Aspergillus oryzae α-l-rhamnosidase: Crystal structure and insight into the substrate specificity

The subsequent biochemical and structural investigations of the purified recombinant α-l-rhamnosidase from Aspergillus oryzae expressed in Pichia pastoris, designated as rAoRhaA, were performed. The specific activity of the rAoRhaA wild-type was higher toward hesperidin and narirutin, where the l-rhamnose residue was α-1,6-linked to β-d-glucoside, than toward neohesperidin and naringin with an α-1,2-linkage to β-d-glucoside. However, no activity was detected toward quercitrin, myricitrin, and epimedin C. rAoRhaA kinetic analysis indicated that Km values for neohesperidin, naringin, and rutin were lower compared to those for hesperidin and narirutin. kcat values for hesperidin and narirutin were higher than those for neohesperidin, naringin, and rutin. High catalytic efficiency (kcat /Km ) toward hesperidin and narirutin was a result of a considerably high kcat value, while Km values for hesperidin and narirutin were higher than those for naringin, neohesperidin, and rutin. The crystal structure of rAoRhaA revealed that the catalytic domain was represented by an (α/α)6 -barrel with the active site located in a deep cleft and two β-sheet domains were also present in the N- and C-terminal sites of the catalytic domain. Additionally, five asparagine-attached N-acetylglucosamine molecules were observed. The catalytic residues of AoRhaA were suggested to be Asp254 and Glu524, and their catalytic roles were confirmed by mutational studies of D254N and E524Q variants, which lost their activity completely. Notably, three aspartic acids (Asp117, Asp249, and Asp261) located at the catalytic pocket were replaced with asparagine. D117N variant showed reduced activity. D249N and D261N variants activities drastically decreased.

Photocatalytic 1,2-Phosphorus-Migrative [3 + 2] Cycloaddition of Tri(t-butyl)phosphine with Terminal Alkynes

Tri(t-butyl)phosphine and terminal alkynes undergo 1,2-phosphorus-migrative [3 + 2] cycloaddition in the presence of a proton source under photocatalytic conditions. The reaction exhibits broad functional group tolerance and affords substituted cyclic phosphonium salts, which are amenable to further derivatization by Wittig olefination. Theoretical studies suggest that the phosphorus 1,2-migration of a β-phosphonioalkyl radical proceeds through a phosphine radical cation-alkene complex as a pseudointermediate, and the two fragments in the intermediate are bound to each other through multiple noncovalent interactions.

Enhancement and maintenance of hepatic metabolic functions by controlling 3D aggregation of cryopreserved human iPS cell-derived hepatocyte-like cells

Hepatocyte-like cells (HLCs) generated from human induced pluripotent stem cells are potent cells to study individual-specific hepatotoxicity for drug screening test. However, the functions of metabolic enzymes are practically low. Here, we reconstituted stable and compact 3D spheroids of commercially available cryopreserved HLCs by our original spheroid formation method with high viscous methylcellulose medium. 3D formation enhanced the hepatic functions and maintained the functions for 14 days. Especially, the expression of cytochrome P450s was 10- to 100-fold enhanced compared to conventional 2D culture, which is applicable to a typical drug-metabolizing test using liquid chromatograph-tandem mass spectrometer. In conclusion, we successfully formed human HLC spheroid from commercially available cryo-preserved cells, which realized remarkable hepatic maturation by prolonged 3D culture, especially in terms of drug-metabolizing enzymes. Our spheroid formation technology has the potential to make HLC spheroids a potent tool in aspects of pharmaceutical research, such as drug screening and pharmacokinetic studies.

Spontaneous beat synchronization in rats: Neural dynamics and motor entrainment

Beat perception and synchronization within 120 to 140 beats/min (BPM) are common in humans and frequently used in music composition. Why beat synchronization is uncommon in some species and the mechanism determining the optimal tempo are unclear. Here, we examined physical movements and neural activities in rats to determine their beat sensitivity. Close inspection of head movements and neural recordings revealed that rats displayed prominent beat synchronization and activities in the auditory cortex within 120 to 140 BPM. Mathematical modeling suggests that short-term adaptation underlies this beat tuning. Our results support the hypothesis that the optimal tempo for beat synchronization is determined by the time constant of neural dynamics conserved across species, rather than the species-specific time constant of physical movements. Thus, latent neural propensity for auditory motor entrainment may provide a basis for human entrainment that is much more widespread than currently thought. Further studies comparing humans and animals will offer insights into the origins of music and dancing.

