N-Desmethylmajusculamide B, a lipopeptide isolated from the Okinawan cyanobacterium Okeania hirsuta

A new lipopeptide, N-desmethylmajusculamide B (1), was isolated from the Okinawan cyanobacterium Okeania hirsuta along with 2 known compounds majusculamide A (2) and majusculamide B (3). The planar structure of (1) was elucidated by a detailed analysis of mass spectrometry and nuclear magnetic resonance spectra. The absolute configurations of the amino acid residues were determined using Marfey's analysis. The configuration of C-16 in the α-methyl-β-keto-decanoyl moiety was determined unambiguously to be S by conducting a semisynthesis of N-desmethylmajusculamide B from 3. The cytotoxicity against mouse L1210 leukemia cells was evaluated for majusculamides (1-3).

Okeanic acid-A, a trihydroxy fatty acid from the Okinawan cyanobacterium Okeania hirsuta

Trihydroxy fatty acids are oxidative metabolites of polyunsaturated fatty acids isolated from plants, bacteria, fungi, and microalgae and have a variety of biological activities. In this study, a new trihydroxy fatty acid, okeanic acid-A (1), was isolated together with malyngic acid (2) and 15,16-dihydromalyngic acid (3) from the cyanobacterium Okeania hirsuta collected in Okinawa, Japan. The planar structure of 1 was elucidated by detailed analyses using high-resolution ESI-MS and 1D and 2D NMR spectroscopy. The absolute configurations of the hydroxy groups in 1 were determined unambiguously by chemical derivatisation and a modified Mosher's method. These cyanobacterial trihydroxy fatty acids (1-3) have identical configurations at their respective trihydroxy parts. Okeanic acid-A (1) showed mild growth-inhibitory activity against the marine diatom Nitzschia amabilis.

Haneummycin, a new 22-membered macrolide lactam antibiotic, produced by marine-derived Streptomyces sp. KM77-8

A new antibiotic named haneummycin (1) was isolated from a culture broth of marine-derived Streptomyces sp. KM77-8 by solvent extraction and HPLC using a C4 column. The structure of 1 was elucidated including relative stereochemistry as a new 22-membered macrolide lactam associated with a cyclopentanone and three sugars by various spectroscopic analyses, such as MS and NMR. Compound 1 displayed significant antibacterial activities against Gram-positive bacteria including vancomycin-resistant Enterococcus faecium (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) with both MIC values of 8.0 µg ml-1.

Sex recognition and agonistic strategies of male and female crayfish

Intraspecific communication is essential for agonistic and mating behaviours. Agonistic strategy of males must change according to the sex of opponents and that of females is also dependent on their physiological state as to whether they are brooding or not. We have analysed here the agonistic encounters between pairs of male and female crayfish in various combinations to reveal the interaction between agonistic and mating behaviours. After male crayfish became dominant, they aggressively chased subordinate males with attacks, while they did not attack female opponents. Furthermore, the agonistic behaviour of males changed depending on whether females were ovigerous or not. On the other hand, two females showed intense combats despite being ovigerous or not. Crayfish discriminated the sex of opponents via chemical signals in the urine. However, the dominant and subordinate social order of crayfish had no effect on selecting mating partners.

Abstract P4-13-16: Impact of immediate breast reconstruction after mastectomy on the outcome of patients receiving neoadjuvant chemotherapy

Background and purpose

In breast cancer patients receiving neoadjuvant chemotherapy (NAC), immediate breast reconstruction (IBR) is controversial. IBR might favor recurrences and metastases due to delayed adjuvant radiation therapy.

We retrospectively investigated whether IBR after mastectomy influenced the outcome of patients receiving neoadjuvant chemotherapy.

Patients and methods

Between 2006 and 2016, 243 breast cancer patients received total mastectomy after NAC, 48 of whom underwent IBR. Patients receiving IBR (IBR group) were compared to patients who did not receive IBR (no-IBR group) over a prolonged median follow-up time (72.3 moths).

The regimen was 4 cycles of epirubicin (100 or 75 mg/m2), 5-fluorouracil (500 mg/m2), and cyclophosphamide (500 mg/m2) followed by 4 cycles of docetaxel (75 mg/m2). Post-mastectomy radiation was applied in cases treated by IBR following the same selection criteria as for standard mastectomy regardless of the reconstruction approach.

Results

Patients in the IBR group were on average younger than patients in no-IBR

group (p<0.001). The percentage of patients with clinical T1/2 tumor was 81.2% in the IBR group and 58.4% in no-IBR group (p=0.0042). 2 patients (4.2%) in the IBR group and 9 patients (4.6%) in no-IBR group showed the locoregional recurrences. 2 patients (4.2%) in the IBR group and 20 patients (10.3%) showed distant metastases. There were no significant differences.

Conclusions

IBR after total mastectomy was not associated with worse rate of locoregional recurrences in patients receiving NAC.

Citation Format: Nogi H, Tomita S, Kamio M, Shioya H, Toriumi Y, Takeyama H. Impact of immediate breast reconstruction after mastectomy on the outcome of patients receiving neoadjuvant chemotherapy [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 P4-13-16.

The Molting Biomarker Molecule Exists as 2-Acetamido-2-deoxy-gluconic Acid in Urine of Blue Crabs and Helmet Crabs

N-Acetyl-d-glucosamino-1,5-lactone 1 has been reported as a candidate component of the sex pheromone mixture of female blue crabs, Callinectes sapidus, since it is present in the urine of reproductive females and males detect it. Theoretically, 1 can convert to a 1,4-lactone isomer 2 or to the corresponding carboxylic acid, 2-acetamido-2-deoxygluconic acid 3 by hydrolysis in aqueous solution. In this study, we examined the biologically relevant state of equilibrium mixture of 1, 2, and 3 in crab urine using ESI-MS and NMR analyses. The ESI-MS analysis showed that the dominant form of solubilized synthetic 1 is lactone 1 and/or 2, immediately after solubilization in deuterated water, seawater, and phosphate buffer and gradually changing to carboxylic acid 3 which becomes most predominant in phosphate buffer. The NMR analysis showed that synthetic 1 converts to other forms in deuterated water and seawater, and reaches an equilibrium mixture of at least three forms within 24 h. In contrast, 1 converts to a single state of another form in deuterated water with 35 mm phosphate buffer pH 7.6 within 24 h, which is identical to the state in urine with or without phosphate buffer. Thus, we conclude that the molting biomarker sensed by male crabs is 3.

Abstract P5-07-07: DYRK2 contributes to the generation of breast cancer stem cells through KLF4

<Introduction>

Cancer stem cells (CSCs) have been defined by the potential to self-renew and to differentiate. CSCs pose a major hurdle in the treatment of cancer. However, the mechanisms by which cells acquire CSC properties such as drug resistance remain unclear.

Dual-specificity tyrosine-regulated kinase 2 (DYRK2) is a protein kinase that phosphorylates its substrates on serine/threonine. Initially, we found that DYRK2 phosphorylates p53 at Ser 46 to regulate apoptotic cell death in response to DNA damage. Recently, we have shown that DYRK2 controls Snail degradation in breast cancer and ovarian serous adenocarcinoma. We also found that knockdown of DYRK2 in luminal-type breast cancer MCF-7 cells increased the cancer stem cell population.

