Insight into the latitudinal gradient of biodiversity based on spatial variations in pelagic ciliate communities along the western Arctic Ocean

The latitudinal dynamics of biodiversity has been the focus of global attention. This study is based on the latitude gradient of biodiversity in the spatial changes of pelagic ciliate communities in the western Arctic Ocean. The gradient pattern of pelagic ciliate communities across four latitudes were investigated from the water surface at 22 sampling station in the northern Bering Sea of the western Arctic Ocean and Chukchi Sea from August 5 to August 24, 2016. Based on multivariate analyses, the results showed that (1) the spatial patterns of pelagic ciliates represented a significant latitudinal gradient along the western Arctic Ocean; (2) the species number and abundance of pelagic ciliate communities declined from 64°N to 80°N; (3) variations in the horizontal distribution of ciliates were significantly correlated with changes in physicochemical variables, especially water temperature and Chl a; Thus it is suggested that the expected latitudinal decline of biodiversity was evident along the western Arctic Ocean.

Atlantic-origin water extension into the Pacific Arctic induced an anomalous biogeochemical event

The Arctic Ocean is facing dramatic environmental and ecosystem changes. In this context, an international multiship survey project was undertaken in 2020 to obtain current baseline data. During the survey, unusually low dissolved oxygen and acidified water were found in a high-seas fishable area of the western (Pacific-side) Arctic Ocean. Herein, we show that the Beaufort Gyre shrinks to the east of an ocean ridge and forms a front between the water within the gyre and the water from the eastern (Atlantic-side) Arctic. That phenomenon triggers a frontal northward flow along the ocean ridge. This flow likely transports the low oxygen and acidified water toward the high-seas fishable area; similar biogeochemical properties had previously been observed only on the shelf-slope north of the East Siberian Sea.

[The implementation and management of disease risk reduction claims in the European Union and the United States]

The improvement of food labeling can improve consumers' health awareness, reduce the burden of chronic diseases on the health and economy, and promote the development of the healthy food industry. Disease Risk Reduction Claim has been developed in European Union and the U.S. for over 20 years, with mature management methods and experience, but it is still lacking in China. Learning and drawing on the international management experience of food disease risk reduction claims can assist China to establish food disease risk reduction claims and improve the food health claims and labeling system.

Regional inequality of socioeconomic status and the prevalence of hypertension between rural and urban areas

Background

Lower socioeconomic status (SES) is associated with greater burdens of cardiovascular disease in a community. The regional disparity of SES may result in an uneven distribution of hypertension (HTN) by a region. This study aims to analyze the regional disparity in the SES and HTN burden between rural and urban areas of the Korea.

Methods

We used data from the Korea National Health and Nutrition Examination Survey (KNHANES) V (2010–2012), VI (2013–2015), and VII (201–2018). We analyzed 11,206 and 1739 subjects from Seoul metropolitan and rural area (Gangwon province), respectively. We compared socioeconomic characteristics, the distribution of HTN between two regions. Finally, we performed a multivariate logistic regression adjusting for traditional CV risk factors and SES status to examine differences in the prevalence of HTN.

Results

Subjects in Gangwon province were older than Seoul (54.6±0.4 vs 49.4±0.2 years old, p<0.001). The proportions of subjects with low economic status and low education level were significantly higher in Gangwon province compared to Seoul (low economic status; 25.6 vs 14.4%, p<0.001, low education level; 35.3 vs 16.5%, p<0.001). Mean systolic blood pressure (SBP) was higher in Gangwon compared to Seoul (121.6±0.4 vs 118.1±0.2 mmHg, p<0.001). In the longitudinal trend from KNHANES V to VII, the difference of SBP between the two regions increased (Figure). The age-matched prevalence of HTN was significantly higher in Gangwon compared to Seoul (23.8 vs 21.6%, p<0.05), and the difference of prevalence of HTN by regions longitudinally increased (Figure). In the univariate analysis, the residency in Gangwon was associated with the presence of HTN (reference: Seoul, OR=1.63; 95% CI: 1.45–1.83). In the multivariate logistic regression model, the residency in Gangwon was not associated, however, low economic status and low education level were significantly associated with the presence of HTN (economic status, OR=1.39; 95% CI: 1.17–1.67, education level, OR=1.88; 95% CI: 1.57–2.24).

Conclusion

The SES status was lower and the prevalence of HTN was higher in Gangwon compared to Seoul. The burden of HTN longitudinally increased in Gangwon, but not in Seoul. The poor SES was significantly associated with HTN. It suggests that the inequalities of SES in Gangwon may contribute to the increasing prevalence of HTN. The regional and individual disparity of SES should be considered in the establishment of public health strategies for HTN.

Funding Acknowledgement

Type of funding sources: None.

Impact of dementia and drug compliance on patients with acute myocardial infarction

Background

There has been a worrying rise in the number of people with dementia, especially with many of them also suffering from acute myocardial infarction (AMI), a disease with a high mortality rate.

Purpose

We evaluated the impact of dementia on the mortality of patients with AMI and how drug compliance affects this relationship.

Methods

The data were derived from National Health Insurance Service-Senior. The total number of patients diagnosed with AMI for the first time between 2007 and 2013 was 16,835, among whom 2,021 had dementia. Medication possession ratio (MPR) was used to assess medication adherence.

