Abstract P2-07-16: Alcohol consumption increases mammographic density in women aged ≥55 years

Background: Incresed mammographic density is a significant risk factor for breast cancer and decreses the sensitivity of mammography screening. The aim of this study is to examine the factors affecting breast density in Japanese women.

Data sources and methods: Between Apr. 2014 and Mar. 2016, 3492 women were received mammography screening. According to the results of mammography, breast density was categorized as non-dense(BI-RADS 1 and 2, n=1670) and dense(BI-RADS 3 and 4, n=2222) . Logistic regression was used to estimate the odds of having dense breasts by age, body mass index(BMI), alcohol consumption, smoking, parity, menopausal status, dysmenorrhea, hormone use, family history of breast cancer, physical activity, fried foods intake, brightly colored vegetables intake, coffee intake and tea or green tea intake. All statistical tests were two-sided.

Results: There was a statistically significant negative interaction of age(OR=0.97, <0.001), BMI(OR=0.78, <0.001), number of live birth (one; OR=0.77, <0.030, two or more; OR0.37, <0.001), post-menopause(OR=0.6, <0.001) on breast density. On the other, there was a statistically significant positive interaction of alcohol intake(20g or more a day, OR=1.62, 0.026) in dense breast women aged ≥55 years. A trend of bone mineral density ≥80% and dense breast was seen in women aged ≥40 years(OR=0.63, <0.086, n=510).

Results of analysis of factors influencing breast density among all study participants  Odds ratio95% CIPAgeContinuoous variables0.970.95-0.98<0.001BMIContinuoous variables0.780.76-0.80<0.001Alcohol intakenone1.00 0.325 <20g a day1.120.94-1.350.209 ≥20g a day1.210.91-1.600.186Smokingno1.00   yes0.940.71-1.230.644Birth01.00 <0.001 once0.770.61-0.970.030 ≥20.370.31-0.45<0.001Menopausepre1.00   post0.600.47-0.77<0.001Dysminorrheano1.00   yes0.780.41-1.480.446Family history of breast cancerno1.00   yes1.000.81-1.240.991Physical activityno1.00   yes0.890.74-1.070.207Fried foods intakenone1.00 0.087 once two days0.780.60-1.020.068 ≥once a day0.760.51-1.120.166Brightly coloredd vegetablesnone1.00 0.910 once two days0.950.70-1.280.737 ≥once a day0.950.73-1.220.666Coffee intakenone1.00 0.105 once two days1.060.75-1.510.729 ≥once a day1.221.01-1.470.040Tea/Green tea intakenone1.001.01-1.470.098 once two days0.760.55-1.050.097 ≥once a day0.840.70-1.000.055bone mineral density(n=510)<80%1.00    ≥80%0.630.38-1.070.068

Results of analysis of factors influencing breast density in women aged ≥55 years (n=1382)  Odds ratio95% CIPBMI<25kg/m21.00   ≥25kg/m20.300.21-0.44<0.001Birth0  Trend P<0.001 once0.690.46-1.040.0076 ≥two0.310.23-0.41<0.001Alcohol intakenone  0.052 <20g/day1.260.98-1.620.074 ≥20g/day1.621.06-2.480.026

Conclusion: Alcohol consumption increase mammographic breast density in women aged ≥55 years. As both of increased breast density and alcohol consumption have been suggested to increase risk of breast cancer, more cautious mammographic screening should be considered for those women aged ≥55 years.

Citation Format: Uchida K, Ohashi H, Kitano N, Tsunoda K, Nagamatsu T, Sekine C, Imawari Y, Nogi H, Takeyama H. Alcohol consumption increases mammographic density in women aged ≥55 years [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 P2-07-16.

Post-operative swallowing in multiple system atrophy

BACKGROUND

Some patients with multiple system atrophy (MSA) require surgical interventions such as tracheostomy and aspiration prevention. Few studies have investigated the postoperative clinical course of MSA patients. The aim of this study was to determine a management strategy for dysphagia and respiratory disorder in MSA.

METHODS

From 2001 to 2014, 18 MSA patients (13 males and 5 females, 52-76 years) underwent tracheostomy (TR, n = 11) or laryngeal closure (LC, n = 12). Five patients underwent LC following TR. Vocal fold impairment, the degree of dysphagia and pre/post-operative oral ingestion, and postoperative survival time were evaluated retrospectively. Swallowing function was assessed using the penetration aspiration scale (PAS).

RESULTS

TR was performed due to respiratory disorder in seven patients and due to dysphagia in four patients. PAS scores ranged 1-8 in TR patients and 7-8 in LC patients. Seven of 11 patients who underwent TR displayed worsened PAS scores, and no patients displayed improved PAS scores following TR. All patients who underwent LC regained complete or partial oral intake after surgery. There were no significant differences in postoperative survival time between the two groups.

CONCLUSIONS

Considering the impacts of TR and LC on survival time, postoperative feeding and swallowing, LC is a good option for treating MSA patients with dysphagia.

