Open Cross-gap Gold Nanocubes with Strong, Large-Area, Symmetric Electromagnetic Field Enhancement for On-Particle Molecular-Fingerprint Raman Bioassays

Plasmonic nanoparticles with an externally open nanogap can localize the electromagnetic (EM) field inside the gap and directly detect the target via the open nanogap with surface-enhanced Raman scattering (SERS). It would be beneficial to design and synthesize the open gap nanoprobes in a high yield for obtaining uniform and quantitative signals from randomly oriented nanoparticles and utilizing these particles for direct SERS analysis. Here, we report a facile strategy to synthesize open cross-gap (X-gap) nanocubes (OXNCs) with size- and EM field-tunable gaps in a high yield. The site-specific growth of Au budding structures at the corners of the AuNC using the principle that the Au deposition rate is faster than the surface diffusion rate of the adatoms allows for a uniform X-gap formation. The average SERS enhancement factor (EF) for the OXNCs with 2.6 nm X-gaps was 1.2 × 109, and the EFs were narrowly distributed within 1 order of magnitude for ∼93% of the measured OXNCs. OXNCs consistently displayed strong EM field enhancement on large particle surfaces for widely varying incident light polarization directions, and this can be attributed to the symmetric X-gap geometry and the availability of these gaps on all 6 faces of a cube. Finally, the OXNC probes with varying X-gap sizes have been utilized in directly detecting biomolecules with varying sizes without Raman dyes. The concept, synthetic method, and biosensing results shown here with OXNCs pave the way for designing, synthesizing, and utilizing plasmonic nanoparticles for selective, quantitative molecular-fingerprint Raman sensing and imaging applications.

Biomechanical comparison of bone staple fixation methods with suture material for median sternotomy closure using 3D-printed bone models

AIM

To compare the biomechanical properties of three different sternal closure techniques in a 3D-printed bone model of a sternum from a 30-kg dog.

METHODS

Median sternotomy was performed on a total of 90 three-dimensional (3D) copies of a polycarbonate (PC) model of a sternum, generated from the CT images of the sternum of a 30-kg German Shepherd dog. Three different methods were used to repair the sternotomies: polydioxanone suture (group PDS, n = 30), stainless steel bone staples (group SS, n = 30), and nitinol bone staples (group NS, n = 30). Each repair method was tested by applying tensile force in one of three ways (longitudinally, laterally, or torsionally) resulting in a sample size of n = 10 for each repair method-loading combination. In all experiments, the loads at 1-mm and 2-mm gap formation, failure, and the displacement at the failure point were measured.

RESULTS

In lateral distraction and longitudinal shear tests, NS and SS staple repairs required application of significantly greater force than PDS across all displacement criteria (1 and 2 mm). NS exhibited significantly greater failure load than PDS. In torsion tests, NS required significantly greater application of force compared to SS or PDS at all displacement criteria (1 and 2 mm) and exhibited a greater failure load than PDS. In terms of displacement at failure point, PDS suture showed more displacement than SS or NS across all experiments (laterally, longitudinally, torsionally).

CONCLUSIONS

In this study, bone staples were mechanically superior to PDS suture in median sternotomy closure using 3D-printed bone model in terms of 1-mm, 2-mm displacement loads, and displacement at failure. NS had a higher failure load than PDS under lateral, longitudinal, and torsional distraction.

CLINICAL RELEVANCE

These study results imply that bone staples can be considered as an alternative surgical method for median sternotomy closure in dogs.

Acute effects of (-)-gallocatechin gallate-rich green tea extract on the cerebral hemodynamic response of the prefrontal cortex in healthy humans

Objective

The benefits of long-term consumption of green tea on the brain are well known. However, among many ingredients of green tea, the acute effects of (-)-gallocatechin gallate-rich green tea extract (GCG-GTE), have received comparatively less attention. Herein, we investigated the acute effects of oral ingestion of green tea with GCG-GTE, which contains close replicas of the ingredients of hot green tea, on task-dependent hemodynamics in the prefrontal cortex of healthy adult human brains.

Methods

In this randomized, double-blind, placebo-controlled, parallel group trial, 35 healthy adults completed computerized cognitive tasks that demand activation of the prefrontal cortex at baseline and 1 h after consumption of placebo and 900 mg of GCG-GTE extract supplement. During cognitive testing, hemodynamic responses (change in HbO2 concentration) in the prefrontal cortex were assessed using functional near-infrared spectroscopy (fNIRS).

Results

In fNIRS data, significant group x session interactions were found in the left (p = 0.035) and right (p = 0.036) dorsolateral prefrontal cortex (DLPFC). In behavioral data, despite the numerical increase in the GCG-GTE group and the numerical decrease in the Placebo group, no significant differences were observed in the cognitive performance measure between the groups.

Conclusion

The result suggests a single dose of orally administered GCG-GTE can reduce DLPFC activation in healthy humans even with increased task demand. GCG-GTE is a promising functional material that can affect neural efficiency to lower mental workload during cognitively demanding tasks. However, further studies are needed to verify this.

Plasmonic Dual-Gap Nanodumbbells for Label-Free On-Particle Raman DNA Assays

Metal nanostructures with a tunable plasmonic gap are useful for photonics, surface-enhanced spectroscopy, biosensing, and bioimaging applications. The use of these structures as chemical and biological sensing/imaging probes typically requires an ultra-precise synthesis of the targeted nanostructure in a high yield, with Raman dye-labeling and complex assay components and procedures. Here, a plasmonic nanostructure with tunable dual nanogaps, Au dual-gap nanodumbbells (AuDGNs), is designed and synthesized via the anisotropic adsorption of polyethyleneimine on Au nanorods to facilitate tip-selective Au growths on nanorod tips for forming mushroom-shaped dumbbell-head structures at both tips and results in dual gaps (intra-head and inter-head gaps) within a single particle. AuDGNs are synthesized in a high yield (>90%) while controlling the inter-head gap size, and the average surface-enhanced Raman scattering (SERS) enhancement factor (EF) value is 7.5 × 10⁸ with a very narrow EF distribution from 1.5 × 10⁸ to 1.5 × 10⁹ for >90% of analyzed particles. Importantly, AuDGNs enable label-free on-particle SERS detection assays through the diffusion of target molecules into the intraparticle gap for different DNA sequences with varying ATGC combinations in a highly specific and sensitive manner without a need for Raman dyes.

Dynamic alterations in cerebral hemodynamics measured by portable near-infrared spectroscopy in orthostatic hypotension and intolerance

BACKGROUND

We aimed to evaluate dynamic alterations in cerebral total hemoglobin concentration (HbT) in individuals with orthostatic hypotension (OH) and orthostatic intolerance (OI) symptoms using a portable NIRS system.

METHODS

Participants comprised 238 individuals (mean age, 47.9 years) without a history of cardiovascular, neurodegenerative, or cerebrovascular diseases, including those with unexplained OI symptoms and healthy volunteers. Participants were categorized by the presence of OH based on the supine-to-stand blood pressure (BP) drop and OI symptoms using on OH questionnaires: classic OH (OH-BP), OH symptoms alone (OH-Sx), and control groups. Random case-control matching sets were constructed, resulting in 16 OH-BP and 69 OH-Sx-control sets. The time-derivative of HbT change in the prefrontal cortex during the squat-to-stand maneuver was measured using a portable near-infrared spectroscopy system.

RESULTS

There were no differences in demographics, baseline BP, and heart rate among matched sets. The peak-time of maximum slope variation in HbT change, indicating the recovery rate and speed of cerebral blood volume (CBV) change, was significantly longer in OH-Sx and OH-BP groups than in the control group under transition to a standing position after squatting. In the OH-BP subgrouping, the peak-time of maximum slope variation in HbT change was significantly longer only in OH-BP with OI symptoms, but did not differ between OH-BP without OI symptoms and controls.

