Retrospective observational study.

Artificial neural network classification based on capillary electrophoresis of urinary nucleosides for the clinical diagnosis of tumors

Nucleosides in human urine have been studied frequently as a possible biomedical marker for cancers, acquired immune deficiency syndrome (AIDS) and the whole-body turnover of RNAs. A capillary electrophoretic method that can quantitatively analyze urinary normal and modified nucleosides in less than 40 min with a good resolution and sufficient sensitivity has been developed. Twelve kinds of normal and modified nucleosides were determined in urine samples from 25 healthy persons and 25 cancer patients of 14 kinds of cancers. Artificial neural networks have been used as a powerful pattern recognition tool to distinguish cancer patients from healthy persons. The recognition rate for the training set reached to 100% and above 85% of the members in the predicting set were correctly classified. In addition, the neural network technique was compared with methods of the principal component analysis and the canonical discriminant analysis. The results demonstrate that the predictive ability of the artificial neural network is stronger than the others in this study.

BMP2 gene therapy on the repair of bone defects of aged rats

Age-related decline in the number of mesenchymal stem cells (MSCs) and their reduced capability to differentiate osteogenically, along with diminished availability of growth factors, may be major factors accounting for reduced bone formation in the aging mammalian body. In the first part of the study, we compared the number of MSCs in bone marrow (BM) and the content of bone morphogenetic protein 2 (BMP2) in cortical bone tissue in juvenile, adult, and aged (1, 9, and 24 months, respectively) male rats. To assay the influence of aging on osteogenic differentiation ability, MSCs from the three age groups were transduced with the BMP2 gene. Following gene transduction, the production of BMP2 in culture media, expression of osteogenic proteins (e.g., alkaline phosphatase, type Ialpha1 collagen, osteopontin, and bone sialoprotein), as well as ectopic bone formation in athymic mice were compared. Results showed that the number of MSCs in BM as well as the content of BMP2 in cortical bone tissue decreased with age, but no significant differences between the three age groups were found with regard to production of BMP2 or capability of BMP2 gene-modified MSCs to differentiate osteogenically. The second part of the study applied BMP2 gene-modified autologous MSCs/beta-tricalcium phosphate for repair of bone defects in aged rats with positive results. Our data indicate that the osteogenic potential of MSCs of aged rats can be restored following BMP2 gene transduction and that this technique may be a useful approach in the future planning of gene therapy for age-related osteoporotic fractures.

Comparative outcomes for three-dimensional conformal versus intensity-modulated radiation therapy for esophageal cancer

Emerging data suggests a benefit for using intensity modulated radiation therapy (IMRT) for the management of esophageal cancer. We retrospectively reviewed patients treated at our institution who received definitive or preoperative chemoradiation with either IMRT or 3D conformal radiation therapy (3DCRT) between October 2000 and January 2012. Kaplan Meier analysis and the Cox proportional hazard model were used to evaluate survival outcomes. We evaluated a total of 232 patients (138 IMRT, 94 3DCRT) who received a median dose of 50.4 Gy (range, 44-64.8) to gross disease. Median follow up for all patients, IMRT patients alone, and 3DCRT patients alone was 18.5 (range, 2.5-124.2), 16.5 (range, 3-59), and 25.9 months (range, 2.5-124.2), respectively. We observed no significant difference based on radiation technique (3DCRT vs. IMRT) with respect to median overall survival (OS) (median 29 vs. 32 months; P = 0.74) or median relapse free survival (median 20 vs. 25 months; P = 0.66). On multivariable analysis (MVA), surgical resection resulted in improved OS (HR 0.444; P < 0.0001). Superior OS was also associated on MVA with stage I/II disease (HR 0.523; P = 0.010) and tumor length ≤5 cm (HR 0.567; P = 0.006). IMRT was also associated on univariate analysis with a significant decrease in acute weight loss (mean 6% + 4.3% vs 9% + 7.4%, P = 0.012) and on MVA with a decrease in objective grade ≥3 toxicity, defined as any hospitalization, feeding tube, or >20% weight loss (OR 0.51; P = 0.050). Our data suggest that while IMRT-based chemoradiation for esophageal cancer does not impact survival there was significantly less toxicity. In the IMRT group there was significant decrease in weight loss and grade ≥3 toxicity compared to 3DCRT.