The phylogeographic system survey of native sheep breeds in the eastern and southern Central Asia

The genetic diversity and phylogenetic survey of native sheep breeds in the eastern and southern Central Asia were assessed in the present study. The clustering, principal components, structure and F statistics all demonstrate that the native sheep breeds in these regions be classified into two genetic groups: Mongolia-Tibetan sheep group and South-Southeast Asia sheep group. The Mongolia sheep group and the Tibetan sheep group had a certain degree of gene communication from the ancient times. In the present study we demonstrated that the Chinese native sheep populations belonged to Mongolia-Tibetan sheep group. However, the relationships among the sheep populations in Mongolia sheep group in China were not closely related to the geographical distance among sheep populations.

A full digital, high definition video system (1080i) for laryngoscopy and stroboscopy

Objective:

This study aimed to estimate the effectiveness of a full digital, high definition video system for laryngeal observations.

Methods:

A newly available, full digital, high definition video camera and high definition video monitor were used. With an endoscopic adaptor and rigid telescope, laryngoscopy and stroboscopy were performed on patients with various kinds of laryngeal lesions.

Results:

All laryngeal lesions were observed and recorded by the full digital, high definition video camera without incident. The image quality for laryngoscopy and stroboscopy was far superior to that of a conventional video system, including video-endoscopy. Even tiny structures or lesions could clearly be visualised on the monitor. The still image obtained from the full digital, high definition video camera was 1920 × 1080 pixels and was comparable to that obtained from a still camera.

Conclusions:

Full digital, high definition video cameras are now commonplace products and can easily be applied to patients with laryngeal disorders. They provide superior laryngeal images, compared with conventional video systems. Furthermore, high definition video systems are cheaper than proprietary medical video systems. We consider our system to represent an accessible technique of gaining superior laryngeal observation in otolaryngological clinics.

Genetic Differentiation of Native Sheep Populations in East and South Asia

Variations of four sheep populations in China were examined by multiloci electrophoresis, and similar data are quoted to analyze the degree of genetic differentiation of native sheep populations in East and South Asia. Among 15 populations, the average heterozygosity is 0.2746, and the effective number of alleles is 1.559. Mongolian sheep possess the highest genetic diversity, and diversity decreases sequentially in the Chinese, Vietnamese, Bangladeshi, and Nepalese populations. Coefficients of genetic differentiation are 0.0126-0.3083, with an average of 0.148, demonstrating that the major genetic variation (85%) exists within populations. Genetic identity and genetic distance all show relatively low genetic differentiation. No relationship was found between geographic distance and genetic distance. Gene flow is common among the mass of populations, which leads to the inconsistency between geographic distance and genetic distance. The 15 native sheep populations in East and South Asia can be divided into two groups, one group including part of the Chinese and Mongolian populations and another including the Yunnan population of China and part of the Nepalese and Bangladeshi populations. Other populations did not separate into groups, merging instead into the two main groups.

Head torsion technique for detailed observation of larynx and hypopharynx

We introduce here an easy but effective method for detailed observation of the larynx and hypopharynx. During the endoscopic observation, the patient's head is turned to one side. Anatomical structures on the same side of the endolarynx, such as the laryngeal ventricle and inferior surface of the vocal fold, are easily observed. In addition, observation of the opposite side of the hypopharynx also becomes easier. Such head turning is also useful in patients with an oblique larynx, in whom the epiglottis obstructs insertion of the endoscope. This is a simple but very effective technique for laryngeal and hypopharyngeal observation.

Use of percutaneous cardiopulmonary support in catastrophic massive pulmonary fat embolism

We report a patient who sustained massive catastrophic pulmonary fat embolism while undergoing surgery for intramedullary nail of femur. Application of percutaneous cardiopulmonary support, in our view, saved the patient from cardiopulmonary collapse.

Reactions of Radicals in Filled Rubber Compounds: I. Detection of Free Radicals in Rubbers by ESR

ESR measurements were made with vulcanized rubbers of a gum, three carbon black filled and a silica filled compounds. The radicals in the filled rubbers were found to have long lives unlike the gum rubber. Carbon black was found to reduce the sensitivity of ESR due to shielding effect in the magnetic field. The degree of sensitivity reduction appeared to depend on the inter-aggregate distance. Upon exposure to toluene vapor, the ESR intensity of black filled rubbers increased for a short period as swelling widened the inter-aggregate distance and then decayed steadily with further exposure. Such a variation was not found with the gum and silica filled vulcanizates. The decay was faster with higher oxygen content of the environment. In a given environment, however, the decay could be dealt by simple kinetics. Diffusion of oxygen did not seem to play any part. It was inferred that ESR observes radicals only in a thin surface layer of the black filled rubber. The kinetic zero-time radical concentration, obtained by toluene vapor exposure in a nitrogen environment, was considered to be the surface radical concentration in the absence of the shielding effect. Among the rubbers of different black loadings, it showed an exponential relation with the value obtained by direct observation due to the difference in the shielding effect arising from difference in loadings. With the rubber of the same formulation, however, the radical concentration obtained by direct observation showed a linear relation with the kinetic zero-time value, suggesting possibility of quantitative comparison by ESR among the rubbers with the same carbon black content.