CONCLUSIONS

Our results suggest that OH and OI symptoms are associated with dynamic alterations in cerebral HbT. Regardless of the severity of the postural BP drop, OI symptoms are associated with prolonged CBV recovery.

Hepatic transcriptome profiling according to growth rate reveals acclimation in metabolic regulatory mechanisms to cyclic heat stress in broiler chickens

Climate change has numerous effects on poultry that result in welfare concerns and economic losses in agricultural industries. However, the mechanisms underlying the acclimation to heat stress in poultry have not been comprehensively defined. Therefore, identifying associated patterns of gene regulation and understanding the molecular mechanisms of acclimation to a warmer environment will provide insights into the acclimation system of broiler chickens. We profiled differentially expressed genes (DEGs) associated with differences in growth performance under heat stress conditions in the liver tissues of broilers based on RNA sequencing data. The DEGs were identified by comparison to the gene expression levels of broilers exhibiting average growth at 28 d of age (D28A) and D36A relative to those at D21A. In D36A, 507 and 312 DEGs were up- and downregulated, respectively, whereas 400 and 156 DEGs were up- and downregulated in D28A, respectively. Pathway enrichment analysis further revealed that “fatty acid degradation” and “heat shock protein expression” were upregulated in broilers exhibiting a higher growth and weight, whereas “cell cycle arrest” and “amino acid metabolism” were downregulated. Transcriptome profiling revealed that the acclimatized group supplied fat and energy from the liver to tissues through the breakdown of fatty acids. Furthermore, homeostasis was maintained via heat shock proteins and antioxidant enzymes. The characterized candidate genes and mechanisms associated with the response to heat stress might serve as a foundation for improving the ability of broilers to acclimatize under heat stress conditions.

Ring-in-a-Triangle Nanoframes: Integrating with Intra- and Interhotspots for Highly Amplified Near-Field Focusing

The development of a stepwise synthetic strategy for Au ring-in-a-triangle nanoframes with a high degree of structural solidity is essential to the advancement of highly amplified near-field focusing. This strategy leads to the formation of an inscribed nanoring in a triangular metal frame with stability to withstand elevated temperatures and an oxidizing environment, which is critical for successful single-particle surface-enhanced Raman scattering (SERS). The existence of inscribed nanorings plays an important role in enhancing the so-called "lightning rod effect," whereby the electromagnetic near-field enhancement occurs on the highly curved curvature of a metallic interface. We evaluated the corresponding single-particle SERS as a function of the thickness of the rims and then constructed two-dimensional (2D) bulk SERS substrates, wherein an ensemble of hotspots exists. The synergic contribution from both inter- and intrahotspots allowed the outstanding linearity of the calibration curve and the lowest limit of detection, ∼10^-18 M for the analyte concentration.

Polysorbate- and DNA-Mediated Synthesis and Strong, Stable, and Tunable Near-Infrared Photoluminescence of Plasmonic Long-Body Nanosnowmen

Direct photoluminescence (PL) from metal nanoparticles (NPs) without chemical dyes is promising for sensing and imaging applications since this offers a highly tunable platform for controlling and enhancing the signals in various conditions and does not suffer from photobleaching or photoblinking. It is, however, difficult to synthesize metal NPs with a high quantum yield (QY), particularly in the near-infrared (NIR) region where deep penetration and reduced light scattering are advantageous for bioimaging. Herein, we designed and synthesized Au-Ag long-body nanosnowman structures (LNSs), facilitated by polysorbate 20 (Tween 20). The DNA-engineered conductive junction between the head and body parts results in a charge transfer plasmon (CTP) mode in the NIR region. The junction morphology can be controlled by the DNA sequence on the Au core, and polythymine and polyadenine induced thick and thin junctions, respectively. We found that the LNSs with a thicker conductive junction generates the stronger CTP peak and PL signal than the LNSs with a thinner junction. The Au-Ag LNSs showed much higher intensities in both PL and QY than widely studied Au nanorods with similar localized surface plasmon resonance wavelengths, and notably, the LNSs displayed high photostability and robust, sustainable PL signals under continuous laser exposure for >15 h. Moreover, the PL emission from Au-Ag LNSs could be imaged in a deeper scattering medium than fluorescent silica NPs. Finally, highly robust PL-based cell images can be obtained using Au-Ag LNSs without significant signal change while repetitively imaging cells. The results offer the insights in plasmonic NIR probe design, and show that chemical dye-free LNSs can be a very promising candidate with a high QY and a robust, reliable NIR PL signal for NIR sensing and imaging applications.

Synthesis, Assembly, Optical Properties, and Sensing Applications of Plasmonic Gap Nanostructures

Plasmonic gap nanostructures (PGNs) have been extensively investigated mainly because of their strongly enhanced optical responses, which stem from the high intensity of the localized field in the nanogap. The recently developed methods for the preparation of versatile nanogap structures open new avenues for the exploration of unprecedented optical properties and development of sensing applications relying on the amplification of various optical signals. However, the reproducible and controlled preparation of highly uniform plasmonic nanogaps and the prediction, understanding, and control of their optical properties, especially for nanogaps in the nanometer or sub-nanometer range, remain challenging. This is because subtle changes in the nanogap significantly affect the plasmonic response and are of paramount importance to the desired optical performance and further applications. Here, recent advances in the synthesis, assembly, and fabrication strategies, prediction and control of optical properties, and sensing applications of PGNs are discussed, and perspectives toward addressing these challenging issues and the future research directions are presented.

Structural, magnetic, and magnetocaloric properties of R2NiMnO6 (R = Eu, Gd, Tb)

The crystal structure, cryogenic magnetic properties, and magnetocaloric performance of double perovskite Eu₂NiMnO₆ (ENMO), Gd₂NiMnO₆ (GNMO), and Tb₂NiMnO₆ (TNMO) ceramic powder samples synthesized by solid-state method have been investigated. X-ray diffraction structural investigation reveal that all compounds crystallize in the monoclinic structure with a P2₁/n space group. A ferromagnetic to paramagnetic (FM-PM) second-order phase transition occurred in ENMO, GNMO, and TNMO at 143, 130, and 112 K, respectively. Maximum magnetic entropy changes and relative cooling power with a 5 T applied magnetic field are determined to be 3.2, 3.8, 3.5 J/kgK and 150, 182, 176 J/kg for the investigated samples, respectively. The change in structural, magnetic, and magnetocaloric effect attributed to the superexchange mechanism of Ni²⁺–O–Mn³⁺ and Ni²⁺–O–Mn⁴⁺. The various atomic sizes of Eu, Gd, and Tb affect the ratio of Mn⁴⁺/Mn³⁺, which is responsible for the considerable change in properties of double perovskite.

Au Nanorings with Intertwined Triple Rings

We designed complex Au nanorings with intertwined triple rings (ANITs) in a single entity to amplify the efficacy of near-field focusing. Such a complex and unprecedented morphology at the nanoscale was realized through on-demand multistepwise reactions. Triangular nanoprisms were first sculpted into circular nanorings, followed by a series of chemical etching and deposition reactions eventually leading to ANITs wherein thin metal bridges hold the structure together without any linker molecules. In the multistepwise reaction, the well-faceted growth pattern of Au, which induces the growth of two distinctive flat facets in a lateral direction, is important to evolve the morphology from single to multiple nanorings. Although our synthesis proceeds through multiple steps in one batch without purification steps, it shows a remarkably high yield (>∼90%) at the final stage. The obtained high degree of homogeneity (in both shape and size) of the resulting ANITs allowed us to systematically investigate the corresponding localized surface plasmon resonance (LSPR) coupling with varying nanoring arrangements and observe their single-particle surface enhanced Raman scattering (SERS). Surprisingly, individual ANITs exhibited an enormously large enhancement factor (∼10⁹), which confirms their superior near-field focusing relative to other reported nanoparticles.