Kruppel-like factor 4 (KLF4) is one of the Yamanaka factors. It has been reported that pluripotent stem cells from mouse embryonic or adult fibroblasts are induced by introducing four factors, Oct3/4, Sox2, c-Myc, and Klf4. This finding led us to determine if KLF4 is indispensable for the maintenance of CSCs.

The aim of this study is to clarify whether DYRK2 regulates CSCs through KLF4 in breast cancer.

<Methods>

Cell lines: MCF-7 (human mammary carcinoma: ATCC) cells were grown according to standard protocols.

We established stable DYRK2-depleted cells. MCF-7 cells were transfected with pSuper-puro vector (pSuper control) or pSuper-puro DYRK2 shRNAs (shDYRK2) with puromycin to isolate stable cell lines.

In turn, we established both stable DYRK2- and KLF4-depleted cells. shDYRK2 cells were transfected with pSuper-neo vector (pSuper-neo control) or pSuper-neo KLF4 shRNAs (shKLF4) with puromycin and G418. Knockdown of DYRK2 or KLF4 was confirmed by real-time RT-PCR and immunoblotting.

The depleted cells were compared with the control cells using real-time RT-PCR, immunoblotting, flow cytometric analysis, mammosphere assay, xenograft models and immunohistological staining.

<Results>

We analyzed the population of breast cancer stem cells by flow cytometric analysis and in vitro mammosphere assay. The results showed that knockdown of DYRK2 was associated with the increase of CD44+/CD24- cells. While pSuper control cells formed mammospheres, they did in a lesser extent compared to shDYRK2 cells.

In real-time RT-PCR and immunoblotting analysis, stable DYRK2 depletion in MCF-7 cells induced KLF4 accumulation.

We then investigated the effect of KLF4 on stemness by flow cytometric analysis and in vitro mammosphere assay. The results showed that knockdown of KLF4 in shDYRK2 cells reduced the proportion of CD44+/CD24- cells. Whereas shDYRK2/shKLF4 cells formed mammospheres, they did in a lesser extent compared to shDYRK2/pSuper-neo control cells. Moreover, the scale of the mammospheres formed in shDYRK2/shKLF4 cells was significantly smaller, as compared with that in shDYRK2/pSuper-neo control cells.

In xenograft models, the loss of KLF4 protein expression significantly decreased tumor formation.

Immunohistological staining of fifty-nine samples from surgically treated breast cancer patients showed an inverse correlation between DYRK2 and KLF4 expression.

<Conclusion>

These findings revealed that DYRK2 contributes to the generation of breast cancer stem cells through KLF4.

Citation Format: Imawari Y, Mimoto RK, Yamaguchi N, Kamio M, Kato K, Nogi H, Toriumi Y, Uchida K, Takeyama H, Yoshida K. DYRK2 contributes to the generation of breast cancer stem cells through KLF4 [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 P5-07-07.

Finding food: how marine invertebrates use chemical cues to track and select food

This review covers recent research on how marine invertebrates use chemical cues to find and select food.

The Molting Biomarker Metabolite N-acetylglucosamino-1,5-lactone in Female Urine of the Helmet Crab Telmessus cheiragonus

N-acetylglucosamino-1,5-lactone (NAGL) is a molting biomarker in the blue crab Callinectes sapidus The concentration of this compound in urine is highest at the premolt stage. Since sexually mature premolt females release sex pheromone in their urine, NAGL is a candidate sex pheromone molecule in C. sapidus This compound has not been reported in other species. In the present study, we quantified the concentration of NAGL in the urine of the helmet crab Telmessus cheiragonus, using nuclear magnetic resonance spectroscopy, and found that the concentration increases toward the day of molting and decreases after molting. However, the total amount of NAGL collected from individual animals was greatest two to five days after molting, because the amount of urine collected was the lowest at the premolt stage, and it increased after molting. The highest median concentration of NAGL in T. cheiragonas was 29 μmol l(-1), which is 75% of the highest concentration reported in C. sapidus This is the first report of NAGL as a molting biomarker in a species other than C. sapidus We assume that NAGL is part of a pheromone bouquet in these two species.

A rare case of microinvasive squamous cell carcinoma arising in mature cystic teratoma of the ovary

Malignant transformation of a mature cystic teratoma (MCT) of the ovary is rare, with squamous cell carcinoma (SCC) being the most common type. The authors report a novel case of microinvasive squamous cell carcinoma arising in a mature cystic teratoma of the ovary. A 56-year-old woman presented with a 12-cm mass, which was diagnosed as a left ovarian mature cystic teratoma preoperatively by ultrasonography. Subsequently, laparoscopic surgery for the ovarian tumor was performed. The pathologic diagnosis was microinvasive squamous cell carcinoma arising in a mature cystic teratoma of the ovary. Appropriate staging surgery was then performed, with no evidence of malignant tissue except for the removed left ovary. Microinvasive SCC arising in MCT of the ovary is extremely rare, and, to the best of the authors' knowledge, this has not previously been reported in the literature.

Length Is Associated with Pain: Jellyfish with Painful Sting Have Longer Nematocyst Tubules than Harmless Jellyfish

A large number of humans are stung by jellyfish all over the world. The stings cause acute pain followed by persistent pain and local inflammation. Harmful jellyfish species typically cause strong pain, whereas harmless jellyfish cause subtle or no pain. Jellyfish sting humans by injecting a tubule, contained in the nematocyst, the stinging organ of jellyfish. The tubule penetrates into the skin leading to venom injection. The detailed morphology of the nematocyst tubule and molecular structure of the venom in the nematocyst has been reported; however, the mechanism responsible for the difference in pain that is caused by harmful and harmless jellyfish sting has not yet been explored or explained. Therefore, we hypothesized that differences in the length of the nematocyst tubule leads to different degrees of epithelial damage. The initial acute pain might be generated by penetration of the tubule, which stimulates pain receptor neurons, whilst persistent pain might be caused by injection of venom into the epithelium. To test this hypothesis we compared the lengths of discharged nematocyst tubules from harmful and harmless jellyfish species and evaluated their ability to penetrate human skin. The results showed that the harmful jellyfish species, Chrysaora pacifica, Carybdea brevipedalia, and Chironex yamaguchii, causing moderate to severe pain, have nematocyst tubules longer than 200 μm, compared with a jellyfish species that cause little or no pain, Aurelia aurita. The majority of the tubules of harmful jellyfishes, C. yamaguchii and C. brevipedalia, were sufficiently long to penetrate the human epidermis and physically stimulate the free nerve endings of Aδ pain receptor fibers around plexuses to cause acute pain and inject the venom into the human skin epithelium to cause persistent pain and inflammation.