Results

AMI patients with dementia had unfavorable baseline characteristics; they had significantly higher risk of all-cause mortality (Hazard ratio [HR]: 2.49; 95% confidence interval (CI): 2.34–2.66; P<0.001) and lower MPR (aspirin: 21.9% vs. 42.8%; P<0.001). AMI patients were stratified by presence of dementia and medication adherence, and the survival rate was the highest among those with no dementia and good adherence. followed by those with no dementia and poor adherence, those with dementia and good adherence, and those with dementia and poor adherence. The multivariable analysis revealed that dementia (HR: 1.64; 95% CI: 1.53–1.75; P<0.001) and poor adherence to medication (HR: 1.60; 95% CI: 1.49–1.71; P<0.001) had a significant association with all-cause mortality in AMI patients.

Conclusions

AMI patients with dementia have a higher mortality rate. Patients with dementia have poorer medication adherence than those without, negatively affecting their prognosis.

Funding Acknowledgement

Type of funding sources: None.

Factors affecting the subsurface aragonite undersaturation layer in the Pacific Arctic region

This study evaluated interannual variation in the subsurface aragonite undersaturation zone (Ω_Ar<1 layer) in the Pacific Arctic Ocean, using data from the 2016-2019 period. The upper boundary (DEP_Ω<1^UB) of the Ω_Ar<1 layer generally formed at a depth where the contribution of corrosive Pacific water was approximately 98 %. The intensity of the Beaufort Gyre associated with freshwater accumulation mainly determined interannual variation in DEP_Ω<1^UB, but the direction of its effect was opposite west and east of ~166°W. The lower boundary (DEP_Ω<1^LB) of the Ω_Ar<1 layer was generally found at a depth range where equal contributions of Pacific and Atlantic water were expected. An Atlantic-origin cold saline water intrusion event in 2017 caused by an anomalous atmospheric circulation pattern significantly lifted the DEP_Ω<1^LB, thus the thickness of the Ω_Ar<1 layer decreased.

The Interplay of Mycosporine-like Amino Acids between Phytoplankton Groups and Northern Krill (Thysanoessa sp.) in a High-Latitude Fjord (Kongsfjorden, Svalbard)

We investigated pigment and mycosporine-like amino acid (MAA) concentrations of phytoplankton and Northern krill (Thysanoessa sp.) in sub-Arctic Kongsfjorden. Chlorophyll a (Chl-a) concentrations in the surface and middle-layer water were 0.44 μg L⁻¹ (±0.17 μg L⁻¹) and 0.63 μg L⁻¹ (±0.25 μg L⁻¹), respectively. Alloxanthin (Allo, a marker of cryptophytes) was observed at all stations, and its mean values for surface and middle-layer water were 0.09 μg L⁻¹ (±0.05 μg L⁻¹) and 0.05 (±0.02 μg L⁻¹), respectively. The mean MAA-to-Chl-a ratios at the surface (3.31 ± 2.58 μg (μg Chl-a)⁻¹) were significantly higher than those in the middle-layer water (0.88 ± 0.49 μg (μg Chl-a)⁻¹), suggesting that these compounds play an important role in reducing UV photodamage. In gut pigment levels of Northern krill, the most abundant accessory pigment was Allo (2.79 ± 0.33 μg g⁻¹ dry weight; d.w.), as was the accumulation of Chl-a (8.29 ± 1.13 μg g⁻¹ d.w.). The average concentration of MAAs was 1.87 mg g⁻¹ d.w. (±0.88 mg g⁻¹ d.w.) in krill eyes, which was higher than that in all other body parts (0.99 ± 0.41 mg g⁻¹ d.w.), except for the gut. Thysanoessa sp. was found to contain five identified MAAs (shinorine, palythine, porphyra-334, mycosporine-glycine, and M-332) in the krill eye, whereas shinorine and porphyra-334 were only observed in the krill body, not the eyes and gut. These findings suggest that Northern krill accumulate MAAs of various compositions through the diet (mainly cryptophytes) and translocate them among their body parts as an adaptation for photoprotection and physiological demands.

Importance of seasonal sea ice in the western Arctic ocean to the Arctic and global microplastic budgets

Arctic sea ice entraps microplastics (MP) from seawater and atmosphere and is recognized as sink and transport vector of MPs. However, ice-trapped fraction in the global MP budget, contribution of atmospheric input, and linkage among Arctic basins remain unclear. To assess them, we investigated the number- and mass-based data separated by size and shape geometry for MPs in sea ice, snow, and melt pond water from the western Arctic Ocean (WAO). A significant dependency of MP data on measured cutoff size and geometry was found. For the same size range and geometry, sea ice MPs in WAO ((11.4 ± 9.12) × 10³ N m^-3 for ≥ 100 µm) were within comparable levels with those in other Arctic basins, but showed closer similarity in polymer and shape compositions between WAO and Arctic Central Basin, indicating the strong linkage of the two basins by the Transpolar Drift. Our budgeting shows that a significant amount of plastic particles ((3.4 ± 2.6) × 10¹⁶ N; 280 ± 701 kilotons), which are missed from the global inventory, is trapped in WAO seasonal sea ice, with < 1% snowfall contribution. Our findings highlight that WAO ice zone may play a role as a sink of global MPs as well as a source of Arctic MPs.