Genetic diversity of captive forest musk deer (Moschus berezovskii) inferred from the mitochondrial DNA control region

Forest musk deer (Moschus berezovskii) were once distributed widely in China. However, wild populations have declined dramatically because of poaching and habitat loss. Captive breeding populations have been established for several decades, but the genetic backgrounds of most captive populations were unclear and the population sizes increased very slowly. To provide useful information for conservation and management of this species, we investigated the genetic diversity and population structure of forest musk deer by analysing a 582-bp fragment of the mitochondrial DNA (mtDNA) control region (CR) in three captive breeding populations in Sichuan Province, China. Ninety-four variable sites and 27 haplotypes were observed in 109 individuals, and the nucleotide and haplotype diversities were relatively high compared with those of other endangered mammals. Of the three investigated populations, the Maerkang population had the highest nucleotide diversity (pi=0.0568), haplotype diversity (h=0.836) and average intra-population genetic distance (0.062). The analysis of molecular variance demonstrated that most variation occurred within samples and that there was significant differentiation of the three populations. Estimates of gene flow indicated that there were few genetic exchanges among the three populations. Building pedigree records and increasing gene flow between populations will be helpful for conserving these populations and this species.

Delayed healing of lower limb fractures with bisphosphonate therapy

INTRODUCTION

Bisphosphonate therapy (BT) is used commonly in the management of osteoporosis. A systematic review was conducted investigating delayed union of lower limb, long bone fractures in patients on BT. We specifically assessed whether BT increases the risk of delayed union or non-union in lower limb, long bone fractures.

METHODS

A literature search was conducted in the PubMed and Embase™ on 4 November 2014. Articles that investigated lower limb fractures, history of BT and fracture union were included in the review.

RESULTS

A total of 9,809 papers were retrieved and 14 were deemed suitable for this review. The mean time to union in patients on BT was 8.5 months. A longer time to union was reported in a study investigating BT users versus controls (6.5 vs 4.8 months respectively). The mean rate of delayed or non-union for BT associated atypical fractures was 20% per fracture. Specifically in one study, delayed union was more common in the cohort with more than three years of BT (67%) than in the group with less than three years of BT (26%). Surgical fixation was associated with improved outcomes compared with non-operative management.

CONCLUSIONS

BT has been described to be associated with multiple adverse outcomes related to atypical fractures. Current evidence recommends operative management for this patient group. Further investigation is required to evaluate the exact effects of BT on lower limb fractures, in particular typical femoral fractures.

Comparison of 1-day vs 2-day dosing of high-dose melphalan followed by autologous hematopoietic cell transplantation in patients with multiple myeloma

High-dose melphalan at 200 mg/m(2) can be administered in 1 day or over 2 consecutive days before autologous hematopoietic cell transplantation (HCT) for multiple myeloma (MM). Limited data exist on the comparison of the two dosing schedules. A retrospective study of 278 consecutive MM patients receiving high-dose melphalan from January 2010 to December 2012 was conducted. Objectives were to compare the length of hospitalization, toxicity profile, response rates, PFS and OS. One hundred and eighty five patients received 2-day dosing and 93 received 1-day dosing. The two end points of the 95% confidence interval (CI) for the difference did not exceed the preselected margin, therefore the length of hospitalization was considered equivalent. No significant differences were found for response rates, PFS and OS.  The toxicity profile was similar with the exception of more frequent ⩾grade 3 oral mucositis in the 2-day group (13.5% vs 5.4%; odds ratio 3.07 (95% CI:1.11-8.48); P=0.03). High-dose melphalan, given either in 1 day or over 2 days, produced comparable treatment outcomes except for increased grade 3/4 mucositis in the 2-day regimen. One-day dosing could shorten the hospital stay by 1 day and may allow better resource utilization.

Identifying quantitative trait loci for resistance to Sclerotinia head rot in two USDA sunflower germplasms

Sclerotinia head rot is a major disease of sunflower in the world, and quantitative trait loci (QTL) mapping could facilitate understanding of the genetic basis of head rot resistance and breeding in sunflower. One hundred twenty-three F2:3 and F2:4 families from a cross between HA 441 and RHA 439 were studied. The mapping population was evaluated for disease resistance in three field experiments in a randomized complete block design with two replicates. Disease incidence (DI) and disease severity (DS) were assessed. A genetic map with 180 target region amplification polymorphism, 32 simple sequence repeats, 11 insertion-deletion, and 2 morphological markers was constructed. Nine DI and seven DS QTL were identified with each QTL explaining 8.4 to 34.5% of phenotypic variance, suggesting the polygenic basis of the resistance to head rot. Five of these QTL were identified in more than one experiment, and each QTL explained more than 12.9% of phenotypic variance. These QTL could be useful in sunflower breeding. Although a positive correlation existed between the two disease indices, most of the respective QTL were located in different chromosomal regions, suggesting a different genetic basis for the two indices.