Web-above-a-Ring (WAR) and Web-above-a-Lens (WAL): Nanostructures for Highly Engineered Plasmonic-Field Tuning and SERS Enhancement

Synthetic strategies of web-above-a-ring (WAR) and web-above-a-lens (WAL) nanostructures are reported. The WAR has a controllable gap between the nanoring core and a nanoweb with nanopores for the effective confinement of electromagnetic field in the nanogap and subsequent surface-enhanced Raman scattering (SERS) of Raman dyes inside the gap with high signal reproducibility, which are attributed to the generation of circular 3D hot zones along the rim of Pt@Au nanorings with wrapping nanoweb architecture. More specifically, Pt@Au nanorings are adopted as a plasmonic core for structural rigidity and built porous nanowebs above them through a controlled combination of galvanic exchange and the Kirkendall effect. Both nanoweb and nanolens structures are also formed on Pt@Au nanoring, which is WAL. structure. Remarkably, plasmonic hot zone, nanopores, and hot lens are formed inside a single WAL nanostructure, and these structural components are orchestrated to generate stronger SERS signals.

Au nanolenses for near-field focusing

We report a novel strategy for the synthesis of Pt@Au nanorings possessing near-field focusing capabilities at the center through which single-particle surface enhanced Raman scattering could be readily observed. We utilized Pt@Au nanorings as a light-absorber; the absorbed light could be focused at the center with the aid of a Au nanoporous structure. We synthesized the Au nanolens structure through a Galvanic exchange process between Au ions and Ag block at the inner domain of the Pt@Au nanoring. For this step, Ag was selectively pre-deposited at the inner domain of the Pt@Au nanorings through electrochemical potential-tuned growth control and different surface energies with regard to the inner and outer boundaries of the nanoring. Then, the central nanoporous architecture was fabricated through the Galvanic exchange of sacrificial Ag with Au ions leading to the resulting Au nanoring with a Au nanoporous structure at the center. We monitored the shape-transformation by observing their corresponding localized surface plasmon resonance (LSPR) profiles. By varying the rim thickness of the starting Pt@Au nanorings, the inner diameter of the nanolens was accordingly tuned to maximize near-field focusing, which enabled us to obtain the reproducible and light-polarization independent measurements of single-particle SERS. Through theoretical simulation, the near-field electromagnetic field focusing capability was visualized and confirmed through single-particle SERS measurement showing an enhancement factor of 1.9 × 10⁸ to 1.0 × 10⁹.

We synthesized a Au nanolens with electromagnetic near-field focusing capability by integrating a Au nanoporous structure at the center of the Pt@Au nanoring via synthetic steps of eccentric growth of Ag and nanoscale Galvanic exchange reaction.

Synthesis and Surface Plasmonic Characterization of Asymmetric Au Split Nanorings

In this Letter, a rational and stepwise method for the solution-phase synthesis of asymmetric Au split nanorings by adopting Au nanoprisms as a template has been demonstrated. The selective chemical etching of Au nanoprism tips activated the surface reactivity of edges and led to the selective deposition of Pt at the periphery of Au nanoplates. By controlling the total amount of Pt on the edges, different degrees of split Au@Pt nanorings were obtained; the subsequent Au coating around the Au@Pt scaffold eventually resulted in asymmetric Au hexagonal split nanorings. Their surface plasmonic features as a function of split degrees were investigated, including straight nanorods, bent nanorods, split nanorings, and full nanorings. The electrical field focusing using single-particle surface-enhanced Raman spectroscopy was evaluated under different polarization angles of the incident light for two different structures with the point gap and line gap between two arms.

Cyclodextrin-Based Synthesis and Host-Guest Chemistry of Plasmonic Nanogap Particles with Strong, Quantitative, and Highly Multiplexable Surface-Enhanced Raman Scattering Signals

We developed a synthetic strategy to form cyclodextrin-based intrananogap particles (CIPs) with a well-defined ∼1 nm interior gap in a high yield (∼97%), and were able to incorporate 10 different Raman dyes inside the gap using the cyclodextrin-based host-guest chemistry, leading to strong, reproducible, and highly multiplexable surface-enhanced Raman scattering (SERS) signals. The average SERS enhancement factor (EF) for CIPs was 3.0 × 10⁹ with a very narrow distribution of the EFs that range from 9.5 × 10⁸ to 9.5 × 10⁹ for ∼95% of the measured particles. Remarkably, 10 different Raman dyes can be loaded within the nanogap of CIPs, and 6 different Raman dye-loaded CIPs with little spectral overlaps were distinctly detected for cancer cell imaging applications with a single excitation source. Our synthetic strategy provides new platforms in precisely forming plasmonic nanogap structures with all key features for widespread use of SERS including strong signal intensity, reliability in quantification of signal and multiplexing capability.

Synthesis and Single-Particle Surface-Enhanced Raman Scattering Study of Plasmonic Tripod Nanoframes with Y-Shaped Hot-Zones

Herein, plasmonic metal tripod nanoframes with three-fold symmetry were synthesized in a high yield (∼83%), and their electric field distribution and single-particle surface-enhanced Raman scattering (SERS) were studied. We realized such complex frame morphology by synthesizing analogous tripod nanoframes through multiple transformations. The precise control of the Au growth pattern led to uniform tripod nanoframes embedded with circle or line-shaped hot spots. The linear-shaped nanogaps ("Y"-shaped hot-zone) of the frame structures can strongly and efficiently confine the electric field, allowing for strong SERS signals. Coupled with a high synthetic yield of the targeted frame structure, strong and uniform SERS signals were obtained inside the nanoframe gaps. Remarkably, quite reproducible SERS signals were obtained with these structures-the SERS enhancement factors with an average value of 7.9 × 10⁷ with a distribution of enhancement factors from 2.2 × 10⁷ to 2.2 × 10⁸ for 45 measured individual particles.

Prognostication of neurological outcome after cardiac arrest using wavelet phase coherence analysis of cerebral oxygen

BACKGROUND

The prognosis for cardiac arrest (CA) is associated with the degree of cerebral ischemia. We investigated the relationship between the wavelet coherence of cerebral oxyhemoglobin (HbO₂) among different channels and outcomes after CA. Moreover, we aimed to develop a prognostication method after CA.

METHODS

Eighty-three post-resuscitation patients were included. The HbO₂ data were collected during the post-resuscitation period (median day, 1) using functional near-infrared spectroscopy. The coherence between sections of prefrontal HbO₂ oscillations in five frequency intervals (I, 0.6-2 Hz; II, 0.15-0.6 Hz; III, 0.05-0.15 Hz; IV, 0.02-0.05 Hz; and V, 0.0095-0.02 Hz) were analyzed. We evaluated the outcomes using cerebral performance category (CPC) scores (good outcome, CPC ≤ 2 and poor outcome, CPC ≥ 3) at 3 months after CA. Additionally, the predictive method was developed using the biomarker and coherence value after CA.

RESULTS

Among the included patients, 19 patients (22.9%) had a good outcome. Poor outcome group had significantly lower phase coherence in the myogenic frequency interval III compared to good outcome group (0.36 ± 0.14 vs. 0.54 ± 0.18, P < 0.001). The predictive method using neuron-specific enolase (NSE) and interval III value demonstrated good discrimination (area under the curve 0.919; 95% confidence interval, 0.850-0.989).

CONCLUSIONS

The predictive method using NSE and phase coherence of HbO₂ in the interval III from the vascular smooth muscle cells could be a useful tool for prognosticating after CA. This suggests that evaluating cerebral ischemia using phase coherence of HbO₂ might be a helpful outcome predictor following CA.

Learning curve of laparoscopic living donor right hepatectomy

Background

The feasibility and learning curve of laparoscopic living donor right hepatectomy was assessed.