Two new lyngbyatoxin derivatives from the Cyanobacterium, Moorea producens

The toxin-producing cyanobacterium, Moorea producens, is a known causative organism of food poisoning and seaweed dermatitis (also known as "swimmer's itch"). Two new toxic compounds were isolated and structurally elucidated from an ethyl acetate extract of M. producens collected from Hawaii. Analyses of HR-ESI-MS and NMR spectroscopies, as well as optical rotations and CD spectra indicated two new lyngbyatoxin derivatives, 2-oxo-3(R)-hydroxy-lyngbyatoxin A (1) and 2-oxo-3(R)-hydroxy-13-N-desmethyl-lyngbyatoxin A (2). The cytotoxicity and lethal activities of 1 and 2 were approximately 10- to 150-times less potent than lyngbyatoxin A. Additionally, the binding activities of 1 and 2 possessed 10,000-times lower affinity for the protein kinase Cδ (PKCδ)-C1B peptide when compared to lyngbyatoxin A. These findings suggest that these new lyngbyatoxin derivatives may mediate their acute toxicities through a non-PKC activation pathway.

A convenient HPLC method for detection of okadaic acid analogs as 9-anthrylmethyl esters with automated sample cleanup by column switching

A convenient HPLC-fluorometric detection (FLD) method for okadaic acid (OA) analogs as 9-anthrylmethyl esters was developed with the addition of column switching to simplify and automate cleanup. Methanol extracts of shellfish were first treated to hydrolyze OA esters and then reacted with 9-anthryldiazomethane (ADAM). ADAM derivatives of OA and dinophysistoxin-1 (DTX1) were subsequently determined by HPLC-FLD following automated column-switching cleanup. The LOD (S/N = 3) and LOQ (S/N = 10) of OA and DTX1 obtained from bivalves fortified with toxin in our method were approximately 2.6 and 8.6 ng/g whole meat, respectively. The recoveries of OA and DTX1 at all fortification levels of bivalve extracts ranged from 90 to 113%, with RSD values of 0.9-9.9%. The new method is applicable to the routine monitoring of OA analogs as an inexpensive and convenient alternative to HPLC/MS.

A new lyngbyatoxin from the Hawaiian cyanobacterium Moorea producens

Lyngbyatoxin A from the marine cyanobacterium Moorea producens (formerly Lyngbya majuscula) is known as the causative agent of “swimmer’s itch” with its highly inflammatory effect. A new toxic compound was isolated along with lyngbyatoxin A from an ethyl acetate extract of M. producens collected from Hawaii. Analyses of HR-ESI-MS and NMR spectroscopies revealed the isolated compound had the same planar structure with that of lyngbyatoxin A. The results of optical rotation and CD spectra indicated that the compound was a new lyngbyatoxin A derivative, 12-epi-lyngbyatoxin A (1). While 12-epi-lyngbyatoxin A showed comparable toxicities with lyngbyatoxin A in cytotoxicity and crustacean lethality tests, it showed more than 100 times lower affinity for protein kinase Cδ (PKCδ) using the PKCδ-C1B peptide when compared to lyngbyatoxin A.

Clinical usefulness of concentrated ascites reinfusion therapy (CART) for gynecological cancer patients with refractory massive ascites due to cancerous peritonitis

PURPOSE

Cell-free and concentrated ascites reinfusion therapy (CART) is intended to treat patients by ultrafiltration and reinfusion of their refractory ascites. In the CART system, bacteria and cancer cells in removed massive ascites are filtrated. Then, water is removed in the condenser, resulting in a higher protein concentration. The purpose of this study was to assess the clinical usefulness of CART in the treatment of refractory massive ascites in patients with cancerous peritonitis.

MATERIALS AND METHODS

CART was performed 13 times in four patients with ovarian and endometrial cancer.

RESULTS

Autologous protein with a higher concentration was intravenously administered. The amount of aspirated and condensed ascites was 3,190 +/- 1,086 ml (975 4,500 ml) and 538 +/- 249 ml (100 - 860 ml), respectively. Condensed albumin, albumin concentration, and concentration time were 43.2 +/- 25.8 g, 8.2 +/- 3.3 g/dl, and 73.3 +/- 24.8 min (28 - 122 min), respectively. CART was effective in maintaining serum albumin concentrations, and it is possible to repeat infusion. During CART, patients performance status was 1-2 and vital signs were stable except for mild elevations in body temperature. Daily life was maintained without serious side-effects.

CONCLUSIONS

The use of CART for gynecological cancer patients with refractory massive ascites due to cancerous peritonitis contributes to improvements in quality of life and relief of symptoms. With autologous infusion of condensed ascites, patients can avoid infection, allergic reactions, and administration of expensive blood products.

The smell of moulting: N-acetylglucosamino-1,5-lactone is a premoult biomarker and candidate component of the courtship pheromone in the urine of the blue crab, Callinectes sapidus

Female blue crabs (Callinectes sapidus) in their pubertal moult stage release unidentified sex pheromone molecules in their urine, causing males to respond with courtship behaviours including a display called courtship stationary paddling and a form of precopulatory guarding called cradle carry. We hypothesized that pheromones are mixtures of molecules and are more concentrated in urine of pubertal premoult females compared with other moulting stages and thus that these molecules are biomarkers (i.e. metabolites that can be used as an indicator of some biological state or condition) of pubertal premoult females. We tested this hypothesis by combining bioassay-guided fractionation and biomarker targeting. To evaluate the molecular mass of the putative pheromone by bioassay-guided fractionation, we separated urine from pubertal premoult females and intermoult males by ultrafiltration into three molecular mass fractions. The <500 Da fraction and the 500-1000 Da fraction but not the >1000 Da fraction of female urine induced male courtship stationary paddling, but none of the fractions of male urine did. Thus, female urine contains molecules of <1000 Da that stimulate courtship behaviours in males. Biomarker targeting using nuclear magnetic resonance (NMR) spectral analysis of the 500-1000 Da fraction of urine from premoult and postmoult males and females revealed a premoult biomarker. Purification, nuclear magnetic resonance, mass spectrometry and high pressure liquid chromatography analysis of this premoult biomarker identified it as N-acetylglucosamino-1,5-lactone (NAGL) and showed that it is more abundant in urine of premoult females and males than in urine of either postmoult or juvenile females and males. NAGL has not been reported before as a natural product or as a molecule of the chitin metabolic pathway. Physiological and behavioural experiments demonstrated that blue crabs can detect NAGL through their olfactory pathway. Thus, we hypothesize that NAGL is a component of the sex pheromone and that it acts in conjunction with other yet unidentified components.

Abstract P4-06-11: HER2 type DCIS acquires histological diversity by p53 mutation

[Introduction]

It is widely known that breast cancer is a heterogeneous disease of various phenotypes and biological characteristics.

Several studies have identified distinct subtypes of invasive ductal carcinoma by gene expression profiling or staining pattern of estrogen receptor (ER), progesterone receptor (PR), and HER2/neu protein.

Ductal carcinoma in situ (DCIS) is a non-invasive form of breast cancer, and is thought to be the precursor of invasive breast cancer.

One of the most well-known hypothesis shows that breast cancer occurs in a normal terminal duct lobular unit, and a histological continuity exists between the precursor and breast cancer.

The aim of this analysis is to reveal how DCIS acquires histological diversity and progresses to invasive ductal carcinoma.

We hypothesized that p53 gene mutation is responsible for this acquisition of histological diversity, and performed immunohistochemical analysis to pursue this hypothesis.

[Material and methods]

The participants of this study were taken from a database established by Jikei University School of Medicine. Between the period of April 2000 and April 2011, 84 cases of pure DCIS patients underwent operation.