Reactions of Radicals in Filled Rubber Compounds: II. Generation and Subsequent Reactions of Radicals Upon Deformation

Effect of stretching on oxidative crosslinking of a carbon black filled IR vulcanizate at a normal temperature was studied by means of ESR and crosslink density measurements. Upon deformation, ESR intensity increased and crosslink density decreased, indicating scission of load supporting bonds generating free radicals. Bond scission increased with increasing strain. Resting after deformation, the ESR intensity decayed steadily following simple combination of first order and second order kinetics. The decay was overwhelmingly caused by first order reactions, which were considered to be irrelevant to crosslinking. On the other hand, crosslink density increased during resting. The results strongly suggested that ESR observed the radicals at the surface of the carbon black filled rubber, while crosslink density evaluated the bulk property. The crosslink density increase during resting outweighed the reduction due to deformation. Deformation accompanied by radical generation apparently accelerated oxidative crosslinking.

A mouse model of pemphigus vulgaris by adoptive transfer of naive splenocytes from desmoglein 3 knockout mice

BACKGROUND

Pemphigus vulgaris (PV) is an autoimmune blistering disease caused by antidesmoglein3 (anti-Dsg3) IgG autoantibodies. Recently, we developed a PV mouse model by adoptive transfer of splenocytes from recombinant Dsg3-immunized Dsg3(-/-) mice to Rag2(-/-) immunodeficient mice that expressed Dsg3.

OBJECTIVES

We determined whether the adoptive transfer of naive splenocytes from nonimmunized Dsg3(-/-) mice induces the anti-Dsg3 IgG production and the PV phenoytpe in recipient mice.

METHODS

We adoptively transferred naive Dsg3(-/-) splenocytes into Rag2(-/-) mice and compared their PV phenoytpe with those mice receiving immunized Dsg3(-/-) splenocytes. The numbers of splenocytes and their subpopulations required for anti-Dsg3 IgG production were examined.

RESULTS

Mice that received naive Dsg3(-/-) splenocytes produced anti-Dsg3 IgG, which bound to keratinocyte cell surfaces in vivo, and developed the PV phenotype, including oral erosions with suprabasilar acantholysis. Antibody production and the appearance of the PV phenotype were delayed by approximately 2 weeks in mice that received naive splenocytes compared with mice that received immunized splenocytes. However, once the PV phenotypes developed, there were no apparent differences in disease severity between the two models. Interestingly, the anti-Dsg3 IgG titres were significantly lower in mice that received naive splenocytes than in mice that received immunized splenocytes, suggesting that the former antibodies were more potent than the latter. The frequency of anti-Dsg3 IgG production depended on the number of transferred naive splenocytes. Both CD4+ T cells and B220+ B cells from naive Dsg3(-/-) mice were essential for the production of anti-Dsg3 IgG antibodies.

CONCLUSIONS

Dsg3-specific naive lymphocytes in Dsg3(-/-) mice can be primed and activated by the endogenous Dsg3 in recipient mice to produce pathogenic anti-Dsg3 IgG without active immunization. This approach using naive lymphocytes provides a unique model to dissect immunological mechanisms of tolerance against peripheral autoimmune targets.

Contributions of Time Dependent and Cyclic Crack Growth to the Crack Growth Behavior of Non Strain-Crystallizing Elastomers

Engineering components are observed to fail more rapidly under cyclic loading than under static loading. This reflects features of the underlying crack growth behavior. This behavior is characterized by the relation between the tearing energy, T, and the crack growth per cycle, dc/dn. The increment of crack growth during each cycle is shown here to result from the sum of time dependent and cyclic crack growth components. The time dependent component represents the crack growth behavior that would be present in a conventional constant T crack growth test. Under repeated stressing additional crack growth, termed the cyclic crack growth component, occurs. For a non-crystallizing elastomer, significant effects of frequency have been found on the cyclic crack growth behavior, reflecting the presence of this cyclic element of crack growth. The cyclic crack growth behavior over a wide range of frequencies was investigated for unfilled and swollen SBR materials. The time dependent crack growth component was calculated from constant T crack growth tests and the cyclic contribution derived from comparison with the observed cyclic growth. It is shown that decreasing the frequency or increasing the maximum tearing energy during a cycle results in the cyclic crack growth behavior being dominated by time dependent crack growth. Conversely at high frequency and at low tearing energy, cyclic crack growth is dominated by the cyclic crack growth component. A large effect of frequency on cyclic crack growth behavior was observed for highly swollen SBR. The cyclic crack growth behavior was dominated by the time dependent crack growth component over the entire range of tearing energy and/or crack growth rate. The origin of the cyclic component may be the formation/melting of quasi crystals at the crack tip, which is absent at fast crack growth rates in the unswollen SBR and is absent at all rates in the swollen SBR.