Extraction and Biological Evaluation of Matrix-Bound Nanovesicles (MBVs) from High-Hydrostatic Pressure-Decellularized Tissues

Decellularized tissues are widely used as promising materials in tissue engineering and regenerative medicine. Research on the microstructure and components of the extracellular matrix (ECM) was conducted to improve the current understanding of decellularized tissue functionality. The presence of matrix-bound nanovesicles (MBVs) embedded within the ECM was recently reported. Results of a previous experimental investigation revealed that decellularized tissues prepared using high hydrostatic pressure (HHP) exhibited good in vivo performance. In the current study, according to the hypothesis that MBVs are one of the functional components in HHP-decellularized tissue, we investigated the extraction of MBVs and the associated effects on vascular endothelial cells. Using nanoparticle tracking assay (NTA), transmission electron microscopy (TEM), and RNA analysis, nanosized (100–300 nm) and membranous particles containing small RNA were detected in MBVs derived from HHP-decellularized small intestinal submucosa (SIS), urinary bladder matrix (UBM), and liver. To evaluate the effect on the growth of vascular endothelial cells, which are important in the tissue regeneration process, isolated SIS-derived MBVs were exposed to vascular endothelial cells to induce cell proliferation. These results indicate that MBVs can be extracted from HHP-decellularized tissues and may play a significant role in tissue remodeling.

Mutational analysis of the effects of N-glycosylation sites on the activity and thermal stability of rutinosidase from Aspergillus oryzae

Purified recombinant rutinosidase from Aspergillus oryzae expressed in Pichia pastoris (rAoRutM) exhibits increase in thermal stability after treatment with endo-β-N-acetylglucosaminidase H (endo-H). In this study, the role of N-glycosylation in the activity and thermal stability of rAoRutM was analyzed via site-directed mutagenesis. Based on the crystal structure of AoRutM, five N-glycosylation sites (N32, N128, N176, N288, and N359) were identified in the AoRut protein. Among five single variants constructed for these sites, the N128D, N176D, and N359D variants exhibited similar mobility bands compared to that of the wild-type enzyme based on sodium dodecyl sulfate-polyacrylamide gel electrophoresis, whereas the N32D and N288D variants exhibited slightly and considerably increasing mobility bands, respectively. The N128D and N288D variants showed increasing and decreasing rutinosidase activity, respectively, compared to the case for the wild-type, without and with endo-H treatments. While the N128D and N176D variants had lower K_m values, the N288D and N359D variants had higher K_m values, compared to the wild-type, without and with endo-H treatments. Surprisingly, the N32D and N176D variants exhibited considerably greater thermal stability than the wild-type, without or with the endo-H treatments, whereas the N128D and N359D variants exhibited drastically decreased thermal stability. Circular dichroism (CD) spectra of the N128D and N359D variants showed a similar CD profile to that of the wild-type treated with endo-H; however, the molar ellipticity values of the peaks at 208 nm and 212 nm in the above variants varied from those of the intact wild-type and other variants.

Comprehensive validation of a wearable foot sensor system for estimating spatiotemporal gait parameters by simultaneous three-dimensional optical motion analysis

BACKGROUND

Use of a wearable gait analysis system (WGAS) is becoming common when conducting gait analysis studies due to its versatility. At the same time, its versatility raises a concern about its accuracy, because its calculations rely on assumptions embedded in its algorithms. The purpose of the present study was to validate twenty spatiotemporal gait parameters calculated by the WGAS by comparison with simultaneous measurements taken with an optical motion capture system (OMCS).