Methods

Donors who underwent right hepatectomy performed by a single surgeon were reviewed. Comparisons between open and laparoscopy regarding operative outcomes, including number of bile duct openings in the graft, were performed using propensity score matching.

Results

From 2014 to 2018, 103 and 96 donors underwent laparoscopic and open living donor right hepatectomy respectively, of whom 64 donors from each group were matched. Mean(s.d.) duration of operation (252·2(41·9) versus 304·4(66·5) min; P &lt; 0·001) and median duration of hospital stay (8 versus 10 days; P = 0·002) were shorter in the laparoscopy group. There was no difference in complication rates of donors (P = 0·298) or recipients (P = 0·394) between the two groups. Total time for laparoscopy decreased linearly (R2 = 0·407, β = –0·914, P = 0·001), with the decrease starting after approximately 50 procedures when cases were divided into four quartiles (2nd versus 3rd quartile, P = 0·001; 3rd versus 4th quartile, P = 0·023). Although grafts with bile duct openings were more abundant in the laparoscopy group (P = 0·022), no difference was found in the last two quartiles (P = 0·207).

Conclusion

Laparoscopic living donor right hepatectomy is feasible and an experience of approximately 50 cases may surpass the learning curve.

ALK-positive anaplastic large cell lymphoma with a monomorphic small-cell pattern masquerading as inflammatory gastric lesions

INTRODUCTION

Anaplastic lymphoma kinase-positive (ALK+) anaplastic large cell lymphoma (ALCL) with a non-common pattern can be diagnostic challenging. Pathologists can be unavoidably and unintentionally blind to non-descript tumor cells in a lymphohistiocytic- (LH) or small-cell (SC)-pattern. We report a case of primary systemic ALK+ ALCL with a SC pattern that presented as secondary gastric lesions with a mixed LH and SC pattern that was masqueraded as inflammatory lesions.

CASE REPORT

A 34-year-old woman with intractable epigastric pain was referred to have repeated endoscopy with biopsy. She was found to multiple gastric erosions and nodules that were diagnosed as inflammatory lesions both endoscopically and histologically. Meanwhile, she developed an acute onset of severe back pain associated with a pathologic compression fracture in the T3 thoracic vertebral body. Imaging studies disclosed a disseminated systemic disease involving abdominopelvic lymph nodes and cervical and thoracic vertebral bodies. The needle biopsy of the pelvic lymph node disclosed diffuse proliferation of monomorphic small round cells that were diffusely positive for CD30 and ALK. A diagnosis of ALK+ ALCL with a monomorphic SC pattern was rendered.

DISCUSSION

A retrospective review of the gastric biopsies with the aid of immunohistochemistry enabled us to recognise the presence of lymphomatous infiltrates with a mixed LH and SC pattern in every piece of gastric biopsies that were repeatedly misdiagnosed as inflammatory lesions. This case illustrates a significant diagnostic pitfall of the LH- and SC-patterns in ALK+ ALCL, in which the tumour cells featuring lymphoid, plasmacytoid or histiocytoid appearance can be masqueraded as inflammatory cells.

Hierarchic Interfacial Nanocube Assembly for Sensitive, Selective, and Quantitative DNA Detection with Surface-Enhanced Raman Scattering

Surface-enhanced Raman scattering (SERS)-based sensing is promising in that it has potential to allow for highly sensitive, selective, and multiplexed detection and imaging. However, the controlled assembly and gap formation between plasmonic particles for generating strong SERS signals in a quantitative manner is highly challenging, especially on biodetection platforms, and particle-to-particle variation in the signal enhancement can vary by several orders of magnitude in a single batch, largely limiting the reliable use of SERS for practical sensing applications. Here, a hierarchic-nanocube-assembly based SERS (H-Cube-SERS) bioassay to controllably amplify the electromagnetic field between gold nanocubes (AuNCs) is developed. Based on this strategy, H-Cube-SERS assay allows for detecting target DNA with a wide dynamic range from 100 aM to 10 pM concentrations in a stable and reproducible manner. It is also found that the uniformly formed AuNCs with flat surfaces are much more suitable for highly sensitive, reliable, and quantitative biodetection assays due to faster DNA binding kinetics, sharper DNA melting transition, wider hot spot regions, and less dependence on light polarization direction than spherical Au nanoparticles with curved interfaces. This work paves the pathways to the quantitative and sensitive biodetection on a SERS platform and can be extended to other particle assembly systems.

Acquisition of Carbapenemase-Producing Enterobacteriaceae in Solid Organ Transplantation Recipients

BACKGROUND

Carbapenemase-producing Enterobacteriaceae (CPE) can lead to life-threatening outcomes with rapid spread of the carbapenemase gene in solid organ transplantation (SOT) recipients because of limitations of available antibiotics. We examined the characteristics and importance of CPE acquisition in SOT recipients with large numbers of CPE isolates.

METHODS

Between November 2015 and October 2016, 584 CPE isolates were found in 37 recipients and verified by carbapenemase gene multiplex polymerase chain reaction (PCR). One hundred recipients with at least 2 negative results in carbapenemase PCR for stool surveillance and no CPE isolates in clinical samples were retrospectively included.

RESULTS

Most CPE isolates were Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae (546, 93.5%). The most frequent transplantation organ was lung (43.3%), and the most common sample with CPE isolates other than stool was respiratory tract (22.6%). The median time between SOT and first CPE acquisition was 7 days. All-cause mortality was significantly higher in recipients with CPE than in those without CPE (24.3% vs 10.0%; P = .03). In multivariate regression analysis, stool colonization of vancomycin-resistant Enterococci and/or Clostridium difficile during 30 days before SOT (odds ratio [OR], 3.28; 95% CI, 1.24-8.68; P = .02), lung transplantation (OR, 4.50; 95% CI, 1.19-17.03; P = .03), and intensive care unit stay ≥2 weeks (OR, 6.21; 95% CI, 1.72-22.45; P = .005) were associated with acquisition of CPE.

CONCLUSIONS

Early posttransplantation CPE acquisition may affect the clinical outcome of SOT recipients. Careful screening for CPE during the early posttransplantation period would be meaningful in recipients with risk factors.

Correction: RCP induces Slug expression and cancer cell invasion by stabilizing β1 integrin

Following the publication of this article the authors noted that images were inadvertently duplicated in Fig. 1b. The corrected Fig. 1 can be found in the associated Correction. The conclusions of this paper are not affected. The authors sincerely apologize for this error. This error has not been corrected in the HTML or PDF of the original Article.

Predictors of incisional hernia in adult liver transplant recipients

PURPOSE

Incisional hernia is a complication following abdominal operation. Patients undergoing liver transplantation have a high risk of developing incisional hernia because of immunosuppression. The purpose of this study was to evaluate incisional hernia after liver transplantation and to identify risk factors for hernia formation in those patients.

METHODS

We retrospectively reviewed 1044 adult patients with more than 2 years of follow-up in patients who underwent liver transplantation from January 2000 to December 2015.

RESULTS

Incisional hernia was identified in 79 patients with more than 2 years of follow-up. The overall incisional hernia rate was 7.6%. The mean age and body mass index (BMI) of the patients with incisional hernia were 55 ± 9 years and 25.3 ± 3.7 kg/m², respectively. No significant differences in gender, diagnosis, diabetes, Child-Pugh score, model for end-stage liver disease (MELD) score, donor type, hepatorenal syndrome, varix bleeding, ascites, hepatic encephalopathy, ventilator use, spontaneous bacterial peritonitis (SBP), or bile leakage were found between patients who did and did not develop incisional hernia. Patients with acute rejection before hernia development were more to have herniated patients hernia (p < 0.05).

CONCLUSION

Age greater than 55 years and high BMI were significant risk factors. We identified risk factors for the development of incisional hernia. Based on these risk factors, attention should be paid to incisional hernia in older and obese patients.