A high-efficiency cross-flow micronebulizer interface for capillary electrophoresis and inductively coupled plasma mass spectrometry

A pneumatic nebulizer interface for capillary electrophoresis (CE) and inductively coupled plasma mass spectrometry (ICPMS) is reported. The interface is constructed using a high-efficiency cross-flow micronebulizer (HECFMN) and has the following features. (1) Makeup solutions can be fed to the interface by nebulizer self-aspiration and liquid gravity pressurization. (2) The liquid dead volume of the interface is approximately 65 nL, much smaller than those (200-2500 nL) reported for other interfaces. (3) The interface can be stably operated at a liquid flow rate down to 5 microL/min with a high analyte transport efficiency up to 95% to the plasma and (4) does not induce noticeable laminar flow in the CE capillary at typical nebulizer gas flow rates of 0.8-1.2 L/min. Because of these features, baseline resolution of 10 lanthanides with a CE-ICPMS system using the HECFMN interface is achieved, and detection limits and peak asymmetry are 0.05-1 microg/L and 0.93-1.23, respectively, improved significantly over those reported previously for a CE-ICPMS system using a high-efficiency nebulizer interface. Peak precision for the 10 lanthanides is in the range of 6.2-12.3% RSD (N = 5). Peak widths are from 9.1 s for 139La to 17.9 s for 175Lu. The effects of nebulizer gas flow rate, makeup solution flow rate, and spray chamber volume on CE-ICPMS signal intensity and separation are also evaluated for the HECFMN interface by the separation of Cr3+ and Cr2O7(2-).

Specific frequency distribution of erythrocytic X-protein alleles in indigenous sheep populations in East Asia

The nonhemoglobin erythrocytic X-protein polymorphism consisting of two phenotypes called X-positive [X(+)] and X-negative [X(-)] was determined in 576 unrelated healthy native sheep of East Asia, using one-dimensional and horizontal starch gel electrophoresis. A striking difference in the frequency of the X allele coding dominantly for the X(+) type between the northern and southern populations of native East Asian sheep divided by the boundary of the Himalaya Mountains was seen (P < 0.0001). The X allele frequency ranged from 0 to 0.0438 with an average of 0.0323 in the northern population examined, consisting of the Bhyanglung, Baruwal, Yunnan, and Khalkhas sheep belonging to the Tibetan and Mongolian sheep groups. In contrast, the frequency of the same allele was in the range of 0.2037-0.4655 and the mean frequency was 0.2998 in the southern population tested, consisting of the Bengal, Kagi, Lampuchhre, Vietnamese, and Myanmar sheep, which belong to the Indian sheep group. This finding suggests that the X allele appears to be an Indian sheep marker and is potentially important in phylogenetic studies on native sheep populations, especially in East Asia.

Single nucleotide polymorphism (D68D, T to C) in the syntaxin 1A gene correlates to age at onset and insulin requirement in Type II diabetic patients

AIM/HYPOTHESIS

Syntaxin 1A is a candidate gene for Type II (non-insulin-dependent) diabetes mellitus, because it plays an important role in insulin secretion from the islet beta cells. We aimed to scan this gene for mutations or genetic markers that correlate with Type II diabetes.

METHODS

We identified and characterized coding exons of the syntaxin 1A gene and scanned the newly identified 10 exons using direct sequencing.

RESULTS

In the single nucleotide polymorphism (SNP) of exon 3 (D68D, T to C) among three newly identified SNPs, genotype frequency of the homozygote of C allele (CC) occurred more frequently in a Type II diabetic group than in a non-diabetic group (16.48 %, n = 182, vs 11.05 %, n = 181, p = 0.0499). Among the diabetic patients, age of onset in patients with CC genotype was lower than that in patients with the TT and TC genotypes [40.10 +/- 1.50 years old (means +/- SEM) vs 44.20 +/- 0.58, p = 0.005]. Patients with the CC genotype had a higher frequency of insulin treatment (78.30 % vs 46.80 %, p = 0.006) with a duration equal to, or longer than, 10 years. Multiple regression analysis confirmed that the genotype was significantly and independently associated with age at onset and mode of treatment, respectively.

CONCLUSION/INTERPRETATION

These data indicate that the SNP in the syntaxin 1A gene (D68D, T to C) correlates to the age of onset and insulin requirements of Type II diabetic Japanese patients.

Complex objects are represented in macaque inferotemporal cortex by the combination of feature columns

Intrinsic signal imaging from inferotemporal (IT) cortex, a visual area essential for object perception and recognition, revealed that visually presented objects activated patches in a distributed manner. When visual features of these objects were partially removed, the simplified stimuli activated only a subset of the patches elicited by the originals. This result, in conjunction with extracellular recording, suggests that an object is represented by a combination of cortical columns, each of which represents a visual feature (feature column). Simplification of an object occasionally caused the appearance of columns that were not active when viewing the more complex form. Thus, not all the columns related to a particular feature were necessarily activated by the original objects. Taken together, these results suggest that objects may be represented not only by simply combining feature columns but also by using a variety of combinations of active and inactive columns for individual features.