N2O dynamics in the western Arctic Ocean during the summer of 2017

The western Arctic Ocean (WAO) has experienced increased heat transport into the region, sea-ice reduction, and changes to the WAO nitrous oxide (N₂O) cycles from greenhouse gases. We investigated WAO N₂O dynamics through an intensive and precise N₂O survey during the open-water season of summer 2017. The effects of physical processes (i.e., solubility and advection) were dominant in both the surface (0–50 m) and deep layers (200–2200 m) of the northern Chukchi Sea with an under-saturation of N₂O. By contrast, both the surface layer (0–50 m) of the southern Chukchi Sea and the intermediate (50–200 m) layer of the northern Chukchi Sea were significantly influenced by biogeochemically derived N₂O production (i.e., through nitrification), with N₂O over-saturation. During summer 2017, the southern region acted as a source of atmospheric N₂O (mean: + 2.3 ± 2.7 μmol N₂O m⁻² day⁻¹), whereas the northern region acted as a sink (mean − 1.3 ± 1.5 μmol N₂O m⁻² day⁻¹). If Arctic environmental changes continue to accelerate and consequently drive the productivity of the Arctic Ocean, the WAO may become a N₂O “hot spot”, and therefore, a key region requiring continued observations to both understand N₂O dynamics and possibly predict their future changes.

Tracing riverine dissolved organic carbon and its transport to the halocline layer in the Chukchi Sea (western Arctic Ocean) using humic-like fluorescence fingerprinting

Dissolved organic carbon (DOC) and the fluorescence properties of dissolved organic matter (FDOM) were investigated using parallel factor analysis (PARAFAC) for seawater samples collected in the Chukchi Sea (65°N-78°N, 170°E-160°W) during summer 2017. River water (f_river) and sea-ice meltwater (f_{sea ice melt}) fractions were also derived using oxygen isotopes ratios (δ¹⁸O) to examine the influence of sea ice on riverine DOM. The spatial distributions of f_river, riverine DOC, and the humic-like fluorescent component (C1) showed an overall south-north gradient, with higher values in the northern Chukchi Sea in summer. Pronounced accumulation of river water and riverine DOM was also observed in the anticyclonic Beaufort Gyre at the eastern stations of the northern Chukchi Sea in association with a long water residence time. Estimated riverine DOC in the surface layer accounted for 27 ± 9% (range: 17-47%) of the total DOC in the southern Chukchi Sea, and 39 ± 6% (range: 32-49%) and 31 ± 4% (range: 25-37%) for the eastern and western stations of the northern Chukchi Sea, respectively. Humic-like C1 showed negative and positive relationships with sea-ice meltwater-corrected salinity (S_{sim_corrected}) and f_river, respectively. However, Arctic river waters with distinct humic-like C1 characteristics were likely mixed in the northern Chukchi Sea. The vertical distributions of riverine DOC, humic-like C1 fluorescence, and f_river generally decreased with water depth, reflecting the strong influence of riverine DOM in the surface layer. Although riverine DOM and f_river were dominant in the upper 50 m of the water column, they were also pronounced in the upper halocline (50-200 m), in which f_{sea ice melt} dropped below zero. Our results indicated the existence of brine rejected from growing sea ice, and that sea-ice formation was a key factor for the transport of riverine DOM to the upper halocline layer in the northern Chukchi Sea.

Use of a broad β-diversity measure of pelagic ciliate communities for assessing vertical heterogeneity of water columns in the Pacific Arctic Ocean

Multivariate dispersion has proven to be a broad β-diversity measure that shows the heterogeneity of environmental conditions. The dispersion patterns of pelagic ciliate communities were investigated at eight water depths in the northern Bering Sea of the western Arctic Ocean and Chukchi Sea. Multivariate analysis indicated that (1) pelagic ciliates showed significant variability in multivariate dispersion on a vertical scale, (2) dispersion patterns were shaped by both the species composition and individual abundance, (3) vertical variation in species occurrence was significantly related to nutrients and chlorophyll a, and (4) the dispersion measures at both species occurrence and species abundance resolutions were significantly negatively related to salinity and dissolved oxygen. This suggests that multivariate dispersion measures driven by both species composition and the individual abundance of pelagic ciliates may be a useful indicator of environmental heterogeneity in marine ecosystems.

Evolution of structural and magnetic properties in iron oxide nanoparticles synthesized using Azadirachta indica leaf extract

The novel superparamagnetic nature of magnetic nanoparticles (MNPs) has received significant attention in the wide variety of fields. However, the prerequisites to use these MNPs, particularly in biomedical applications are biocompatibility and high saturation magnetization (Ms). Thus, the development of a sustainable approach for the synthesis of biocompatible MNPs, which utilizes the redox properties of natural compounds from plant extracts, is highly desired. Herein, we have examined the growth of phase selective MNPs synthesized using Azadirachta indica (Neem) extract as a reducing and capping agent. The physical and biological properties of MNPs synthesized with the modified green hydrothermal method at different reaction times and temperatures were investigated. It was observed that the reaction time and temperature strongly modulated the magnetic and structural characteristics of MNPs. At lower reaction time and temperature of 200 °C for 2 h, primarily iron oxalate hydrate (Fe(C2O4).2(H2O)) was formed. Further, with increasing reaction temperature, the phase transformation from iron oxalate hydrate to pure magnetite (Fe3O4) phase was observed. The MNPs prepared with optimum conditions of 220 °C for 4 h show superparamagnetic nature with improved Ms value of 58 emu g−1. The antibacterial study of MNPs against gram-positive bacteria Staphylococcus aureus showed that the MNPs inhibits the growth of bacteria with the least inhibitory MNPs concentration of 6 μl. Thus, the MNPs obtained by this modified biogenic approach will widen the scope and their applicability in future biomedical applications.