Nonnoble-Metal-Based Plasmonic Nanomaterials: Recent Advances and Future Perspectives

The application scope of plasmonic nanostructures is rapidly expanding to keep pace with the ongoing development of various scientific findings and emerging technologies. However, most plasmonic nanostructures heavily depend on rare, expensive, and extensively studied noble metals such as Au and Ag, with the limited choice of elements hindering their broad and practical applications in a wide spectral range. Therefore, abundant and inexpensive nonnoble metals have attracted attention as new plasmonic nanomaterial components, allowing these nonnoble-metal-based materials to be used in areas such as photocatalysis, sensing, nanoantennas, metamaterials, and magnetoplasmonics with new compositions, structures, and properties. Furthermore, the use of nonnoble metal hybrids results in newly emerging or synergistic properties not observed from single-metal component systems. Here, the synthetic strategies and recent advances in nonnoble-metal-based plasmonic nanostructures comprising Cu, Al, Mg, In, Ga, Pb, Ni, Co, Fe, and related hybrids are highlighted, and a discussion and perspectives in their synthesis, properties, applications, and challenges are presented.

Nonnoble-Metal-Based Plasmonic Nanomaterials: Recent Advances and Future Perspectives

The application scope of plasmonic nanostructures is rapidly expanding to keep pace with the ongoing development of various scientific findings and emerging technologies. However, most plasmonic nanostructures heavily depend on rare, expensive, and extensively studied noble metals such as Au and Ag, with the limited choice of elements hindering their broad and practical applications in a wide spectral range. Therefore, abundant and inexpensive nonnoble metals have attracted attention as new plasmonic nanomaterial components, allowing these nonnoble-metal-based materials to be used in areas such as photocatalysis, sensing, nanoantennas, metamaterials, and magnetoplasmonics with new compositions, structures, and properties. Furthermore, the use of nonnoble metal hybrids results in newly emerging or synergistic properties not observed from single-metal component systems. Here, the synthetic strategies and recent advances in nonnoble-metal-based plasmonic nanostructures comprising Cu, Al, Mg, In, Ga, Pb, Ni, Co, Fe, and related hybrids are highlighted, and a discussion and perspectives in their synthesis, properties, applications, and challenges are presented.

Laparoscopic right posterior sectionectomy versus laparoscopic right hemihepatectomy for hepatocellular carcinoma in posterior segments: Propensity Score Matching Analysis

BACKGROUND AND AIMS:

This study was designed to analyze the feasibility of laparoscopic right posterior sectionectomy compared to laparoscopic right hemihepatectomy in patients with hepatocellular carcinoma located in the posterior segments.

MATERIAL AND METHODS:

The study included patients who underwent either laparoscopic right posterior sectionectomy or laparoscopic right hemihepatectomy for hepatocellular carcinoma located in segment 6 or 7 from January 2009 to December 2016 at Samsung Medical Center. After 1:1 propensity score matching, patient baseline characteristics and operative and postoperative outcomes were compared between the two groups. Disease-free survival and overall survival were compared using Kaplan-Meier log-rank test.

RESULTS:

Among 61 patients with laparoscopic right posterior sectionectomy and 37 patients with laparoscopic right hemihepatectomy, 30 patients from each group were analyzed after propensity score matching. After matching, baseline characteristics of the two groups were similar including tumor size (3.4 ± 1.2 cm in laparoscopic right posterior sectionectomy vs 3.7 ± 2.1 cm in laparoscopic right hemihepatectomy, P = 0.483); differences were significant before matching (3.1 ± 1.3 cm in laparoscopic right posterior sectionectomy vs 4.3 ± 2.7 cm in laparoscopic right hemihepatectomy, P = 0.035). No significant differences were observed in operative and postoperative data except for free margin size (1.04 ± 0.71 cm in laparoscopic right posterior sectionectomy vs 2.95 ± 1.75 cm in laparoscopic right hemihepatectomy, P < 0.001). Disease-free survival (5-year survival: 38.0% in laparoscopic right posterior sectionectomy vs 47.0% in laparoscopic right hemihepatectomy, P = 0.510) and overall survival (5-year survival: 92.7% in laparoscopic right posterior sectionectomy vs 89.6% in laparoscopic right hemihepatectomy, P = 0.593) did not differ between the groups based on Kaplan-Meier log-rank test.

CONCLUSION:

For hepatocellular carcinoma in the posterior segments, laparoscopic right posterior sectionectomy was feasible compared to laparoscopic right hemihepatectomy when performed by experienced laparoscopic surgeons.

Voltage-dependent Ca2+ channels promote branching morphogenesis of salivary glands by patterning differential growth

Branching morphogenesis is a crucial part of early developmental processes in diverse organs, but the detailed mechanism of this morphogenic event remains to be elucidated. Here we introduce an unknown mechanism leading to branching morphogenesis using mouse embryonic organotypic cultures with time-lapse live imaging. We found spatially expressed L-type voltage-dependent Ca²⁺ channels (VDCCs) in the peripheral layers of developing epithelial buds and identified the VDCCs as a core signaling mediator for patterning branching architecture. In this process, differential growth in peripheral layers by VDCC-induced ERK activity promoted cleft formation through an epithelial buckling-folding mechanism. Our findings reveal an unexpected role of VDCCs in developmental processes, and address a fundamental question regarding the initial process of branching morphogenesis.

Oral Administration of α-Asarone Promotes Functional Recovery in Rats With Spinal Cord Injury

α-asarone, a bioactive compound found in Acorus plant species, has been shown to exhibit neuroprotective, anti-oxidative, anti-inflammatory, and cognitive-enhancing effects. However, the effects of α-asarone on spinal cord injury (SCI) have not yet been elucidated. The present study investigated the effects of α-asarone on the mRNA of pro-inflammatory cytokines, macrophage polarization toward an anti-inflammatory M2 phenotype, and angiogenesis in rats with compressive SCI. α-Asarone was orally administered (10 mg/kg) once per day for 14 days following moderate static compression SCI. Compared to controls, α-asarone treatment significantly improved locomotor score, prevented neuroinflammation, and facilitated angiogenesis in the spinal cord at 14 days after SCI. Furthermore, α-asarone significantly reduced the TNF-α, IL-1β, IL-6, monocyte chemoattractant protein 1 (MCP-1), macrophage inflammatory protein 2 (MIP-2), and inducible nitric oxide synthase (iNOS) levels but increased the IL-4, IL-10, and arginase 1 levels at 24 h after SCI. At 7 and 14 days after SCI, immunohistochemistry showed reduced reactive gliosis and neuroinflammation and an increased expression of M2 macrophage markers and angiogenesis. The results suggest that the inhibition of pro-inflammatory cytokines, macrophage polarization toward an anti-inflammatory M2 phenotype, and angiogenesis by α-asarone may be some of the mechanisms underlying the α-asarone-mediated neuroprotective effects on an injured spinal cord.

Radiofrequency ablation versus surgical resection for multiple HCCs meeting the Milan criteria: propensity score analyses of 10-year therapeutic outcomes

AIM

To assess the long-term therapeutic outcomes of radiofrequency ablation (RFA) versus surgical resection (SR) as a first-line treatment for patients meeting the Milan criteria with multiple hepatocellular carcinomas (HCCs).

MATERIALS AND METHODS

This retrospective study was approved by the institutional review board and the requirement for informed consent was waived. Between January 2004 and December 2009, among 3,441 patients with treatment-naive HCCs, 88 patients meeting the Milan criteria with multiple HCCs (Barcelona Clinic Liver Cancer [BCLC] A stage) who underwent either RFA (n=62) or SR (n=26) were included. Recurrence-free survival (RFS) and overall survival (OS) rates were compared by using propensity score matching. In addition, multivariate analysis was performed for assess the prognostic factor.