A high-efficiency cross-flow micronebulizer for inductively coupled plasma mass spectrometry

A pneumatically driven, high-efficiency cross-flow micronebulizer (HECFMN) is introduced for inductively coupled plasma (ICP) spectrometries. The HECFMN uses a smaller nozzle orifice for nebulizer gas (75 microm in diameter) and a replaceable and adjustable fused-silica capillary for sample uptake. The HECFMN is optimally operated over a wide range of sample uptake rate (5-120 microL/min) at a rf power of 1100 W and nebulizer gas flow rates of 0.8-1.0 L/min when a 50 microm i.d. by 150 microm o.d. capillary is used. The aerosol quality is qualitatively examined in a simple manner, and the transport efficiencies are determined by direct filter collection. Compared with conventional cross-flow nebulizers (CFNs), the HECFMN produces much smaller and more uniform droplets and thus provides much higher analyte transport efficiencies (generally 24-95%) at the sample uptake rates of 5-100 microL/min. Several analytical performance indexes are acquired using an Ar ICPMS system. The sensitivities and detection limits measured with the HECFMN at 50 microL/min sample uptake rate are comparable to or improved over those obtained with a conventional CFN consuming 1 mL/min sample, and the precisions with the HECFMN (typically 1.1-1.7% RSDs) are slightly better than those with the CFN (1.6-2.3% RSDs). The ratios of refractory oxide ion-to-singly charged ion (CeO+/Ce+) are typically in the range from 0.7 to 3.3% for the sample uptake rates of 5-100 microL/min. The free aspiration rate of the HECFMN is 8.9 microL/min for distilled deionized water at the nebulizer gas flow rate of 1.0 L/min without any effect of pressure. The features of the HECFMN suggest good potential for HECFMN use in interfacing ICPMS with capillary electrophoresis and microcolumn high-performance liquid chromatography.

Sensorineural hearing loss as the initial manifestation of polyarteritis nodosa

A 74-year-old male was referred for the sudden onset of bilateral sudden deafness. The patient had no history of any disease or trauma to the head. Pure tone audiometry revealed bilateral moderate, to severe, sensorineural hearing loss. Auditory brain stem responses (ABRs) showed normal peak and interpeak latencies. These audiological findings suggested that his hearing loss could be attributed to inner ear lesions. However, we felt an alternative explanation for this sudden deafness was likely to exist because the patient also had a month-long fever of unknown origin (FUO) and weight loss of 5 kg/month. Using the criteria of The American College of Rheumatology, we made the diagnosis of polyarteritis nodosa (PAN). Serum MPO-ANCA was positive (x 661). For treatment, the patient was begun on prednisolone and cyclophosphamide. Nine months later, fever, hypertension, nephritis, pneumonitis, and arthritis had completely resolved, the MPO-ANCA became negative (MPO-ANCA < x 10). Furthermore, his hearing improved.

Autologous transplantation of fascia into the vocal fold: long-term results of a new phonosurgical technique for glottal incompetence

OBJECTIVES

To study the long-term results of autologous transplantation of fascia into the vocal fold, and to evaluate our use of autologous transplantation instead of bovine collagen injection in cases of glottal incompetence.

STUDY DESIGN

Retrospective study of the patients who have undergone autologous fascia transplantation using our new technique.

METHODS

Follow-up studies were performed for at least 1 year (up to 3 y) on 9 autologous fascia transplant patients (6 cases with type 1 procedures and 3 cases with type 2 procedures). Clinical observations, including laryngeal stroboscopy, and measurement of maximum phonation time (MPT) were carried out.

RESULTS

During 3 months after autologous fascia transplantation, MPT gradually increased and stroboscopy showed improved glottal closure. These improvements continued beyond 1 year in all cases of type 1 surgery and 2 of 3 cases of type 2 surgery.

CONCLUSIONS

Autologous transplantation of fascia into the vocal folds as a phonosurgical treatment for glottal incompetence yields excellent long-term results. Temporal fascia appears to be a highly suitable tissue for transplantation in Reinke's space. However, the fascia is less suitable for transplantation in the muscle. We speculate that transplantation of temporal fascia leads to regeneration of vocal fold tissue, perhaps using a mechanism similar to stem cell transplantation in other organs.

Immunohistochemical expression of Ets-1 transcription factor and the urokinase-type plasminogen activator is correlated with the malignant and invasive potential in meningiomas

BACKGROUND

The Ets-1 transcription factor has been proposed to play an important role in the invasive process of tumor cells through the induction of urokinase-type plasminogen activator (u-PA).

METHODS

Because meningiomas are potentially invasive tumors, irrespective of their malignancy grades, the authors immunohistochemically investigated Ets-1 and u-PA expression in tissues obtained from 50 benign (16 meningotheliomatous, 14 fibrous, 13 transitional, 6 angiomatous, and 1 microcystic), 4 atypical, and 6 anaplastic meningiomas and correlated their results with the malignancy and invasive potential.