Association of exposure to secondhand smoke at home with early age at menarche in South Korea

OBJECTIVES

The secular trend in age at menarche (AAM) has declined both worldwide and in Korea. Early AAM is associated with the risk of several diseases, reproductive capacity, and psychological problems. We aimed to investigate the relationship between secondhand smoke (SHS) exposure at home and early puberty onset using AAM in Korean adolescents.

STUDY DESIGN

This is a retrospective cross-sectional study.

METHODS

This study used data from the Korea Youth Risk Behavior Web-based Survey 2014-2015. We used the mean AAM (12.2 years) as a determinant of early AAM. After the exclusion of girls without menarche or who did not respond, the total population comprised 63,618 participants. We categorized AAM as 'early' and 'average or late.' Adolescents with SHS exposure were assigned to the 'never exposed,' 'light exposure,' and 'heavy exposure' groups. Multiple logistic regression analyses were performed.

RESULTS

We observed a positive association, approximately 1.12 times, between early AAM and high SHS exposure (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.05-1.19). Girls who started smoking before the age of 12 years (OR, 1.68; 95% CI, 1.41-1.99) showed a stronger association with early AAM than non-smokers. Active smoking showed a stronger association with early AAM. Never smokers with high SHS exposure at home were 1.13 times likelier to have an early AAM (OR, 1.13; 95% CI, 1.05-1.22) than those without SHS exposure.

CONCLUSIONS

In addition to active smoking, SHS may also be a risk factor for early AAM. Education aimed at active and secondhand smoking prevention is needed to protect children against early AAM.

Contrasting Community Composition of Active Microbial Eukaryotes in Melt Ponds and Sea Water of the Arctic Ocean Revealed by High Throughput Sequencing

Melt ponds (MPs), form as the result of thawing of snow and sea ice in the summer, have lower albedo than the sea ice and are thus partly responsible for the polar amplification of global warming. Knowing the community composition of MP organisms is key to understanding their roles in the biogeochemical cycles of nutrients and elements. However, the community composition of MP microbial eukaryotes has rarely been studied. In the present study, we assessed the microbial eukaryote biodiversity, community composition, and assembly processes in MPs and surface sea water (SW) using high throughput sequencing of 18S rRNA of size-fractionated samples. Alpha diversity estimates were lower in the MPs than SW across all size fractions. The community composition of MPs was significantly different from that of SW. The MP communities were dominated by members from Chrysophyceae, the ciliate classes Litostomatea and Spirotrichea, and the cercozoan groups Filosa-Thecofilosea. One open MP community was similar to SW communities, which was probably due to the advanced stage of development of the MP enabling the exchange of species between it and adjacent SW. High portions of shared species between MPs and SW may indicate the vigorous exchange of species between these two major types of environments in the Arctic Ocean. SW microbial eukaryote communities are mainly controlled by dispersal limitation whereas those of MP are mainly controlled by ecological drift.

Analysis of Electroencephalography Signals on the Contents of Cognitive Function Game: Attention and Memory

In the current study, contents of cognitive function game were developed, and variations in Electroencephalography signals were measured and compared before performing the game tasks and during performing the game. The study sought to assess how much the game contents activated brain to see if they were suitable for cognitive functional training. For Electroencephalography signal analysis, power spectral analysis was implemented to classify signals according to frequency. To test signal variation according to the degree of brain activation before and after performing the game, variation comparison and paired t-test were conducted. Results showed that there was reduction in α wave signaling which implied that the subjects concentrate on the content, and increase in β wave signifying that they were engaged in cognitive activities such as remembering and assessing. Consequentially, the produced contents in this study are expected to be useful for cognitive functional training.

Effect of Sedentary Time on the Risk of Orthopaedic Problems in People Aged 50 Years and Older

OBJECTIVE

Many people experience orthopaedic problems (OPPs), such as knee joint pain, hip joint pain, low back pain, and knee stiffness in their lifetimes. OPPs can impair lower extremity function, cause depression, and worsen quality of life. The aim of this study was to investigate the association between sedentary time (SDT) and OPPs.

DESIGN

Retrospective cross-sectional study.

SETTING

This study used data from the 2014-2015 Korea National Health and Nutrition Examination Survey. Survey participants with previous or current osteoarthritis or rheumatoid arthritis, as diagnosed by a doctor, were excluded. OPPs were defined as knee joint pain, hip joint pain, low back pain, and knee stiffness. The cut-off value for SDT was 7.5 hours/day. The study population comprised 3,671 people (1,856 men and 1,815 women), all of whom were ≥50 years-old. Multiple logistic regression analyses were performed.

RESULTS

A total of 328 men (17.7%) and 519 women (28.6%) had OPPs. Men with SDTs ≥7.5 hours had a greater risk of OPPs than did men with SDTs <7.5 hours (odds ratio [OR], 1.45; 95% confidence interval [CI], 1.08-1.93). A pink-collar job, physical inactivity during leisure time, and passive (e.g. riding in a car or train) versus active (e.g. walking or riding a bicycle) transportation predicted OPPs in men with SDTs ≥7.5 hours. SDT was a risk factor for knee joint pain in men (OR, 1.80; 95% CI, 1.11-2.92) and hip joint pain in women (OR, 2.05; 95% CI, 1.35-3.11).

CONCLUSIONS

In men, prolonged SDT is a risk factor for OPPs. More physical activity programmes should be launched at the community level for people ≥50 years-old to reduce the occurrence of OPPs.