METHODS

Ten young healthy volunteers wore two inertial sensors of the commercially available WGAS, Physilog®, on their feet and 23 markers for the OMCS on the lower part of the body. The participants performed at least three sets of 10-m walk tests at their self-paced speed in the laboratory equipped with 12 high-speed digital cameras with embedded force plates. To measure repeatability, all participants returned for a second day of testing within two weeks.

RESULTS

Twenty gait parameters calculated by the WGAS had a significant correlation with the ones determined by the OMCS. Bland and Altman analysis showed that the between-device agreement for twenty gait parameters was within clinically acceptable limits. The validity of the gait parameters generated by the WGAS was found to be excellent except for two parameters, swing width and maximal heel clearance. The repeatability of the WGAS was excellent when measured between sessions.

CONCLUSION

The present study showed that spatiotemporal gait parameters estimated by the WGAS were reasonably accurate and repeatable in healthy young adults, providing a scientific basis for applying this system to clinical studies.

Photoinduced Hydrophosphination of Terminal Alkynes with Tri(o-tolyl)phosphine: Synthesis of Alkenylphosphonium Salts

Herein reported is a photoinduced hydrophosphination reaction of terminal alkynes with tri(o-tolyl)phosphine to form alkenylphosphonium salts. The reaction is more sustainable than conventional methods since it dispenses with the need for elaborated starting materials and precious transition metals. The o-methyl groups of tri(o-tolyl)phosphine play two important roles: (1) to guide the phosphorus radical to add onto the terminal sp carbon and (2) to donate a hydrogen atom onto the developing sp² carbon radical intramolecularly.

Laparoscopic remnant cholecystectomy for calculi in the remnant gallbladder following subtotal-cholecystectomy: a report of two cases

Two cases of laparoscopic remnant cholecystectomy using near-infrared fluorescence cholangiography (NIFC) for remnant gallbladder calculi following subtotal-cholecystectomy are reported. Case 1: a 36-year-old woman was referred to our hospital with acute abdomen. Computed tomography showed remnant gallbladder calculi, with detected no other findings as the cause of the abdominal pain. For intraoperative exploration of the biliary anatomy, 0.25 mg/kg of indocyanine green (ICG) was administered intravenously the day before the operation. NIFC clearly showed the common bile duct and enabled safe laparoscopic remnant cholecystectomy. She was free from symptoms after the operation. Case 2: a 40-year-old woman was referred to our hospital with epigastralgia due to remnant gallbladder calculi after open cholecystectomy. ICG was administered intravenously the day before the operation. Severe adhesions were observed in the upper abdominal cavity and there was tight adherence of the duodenum to the remnant gallbladder. NIFC showed a clear margin that appeared to be the margin between the duodenum and remnant gallbladder. However, dissection of the margin observed by NIFC caused perforation of the duodenum. The clear margin seen with NIFC was likely due to visualization of the gallbladder through the duodenum. Although NIFC is a useful modality for confirming the intraoperative biliary anatomy, it is important not to rely too heavily on NIFC alone, which may lead to misinterpretation of the anatomy.

Visible-Light-Driven Dehydrogenative Coupling of Primary Alcohols with Phenols Forming Aryl Carboxylates

A preparative method for obtaining aryl esters from aliphatic primary alcohols and phenols was developed. The reaction proceeds under the irradiation of visible light at ambient temperature, dispensing with any oxidant or hydrogen acceptor. Primary alcohols having a variety of functional groups are successfully esterified with phenols. The produced esters can be utilized as the precursor of various carbonyl compounds.

Photodriven Dehydrogenative Homocoupling of Benzylic C–H Bonds Forming Strained C–C Bonds

A photoinduced dehydrogenative homocoupling reaction of alkylarenes is reported. Gaseous hydrogen is evolved as the sole byproduct and neither oxidants nor hydrogen acceptors are required. The present reaction offers an environmentally benign and atom-economical means for forming sterically strained C–C single bonds. It also gives a remarkable example of photodriven reactions overcoming a considerable rise in energy.