RESULTS

Ets-1 protein was expressed in 19 of the benign meningiomas (38%)whereas 31 (62%) were u-PA positive. The percentage of positive cells frequently was < 50%. In contrast, Ets-1 and u-PA expression was observed in all 4 atypical (100%) and all 6 anaplastic (100%) cases, respectively. The proportion of cells positive for Ets-1 and u-PA frequently were > or = 50%. A significant difference was observed between Ets-1 and u-PA expression in benign and high grade meningiomas (P < 0.0001). Moreover, Ets-1 expression was found to correlate significantly with u-PA positivity in meningiomas (P < 0.0001). Twenty-one of 60 meningioma cases (35%) showed infiltration either to the brain, dura mater, or bone. Eighteen of these 21 cases (85.7%) were positive for Ets-1 and u-PA. Ets-1 and u-PA positivity was found to correlate well with the invasive phenotype in meningiomas (P < 0.001).

CONCLUSIONS

The findings of the current study support the possibility that the Ets-1 transcription factor, through u-PA induction, may be involved in the invasive process in meningiomas.

Highly sensitive and direct detection of DNA fragments using a laser-induced capillary vibration effect

A pulsed laser-induced stationary wave capillary vibration detection method was applied to the sensitive detection of capillary gel electrophoresis, and the direct detection of non-labeled nucleic acids, such as DNA sequencing products, was demonstrated. An excimer laser operating at 248 nm was used as a CVL excitation source, and polynucleotides were sensitively detected without derivatization. From an investigation on the endurance of several matrixes to pulsed laser irradiation, a polyacrylamide without a cross-linker (0%C) was found to have adequate endurance, and it exhibited no serious damage during an analysis. A cytosine-terminated sequence reaction product was detected with a sensitivity close to that of laser-induced fluorometry (LIF). These results suggest the feasibility of the highly sensitive detection of ultramicro amounts of biological materials without a pre- or post-column derivatization, which has usually been required in sensitive detection procedures, such as LIF. Furthermore, the feasibility of a novel DNA sequencing method is also suggested.

Immunohistochemical expression of Ets-1 transcription factor and the urokinase-type plasminogen activator is correlated with the malignant and invasive potential in meningiomas

BACKGROUND

The Ets-1 transcription factor has been proposed to play an important role in the invasive process of tumor cells through the induction of urokinase-type plasminogen activator (u-PA).

METHODS

Because meningiomas are potentially invasive tumors, irrespective of their malignancy grades, the authors immunohistochemically investigated Ets-1 and u-PA expression in tissues obtained from 50 benign (16 meningotheliomatous, 14 fibrous, 13 transitional, 6 angiomatous, and 1 microcystic), 4 atypical, and 6 anaplastic meningiomas and correlated their results with the malignancy and invasive potential.

RESULTS

Ets-1 protein was expressed in 19 of the benign meningiomas (38%)whereas 31 (62%) were u-PA positive. The percentage of positive cells frequently was < 50%. In contrast, Ets-1 and u-PA expression was observed in all 4 atypical (100%) and all 6 anaplastic (100%) cases, respectively. The proportion of cells positive for Ets-1 and u-PA frequently were > or = 50%. A significant difference was observed between Ets-1 and u-PA expression in benign and high grade meningiomas (P < 0.0001). Moreover, Ets-1 expression was found to correlate significantly with u-PA positivity in meningiomas (P < 0.0001). Twenty-one of 60 meningioma cases (35%) showed infiltration either to the brain, dura mater, or bone. Eighteen of these 21 cases (85.7%) were positive for Ets-1 and u-PA. Ets-1 and u-PA positivity was found to correlate well with the invasive phenotype in meningiomas (P < 0.001).

CONCLUSIONS

The findings of the current study support the possibility that the Ets-1 transcription factor, through u-PA induction, may be involved in the invasive process in meningiomas.

Nonsense mutation of islet-1 gene (Q310X) found in a type 2 diabetic patient with a strong family history

Islet-1 (Isl-1) is one of the transcription factors that play an important role for the formation of the islet cells. We scanned the Isl-1 gene in 77 Japanese type 2 diabetic patients with a family history and found a heterozygous nonsense mutation (Q310X) in 1 diabetic patient. The mutation was not found in 180 nondiabetic subjects. This mutation is located in the putative transactivation domain and deletes 40 amino acids of the COOH-terminal lesion. The Q310X mutant exhibited a 50% reduction in activity compared with the wild-type when tested for stimulation of transcription of a human amylin promoter-linked luciferase reporter gene in betaTC3 cells. The patient was a 49-year-old nonobese man who was diagnosed as having type 2 diabetes at 32 years of age and has been treated with sulfonylureas. The mutation was found in his mother, who has type 2 diabetes, and in his 14-year-old daughter, who has normal glucose tolerance but a relatively low insulin response. This is the first reported finding of Isl-1 gene mutation in type 2 diabetes. Although Isl-1 is not a common predisposing gene for Japanese type 2 diabetes, the mutation in this gene may be a rare cause of diabetes in isolated families.