Potential Implications of Changing Photosynthetic End-Products of Phytoplankton Caused by Sea Ice Conditions in the Northern Chukchi Sea

The recent dramatic decline in sea ice conditions in the Arctic Ocean has led to the ecophysiological changes in the phytoplankton community. Little is currently known about how the physiological status of phytoplankton has changed under rapidly changing environmental conditions in the Arctic Ocean. Using the ¹³C isotope tracer technique, the carbon allocation of phytoplankton into different photosynthetic end-products was determined in the northern Chukchi Sea on the basis of two Arctic expeditions conducted in 2011 and 2012 to identify the physiological status of phytoplankton. Lipids were the predominant photosynthetic biochemical fraction (42.5%) in 2011, whereas carbon allocation to proteins was most dominant under ice-free conditions in 2012 (47.7%). Based on a comparison of the photosynthetic carbon allocation of phytoplankton according to sea ice conditions, we found that photosynthetic carbon allocation to different macromolecular pools was significantly different depending on the sea ice conditions and that the light conditions caused by different sea ice conditions could be an important reason for the differences in carbon allocation to photosynthetic end-products. Different dominant phytoplankton groups related to size classes also could cause changes in the photosynthetic carbon allocation of phytoplankton related mainly to the lipid synthesis. Our results showed that the physiological status of Arctic phytoplankton could be changed by producing different photosynthetic end-products under current environmental changes. This change in photosynthetic end-products of phytoplankton as a basic food source could be further linked to higher trophic levels in regards to their nutritional and energetic aspects, which could have potential consequences for Arctic marine ecosystems.

1272Physical activity and mortality with and without cardiovascular disease

Background/Introduction

Physical activity has been shown to reduce mortality in a dose-response fashion. Current guidelines recommend 500 to 1,000 MET-min per week of regular physical activity. However, evidence is limited regarding the specific dose-response relationship in patients with cardiovascular disease.

Purpose

Our aim was to compare the impact of physical activity on mortality in primary versus secondary cardiovascular prevention.

Methods

We analyzed 441,798 individuals with complete information on physical activity levels between 2009 and 2015 were extracted from a population-based cohort (National Health Insurance Service-National Health Screening cohort). Physical activity measured by self-report questionnaires. A rating of 2.9, 4.0, and 7.0 METs were assigned for light-intensity, moderate-intensity, and vigorous-intensity activities, respectively. Physical activity-related energy expenditure (MET-min/week) was calculated by summing the product of frequency, intensity, and duration. The level of physical activity was classified into 0, 0 to 499, 500 to 999, 1,000 to 1,499, and ≥1,500 MET-min/week. Study participants were stratified by the presence of cardiovascular disease, defined as prior myocardial infarction, ischemic heart disease, prior stroke, and/or chronic heart failure. The main study outcome was all-cause mortality. The median follow-up duration was 5.9 years.

Results

Individuals with cardiovascular disease had lower physical activity levels and a higher risk of mortality than those without cardiovascular disease. There was an inverse relationship between the physical activity level and the mortality risk in both groups. The benefit in the secondary prevention group was shown to be greater than that in the primary prevention group: every 500 MET-min/week increase in physical activity resulted in a 14% and 7% risk reduction in mortality in the secondary and primary prevention groups, respectively (interaction P<0.001). In addition, while individuals without cardiovascular disease benefited the most between 0 and 500 MET-min/week of physical activity, the benefit in those with cardiovascular disease continued above 500 to 1,000 MET-min/week. The adjusted mortality risk of individuals with cardiovascular disease who performed a high level of physical activity (≥1,000 MET-min/week) was shown to be comparable to or lower than that of their counterparts without cardiovascular disease.

Adjusted risk of mortality

Conclusion

Individuals with cardiovascular disease may benefit from physical activity to a greater extent than do healthy subjects without cardiovascular disease. Clinicians should encourage patients with cardiovascular disease to maintain a physically active lifestyle as much as possible.

Feasibility of Minimal Inferior Meatal Antrostomy and Fiber-Optic Sinus Exam for Fungal Sinusitis

Background/objective

The aim of this study was to evaluate the usefulness of simultaneous middle and inferior meatal antrostomies (SMIAs) as a treatment modality in patients with maxillary fungal sinusitis and to compare the efficacy of SMIA with that of conventional middle meatal antrostomy (MMA).

Methods

A retrospective study was performed on consecutive patients with noninvasive fungal maxillary sinusitis. Twenty-one patients underwent endoscopic sinus surgery with SMIA group and the remaining 24 patients were treated with the conventional MMA group. Medical records were reviewed for history, clinical presentation, radiographic findings, surgical intervention, complications, and outcomes. Outcomes consisted of the visual analog scale (VAS) for the main symptoms and maxillary sinus endoscopic scores. The stenosis or obstruction of the antrostomy site and postoperative mucociliary function was also evaluated.

Results

VAS scores for facial pain and nasal discharge/postnasal drip were significantly improved in the SMIA group. The maxillary endoscopic score was also significantly reduced in the SMIA group. There were no significant differences between 2 groups with respect to the preoperative Lund–Mackay score, VAS score of nasal obstruction, nasal bleeding, postoperative mucociliary function, and MMA patency.

Conclusions

The SMIA technique is useful for identifying and removing fungal debris that cannot be reached through the MMA and could bring better surgical outcomes.