A Kinetic Pump Integrated Microfluidic Plate (KIM-Plate) with High Usability for Cell Culture-Based Multiorgan Microphysiological Systems

Microphysiological systems (MPSs), including organ-on-a-chip (OoC), have attracted attention as a novel method for estimating the effects and side effects of drugs in drug discovery. To reproduce the dynamic in vivo environment, previous MPSs were connected to pump systems to perfuse culture medium. Therefore, most MPSs are not user-friendly and have poor throughput. We aimed to develop a kinetic pump integrated microfluidic plate (KIM-Plate) by applying the stirrer-based micropump to an open access culture plate to improve the usability of MPSs. The KIM-Plate integrates six multiorgan MPS (MO-MPS) units and meets the ANSI/SBS microplate standards. We evaluated the perfusion function of the kinetic pump and found that the KIM-Plate had sufficient agitation effect. Coculture experiments with PXB cells and hiPS intestinal cells showed that the TEER of hiPS intestinal cells and gene expression levels related to the metabolism of PXB cells were increased. Hence, the KIM-Plate is an innovative tool for the easy coculture of highly conditioned cells that is expected to facilitate cell-based assays in the fields of drug discovery and biology because of its usability and high throughput nature.

Pseudocystic Osteosarcoma: A Potential Diagnostic Pitfall – Case Report

Introduction:

Pseudocystic osteosarcoma (OS) is an uncommon variant of conventional OS. Clinical and radiological features are presented as benign process with a non-rapid growth rate. Treatment may be adversely affected by the delay in diagnosis or an appropriate invasive procedure.

Case Presentation:

We report a rare case of pseudocystic OS of the distal femur in a 6-year-old boy. Imaging findings revealed an osteolytic intra-compartmental tumor, that suggested either simple bone cyst or subacute osteomyelitis. The patient was first operated by lateral approach for curettage but histopathology showed conventional OS. Treatment had been managed by standard current chemotherapy and trans-epiphyseal intercalary resection through lateral approach. Reconstruction was done by a non-vascularized autograft within the induced membrane technique. At 3 years of follow-up, the patient remained disease-free with good anatomical and functional results.

Conclusion:

conventional OS can be presented in rare cases as a benign bone cyst tumor. This type of pseudocystic OS should be included in the differential diagnosis of bone cyst tumors and pseudo-tumors.

Intra-articular Lipoma of the Knee Joint Located in the Lateral Recess: A Case Report

Introduction:

Lipomas are the most common type of soft-tissue tumor, but intra-articular lipomas are very rare. Most cases occur in the knee joint. This is a report of intra-articular lipoma in the knee joint, 8 months after removal with good post-operative outcome.

Case Report:

A 56-year-old female who presented soft-tissue mass on her right knee. She felt uncomfortable but not in pain. The mass grew gradually and she wanted to be surgically removed. The mass was too large (5 cm × 4 cm × 2 cm) to be removed endoscopically, so arthrotomy was made. The mass was true lipoma histologically. She is living happily without recurrence after surgery.

Conclusion:

We have described an intra-articular synovial lipoma in the knee of a middle-aged female. Intra-articular lipomas are very rare. The tumor in this case was relatively large but painless, and the chief complaint was discomfort. It grew gradually, so the removal was performed. At present, the patient is living happy without recurrence after surgery.

Nickel-Catalyzed α-1,3-Dienylation of 1,3-Dicarbonyl Compounds with Propargylic Carbonates

Herein reported is a nickel-catalyzed α-1,3-dienylation reaction of 1,3-dicarbonyl compounds with substituted propargylic (e.g., but-2-ynyl) carbonates. The propargyl unit changes into a 1,3-dienyl unit, which is incorporated at the α-position of the 1,3-dicarbonyl compounds.

Cleavage of Carbon-Carbon σ-Bonds of Four-Membered Rings

This article reviews synthetic transformations involving cleavage of a carbon-carbon bond of a four-membered ring, with a particular focus on the examples reported during the period from 2011 to the end of 2019. Most significant is the progress of catalytic reactions involving oxidative addition of carbon-carbon bonds onto transition metals or β-carbon elimination of transition metal alkoxides. When they are looked at from synthetic perspectives, they offer unique and efficient methods to build complex natural products and structures that are difficult to construct by conventional methods. On the other hand, β-scission of radical intermediates has also attracted increasing attention as an alternative elementary step to cleave carbon-carbon bonds. Its site-selectivity is often complementary to that of transition metal-catalyzed reactions. In addition, Lewis acid-mediated and thermally induced ring-opening of cyclobutanone derivatives has garnered renewed attention. On the whole, these examples demonstrate unique synthetic potentials of structurally strained four-membered ring compounds for the construction of organic skeletons.