A primary care application of an integrated computer-based pharmacy system

Primary care demands a continuous flow of current pharmaceutical information to the front lines of patient services. With a wide spectrum of drugs to prescribe and a continuous production of new drug-related information, the practicing physician is faced with a social and professional mandate to deliver the most acceptable drug in a safe and efficacious manner. The legal implications of this product and knowledge explosion have exposed the human brain's inability to store, update, and recall what is currently available. Physicians can no longer trust their memory or their paper-based medical record to protect them from potential liability. The tools to correct this mental imbalance are now available and it should be standard practice to implement a sophisticated computer-based pharmacy system (CBPS) for every outpatient in the United States.

Correlation of serum vitamin A, D, and E with recurrent respiratory infection in children

OBJECTIVE

To investigate the correlation of serum vitamin A, D, and E levels with a recurrent respiratory infection (RRI) in children.

PATIENTS AND METHODS

The medical records of 422 children with RRI (a study group) in Cangzhou Central Hospital from January 2015 to December 2018 were retrospectively analyzed (the study group was divided into an active group and a stable group). Further 100 healthy children who underwent physical examination at the same time were enrolled as a control group. High-performance liquid chromatography (HPLC) was used to determine vitamin A, D, and E levels, so as to analyze their differences between the groups.

RESULTS

Vitamin A, D, and E in the active and stable groups were significantly lower than those in the control group (p < 0.001); in the active group they were significantly lower than those in the stable group (p < 0.001). According to partial correlation analysis, in children with active RRI, vitamin A was respectively positively correlated with vitamin D (r=0.945, p < 0.001), and vitamin E (r=0.988, p < 0.001). Moreover, vitamin E was positively correlated with vitamin D (r=0.959, p < 0.001).

CONCLUSIONS

The deficiency of vitamin A, D, and E is positively correlated with the disease activity of children with RRI. Therefore, the supplement of vitamin A, D, and E through dietary adjustment is beneficial to the rehabilitation of the children.

MDX--a medical diagnostic decision support system

The MDX diagnostic decision support system contains a multitude of clinical facts as reported in a variety of medical textbooks and national medical journals. The database was custom designed for the medical diagnostic process and offers users the widest range of diagnostic knowledge available from a single source in the industry. The database consists of diseases, conditions, chemicals, drugs, and toxins that are known to cause medical illness. Each causal element has an associated file for signs, symptoms and findings. This fully referenced source of encoded clinical knowledge used in MDX comes from the world's experts as they transmit their experience in the written word of books and journals.

Holocord spinal epidural abscess: Case report and literature review

Holocord spinal epidural abscess (SEA) is a rare condition. To our knowledge, five cases of SEA have been reported so far, and no consensus has been made on the treatment yet. In this article, we report a case of holocord SEA and review literature to further understanding of SEA. The advent of antibiotic treatment and the recognition of surgical debridement have been important in searching for alternatives to recovery, so the patient was treated surgically together with systemic antibiotics. The patient remained neurologically stable and continued to be clinically in good condition without any low back pain after 1 year. Surgical drainage, together with systemic antibiotics, is the main treatment choice for extensive SEAs. Although treatment should be considered that highlights the importance of examining the factors related to the health and condition of the patients and the anatomy and extent of the abscess, early surgical treatment associated with prolonged antibiotic treatment is necessary.

Cellular deposits on intraocular lenses

We examined cellular deposits on 14 intraocular lenses (IOL) that were removed after implantation for a variety of clinical reasons. Five of the lenses were cultured to evaluate the growth potential of preexisting cells on the IOLs. The most common cells found were iris pigment epithelial cells. The thickest membranes were probably formed by iris stromal cells. Other cellular deposits included macrophages, multinucleated foreign body giant cells, lens epithelial cells, squamous epithelial ingrowth, red blood cells, uveal melanocytes, and vitreous strands. Cells around the IOL had only limited growth in tissue culture. We propose that a continuous influx of inflammatory cells in conjunction with a disruption of the blood-aqueous barrier may be an important pathogenetic mechanism for the production of thick secondary membranes around an IOL.

Study on the relationship between the Bcl-2/Bax ratio and the growth types of leukemic cells and drug resistance in acute myelogenous leukemia

The ratio of Bcl-2 to Bax (Bcl-2/Bax) in 40 patients with acute myelogenous leukemia (AML) were determined. At the same time, the CFU-L of AML patients and drug resistance were detected by cell culture and MTT assay. The results showed that Bcl-2/Bax in AML was significantly higher than that in normal control (P < 0.001). Bcl-2/Bax ratio in colony growth group was higher than that in no-growth group (P < 0.05). Between drug resistance group and drug sensitivity group there was a significant difference in Bcl-2/Bax ratio (P < 0.05). There were more cases of drug resistance in high ratio group (H) than in low ratio group (L) (P < 0.05). Meanwhile, Complete Remission(CR) rate in group H was obviously lower than that in group L (P < 0.05) and patients in group H tended to have poor response. The above results indicated that the alteration of Bcl-2 and Bax is an important mechanism in the pathogenesis, progress and the development of drug resistance in AML. The determination of Bcl-2/Bax ratio has far-reaching implication in the treatment, choice of chemotherapeutic agents, and prediction of prognosis.