[Magnetic resonance imaging findings and differential diagnosis of renal epithelioid angiomyolipoma comparing with renal no-epithelioid angiomyolipoma]

Objective: To investigate whether MRI findings can differentiate renal epithelioid angiomyolipoma (EAML) from renal no-epithelioid (typical) angiomyolipoma. Methods: A total of 44 patients were collected from General Hospital of PLA.These cases were obtained from January 2009 to June 2015.To retrospectively analyze these mainly MRI findings among 12 cases of EAML (age from 27 to 61 years, male 2 cases, female 10 cases, mean age was 46.7 years); 32 cases of renal no-epithelioid AML (age from 34 to 70 years old, male 9 cases, female 23 cases, mean age was 53.4 years old) as case control study. MRI findings included gender, T(2)WI, the signal on gross fat, pseudocapsle, necrosis or cystic degeneration, DWI, hemorrhage and the peak in three phases of dynamic enhancement.All data were analyzed statistically using SPSS version 19.0 (IBM, Armonk, NY, USA). χ(2) test and a single order chart were used to analyze the enumeration data. Results: Comparing with renal no-epithelioid angiomyolipoma, minimal fat, necrosis or cystic degeneration and hemorrhage were statistical significance. P values were 0.002, 0.007, 0.025, respectively.Gender, solid components of tumors on T(2)WI, the signal of DWI, pesudocapsule and the peak of enhancement had no statistical significance. P values were 0.863, 0.053, 0.479, 0.460, respectively. Conclusion: Comparing with renal no-epithelioid AML, necrosis or cystic degeneration and hemorrhage with minimal fat are characteristic MRI findings of EAML.

Can pelagic ciliates indicate vertical variation in the water quality status of western Arctic pelagic ecosystems?

The vertical pattern of pelagic ciliate communities was observed at eight layers in the Chukchi Sea and the northern Bering Sea of the western Arctic Ocean during the summer sea-ice reduction period (August 5 to August 24, 2016). A total of 44 ciliate species were identified, with seven species dominated the communities in the water column. Multivariate and univariate analyses demonstrated that: (1) community structures of ciliates vary significantly among eight water depths; (2) variations in the vertical distribution of ciliates were significantly correlated with changes in physicochemical variables, especially the ammonia; (3) the distributions of the three dominant species were significantly and positively related to the chlorophyll a and ammonia concentrations; and (4) species richness and abundance were significantly and positively correlated with the concentrations of ammonia and chlorophyll a. These results suggest that pelagic ciliates may reflect vertical variations in the water quality status of western Arctic ecosystems.

Vertical shift in ciliate body-size spectrum and its environmental drivers in western Arctic pelagic ecosystems

As an inherent functional trait, body-size spectrum is widely used as an informative indicator to summarize community structures in taxon-free space. The vertical shift in the body-size spectrum of pelagic ciliates and its environmental drivers were explored at eight depth layers from the water surface to a depth of 100 m in western Arctic pelagic ecosystems. A total of 85 samples were collected at 23 sampling stations during the summer sea-ice reduction period from August 5 to August 24, 2016. Based on equivalent spherical diameter (ESD), six body-size ranks were identified, of which ranks S2 (15-25 μm), S3 (26-38 μm), S4 (39-60 μm), and S6 (79-91 μm) were the top four levels in frequency of occurrence and ranks S2 and S3 were the dominant levels in abundance. The body-size spectrum of the ciliates showed a clear vertical shift, with a significant succession among the dominant body-size units from the water surface to deeper layers in the water column. Multivariate analysis demonstrated a significant vertical variation in the body-size spectrum of the ciliates among the eight depths, which was significantly correlated with nutrients (phosphate and nitrite + nitrate) and chlorophyll a (Chl a), alone or in combination with dissolved oxygen. Four body-size diversity/distinctness indices were significantly correlated with the levels of phosphate, nitrite + nitrate, ammonium, and Chl a. Our results demonstrated that the body-size spectrum of pelagic ciliates can be shifted by environmental drivers (mainly nutrients and Chl a); thus, we suggest that it may be used to indicate water quality status on a vertical scale in the water column in deep seas.

Glutamate mediated metabolic neutralization mitigates propionate toxicity in intracellular Mycobacterium tuberculosis

Metabolic networks in biological systems are interconnected, such that malfunctioning parts can be corrected by other parts within the network, a process termed adaptive metabolism. Unlike Bacillus Calmette-Guérin (BCG), Mycobacterium tuberculosis (Mtb) better manages its intracellular lifestyle by executing adaptive metabolism. Here, we used metabolomics and identified glutamate synthase (GltB/D) that converts glutamine to glutamate (Q → E) as a metabolic effort used to neutralize cytoplasmic pH that is acidified while consuming host propionate carbon through the methylcitrate cycle (MCC). Methylisocitrate lyase, the last step of the MCC, is intrinsically downregulated in BCG, leading to obstruction of carbon flux toward central carbon metabolism, accumulation of MCC intermediates, and interference with GltB/D mediated neutralizing activity against propionate toxicity. Indeed, vitamin B12 mediated bypass MCC and additional supplement of glutamate led to selectively correct the phenotypic attenuation in BCG and restore the adaptive capacity of BCG to the similar level of Mtb phenotype. Collectively, a defective crosstalk between MCC and Q → E contributes to attenuation of intracellular BCG. Furthermore, GltB/D inhibition enhances the level of propionate toxicity in Mtb. Thus, these findings revealed a new adaptive metabolism and propose GltB/D as a synergistic target to improve the antimicrobial outcomes of MCC inhibition in Mtb.

Aerosolized Fibrin Sealant Is Effective for Postoperative Edema and Ecchymosis in Open Rhinoplasty Without Osteotomy

PURPOSE

Fibrin sealant (FS) was approved as a hemostatic agent, sealant, and adhesive by the Food and Drug Administration in 1998. Our study sought to determine whether FS also reduced edema and pain in rhinoplasty without osteotomy.