Patients were classified into 4 subtypes by a combination of hormone receptor (HR) status and HER2 status.

The status of ER, PR, HER2, and p53 was determined by immunohistochemical staining.

Tumors with Allred score above 2 ER / PR nuclear staining were classified as ER / PR positive. Tumors with HER2 membranous staining equivalent to 3+ intensity with Hercep test in more than 30% of the cells were scored as overexpression. p53 was defined as positive when nuclear staining was equal to or greater than 10%.

We evaluated histological nuclear atypia to assess histological diversity of DCIS. When DCIS included different type of atypia cells more than 10%, we judged the histological diversity as positive.

[Results]

Patient characteristics are presented in table1.

Patient characteristics number%Age  median (range)55 (31-83)    Receptor status  ER / PR  positive6780negative1720HER2  positive1821negative6679   Subtype  HR+ / HER2-6274HR+ / HER2+56HR- / HER2+1315HR- / HER2-45

The classifications by the immunohistochemical subtype of DCIS are as follows: HR+/HER2- 62 cases (74%), HR+/HER2+ 5 cases (6%), HR-/HER2+ 13 cases (15%), HR-/HER2- 4 cases (5%).

p53 expression in HR-/HER2+ and HR-/HER2- subtype was significantly higher than HR+/HER2- and HR+/HER2+ subtype (p&lt;0.001).

The frequency of histological diversity by nuclear atypia was high in HR+/HER2- and HR-HER2+ subtype (p = 0.009).

In HR-HER2+ subtype, p53 expression was associated with histological diversity (p = 0.021). But in HR-HER2+ subtype, there was no association with p53 expression and histological diversity.

p53 status and histological diversity of DCIS HR+/HER2-HR+/HER2+HR-/HER2+HR-/HER2-pp53     positive5193&lt;0.001negative57441       histological diversity     positive481910.009negative14443       p0.3310.5760.0210.501 

[Conclusion]

This analysis demonstrates that HR-HER2+ subtype DCIS acquires histological diversity by p53 mutation.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-06-11.

Abstract P1-08-17: Impact of claudin-3 and basal-markers expressions on pathological complete response to neoadjuvant chemotherapy and prognosis in triple negative breast cancer

Background

Triple negative breast cancer (TNBC) has responded well in the neoadjuvant setting, with rates of pathologic complete response (pCR) commonly higher than for other breast tumor types. However, more than half of TNBC patients do not achieve a pCR and have a very poor prognosis. Cluster analysis identified 6 TNBC subtypes displaying unique gene expression, including basal-like and a mesenchymal stem-like (claudin-low) subtype. The object of this study was to evaluate the clinical utility of claudin-3 and basal-markers expressions in the prediction of pCR and prognosis in a cohort of breast cancer patients receiving the combination of taxane and anthracycline as neoadjuvant chemotherapy.

Materials and Methods

A prospective data base of 412 Japanese women with stage I/II/III breast cancer who received neoadjuvant chemotherapy was analyzed. The regimens were 6 cycles of concurrent administration of doxorubicin (50 mg/m2) and docetaxel (60 mg/m2) or 4 cycles of epirubicin (100 mg/m2), 5-fluorouracil (500 mg/m2), and cyclophosphamide (500 mg/m2) followed by 4 cycles of docetaxel (100 mg/m2). We performed immunohistochemical staining for ER, PgR, HER2, epidermal growth factor receptor (EGFR), cytokeratin 5/6 and claudin-3 using specimens obtained at diagnosis by core needle biopsy. Based on immunoreactivity, TNBC tumors were classified into basal/claudin-high (BCH), basal/claudin-low (BCL), non-basal/claudin-high (NBCH) and non-basal/claudin-low (NBCL).

Results

The overall pCR of this patient cohort was 19%. pCR was observed 30 cases of 84 TNBC (36%) and 50 cases of 328 non-TNBC (15%)(p&lt;0.0001). Among the TNBC tumors, pCR rate was significantly different between subgroups. BCH 50%, BCL 23%, NBCH 83% and NBCL 43% (p = 0.039). The 5-year overall survival rate was significantly different between TNBC and non-TNBC. TNBC 81% and non-TNBC 94% (p = 0.0017). The 5-year overall survival rate was different between triple-negative subgroups. BCH 92%, BCL 78%, NBCH 83% and NBCL 46%.

Conclusions

This study indicated that claudin-3 and basal-markers might be predictive biomarkers of pCR and prognosis in triple negative breast cancer patients treated with neoadjuvant chemotherapy.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P1-08-17.

Abstract P4-03-10: Sonographic-pathological correlation in contrast-enhanced ultrasonography in the diagnosis of breast cancers

Background: As contrast-enhanced ultrasonography (CEUS) in the diagnosis of breast masses has been performed less frequently than other imaging modalities, it's efficacy evaluation has not been established. CEUS with Sonazoid, which is microbubble-based contrast agent, allows visualization of the mass bloodstream, therefore the classification of enhancement patterns in CEUS could increase diagnostic yield for breast masses. To achieve this, a clear standard for the CEUS evaluation is needed. The purpose of this study was to identify CEUS findings for malignancies and clarify sonographic-pathological correlation of breast cancers.

Material and Method: Present study included 20 patients with invasive ductal cancer who underwent operation for primary therapy without any chemotherapy or hormonal therapy. We contrasted CEUS features with Sonazoid with surgical specimens retrospectively. As malignant findings, the presence of focal perfusion defects inside masses and enhancement of outside masses were chosen.

Result: All of the 20 cases displayed focal perfusion defects. 9 cases of those could be successfully assessed in the same sections histopathologically and ultrasonographically. Histopathological findings showed those defects to be fibrotic foci inside masses in 7cases (77.7%). While, 6 cases of all (30%) showed stains outside tumor, and only one case was found out to be fibrotic growth with cancer cells.

Conclusion: focal perfusion defects of breast masses in CEUS were considered to be specific for malignancy, and they seemed to be fibrotic foci histopathologically. Desmoplastic reaction has been observed in epithelial solid tumor biology, and if those defects reflect the desmoplasia defects could be the proof of malignancy.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P4-03-10.

Abstract P5-04-02: DYRK2 regulates breast cancer invasion via Snail/E-cadherin pathway

Introduction: Epithelial-Mesenchymal Transition (EMT) is characterized by the loss of cellular adhesion molecule E-cadherin, and plays a fundamental role during early steps of breast cancer invasion. An important regulator of E-cadherin expression is Snail, a zinc finger transcriptional repressor. Snail is posphorylated by GSK3β and then degraded by βTrCP mediated ubiquitination. Here we found another kinase, DYRK2, regulates the stability of Snail. Knockdown of DYRK2 promoted the EMT and cancer invasion both in vitro and in vivo experiments.

Methods: Cell lines: MCF-7 cells were transfected with pSuper vector (pSuper control) and pSuper shRNA DYRK2 (shRNA-DYRK2) with G418 to isolate stable cell lines.

Immunoblotting: Expression of pertinent molecular markers was determined by western blotting.

RT-PCR: RNA was extracted using TRIsure and 500 ng of total RNA was amplified using Primer Script One Step RT-PCR Kit Ver.2.