RESULTS

Matching yielded 20 matched pairs of patients. In the two matched groups, the RFS rates were 30% and 30% at 5- and 10-years, respectively, in the RFA group and 60% and 48.6% in the SR group (p=0.054). The corresponding OS rates were 63.3% and 46.1% in the RFA group and 100% and 73.6% in the SR group, respectively (p=0.061). In multivariate analysis, treatment type was independently associated with RFS (hazard ratio [HR]=0.51; p=0.043) whereas it was not a statistically significant factor for OS (HR=0.50; p=0.088).

CONCLUSION

In patients meeting the Milan criteria with multiple HCCs (BCLC A stage), SR may provide better RFS compared to RFA.

Early Vs Late Liver Retransplantation: Different Characteristics and Prognostic Factors

BACKGROUND

East Asia is a known endemic area for hepatitis B, and living donor liver transplantation is mainly performed. Liver retransplantation (ReLT) is expected to become an increasing problem because of a shortage of organs. This study aimed to compare early and late ReLT with consideration of specific circumstances and disease background of East Asians.

METHODS

Between October 1996 and January 2015, 51 patients underwent ReLT; we performed a retrospective analysis of data obtained from medical records of the patients. Clinical characteristics, indication, causes of death, survival rate, and prognostic factors were investigated.

RESULT

The survival rate for early ReLT (n = 18) was 51.5% and that for late ReLT (n = 33) was 50.1% at 1 year postoperatively. Continuous venovenous hemodialysis and the use of mechanical ventilators were more frequent, and pre-retransplant intensive care unit stay and prothrombin time was longer in early ReLT than in late ReLT. Operation time was longer and the amount of intraoperative blood loss was greater in late ReLT than in early ReLT. Multivariate analysis showed that a higher C-reactive protein level increased mortality in early ReLT (P = .045), whereas a higher total bilirubin level increased the risk of death in late ReLT (P = .03).

CONCLUSION

Patients with early ReLT are likely to be sicker pre-retransplantation and require adequate treatment of the pretransplant infectious disease. On the other hand, late ReLT is likely to be technically more difficult and should be decided before the total bilirubin level increases substantially.

Dealloyed Intra-Nanogap Particles with Highly Robust, Quantifiable Surface-Enhanced Raman Scattering Signals for Biosensing and Bioimaging Applications

Uniformly controlling a large number of metal nanostructures with a plasmonically enhanced signal to generate quantitative optical signals and the widespread use of these structures for surface-enhanced Raman scattering (SERS)-based biosensing and bioimaging applications are of paramount importance but are extremely challenging. Here, we report a highly controllable, facile selective-interdiffusive dealloying chemistry for synthesizing the dealloyed intra-nanogap particles (DIPs) with a ∼2 nm intragap in a high yield (∼95%) without the need for an interlayer. The SERS signals from DIPs are highly quantitative and polarization-independent with polarized laser sources. Remarkably, all the analyzed particles displayed the SERS enhancement factors (EFs) of ≥1.1 × 10⁸ with a very narrow distribution of EFs. Finally, we show that DIPs can be used as ultrasensitive SERS-based DNA detection probes for detecting 10 aM to 1 pM target concentrations and highly robust, quantitative real-time cell imaging probes for long-term imaging with low laser power and short exposure time.

Existence of nontrivial weak solutions for a quasilinear Choquard equation

We are concerned with the following quasilinear Choquard equation: [Formula: see text] where [Formula: see text], [Formula: see text] is the p-Laplacian operator, the potential function [Formula: see text] is continuous and [Formula: see text]. Here, [Formula: see text] is the Riesz potential of order [Formula: see text]. We study the existence of weak solutions for the problem above via the mountain pass theorem and the fountain theorem. Furthermore, we address the behavior of weak solutions to the problem near the origin under suitable assumptions for the nonlinear term f.

Abstract P1-07-25: Differences among young breast cancer patients based on subtype: A study from the Korean Breast Cancer Society – Running head: Do breast cancers in 20s have worse prognosis than 30s?

Purpose Numerous studies demonstrated that breast cancer in young women (BCY) has unfavorable prognostic features and unfavorable subtype. However, there were few studies to evaluate the effect on the prognosis of breast cancer according to the subtype disparities by age especially BCY. We analyzed breast cancer mortality stratified tumor subtype according to age among the patients with less than 50 year-old. Patients and Methods Data obtained from the Korean Breast Cancer Society Registry (KBCSR), patients diagnosed with invasive breast cancer were retrospectively between 2003 and 2010. We excluded patients with male breast cancer, underwent neoadjuvant chemotherapy, distant metastasis or inflammatory breast cancer at presentation, and other histopathology except invasive ductal or invasive lobular carcinoma. We also excluded patients with lack of immunohistochemistry data and short-term follow-up duration (&lt;12 months). Results We identified 37,865 patients, and excluded by study protocol. Among those, 30,793 patients with breast cancer for eligible for analysis, 793 (2.6%) were 20-29 years and 8,926 (28.8%) were 30-39 years of age. Median follow-up duration was 84 months. Mean age was 42.4 years old. Younger patients with breast cancer were more likely to have advanced stage, higher nuclear grade, present lymphovascular invasion, and more likely to be unfavorable subtype such as triple negative breast cancer (TNBC)

Table 1. Baseline Characteristics Age at Presentation 20-29, N(%)30-39, N(%)40-49, N(%)P-valueOverall793 (2.6)8,133 (26.4)21,867 (71.0) Pathologic stage   &lt;.0001I295 (37.2)2,928 (36.0)9,288 (42.5) II373 (47.0)3,644 (44.8)9,078 (41.5) III119 (15.0)1,442 (17.7)3,211 (14.7) Family history   &lt;.0001Yes81 (10.2)674 (8.3)1,391 (6.4) No712 (89.8)7,459 (91.7)20,476 (93.6) Nuclear grade   &lt;.0001Low85 (10.2)941 (11.6)3,824 (17.5) Intermediate288 (36.3)3,340 (41.1)9,688 (44.3) High331 (41.7)3,165 (38.9)6,650 (30.4) LVI   &lt;.0001Yes249 (31.4)2,840 (34.9)6,711 (30.7) No433 (54.6)4,367 (53.7)13,005 (59.5) Subtype   &lt;.0001Luminal A314 (39.6)3,529 (43.4)11,716 (53.6) Luminal B190 (24.0)1,895 (23.3)4,775 (21.8) Her-252 (6.6)724 (8.9)1,723 (7.9) TNBC237 (29.8)1,895 (24.4)3,653 (16.7) HER-2, human epidermal growth factor-2; TNBC, triple negative breast cancer

. Patients with younger age group showed worse prognosis than patients with older age patients. In multivariate analysis for overall survival, as patients were younger group, hazard ratio was increased, and the patients with TNBC showed higher HR than HER-2, Luminal B, and Luminal A subtype (P&lt; .0001, P&lt; .0001, P&lt; .0001, and P&lt; .0001, respectively). Stratified by subtype, luminal subtype showed significant worse prognosis as the age group was younger, while as, Her-2 and TNBC subtype showed no significantly difference by the age group. Conclusion Patients with 20s breast cancer showed unfavorable characteristics and worse prognosis than 30s and older aged group. Stratified by tumor subtype, breast cancer in 20s with luminal subtype showed worse prognosis, while as HER-2 and TNBC showed no significantly different compare to breast cancer in 30s.

Citation Format: Ryu JM, Yu J, Nam SJ, Kim I, Lee JE, Lee SK, Kim JM, Choi HJ, Kim SW. Differences among young breast cancer patients based on subtype: A study from the Korean Breast Cancer Society – Running head: Do breast cancers in 20s have worse prognosis than 30s? [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-07-25.

Prognostic Factors Predicting Poor Outcome in Living-Donor Liver Transplantation for Fulminant Hepatic Failure

BACKGROUND

Living-donor liver transplantation (LDLT) has been accepted as feasible treatment for fulminant hepatic failure (FHF), although it has generated several debatable issues. In this study, we investigated the prognostic factors predicting fatal outcome after LDLT for FHF.