MATERIALS AND METHODS

We conducted a prospective randomized trial involving patients who underwent open rhinoplasty without osteotomy. The patients were randomly assigned to 1 of 2 groups: those treated with aerosolized FS (FS group) and those not treated (control group). The effect of FS on edema of the eyelid, edema of the dorsum and tip of the nose, and periorbital ecchymosis was separately rated postoperatively using a scale of 0 to 4 or 0 to 3. Postoperative pain was evaluated using questionnaires quantified with a visual analog scale. The Mann-Whitney U and Wilcoxon tests were used to compare parameters between the groups.

RESULTS

A total of 41 patients were included in this study. The FS group (n = 20) consisted of 13 male and 7 female patients with a mean age of 34.8 ± 5.8 years. The control group (n = 21) consisted of 15 male and 6 female patients with a mean age of 32.4 ± 4.8 years. There were no statistically significant differences between the 2 groups with respect to age, gender, or combined surgical techniques (P > .05). Aerosolized FS significantly reduced not only ecchymosis and swelling in the periorbital area but also edema of the nasal dorsum (P < .05).

CONCLUSIONS

Aerosolized FS can be effective for reducing eyelid edema, dorsal edema, and periorbital ecchymosis after open rhinoplasty. FS may serve as an adhesive for minimizing dead space by promoting adherence of the skin flap and as a hemostatic agent in reducing the amount of postoperative bleeding by sealing capillary vessels.

Delayed viral suppression during antiviral therapy is associated with increased hepatocellular carcinoma rates in HBeAg-positive high viral load chronic hepatitis B

The treatment option in chronic hepatitis B (CHB) patients with persistent low-level viremia despite entecavir or tenofovir monotherapy is unclear. This study investigated the development of hepatocellular carcinoma (HCC) or cirrhosis in hepatitis B e antigen (HBeAg)-positive high viral load CHB patients, according to the time needed to achieve complete viral suppression. A total of 325 HBeAg-positive CHB patients with high viral load who were recently started on antiviral therapy with entecavir or tenofovir were included. The enrolled patients were divided into 2 groups with 4 separate criteria based on the time needed to achieve complete viral suppression: within 1, 2, 3 or 4 years of therapy initiation. The outcomes were development of HCC and cirrhosis. The cumulative incidence of HCC was significantly higher in patients failing complete viral suppression within 1 year (hazard ratio (HR), 4.54; 95% confidence interval (CI), 1.03-19.93; P = .045) or 2 years (HR, 3.38; 95% CI, 1.24-9.23; P = .018), than patients who achieved complete viral suppression within 1 or 2 years, respectively. Cumulative incidence of cirrhosis was also significantly higher in patients failing suppression within 1 year (HR, 1.95; 95% CI, 1.04-3.66; P = .037) or 2 years (HR, 2.44; 95% CI, 1.41-4.22; P = .001). When the time for achieving viral suppression exceeded 2 years, the cumulative incidence of HCC or cirrhosis was not different regardless of viral suppression. Complete hepatitis B virus suppression within 2 years of antiviral therapy initiation is associated with risk reduction in HCC or cirrhosis development.

Abstract P3-01-16: How hot is enough for accurate sentinel lymph node axillary staging in breast cancer?

Purpose:

Sentinel lymph node (SLN) biopsy is a well-established procedure for staging of the axilla in early-stage breast cancer and has replaced axillary lymph node dissection as the standard of care in patients with clinically lymph node–negative axilla. No consensus exists about the number of sentinel lymph nodes (SLNs) that should be removed based on radioactivity counts in breast cancer, although the “10% rule” is often used. In order to determine the frequency with which the hottest SLN 'fails' to be pathologically positive, and to determine which criteria best define the radioactive lymph node to be removed, we reviewed and analyzed our cases in which more than one SLN was detected and where there was also at least one pathologically positive node.

Methods:

We retrospectively studied 1062 breast cancer patients who underwent lymphoscintigraphy by injection of radioactive colloid and SLN biopsy between 2006 and 2015, with intraoperative determination of radioactive counts of nodes by a gamma probe.

Results:

A total of 247 patients (23.3%) had more than 1 SLN removed (mean 2.29); 53 patients (21.5%) had nodal metastases. Of the node-positive patients, the hottest SLN was positive in 90.6% (48 of 53). The lowest radioactive count of a positive SLN was 32% of that of the hottest node.

Conclusions:

In our study, most positive SLNs had the highest radioactivity and the hottest lymph node was not the pathologically positive node only in 9.4 %. Our institutional experience indicates that to obtain an acceptable false-negative rate, nodes should be removed until the 10% rule is met.

Citation Format: Lee MH, Kang SH, Cho J. How hot is enough for accurate sentinel lymph node axillary staging in 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 P3-01-16.

Rifaximin treatment is associated with reduced risk of cirrhotic complications and prolonged overall survival in patients experiencing hepatic encephalopathy

BACKGROUND

Rifaximin might decrease the risk of portal hypertension-related complications by controlling small intestinal bacterial overgrowth.

AIM

To evaluate whether rifaximin was associated with the risk of death and cirrhotic complications.

METHODS

We conducted a retrospective study that included 1042 patients experiencing hepatic encephalopathy (HE): 421 patients without hepatocellular carcinoma (HCC; the non-HCC cohort) and 621 patients with HCC (the HCC cohort). The primary endpoint was overall survival and secondary endpoints were recurrence of HE and the development of spontaneous bacterial peritonitis (SBP), hepatorenal syndrome (HRS) and variceal bleeding.