Invasion assay: Various cancer cell lines were seeded on the top of the upper chamber with serum free medium while the bottom chambers were filled with medium containing 10% FBS.

In vivo metastasis assay: Cells in PBS were injected into the left ventricle of 7-week-old female nude mice. Metastases to distant organs were confirmed by IVIS2000.

Immunohistochemistry: We acquired paraffin-embedded tissue sections from primary breast tumor cores and from Jikei University of Medicine. Immunohistochemistry for DYRK2 was performed.

Results: In MCF-7 cells, knockdown of DYRK2 increased Snail in the protein level but not in mRNA level. Upon DYRK2 knockdown, MG132 treatment had no effect on additional increase in Snail. DYRK2 knockdown decreased Snail ubiquitination. Stable DYRK2 depletion led to Snail accumulation and E-cadherin abrogation. Fibroblast marker, Vimentin, emerged in DYRK2 depleted cells. For further analysis, we carried out invasion assays. The invasion potential in DYRK2-depleted cells was substantially higher than that in control cells. In xenograft model, we used nude mice received intracardial injections of pSuper control or shRNA-DYRK2 cells. 6 weeks after injections, a significant increase in bone and lung metastasis was observed in shRNA-DYRK2 group. The patients with tumors expressed low DYRK2 showed significantly poor prognosis.

Conclusion: In breast cancer cells, Snail is phosphorylated by DYRK2 and then acquires the ability to be ubiquitinated. In the absence of DYRK2, Snail is unable to be degraded by ubiquitin-proteasome machinery. Accumulation of Snail promotes EMT and cancer invasion, so low expression of DYRK2 leads to poor prognosis in breast cancer.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P5-04-02.

P2-01-24: Triple-Negative Breast Cancer Emerges from the Luminal Progenitor Compartment

Background: Triple-negative breast cancers (TNBC) are defined as tumors that lack expression of estrogen receptor (ER), progesterone receptor (PgR), and human epidermal growth factor receptor type 2 (HER2). Majority of TNBC (approximately 80%) are basal-like breast cancers. The question of whether there is a specific, identifiable cell in the normal breast form which basal-like breast cancers arise is controversial. We evaluated the frequency and receptor status of ductal carcinoma in situ (DCIS) and ductal components associated with T1 invasive ductal carcinoma (IDC) to clarify the developmental pathway of TNBC.

Methods: From our institutional archives between April 2000 and April 2011, we retrieved 758 cases of DCIS and T1 invasive ductal carcinoma without prior operative treatment. Immunohistochemistry for ER, PgR and HER2 was performed on ductal components and invasive components. Statistical analysis was performed using Fisher Extract Test.

Results: The frequencies of triple-negative (TN) subtype at each size were not seen significant differences. Ductal components were seen in 51 (84%) TN-IDC cases. Within 51 cases, the ductal components were TN in 49 cases. The remaining 3 cases were positive for ER and PgR, but negative HER2.

Mycosporine-like amino acids are multifunctional molecules in sea hares and their marine community

Molecules of keystone significance are relatively rare, yet mediate a variety of interactions between organisms. They influence the distribution and abundance of species, the transfer of energy across multiple trophic levels, and thus they play significant roles in structuring ecosystems. Despite their potential importance in facilitating our understanding of ecological systems, only three molecules thus far have been proposed as molecules of keystone significance: saxitoxin and dimethyl sulfide in marine communities and tetrodotoxin in riparian communities. In the course of studying the neuroecology of chemical defenses, we identified three mycosporine-like amino acids (MAAs)--N-ethanol palythine (= asterina-330), N-isopropanol palythine (= aplysiapalythine A), and N-ethyl palythine (= aplysiapalythine B)--as intraspecific alarm cues for sea hares (Aplysia californica). These alarm cues are released in the ink secretion of sea hares and cause avoidance behaviors in neighboring conspecifics. Further, we show that these three bioactive MAAs, two [aplysiapalythine A (APA) and -B (APB)] being previously unknown molecules, are present in the algal diet of sea hares and are concentrated in their defensive secretion as well as in their skin. MAAs are known to be produced by algae, fungi, and cyanobacteria and are acquired by many aquatic animals through trophic interactions. MAAs are widely used as sunscreens, among other uses, but sea hares modify their function to serve a previously undocumented role, as intraspecific chemical cues. Our findings highlight the multifunctionality of MAAs and their role in ecological connectivity, suggesting that they may function as molecules of keystone significance in marine ecosystems.

Spiny lobsters use urine-borne olfactory signaling and physical aggressive behaviors to influence social status of conspecifics

Decapod crustaceans, like many other animals, engage in agonistic behaviors that enhance their ability to compete for resources with conspecifics. These agonistic behaviors include the release of chemical signals as well as physical aggressive and submissive behaviors. In this study, we report that Caribbean spiny lobsters, Panulirus argus, use both urine-borne chemical signaling and physical aggressive behaviors during interactions with conspecifics, and that these agonistic behaviors can influence the behavior and eventual social status of the interactants. Spiny lobsters that engaged primarily in physical aggressive behaviors became dominant, whereas spiny lobsters that received these physical aggressive behaviors responded with avoidance behaviors and became subordinates. Dominant animals frequently released urine during social interactions, more than when they were not in contact with subordinates and more than when they were not paired with another animal. Subordinates released urine significantly less often than dominants, and no more than when not paired. Preventing release of urine by catheterizing the animals resulted in an increase in the number and duration of physical interactions, and this increase was primarily driven by dominants initiating interactions through physical aggressive behaviors. Introducing urine from one of the catheterized animals into an aquarium reduced physical aggressive behavior by dominant animals to normal levels. Urine-borne signals alone were capable of inducing avoidance behaviors from solitary spiny lobsters in both laboratory and field conditions. We conclude that urine serves as a chemical signal that communicates social status to the interactants. Ablation experiments showed that that these urine signals are detected primarily by aesthetasc sensilla of the olfactory pathway.

Investigation of the association between the GLC3A locus and normal tension glaucoma in Japanese patients by microsatellite analysis

Purpose:

To investigate whether the GLC3A locus harboring the CYP1B1 gene is associated with normal tension glaucoma (NTG) in Japanese patients.

Materials and Methods:

One hundred forty-two Japanese patients with NTG and 101 Japanese healthy controls were recruited. Patients exhibiting a comparatively early onset were selected as this suggests that genetic factors may show stronger involvement. Genotyping and assessment of allelic diversity was performed on 13 highly polymorphic microsatellite markers in and around the GLC3A locus.

Results:

There were decreased frequencies of the 444 allele of D2S0416i and the 258 allele of D2S0425i in cases compared to controls (P = 0.022 and P = 0.034, respectively). However, this statistical significance disappeared when corrected (Pc > 0.05). We did not find any significant association between the remaining 11 microsatellite markers, including D2S177, which may be associated with CYP1B1, and NTG (P > 0.05).

Conclusions:

Our study showed no association between the GLCA3 locus and NTG, suggesting that the CYP1B1 gene, which is reportedly involved in a range of glaucoma phenotypes, may not be an associated factor in the pathogenesis of NTG.