Photoinduced Specific Acylation of Phenolic Hydroxy Groups with Aldehydes

A convenient method is reported to specifically acylate phenolic hydroxyl groups through a radical pathway. When a mixture of an aldehyde and a phenol in ethyl acetate is irradiated with blue light in the presence of iridium and nickel bromide catalysts at ambient temperature, phenoxyl and acyl radicals are transiently generated in situ and cross-couple to furnish an ester. Aliphatic hydroxy groups remain untouched under the reaction conditions.

Palliative Care of Malignant Fibrous Histiocytoma of Spine with Cord Compression and Multiple Bone Metastases Treated by Multidisciplinary Therapy: Case Report

Malignant fibrous histiocytoma (MFH) of the spine is rare, with only a few dozen cases reported in the literature. A 60-year-old male was referred to us with symptoms of thoracic myelopathy. A solid tumor in the Th8 right costovertebral junction invading the spinal canal and compressing the spinal cord, and multiple bony metastases were discovered. Biopsy confirmed MFH. The thoracic spine tumor showed good response to irradiation followed by embolization and partial resection. The patient was followed until his death 22 months later. A good quality of life was sustained for more than 18 months. Despite a poor prognosis and an aggressive course of MFH of the spine, a good quality of life could be sustained for more than a year with palliative interventions.

Dehydrogenative Coupling of Benzylic and Aldehydic C-H Bonds

A photoinduced dehydrogenative coupling reaction between benzylic and aldehydic C-H bonds is reported. When a solution of an alkylbenzene and an aldehyde in ethyl acetate is irradiated with visible light in the presence of iridium and nickel catalysts, a coupled α-aryl ketone is formed with evolution of dihydrogen. An analogous C-C bond forming reaction occurs between a C-H bond next to the nitrogen of an N-methylamide and an aldehydic C-H bond to produce an α-amino ketone. These reactions provide a straightforward pathway from readily available materials leading to valued structural motifs of pharmacological relevance.

Intra-articular Mass of the Knee by Gout Tophus: A Case Report

Gout is a relatively common condition in the population today. With progressing of the treatment of the hyperuricaemia, the case of producing a tophus decreases year by year. On the other hand, people who are leaved without treatment is increasing, and severe cases are also seen. Intra-articular tophus is rare, but some cases have been reported in the knee. In this, a case of 33-year-old man who had an intra-articular mass of the knee by gout tophus, causing the limitation of the range of motion is reported. The patient didn’t improve with conservative treatment, so he had to undergo surgery. After arthroscopic excision of the tumour, the patient was symptom free. There had been no recurrence of symptoms at the two-year follow-up.

Carboxylation of Benzylic and Aliphatic C-H Bonds with CO2 Induced by Light/Ketone/Nickel

A photoinduced carboxylation reaction of benzylic and aliphatic C-H bonds with CO₂ is developed. Toluene derivatives capture gaseous CO₂ at the benzylic position to produce phenylacetic acid derivatives when irradiated with UV light in the presence of an aromatic ketone, a nickel complex, and potassium tert-butoxide. Cyclohexane reacts with CO₂ to furnish cyclohexanecarboxylic acid under analogous reaction conditions. The present photoinduced carboxylation reaction provides a direct access from readily available hydrocarbons to the corresponding carboxylic acids with one carbon extension.

Light/Palladium-Promoted Benzylic C-H Acylation Using a Benzoyl Group as the Photo-Directing Group

2-Methylphenyl ketones undergo site-selective acylation at the benzylic position when treated with acid anhydride under UV irradiation in the presence of a palladium catalyst. The benzoyl carbonyl group serves as the photo-directing group so that the ortho benzylic C-H bond is activated site-selectively.