METHODS

From April 1999 to April 2011, 60 patients underwent LT for acute liver failure, including 42 patients for FHF at Samsung Medical Center, Seoul, Korea. Among 42 patients, 30 patients underwent LDLT for FHF, and the database of these patients was analyzed retrospectively to investigate the prognostic factors after LDLT for FHF.

RESULTS

Among 30 patients, 7 patients (23%) died during the in-hospital period within 6 months, and 23 patients (77%) survived until recently. In univariate analyses, donor age (>35 years), graft volume (GV)/standard liver volume (SLV) (<50%), cold ischemic time (>120 minutes), hepatic encephalopathy (grade IV), hepato-renal syndrome (HRS), and history of ventilator care were associated with fatal outcome after LDLT for FHF. In multivariate analyses, HRS, GV/SLV (<50%), and donor age (>35 years) were significantly associated with fatal outcome. Although the statistical significance was not shown in this analysis (P = .059), hepatic encephalopathy grade IV also appears to be a risk factor predicting fatal outcome.

CONCLUSIONS

The survival of patients with FHF undergoing LDLT was comparable to that in published data. In this study, HRS, GV/SLV <50%, and donor age >35 years are the independent poor prognostic factors.

Interregional correlations of glucose metabolism between the basal ganglia and different cortical areas: an ultra-high resolution PET/MRI fusion study using 18F-FDG

Basal ganglia have complex functional connections with the cerebral cortex and are involved in motor control, executive functions of the forebrain, such as the planning of movement, and cognitive behaviors based on their connections. The aim of this study was to provide detailed functional correlation patterns between the basal ganglia and cerebral cortex by conducting an interregional correlation analysis of the ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET) data based on precise structural information. Fifteen participants were scanned with 7-Tesla magnetic resonance imaging (MRI) and high resolution research tomography (HRRT)-PET fusion system using ¹⁸F-FDG. For detailed interregional correlation analysis, 24 subregions of the basal ganglia including pre-commissural dorsal caudate, post-commissural caudate, pre-commissural dorsal putamen, post-commissural putamen, internal globus pallidus, and external globus pallidus and 80 cerebral regions were selected as regions of interest on the MRI image and their glucose metabolism were calculated from the PET images. Pearson's product-moment correlation analysis was conducted for the interregional correlation analysis of the basal ganglia. Functional correlation patterns between the basal ganglia and cerebral cortex were not only consistent with the findings of previous studies, but also showed new functional correlation between the dorsal striatum (i.e., caudate nucleus and putamen) and insula. In this study, we established the detailed basal ganglia subregional functional correlation patterns using ¹⁸F-FDG PET/MRI fusion imaging. Our methods and results could potentially be an important resource for investigating basal ganglia dysfunction as well as for conducting functional studies in the context of movement and psychiatric disorders.

Comparison of Kaposi Sarcoma Risk in Human Immunodeficiency Virus-Positive Adults Across 5 Continents: A Multiregional Multicohort Study

BACKGROUND

We compared Kaposi sarcoma (KS) risk in adults who started antiretroviral therapy (ART) across the Asia-Pacific, South Africa, Europe, Latin, and North America.

METHODS

We included cohort data of human immunodeficiency virus (HIV)-positive adults who started ART after 1995 within the framework of 2 large collaborations of observational HIV cohorts. We present incidence rates and adjusted hazard ratios (aHRs).

RESULTS

We included 208140 patients from 57 countries. Over a period of 1066572 person-years, 2046 KS cases were diagnosed. KS incidence rates per 100000 person-years were 52 in the Asia-Pacific and ranged between 180 and 280 in the other regions. KS risk was 5 times higher in South African women (aHR, 4.56; 95% confidence intervals [CI], 2.73-7.62) than in their European counterparts, and 2 times higher in South African men (2.21; 1.34-3.63). In Europe, Latin, and North America KS risk was 6 times higher in men who have sex with men (aHR, 5.95; 95% CI, 5.09-6.96) than in women. Comparing patients with current CD4 cell counts ≥700 cells/µL with those whose counts were <50 cells/µL, the KS risk was halved in South Africa (aHR, 0.53; 95% CI, .17-1.63) but reduced by ≥95% in other regions.

CONCLUSIONS

Despite important ART-related declines in KS incidence, men and women in South Africa and men who have sex with men remain at increased KS risk, likely due to high human herpesvirus 8 coinfection rates. Early ART initiation and maintenance of high CD4 cell counts are essential to further reducing KS incidence worldwide, but additional measures might be needed, especially in Southern Africa.

Note: Progress on the use of MgB2 superconducting joint technique for the development of MgB2 magnets for magnetic resonance imaging (MRI)

This note presents a superconducting joint technique for the development of MgB₂ magnetic resonance imaging (MRI) magnets. The MgB₂ superconducting joint was fabricated by a powder processing method using Mg and B powders to establish a wire-bulk-wire connection. The joint resistance measured using a field-decay method was <10^-14 Ω, demonstrating that the proposed joint technique could be employed for developing "next-generation" MgB₂ MRI magnets operating in the persistent current mode.

Correlation between socio-economic status and atopic dermatitis in Korean adults: the Korea national health and nutrition examination survey (2007-2014)

INTRODUCTION

Atopic dermatitis (AD) is one of the most common allergic diseases. Its prevalence has been increasing in recent decades. Socio-economic status is well-known risk factor of allergic diseases.

OBJECTIVE

This study was performed to investigate the relationship between socio-economic status and AD in Korean adults.

METHODS

Data were acquired from 47 351 men and women, ≥19 years of age who participated in the Korea National Health and Nutrition Examination Surveys (KNHANES) conducted from 2007 to 2014. The presence of AD was based on self-reported physician diagnosis of AD in the Health Interview Surveys.

RESULTS

The prevalence of AD was 3.1%, which decreased with increasing age. In univariate analysis, adults with AD were prone to be female, younger, never-married, well educated, lower household members, and urban dwelling (all P < 0.01). Monthly family income and smoking status were not associated with the presence of AD. The prevalence of hypertension, diabetes mellitus and asthma was higher in AD subjects (all P < 0.01), while obesity was not associated with adult AD. After adjusting for confounders, logistic regression analysis showed female sex (adjusted odds ratio [aOR]: 1.483, 95% CI: 1.268-1.734), age (P < 0.01), marital status (Single: aOR: 1.307, 95% CI: 1.012-1.690; Never-married: aOR: 1.938, 95% CI: 1.513-2.482), urban residence (aOR: 1.281, 95% CI: 1.045-1.569) and asthma (aOR: 1.788, 95% CI: 1.416-2.258) were associated with higher prevalence of AD (all P < 0.01).

CONCLUSION

Female sex, age, marital status, urban residence, and the presence of asthma are important risk factors of the prevalence of AD in Korean adults.

Influence of systemic bone mineral density on atlantoaxial subluxation in patients with rheumatoid arthritis

Osteopenia and osteoporosis were independent predictive factors for higher atlantoaxial subluxation occurrence in patients with lower body mass index. Our findings suggest that patients with rheumatoid arthritis with osteopenia or osteoporosis, particularly those with lower body mass index (BMI), should be screened regularly to determine the status of their cervical spines.

INTRODUCTION

Cervical spine involvement in rheumatoid arthritis (RA) patients may cause serious adverse effects on quality of life and overall health. This study aimed to evaluate the association between atlantodental interval (ADI), atlantoaxial subluxation (AAS), and systemic bone mineral density (BMD) based on BMI variations among established patients with RA.

METHODS

The ADI was transformed to the natural log scale to normalize distributions for all analyses. Multivariable linear regression analyses were used to identify independent predictive factors for ADI based on each BMD classification. Multivariate Cox regression analyses were also performed to identify independent predictive factors for the risk of AAS, which were classified by tertile groups of BMI.