The chemistry of escapin: identification and quantification of the components in the complex mixture generated by an L-amino acid oxidase in the defensive secretion of the sea snail Aplysia californica

Escapin is an L-amino acid oxidase in the ink of a marine snail, the sea hare Aplysia californica, which oxidizes L-lysine (1) to produce a mixture of chemicals which is antipredatory and antimicrobial. The goal of our study was to determine the identity and relative abundance of the constituents of this mixture, using molecules generated enzymatically with escapin and also using products of organic syntheses. We examined this mixture under the natural range of pH values for ink-from approximately 5 at full strength to approximately 8 when fully diluted in sea water. The enzymatic reaction likely forms an equilibrium mixture containing the linear form alpha-keto-epsilon-aminocaproic acid (2), the cyclic imine Delta(1)-piperidine-2-carboxylic acid (3), the cyclic enamine Delta(2)-piperidine-2-carboxylic acid (4), possibly the linear enol 6-amino-2-hydroxy-hex-2-enoic acid (7), the alpha-dihydroxy acid 6-amino-2,2-dihydroxy-hexanoic acid (8), and the cyclic aminol 2-hydroxy-piperidine-2-carboxylic acid (9). Using NMR and mass spectroscopy, we show that 3 is the major component of this enzymatic product at any pH, but at more basic conditions, the equilibrium shifts to produce relatively more 4, and at acidic conditions, the equilibrium shifts to produce relatively more 2, 7, and/or 9. Studies of escapin's enzyme kinetics demonstrate that because of the high concentrations of escapin and L-lysine in the ink secretion, millimolar concentrations of 3, H(2)O(2), and ammonia are produced, and also lower concentrations of 2, 4, 7, and 9 as a result. We also show that reactions of this mixture with H(2)O(2) produce delta-aminovaleric acid (5) and delta-valerolactam (6), with 6 being the dominant component under the naturally acidic conditions of ink. Thus, the product of escapin's action on L-lysine contains an equilibrium mixture that is more complex than previously known for any L-amino acid oxidase.

Spiny lobsters detect conspecific blood-borne alarm cues exclusively through olfactory sensilla

When attacked by predators, diverse animals actively or passively release molecules that evoke alarm and related anti-predatory behavior by nearby conspecifics. The actively released molecules are alarm pheromones, whereas the passively released molecules are alarm cues. For example, many insects have alarm-signaling systems that involve active release of alarm pheromones from specialized glands and detection of these signals using specific sensors. Many crustaceans passively release alarm cues, but the nature of the cues,sensors and responses is poorly characterized. Here we show in laboratory and field experiments that injured Caribbean spiny lobsters, Panulirus argus, passively release alarm cues via blood (hemolymph) that induce alarm responses in the form of avoidance and suppression of feeding. These cues are detected exclusively through specific olfactory chemosensors,the aesthetasc sensilla. The alarm cues for Caribbean spiny lobsters are not unique to the species but do show some phylogenetic specificity: P. argus responds primarily with alarm behavior to conspecific blood, but with mixed alarm and appetitive behaviors to blood from the congener Panulirus interruptus, or with appetitive behaviors to blood from the blue crab Callinectes sapidus. This study lays the foundation for future neuroethological studies of alarm cue systems in this and other decapod crustaceans.

To paddle or not: context dependent courtship display by male blue crabs, Callinectes sapidus

The nature of the courtship signalling used by a species is shaped by many factors, one of which is its habitat. Male blue crabs, Callinectes sapidus, have a courtship display in which they elevate their body by standing high on their legs, open their chelae and paddle their swimming legs. This courtship display is not reported in other swimming (portunid) crabs and is rarely expressed in laboratory experiments on male blue crabs. In this study, we characterised this display, which we call ;courtship stationary paddling', and distinguished it from other types of paddling. To explain the species specificity of courtship stationary paddling, we hypothesised that this behaviour is an adaptation to low visibility and abundant refuges in the habitat of blue crabs, and that this behaviour enhances chemical signalling when females are relatively inaccessible to males. We used particle imaging velocimetry to visualise water currents generated during courtship stationary paddling, showing that it created water currents directed away from the male and towards the female, thus enhancing chemical signalling. We also showed that males did not perform courtship stationary paddling when females were freely walking such that males could quickly contact and cradle carry them. Rather, males typically performed courtship stationary paddling only when females were inaccessible to them. These results indicate that courtship stationary paddling is a context-dependent behaviour, occurring only when females are not accessible to males, and suggesting that it evolved as an adaptation to life in habitats with many refuges and low visibility.

L-Kynurenine, an amino acid identified as a sex pheromone in the urine of ovulated female masu salmon

Many animals employ sex pheromones to find mating partners during their reproductive seasons. However, most sex pheromones of vertebrates remain to be identified. Over the past 20 years, steroids and prostaglandins have been identified as sex pheromones in several fishes. These pheromones are broadly termed "hormonal pheromones" because they or their precursors act as hormones in these fishes. Hitherto, no other type of sex pheromone has been unambiguously identified in teleost fish. Here we report the identification of a "nonhormonal pheromone" in teleost fish. The urine of the reproductively mature female masu salmon (Oncorhynchus masou) contains a male-attracting pheromone. Bioassay-guided fractionation yielded an active compound that was identical to L-kynurenine in spectral and chromatographic properties. L-Kynurenine is a major metabolite of L-tryptophan in vertebrates. This pheromone elicits a male-specific behavior at even picomolar concentrations; its electrophysiological threshold is 10(-14) M. L-Kynurenine is a reasonable substance for female masu salmon to advertise their readiness for mating.

Packaging of chemicals in the defensive secretory glands of the sea hare Aplysia californica

Sea hares protect themselves from predatory attacks with several modes of chemical defenses. One of these is inking, which is an active release of a protective fluid upon predatory attack. In many sea hares including Aplysia californica and A. dactylomela, this fluid is a mixture of two secretions from two separate glands, usually co-released: ink, a purple fluid from the ink gland; and opaline, a white viscous secretion from the opaline gland. These two secretions are mixed in the mantle cavity and directed toward the attacking predator. Some of the chemicals in these secretions and their mechanism of action have been identified. In our study, we used western blots, immunocytochemistry, amino acid analysis, and bioassays to examine the distribution of these components: (1) an L-amino acid oxidase called escapin for A. californica and dactylomelin-P for A. dactylomela, which has antimicrobial activity but we believe its main function is in defending sea hares against predators that evoke its release; and (2) escapin's major amino acid substrates--L-lysine and L-arginine. Escapin is exclusively produced in the ink gland and is not present in any other tissues or secretions. Furthermore, escapin is only sequestered in the amber vesicles of the ink glandand not in the red-purple vesicles, which contain algal-derived chromophores that give ink its distinctive purple color. The concentration of escapin and dactylomelin-P in ink, both in the gland and after its release, is as high as 2 mg ml(-1), or 30 micromol ml(-1), which is well above its antimicrobial threshold. Lysine and arginine (and other amino acids) are packaged into vesicles in the ink and opaline glands, but arginine is present in ink and opaline at <1 mmol l(-1) and lysine is present in ink at <1 mmol l(-1) but in opaline at 65 mmol l(-1). Our previous results showed that both lysine and arginine mediate escapin's bacteriostatic effects, but only lysine mediates its bactericidal effects. Given that escapin's antimicrobial effects require concentrations of lysine and/or arginine >1 mmol l(-1), our data lead us to conclude that lysine in opaline is the primary natural substrate for escapin in ink. Furthermore, packaging of the enzyme escapin and its substrate lysine into two separate glands and their co-release and mixing at the time of predatory attack allows for the generation of bioactive defensive compounds from innocuous precursors at the precise time they are needed. Whether lysine and/or arginine are substrates for escapin's antipredatory functions remains to be determined.