Host selection, development, survival, and reproduction of turnip aphid (Homoptera: Aphididae) on green and red cabbage varieties

Host selection, development, survival, and reproduction of the turnip aphid, Lipaphis erysimi (Kaltenbach), on selected green and red cabbage varieties, Brassicae oleracea L. variety capitata, were studied in the laboratory. Although numbers of alate L. erysimi on different varieties varied generally, more alate adults and nymphs were observed on green than on red varieties on day 3; whereas, these differences were not so significant on day 15. There were no significant differences in alate adults on all six varieties on day 15. Numbers of nymphs and apterous adults of L. erysimi varied among the varieties. When mean numbers of those aphids on green varieties were compared with those on red varieties, the green varieties had more nymphs and apterous adults than those on the red varieties. Developmental durations of L. erysimi nymphs also varied among all varieties, and the nymphs fed on green varieties developed longer than those fed on red varieties. Adult longevities on these cabbage varieties were not significantly different; whereas, the adult fecundities were. Survival rates of L. erysimi varied greatly among all varieties, but there are no significant differences between the green and red varieties. Factors that might affect aphid host selection, growth, longevity, fecundity, and survivorship were discussed.

Abstract P2-10-40: Correlation between expression of the prognostic marker Progranulin (GP88) with Oncotype Dx Recurrence Score in estrogen receptor positive breast tumors

Background: GP88 (Progranulin, acrogranin) is an 88kDa glycoprotein overexpressed in breast tumors and involved in their proliferation and survival. Biological studies have shown that GP88 in ER+ breast cancer cells was associated with estrogen independence and resistance to anti-estrogen therapies and aromatase inhibitors. In addition, GP88 stimulated migration, invasion and angiogenesis, hallmarks of metastasis. Pathological studies have demonstrated that GP88 was preferentially expressed in invasive ductal carcinoma while lobular carcinoma was mostly negative. No expression was found in normal mammary tissue. Two retrospective studies totaling 530 cases of ER+ formalin-fixed paraffin-embedded invasive ductal carcinoma (IDC) established that high GP88 expression was associated with a 4-fold increase in risk of recurrence and 2.5-fold increase in death when compared to low GP88 scores. Multivariate analysis showed that GP88 remains a predictor of recurrence even when adjusted for prognostic factors such as tumor size, grade, stage, lymph node status and age. High level of GP88 was also found to be elevated in the serum of breast cancer patients when compared to healthy individuals. Since GP88 tumor tissue expression appears as a prognostic factor for ER+ breast cancer, we proposed to investigate whether GP88 tumor tissue expression would correlated to Oncotype Dx® Recurrence Score which is now for early stage ER+ node negative breast cancer patients.

Methods: Eight five cases from women ages 37–77 with ER+ invasive mammary carcinoma from three different institutions and with an available Oncotype Dx recurrence score were selected with approval from each site's IRB. GP88 expression was determined by immunohistochemistry (IHC) using the anti-human GP88 6B3 monoclonal antibody (A&G) on a Ventana automated staining platform. For all cases examined, GP88 IHC scores (0, 1+, 2+, 3+) were compared to routine clinicopathologic factors (tumor size, grade, and stage), PR, HER2/neu and Ki67 expression (by image analysis) and to their Oncotype DX® recurrence score (Genomic Health). The associations of GP88 with the parameters described above were assessed by t test or ANOVA.

Results: The GP88 tissue expression correlated with Oncotype Dx Recurrence score (p &lt; 0.03) as well as with Ki-67 index (p &lt; 0.004). Age, HER2/neu and PR status did not correlate with GP88 expression. Details of these finding will be presented here.

Conclusion: This study shows that GP88, an important tumor aggressiveness indicator, significantly correlates with Oncotype DX score and confirms that GP88 correlates with other tumor clinicopathologic parameters and prognostic markers. Further studies are underway to determine whether GP88 in combination with routine markers, particularly Ki67, could be used instead of Oncotype DX Assay to predict outcome and provide information for the management of ER+ breast cancer patients.

This study is supported by grant 02–2010-010 from the Avon Foundation for Women.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-10-40.