Quality control of hospital preparations: Establishment of a simple and rapid method for quantifying ulinastatin in vaginal suppositories

Ulinastatin vaginal suppositories, used to prevent threatened premature delivery, are frequently used in hospitals. However, there is no established method for quantifying ulinastatin contained in suppositories. Therefore, we investigated a simple and efficient method for quantifying ulinastatin contained in suppositories. Our analytical method involved removal of the base; optimising the enzyme inhibition reaction time and enzyme reaction time; and measuring the absorbance. The modified method was reproducible, operation time was significantly shortened, and cost was reduced to approximately 1/17 of that of the previously reported method. This simple and rapid quantitative method could contribute to the improvement of quality control of ulinastatin vaginal suppositories as an extemporaneous hospital preparation.

Diagonal Trajectory Posterior Screw Instrumentation for Compromised Bone Quality Spine: Groove-Entry Technique/Hooking Screw Hybrid

Introduction

In an attempt to increase anchoring strength of posterior instrumentation in spine with compromised bone quality, we introduced diagonal trajectory pedicle screwing (hooking screws) that do not rely on screw thread purchase in bone but rather hook onto the strong posterior elements of vertebrae from inside the bone.

Methods

Between November 2016 and July 2017 we treated eight patients, mean age 80 years old (75-86 years old) with compromised bone quality for spinal instability. The diagnosis was osteoporotic fracture nonunion in three, ankylosed spine fracture in three, pyogenic spondylitis in two cases. All spines were percutaneously instrumented. Groove-entry technique was used for down-going thoracic screws. No additional hooks, cables, or any other augmentation was used. All patients were mobilized on post-operative day 1.

Results

84 screws were inserted overall. Groove-entry technique was used for 42 screws insertion. On average, 5.3 spinal segments were fixed per case. Mean operation time was 252 min (46 min per one spinal segment). Mean intraoperative bleeding was 112 ml per case (21 ml per one fixed spinal segment). All cases achieved bony union of the fracture site or across the destroyed intervertebral disk. Mean time to union was 4 months postop (3-7 months). All patients were ambulatory at the time of discharge. No nerve injury, no skin irritation caused by implants, no screw loosening, no screw pullout, no loss of correction, and no junctional kyphosis were noted in this series.

Conclusions

Diagonal screw instrumentation (our hooking screws and groove-entry technique) appears to provide sufficient anchoring strength while being minimally invasive and possibly helpful in prevention of junctional kyphosis.

Universal holonomic single quantum gates over a geometric spin with phase-modulated polarized light

We demonstrate universal non-adiabatic non-abelian holonomic single quantum gates over a geometric electron spin with phase-modulated polarized light and 93% average fidelity. This allows purely geometric rotation around an arbitrary axis by any angle defined by light polarization and phase using a degenerate three-level Λ-type system in a negatively charged nitrogen-vacancy center in diamond. Since the control light is completely resonant to the ancillary excited state, the demonstrated holonomic gate not only is fast with low power, but also is precise without the dynamical phase being subject to control error and environmental noise. It thus allows pulse shaping for further fidelity.

Synthetic Approach to Benzocyclobutenones Using Visible Light and a Phosphonate Auxiliary

Reported herein is a two-step procedure to synthesize benzocyclobutenones from (o-alkylbenzoyl)phosphonates. It consists of a visible-light-driven cyclization reaction forming phosphonate-substituted benzocyclobutenols and subsequent elimination reaction of the H-phosphonate, which assumes a key role as the recyclable auxiliary. A wide variety of functionalized benzocyclobutenones, which include those difficult to synthesize by conventional methods, are efficiently synthesized.

Abstract P4-08-07: PIK3CA mutation, reduced AKT serine 473 phosphorylation, and increased ERα serine 167 phosphorylation are positive prognostic indicators in postmenopausal estrogen receptor-positive, HER2-negative early breast cancer

Background: Endocrine therapy is the most important treatment option for women with estrogen receptor (ER)-positive breast cancer. We recently reported that approximately two-thirds of patients who relapsed within 5 years had received anthracyclins and/or taxanes as adjuvant or neoadjuvant chemotherapy in addition to adjuvant endocrine therapy. New strategies, such as signal transduction inhibitors together with endocrine therapy are required to improve survival. PIK3CA mutations are detected in almost 40% of early ER-positive breast cancers, and are therefore the most frequent genetic alterations in this subtype. PIK3CA mutation status is reported to affect activation of AKT and ERα. Moreover, recent studies demonstrate that patients had a better prognosis when tumors expressed ER, androgen receptor (AR), and vitamin D receptor (VDR).