Cloning, characterization and expression of escapin, a broadly antimicrobial FAD-containing L-amino acid oxidase from ink of the sea hare Aplysia californica

A 60 kDa monomeric protein isolated from the defensive purple ink secretion of the sea hare Aplysia californica was cloned and sequenced, and is the first sea hare antimicrobial protein to be functionally expressed in E. coli. Sequence analysis suggested that this protein is a flavin-containing l-amino acid oxidase (LAAO), with one predicted potential glycosylation site, although the glycosylation could not be experimentally confirmed. This protein, which we call ;escapin', has high sequence similarity to several other gastropod proteins. Escapin was verified by NMR, mass spectroscopy and HPLC to have FAD as its flavin cofactor. Escapin's antimicrobial effects, bacteriostasis and bactericidal, were determined using a combination of two assays: (1) incubation of bacteria on solid media followed by assessment of inhibition by direct observation of zones of inhibition or by turbidity measurements; and (2) incubation of bacteria in liquid media followed by counting viable colonies after growing on agar plates. Native escapin inhibited the growth of Gram-positive and Gram-negative bacteria, including marine bacteria (Vibrio harveyii and Staphylococcus aureus) and pathogenic bacteria (Staphylococcus aureus, Streptococcus pyogenes and Pseudomonas aeruginosa). Escapin also inhibited the growth of yeast and fungi, with different efficacies. Escapin's antimicrobial activity was concentration dependent and did not decrease when stored for more than 5 months at room temperature. Escapin was bacteriostatic and not bactericidal in minimal media (e.g. salt media) with glucose, yeast extract, and a mixture of 20 amino acids each at 50 micromol l(-1), but was bactericidal in media enriched with Tryptone Peptone. Escapin was also strongly bactericidal in media with l-lysine at concentrations as low as 3 mmol l(-1) and slightly bactericidal in 50 mmol l(-1) l-arginine, but not in most other amino acids even at 50 mmol l(-1). Escapin had high oxidase activity (producing hydrogen peroxide) with either l-arginine or l-lysine as a substrate and little to no oxidase activity with other l-amino acids. Hydrogen peroxide alone (without escapin or amino acids) was strongly bacteriostatic but poorly bactericidal, similar in this respect to l-arginine but different from l-lysine in the presence of escapin. Together these results suggest that there are multiple mechanisms to escapin's antimicrobial effects, with bacteriostasis resulting largely or entirely from the effects of hydrogen peroxide produced by escapin's LAAO activity, but bactericidal effects resulting from lysine-dependent mechanisms not directly involving hydrogen peroxide. Recombinant escapin expressed in bacteria was also active against Gram-positive and Gram-negative bacteria, suggesting that glycosylation is not essential for antimicrobial activity.

Behavioral and electrophysiological experiments suggest that the antennular outer flagellum is the site of pheromone reception in the male helmet crab Telmessus cheiragonus

Sexually competent females of Telmessus cheiragonus (helmet crab) release two pheromones that elicit grasping and copulation behaviors in males (Kamio et al., 2000, 2002, 2003). Our study aimed to use behavioral and electrophysiological techniques to identify the site of reception of these sex pheromones. In behavioral experiments, either the inner or the outer flagella of the antennules were ablated bilaterally from male crabs, and responses of male crabs to female odor were examined. When the inner flagella were surgically ablated, the sexual response (i.e., grasping and copulation behavior) of male crabs was not significantly changed relative to control animals that had their second antennae ablated. In contrast, the sexual response was significantly reduced when the outer flagella of the antennules were ablated, suggesting that the outer flagellum is the receptor organ that detects the sex pheromones. In electrophysiological experiments, urine, which in females contains the pheromone that elicits grasping behavior by males but does not contain the pheromone eliciting copulation, whose release site is not known, was tested. Female and male urine as well as shrimp extract evoked phasic responses of chemosensory afferents innervating aesthetasc sensilla on the outer flagellum of male crabs. The response of the afferents had significantly higher magnitude and lower threshold when female urine was applied. Thus, behavioral and electrophysiological observations suggest that in male helmet crabs, the outer flagellum of the antennule is the chemosensory organ that detects female sex pheromone.

Problems in health management of professional boxers in Japan

OBJECTIVE

To investigate whether the incidence of boxing accidents is higher in Japan than in other countries.

METHOD

A nationwide survey of boxers was conducted.

RESULTS

A total of 632 boxers responded. Most Japanese boxers were relatively mature when they started boxing (mean starting age of 19.2 years). A high percentage of boxers was found three weight divisions higher than previously reported. Many boxers stated that losing weight was not a big problem. It was found that a punch that turns the head can cause serious physical damage, and it was clarified that only a simple punch, rather than accumulated damage from multiple punches, can cause cerebral concussion. Severe shock causing retrograde amnesia is very rare after a fight and disappears relatively quickly. Many additional symptoms are related to damage to the hearing organs, such as hearing difficulties, tinnitus, and vertigo, but these symptoms also resolve quickly. Many boxers experience memory disturbance, not just after a fight but in daily life.

CONCLUSION

The approach to boxing has become more oriented towards the method of practice and scientific training, rather than psychological factors, which used to be emphasised.

Endoscopic transnasal approach to the pituitary lesions using a navigation system (InstaTrak system): technical note

The endoscopic transnasal approach has become a procedure of choice for the surgical management of pituitary lesions. However, in conventional endoscopic transnasal surgery, the surgeon may become disorientated to the actual operating position. In our series, 31 patients have undergone an endoscopic transnasal approach to the pituitary lesions with the use of the navigation system InstaTrak for real-time imaging. This image guidance system proved valuable for anatomic localization during pituitary surgery. We have reduced the average surgical time, and improved patient outcome. As consequence, complications during surgery should decrease and safety should increase. Intraoperative image guidance is expected to have major advantageous effects on pituitary surgery by allowing the surgeon to remove pathology more efficiently. As this system is improved technically and surgeons become more proficient in its use, there should be better postoperative outcomes.

Endoscopic transnasal approach to the pituitary lesions using navigation system (InstaTrak System)

Endoscopic transnasal approach has become a procedure of choice for the surgical management of pituitary lesions. However, in conventional endoscopic transnasal surgery, the surgeon may become disorientated to the actual operating position. In our series, 47 patients have undergone an endoscopic transnasal approach to the pituitary with the use of the navigation system called InstaTrak for real-time imaging. This image guidance system proved valuable for anatomical localization during pituitary surgery. We have reduced the average surgical time, and improved patient outcome. As a consequence, complications during surgery should decrease and safety should increase. Intra-operative image guidance is expected to have major advantageous effects on pituitary surgery by allowing the surgeon to remove lesions more efficiently. As this system is improved technically and surgeons become more proficient in their use, there should be better postoperative outcomes.