Fentanyl improves analgesia but prolongs the onset of axillary brachial plexus block by peripheral mechanism

We evaluated the effects of fentanyl added to lidocaine for axillary brachial plexus block in 66 adult patients scheduled for elective hand and forearm surgery. In this double-blinded study, all patients received 40 mL of 1.5% lidocaine with 1:200,000 epinephrine, injected into the brachial plexus sheath using the axillary perivascular technique, and they were randomized into three groups. Group 1 was given lidocaine containing 2 mL of normal saline plus 2 mL of normal saline IV. Patients in Group 2 received lidocaine containing 100 microg fentanyl plus 2 mL of normal saline IV. Group 3 patients received lidocaine containing 2 mL of normal saline plus 100 microg fentanyl IV. Sensory and motor blockade were evaluated by using a pinprick technique and by measuring the gripping force, respectively. The success rate of sensory blockade for radial and musculocutaneous nerves and the duration of the sensory blockade significantly increased in Group 2 (323 +/- 96 min) as compared with Group 1 (250 +/- 79 min). However, onset time of analgesia was prolonged in every nerve distribution by adding fentanyl to brachial plexus block. IV fentanyl had no effect on the success rate, onset, or duration of blockade. We conclude that the addition of fentanyl to lidocaine causes an improved success rate of sensory blockade but a delayed onset of analgesia, although this may be accounted for by the decreased pH caused by the fentanyl.

IMPLICATIONS

It is still unclear whether the addition of a peripheral opioid is useful for nerve blockade in humans. Peripheral application of fentanyl to lidocaine for axillary brachial plexus blockade in this study provided an improved success rate of sensory blockade and prolonged duration.

Effect of Zena F-III, a liquid nutritive and tonic drug, on the neurochemical changes elicited by physical fatigue in mice

The effects of a liquid nutritive and tonic drug (NTD) on the neurochemical changes elicited by physical fatigue in mice were investigated in terms of the calcium-dependent dopamine synthesizing function of the brain. In this study, Zena F-III (Taisho Pharmaceutical Co., Ltd., Japan), one of the most popular NTDs in Japan, containing 15 crude drug extracts together with taurine, caffeine, and vitamins, and formulated based on the precepts of traditional Chinese medicine, was used. Male mice were forced to walk for 0-6 h at a speed of 3 m/min using a programmed motor-driven wheel cage. The serum and brain calcium levels in the mice were significantly increased following forced walking. The increase in brain calcium level began later and was more gradual than that in the serum calcium level, and reached its maximum value following forced walking for 3 h. The neostriatal dopamine level was also significantly increased, and locomotor activity significantly decreased following forced walking for 3 h. Prior oral administration of F-III (10 ml/kg) attenuated the increases in the serum and brain calcium levels, the increase in the brain dopamine levels, and the decrease in locomotor activity induced by forced walking. Taking into consideration these findings with our previous reports, it is suggested that physical fatigue leads to an increase in dopamine synthesis in the brain through a calcium/calmodulin-dependent system, thereby inducing behavioral changes, and that F-III inhibits this pathway and may alleviate overwork-induced physical fatigue.

Production of the entire extracellular domain of BP180 (type XVII collagen) by baculovirus expression

Bullous pemphigoid (BP) is an acquired autoimmune skin disease, and its target antigens are a 230 kDa plaque protein (BP230) and a 180 kDa transmembrane protein with interrupted collagenous domains (BP180, type XVII collagen), which localize at the hemidesmosome. In this study we have attempted to express the entire extracellular domain of BP180 (rBP180EC) as a secreted protein by baculovirus expression. Seventy out of 83 BP sera (84.4%) showed positive reactivity against rBP180EC by immunoblot analysis, and 56 out of 83 BP sera (67.5%) were positive against rBP180EC by ELISA. These figures were comparable with those when a bacterial recombinant protein encoding the NC16a domain of BP180 (rNC16a) was used as an antigen source. Reactivity of BP sera against rBP180EC by ELISA was completely abolished or significantly reduced by immunocompetition with rNC16a in 11 out of 14 BP sera tested, while the reactivity was not altered in the rest of the three sera. These findings indicate that the NC16a domain represents the major epitopes on the extracellular domain of BP180, although there are some other minor epitopes outside of NC16a which are uniquely expressed by rBP180EC. rBP180EC will be useful to develop a diagnostic tool for BP as well as to dissect a molecular role for BP180 in interactions of keratinocytes with epidermal basement membrane.

Fentanyl improves analgesia but prolongs the onset of axillary brachial plexus block by peripheral mechanism

We evaluated the effects of fentanyl added to lidocaine for axillary brachial plexus block in 66 adult patients scheduled for elective hand and forearm surgery. In this double-blinded study, all patients received 40 mL of 1.5% lidocaine with 1:200,000 epinephrine, injected into the brachial plexus sheath using the axillary perivascular technique, and they were randomized into three groups. Group 1 was given lidocaine containing 2 mL of normal saline plus 2 mL of normal saline IV. Patients in Group 2 received lidocaine containing 100 microg fentanyl plus 2 mL of normal saline IV. Group 3 patients received lidocaine containing 2 mL of normal saline plus 100 microg fentanyl IV. Sensory and motor blockade were evaluated by using a pinprick technique and by measuring the gripping force, respectively. The success rate of sensory blockade for radial and musculocutaneous nerves and the duration of the sensory blockade significantly increased in Group 2 (323 +/- 96 min) as compared with Group 1 (250 +/- 79 min). However, onset time of analgesia was prolonged in every nerve distribution by adding fentanyl to brachial plexus block. IV fentanyl had no effect on the success rate, onset, or duration of blockade. We conclude that the addition of fentanyl to lidocaine causes an improved success rate of sensory blockade but a delayed onset of analgesia, although this may be accounted for by the decreased pH caused by the fentanyl.