Methods: Expression of AR and VDR, phosphorylation of AKT serine (Ser) 473 (AKT phospho-Ser473) and ERα Ser167 (ERα phospho-Ser167) were examined by immunohistochemistry in ER-positive, HER2-negative early breast cancer tissues. Seventeen mutations in exons 1, 4, 7, 9, and 20 of the PIK3CA gene were detected in genomic DNA extracted from formalin-fixed paraffin-embedded tumor blocks. Correlations between these biological markers and clinicopathological factors and prognosis were analyzed separately in pre- and postmenopausal women.

Results: Levels of AKT phospho-Ser473 were significantly higher in premenopausal women (n = 62) than in postmenopausal women (n = 152) (P < 0.0001 and P = 0.014, respectively). In contrast, expression levels of AR were significantly higher in postmenopausal women than in premenopausal women (P < 0.0001). In premenopausal women, 26 tumors (43%) had a single mutation of PIK3CA gene, and 3 tumors (5%) had mutations at two sites. In postmenopausal women, 64 tumors (44%) had a single PIK3CA mutation, 6 tumors (4%) had mutations at two sites, and one tumor (1%) had mutations at three sites. In premenopausal women, wild type PIK3CA was associated with smaller tumor size, higher ER expression levels, and lower AR expression levels when compared with women in the same cohort with PIK3CA mutant tumors. In postmenopausal women, patients with PIK3CA wild-type tumors had higher Ki67 labeling index, higher AKT phospho-Ser473, and lower ERα phospho-Ser167 when compared to patients with PIK3CA mutant tumors. Postmenopausal women with PIK3CA wild-type tumors had significantly worse disease-free survival than patients with PIK3CA mutant tumors (P = 0.007). In contrast, PIK3CA mutation status was not correlated with survival in premenopausal women. Low levels of AKT phospho-Ser473 and high levels of ERα phospho-Ser167 were strongly associated with increased disease-free survival in postmenopausal women (P = 0.016 and P = 0.0016, respectively).

Conclusion: ERα activation, in addition to PIK3CA mutation, may be biomarkers for highly endocrine-responsive tumors. This would facilitate the selection of postmenopausal ER-positive breast cancer patients who are likely to benefit from endocrine therapy alone from those who are not.

Citation Format: Ishida N, Hatanaka Y, Baba M, Hagio K, Okada H, Hatanaka KC, Matsuno Y, Yamashita H. PIK3CA mutation, reduced AKT serine 473 phosphorylation, and increased ERα serine 167 phosphorylation are positive prognostic indicators in postmenopausal estrogen receptor-positive, HER2-negative early breast cancer [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 P4-08-07.

Gastric liposarcoma resected by laparoscopic total gastrectomy to achieve a wide surgical margin

Gastric liposarcoma is an extremely rare tumour that usually affects the extremities and retroperitoneum. Preoperative diagnosis is difficult, and operative procedures are not well standardised. A 61-year-old woman presented with melaena, epigastric discomfort and palpitations. Upper endoscopy revealed a submucosal tumour at the posterior gastric fundus with an actively bleeding ulcer on the top. Our preoperative diagnosis was lipoma, and we performed laparoscopic intragastric surgery. However, the histopathological diagnosis was liposarcoma. Laparoscopic total gastrectomy was performed to achieve a wide surgical margin. Several recent series have shown that a positive microscopic margin is associated with a higher rate of local recurrence than a negative margin. We have added a staged operation to obtain a wide margin in cases involving a positive surgical margin. Preoperative diagnosis of liposarcoma is still challenging. Gastric lipoma-like tumours should be resected with a wide margin because of their possibility of malignancy.