Endoscopic transethmosphenoidal approach for pituitary tumors with image guidance

The advantages of endoscopic transethmosphenoidal surgery for pituitary tumors using a navigation system were reported. The surgical technique was as follows. First, sphenoidal sinuses were opened via the bilateral ethmoidal sinuses and the olfactory clefts. Then the septum of the sphenoidal sinuses was resected. Next, an endoscope was inserted via the left nasal cavity and fixed in place. The tumor was then removed via the right nasal cavity. Our approach for pituitary tumors provided sufficient working space and permitted the surgeon to carry out the procedure using both hands. In addition, use of the InstaTrak System made it possible to recognize the orientation of the surgical field in the sella turcica. Thus, the tumor could be resected more easily and safely. It is concluded that this approach will be particularly useful for patients with narrow nasal cavities or poor development of the paranasal sinuses.

Neuroendoscopic anatomy and surgery in pineal region tumors: role of neuroendoscopic procedure in the 'minimally-invasive preferential' management

The therapeutic modalities for pineal region tumors in Western countries differ from those in far-eastern countries, that is, Japan and Korea, mainly because of the different patient populations. The majority of pineal region tumors in Japan and Korea are radio sensitive and/or chemosensitive, and adjuvant therapy rather than extensive surgery plays the main part in the treatment of these tumors. The authors have applied minimally-invasive preferential management in pineal region tumors in last 8 years. For the therapeutic regimen, if the tumor markers alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG) were not detected in serum and there was significant ventricular dilation visualized on neuroimages, neuroendoscopic surgery was first applied for tumor debulking with tissue diagnosis and gross morphological analysis of the tumor and the intraventricular structures, followed by third-ventriculostomy. In the results, our minimally-invasive preferential regimen clarified the precise indication for neuroendoscopic procedures, and the majority of our patients with dilated ventricles and no evidence of tumor markers were treated satisfactorily with effective neuroendoscopic procedures as the initial procedure. Then avoided unnecessary craniotomy and radiotherapy and promised excellent therapeutic outcomes. Neuroendoscopic procedures have a great advantage in the management of chemo- or radiosensitive tumors, such as germinoma, pineoblastoma, or primitive neuroectodermal tumor. The neuroendoscopic anatomy including the lateral and third ventricles with a pineal region tumor with or without tumor dissemination was described in detail, together with the neuroendoscopic surgical technique.

Human alpha-and beta-defensin immunoreactivity in oral mucoepidermoid carcinomas

The purpose of this study was to demonstrate the immunohistochemical localization and distribution of human alpha- and beta-defensins, peptides with antimicrobial activity, in oral mucoepidermoid carcinoma tissue. Tissue samples were embedded in paraffin and alpha- and beta-defensins were immunostained by the streptavidin-biotin coupled peroxidase method. Cancer cells that constituted the ducts, as well as neutrophils, were positively immunostained with the anti-alpha-defensin antibody (HNPs). On the other hand, epidermoid cells and intermediate cells were intensely stained with the anti-beta-defensin-2 (HBD-2) antibody. Mucous-secreting cells were clearly not immunostained with the anti-HBD-2 antibody. The epithelial hyperplasia region adjacent to the tumor tissues was also positively immunostained with the anti-HBD-2 antibody.

Differences in umbilical venous and arterial leptin levels by mode of delivery

OBJECTIVE

To investigate the differences in umbilical venous and arterial leptin levels by mode of delivery.

METHODS

Subjects were 30 mothers who had elective cesarean deliveries and 34 mothers who had vaginal deliveries. Umbilical venous and arterial leptin levels were measured immediately after delivery. Maternal age, neonatal gender, neonatal birth weight, placental weight, and gestational duration were recorded. Inter- and intragroup comparisons were made in umbilical venous and arterial leptin levels and obstetric variables. Significant determinants of differences in umbilical venous and arterial leptin levels were investigated.

RESULTS

Umbilical venous and arterial leptin levels were higher in the vaginal delivery group (n = 34) than in the cesarean group (n = 30) (P <.01). In the vaginal delivery group, umbilical venous leptin levels were significantly higher than arterial leptin levels (P <.001). These differences were still significant after adjustment for neonatal gender, neonatal birth weight, and placental weight. However, in the cesarean group, leptin levels did not differ between umbilical vein and artery.

CONCLUSION

Placental leptin release is augumented during advanced labor.

[Efficacy of endoscopic transethmoidal.transsphenoidal surgery for pituitary tumors]

Endoscopic transethmoidal.transsphenoidal surgery was performed on 30 patients with pituitary tumors, and the usefulness of this procedure was evaluated. As with conventional endoscopic intranasal surgery, the ethmoidal sinuses were opened and a broad window was created in the ethmoidal sinus from the directions of the middle meatus and the olfactory cleft. Then an endoscopic washing device was attached to a 0 degree or 30 degrees rigid endoscope and it was immobilized in the left nasal cavity with an endoscope immobilization apparatus. Removal of the tumor was then started from the right side by a bimanual technique. Based on the results, this surgical procedure was judged to be useful for the following reasons (1) it makes it easy to carry out the operative manipulations even in a narrowed nasal cavity, thereby reducing the overall time required for surgery, and (2) it is possible to prevent postoperative deformities of the nasal cavity morphology caused by pressure on its lateral wall. In additional, (3) the surgical wound can be observed, and CSF leakage can be repaired immediately after completion of the operation. Corrective surgery can be performed on an outpatient basis early after the initial operation to correct postoperative deformities of the nasal paranasal cavities, which might later cause nasal obstruction or an olfactory disturbance. Finally, (4) employing the route of endoscopic transethmoidal.transsphenoidal surgery facilitates the performance of a second operation soon, or even several months, after the first operation. A second operation may be necessary in the event of recurrence of the pituitary tumor or complication by chronic sinusitis. On the basis of our experience in the this study, we conclude that our method of endoscopic transethmoidal.transsphenoidal surgery will be useful for reducing invasiveness in the nasal cavities and achieving maximum prevention of postoperative complications. In order to fulfill its potential, neurosurgeons will need to master forceps techniques in the visual field provided by the endoscope and to cooperate with otorhinologists who are skilled in endoscopic techniques.

Immunohistochemical staining of human alpha-defensin-1 (HNP-1), in the submandibular glands of patients with oral carcinomas

The purpose of this study was the immunohistochemical localization and distribution of HNP-1 in the submandibular glands of patients with oral carcinomas. Tissue sections were embedded in paraffin, and HNP-1 was immunostained by the streptavidin-biotin coupled peroxidase method. Striated duct cells in the submandibular glands were stained with anti-defensin antibody. Neutrophils and capillary intimal cells were also stained. Defensins (HNPs) are peptides that occur in neutrophils and protect against bacteria and tumor cells. Human alpha-defensin-1 (HNP-1) is such a peptide, possessing both antimicrobial and cytotoxic activities. The presence of HNP-1 in striated duct cells in the submandibular glands of oral cancer patients, suggests a likely role in tumor immunity, for this peptide.