RESULTS

A total of 1220 patients with RA who had undergone at least one or more cervical radiography and BMD assessments were identified and enrolled. We found that the association between BMD and ADI (β, -0.029; 95% CI, -0.059 to 0.002; p = 0.070) fell short of achieving statistical significance. However, the ADI showed a 3.6% decrease per 1 BMI increase in the osteoporosis group (β, -0.036; 95% CI, -0.061 to -0.011; p = 0.004). The osteopenia and osteoporosis groups showed about a 1.5-fold and a 1.8-fold increased risk of AAS occurrence among the first tertile of the BMI group.

CONCLUSIONS

Our study showed a possible association between lower BMD and AAS occurrence in patients with RA with lower BMI. Further studies are needed to confirm our findings.

TRPM7 Is Involved in Volume Regulation in Salivary Glands

Under hypotonic conditions, the regulatory volume decrease (RVD) is essential to maintain physiological homeostasis and functions in diverse biological systems. Intracellular Ca²⁺ has been reported as an important mediator of this response, but the underlying Ca²⁺ mechanism responsible for RVD is still controversial. Here we investigate the role of Ca²⁺ in the RVD response using live-cell imaging, microspectrofluorimetry, and a patch-clamp technique. A typical RVD was observed in submandibular gland acinar cells after swelling in a hypotonic solution, whereas intracellular Ca²⁺ chelation completely inhibited the RVD response. The incidence and magnitude of the Ca²⁺ transient were proportional to the degree of hypotonicity of the extracellular medium, and there was a close relationship between intracellular Ca²⁺ concentration and the volumetric changes of the cells. Notably, this response was mediated by Ca²⁺-induced Ca²⁺ release, which is triggered by Ca²⁺ influx via stretch-activated TRPM7 channels. Furthermore, we detected the generation of Cl^- currents in the swelling acinar cells upon hypotonic stress, and the current profile matched that of the Ca²⁺-activated Cl^- currents. A specific inhibitor of Cl^- currents also inhibited the RVD response. In conclusion, an intracellular Ca²⁺ increase in response to osmotically induced cell swelling plays a critical role in RVD in salivary gland acinar cells.

A Study on CYP2C19 and CYP2D6 Polymorphic Effects on Pharmacokinetics and Pharmacodynamics of Amitriptyline in Healthy Koreans

We performed a double-blinded, genotype-based stratification study to explore the pharmacokinetics and pharmacodynamics of amitriptyline according to CYP2C19 and CYP2D6 genotype in Korean subjects. Twenty-four healthy adults were grouped by genotype of CYP2C19 and CYP2D6. After a single dose of 25 mg of amitriptyline, blood samples were collected and anticholinergic effects were measured. The extent of N-demethylation of amitriptyline significantly decreased in subjects carrying two nonfunctional alleles of CYP2C19. The extent of hydroxylation of amitriptyline or nortriptyline was significantly reduced in subjects carrying two CYP2D6 decreased functional alleles compared with those with no or one decreased functional allele. The overall metabolic pathway of amitriptyline was more likely to be dominated by CYP2C19 than CYP2D6. The gene variations of CYP2C19 and CYP2D6 did not change the pharmacodynamic effect. The findings of this study will provide useful information on individualized drug treatment with amitriptyline considering both CYP2D6 and CYP2C19 gene variations.

Abstract P5-05-05: The role and regulation mechanism of HOXB5 in human breaset cancer cells

HOX genes are transcription factors that play important roles in body patterning and cell fate specification during normal development. Among of these, HOXB5, is involved in a variety of developmental processes, particularly during the enteric nervous system (ENS) development, and thus, abnormalities in HOXB5 function during embryo stages lead to Hirschsprung's disease. Importantly, many HOX genes, including HOXB5, are expressed not only during embryogenesis but also in adults and are dysregulated in various cancers. In a previous study, we found aberrant overexpression of HOXB5 in breast cancer tissues and cell lines and demonstrated that HOXB5 is important in the regulation of cell proliferation in breast cancer cells. Also, HOXB5 induces invasive potential through epithelial-mesenchymal transition (EMT). The relationship between HOXB5 and phenotypic changes in MCF7 breast cancer cells has been studied, however, HOXB5 functions as a transcription factor and its involvement in signaling pathways remain unclear. In this study, we selected putative downstream target genes of HOXB5, such as interleukin (IL)-6, Snail2 and epidermal growth factor receptor (EGFR) by PCR array analysis. These genes have been reported to be involved in cacner progression, which is characterised by increased growth speed and invasiveness of the tumor cells. Here, we discovered that HOXB5 transcriptionally upregulates the promoter activity of these genes. Chromatin immunoprecipitation (ChIP) analysis to confirm direct binding of HOXB5 to the promoter region is now ongoing. Since we found that HOXB5 induces EGFR protein expression and SRC phosphorylation, we will further investigate signaling pathway components to understand the underlying molecular mechanisms of HOXB5 action in breast cancer.

Citation Format: Kim JM, Lee J-Y, Kim MH. The role and regulation mechanism of HOXB5 in human breaset cancer cells [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-05-05.

A study of the dietary intakes by the pre-pregnancy body mass index in pregnant women

The authors analyzed the difference in weight gain and nutrition, according to the BMI before pregnancy. They divided 91 subjects into BMI group I (normal weight) and BMI group 2 (overweight) before pregnancy. In general, the BMI before pregnancy did not influence weight gain but, in the BMI group 2, the intakes of all of cholesterol, total fatty acids, vitamin B 12, iron, and copper were significantly higher. Neither group exhibited sufficient intake of vitamin B 1, vitamin B2, niacin, vitamin B6, folic acid, calcium, magnesium, iron, or zinc. Pre-pregnancy weight management and nutrition during pregnancy is very important.

Efficacy of computed tomography for the diagnosis of postpartum hemorrhage

The authors evaluated the diagnosis of the cause of post-partum haemorrhage (PPH) by computed tomography (CT). They retrospectively transferred 15 patients with PPH from local clinics between January 2010 and December 2011. CT revealed diverse causes. Only two cases had no additional finding on CT. They found deep tearing extending to the lower uterine segment and uterine artery in two cases, whereas five cases were an arteriovenous malformation, and one case was a uterine pseudoaneurysm.

High-quality cell block preparation from scraping of conventional cytology slide: a technical report on a modified cytoscrape cell block technique

BACKGROUND

Immunocytochemistry (ICC) on formalin-fixed paraffin embedded cell blocks is an ancillary tool commonly recruited for differential diagnoses of fine needle aspiration cytology (FNAC) samples. However, the quality of conventional cell blocks in terms of adequate cellularity and evenness of distribution of cytologic material is not always satisfactory for ICC. We introduce a modified agarose-based cytoscrape cell block (CCB) technique that can be effectively used for the preparation of cell blocks from scrapings of conventional FNAC slides.

METHODS

A decoverslipped FNAC slide was mounted with a small amount of water. The cytological material was scraped off the slide into a tissue mold by scraping with a cell scraper. The cytoscrape material was pelleted by centrifugation and pre-embedded in ultra-low gelling temperature agarose and then re-embedded in conventional agarose. The final agarose gel disk was processed and embedded in paraffin.

RESULTS

The quality of the ICC on the CCB sections was identical to that of the immunohistochemical stains on histological sections. By scrapping and harvesting the entirety of the cytological material off the cytology slide into a compact agarose cell button, we could avoid the risk of losing diagnostic material during the CCB preparation.

CONCLUSION

This modified CCB technique enables concentration and focusing of minute material while maintaining the entire amount of the cytoscrape material on the viewing spot of the CCB sections. We believe this technique can be effectively used to improve the level of confidence in diagnosis of FNAC especially when the FNAC slides are the only sample available.