IMPLICATIONS

It is still unclear whether the addition of a peripheral opioid is useful for nerve blockade in humans. Peripheral application of fentanyl to lidocaine for axillary brachial plexus blockade in this study provided an improved success rate of sensory blockade and prolonged duration.

Time course of left ventricular remodeling after myocardial infarction: a two-dimensional echocardiographic study

In order to forecast the clinical course of acute myocardial infarction (MI), the time course of the functional changes of the left ventricular myocardium that result in remodeling was evaluated with two-dimensional echocardiography (2DE). The study group comprised 45 patients with anterior MI treated with successful percutaneous transluminal coronary angioplasty. 2DE studies were performed on days 1, 3, 7 and 14; months 1 and 3 and 1 year after MI, and the following parameters were recorded: (1) infarcted wall thickness, (2) traced length of the endocardium and of the epicardium on end-diastolic apical long axis images, and (3) wall motion score (total of asynergy scores of 16 segments of left ventricle (LV); normal: 0, hypokinesis: 1, akinesis: 2, dyskinesis: 3). According to the peak creatine kinase (CK) level, patients were classified into L group (CK > or =8000 U/L, n=16), M group (8000> CK > or =4000, n=13) and S group (CK <4000, n=16). The following results were obtained. (1) There was progressive thinning of the infarcted myocardium up to 1 month after (1 day: 9.3+/-1.7, 14 days: 6.3+/-1.7 vs 1 month: 5.9+/-1.8 mm, p<0.05; vs 1 year: 5.9+/-1.9 mm, NS). (2) Dilatation of the LV cavity occurred shortly after MI and continued up to 14 days (endocardium at 14 days: 176.8+/-13.6 vs 1 day: 164.1+/-11.4 mm, p<0.01; vs 1 year: 176.3+/-12.7 mm, NS). (3) The wall motion score improved rapidly by 14 days, and continued to improve gradually to 1 year (1 day: 12.2+/-3.4, 14 days: 6.8+/-4.0, 1 year: 4.6+/-3.1). (4) The expansion ratio (endocardial length at 14 days/1 day) was significantly greater in the L group than in the S group (p<0.05). Comparing the groups, the LV cavity of the L group remained dilated up to 14 days, whereas that of the S and M groups was dilated up to 7 days (L group 14 days: 179.3+/-11.9 vs 1 day: 156.9+/-9.2mm, p<0.01; vs 1 year: 180.0+/-14.1 mm, NS) (S group 7 days: 171.7+/-13.6 vs 1 day: 161.5+/-7.2 mm, p<0.01; vs 1 year: 172.7+/-14.4 mm, NS) (M group 7 days: 170.5+/-10.5 vs 1 day: 157.7+/-14.5 mm, p<0.05; vs 1 year: 177.08+/-9.6 mm, NS). Serial 2DE on days 1 and 14 after MI were useful for evaluating the course of LV remodeling and to forecast cardiac function in the chronic phase of MI. Determining the length of hospital stay on the basis of infarction size is justified.

Use of autoantigen-knockout mice in developing an active autoimmune disease model for pemphigus

The development of experimental models of active autoimmune diseases can be difficult due to tolerance of autoantigens, but knockout mice, which fail to acquire tolerance to the defective gene product, provide a useful tool for this purpose. Using knockout mice lacking desmoglein 3 (Dsg3), the target antigen of pemphigus vulgaris (PV), we have generated an active disease model for this autoantibody-mediated disease. Dsg3(-/-) mice, but not Dsg3(+/-) littermates, produced anti-Dsg3 IgG that binds native Dsg3, when immunized with recombinant mouse Dsg3. Splenocytes from the immunized Dsg3(-/-) mice were then adoptively transferred into Rag-2(-/-) immunodeficient mice expressing Dsg3. Anti-Dsg3 IgG was stably produced in the recipient mice for more than 6 months without further boosting. This IgG bound to Dsg3 in vivo and disrupted the cell-cell adhesion of keratinocytes. Consequently, the recipient mice developed erosions in their oral mucous membranes with typical histologic findings of PV. In addition, the recipient mice showed telogen hair loss, as found in Dsg3(-/-) mice. Collectively, the recipient mice developed the phenotype of PV due to the pathogenic anti-Dsg3 IgG. This model will be valuable for developing novel therapeutic strategies. Furthermore, our approach can be applied broadly for the development of various autoimmune disease models.