RESULTS

In the non-HCC cohort, 145 patients received rifaximin plus lactulose (the rifaximin group) and 276 patients received lactulose alone (the control group). The multivariate analysis revealed that rifaximin was significantly associated with lower risk of death (adjusted hazard ratio [aHR], 0.697; P = .024) and reduced the risk of recurrent HE (aHR, 0.452; P < .001), SBP (aHR, 0.210; P < .001) and variceal bleeding (aHR, 0.425; P = .011) but not HRS (aHR, 0.598; P = .08). In the HCC cohort, 173 patients received rifaximin plus lactulose and 448 patients received lactulose. Rifaximin was not associated with the risk of death (aHR, 1.177; P = .121). Rifaximin was associated with lower risk of SBP (aHR, 0.323; P < .001) but not with variceal bleeding (aHR, 0.660; P = .104) or recurrent HE (aHR, 0.689; P = .057). The risk of Clostridium difficile-associated diarrhoea was not different between the groups (aHR, 0.028; P = .338).

CONCLUSIONS

In patients without HCC, rifaximin treatment was significantly associated with prolonged overall survival and reduced risks of spontaneous bacterial peritonitis, variceal bleeding and recurrent hepatic encephalopathy.

Low appendicular muscle mass is associated with mortality in peritoneal dialysis patients: a single-center cohort study

BACKGROUND/OBJECTIVES

There are few studies of the association between low appendicular muscle mass (LAM) and clinical outcomes in peritoneal dialysis (PD) patients. We aimed to determine the clinical association between LAM and clinical outcomes in PD patients.

SUBJECT/METHODS

We reviewed all PD patients who underwent PD between January 2001 and April 2014. Each patient's appendicular lean mass was estimated using dual-energy X-ray absorptiometry. The appendicular muscle mass index (AMI) was calculated using total appendicular lean mass (kg) over body mass index (kg/m²). The cut-off AMI value for LAM was <0.789 for men and <0.512 for women.

RESULTS

The number of patients in the Non-LAM and LAM groups was 328 and 303, respectively. The median follow-up durations in the Non-LAM and LAM groups were 47 and 49 months, respectively. The numbers of deaths in the Non-LAM and LAM groups were 96 (29.3%) and 160 (52.8%), respectively. In a comparison with the Non-LAM group, the hazard ratio in the LAM group was 1.74 (95% confidence interval (CI), 1.35-2.24) in univariate and 1.71 (95% CI, 1.28-2.26) in multivariate Cox regression analysis. In addition, the hazard ratio for a 0.1 increase in baseline AMI was 0.89 (95% CI, 0.84-0.95) in univariate analysis and 0.84 (95% CI, 0.76-0.91) in multivariate analysis. Analyses using the 1-year AMI showed trends similar to those for the initial AMI.

CONCLUSIONS

Our study showed the association of LAM with mortality in the incident PD patients.

Enzymatic modification by point mutation and functional analysis of an omega-6 fatty acid desaturase from Arctic Chlamydomonas sp

Arctic Chlamydomonas sp. is a dominant microalgal strain in cold or frozen freshwater in the Arctic region. The full-length open reading frame of the omega-6 fatty acid desaturase gene (AChFAD6) was obtained from the transcriptomic database of Arctic Chlamydomonas sp. from the KOPRI culture collection of polar micro-organisms. Amino acid sequence analysis indicated the presence of three conserved histidine-rich segments as unique characteristics of omega-6 fatty acid desaturases, and three transmembrane regions transported to plastidic membranes by chloroplast transit peptides in the N-terminal region. The AChFAD6 desaturase activity was examined by expressing wild-type and V254A mutant (Mut-AChFAD6) heterologous recombinant proteins. Quantitative gas chromatography indicated that the concentration of linoleic acids in AChFAD6-transformed cells increased more than 3-fold [6.73 ± 0.13 mg g^-1 dry cell weight (DCW)] compared with cells transformed with vector alone. In contrast, transformation with Mut-AChFAD6 increased the concentration of oleic acid to 9.23 ± 0.18 mg g^-1 DCW, indicating a change in enzymatic activity to mimic that of stearoyl-CoA desaturase. These results demonstrate that AChFAD6 of Arctic Chlamydomonas sp. increases membrane fluidity by enhancing denaturation of C18 fatty acids and facilitates production of large quantities of linoleic fatty acids in prokaryotic expression systems.

Genetic and Molecular Epidemiological Characterization of a Novel Adenovirus in Antarctic Penguins Collected between 2008 and 2013

Antarctica is considered a relatively uncontaminated region with regard to the infectious diseases because of its extreme environment, and isolated geography. For the genetic characterization and molecular epidemiology of the newly found penguin adenovirus in Antarctica, entire genome sequencing and annual survey of penguin adenovirus were conducted. The entire genome sequences of penguin adenoviruses were completed for two Chinstrap penguins (Pygoscelis antarctica) and two Gentoo penguins (Pygoscelis papua). The whole genome lengths and G+C content of penguin adenoviruses were found to be 24,630-24,662 bp and 35.5-35.6%, respectively. Notably, the presence of putative sialidase gene was not identified in penguin adenoviruses by Rapid Amplification of cDNA Ends (RACE-PCR) as well as consensus specific PCR. The penguin adenoviruses were demonstrated to be a new species within the genus Siadenovirus, with a distance of 29.9-39.3% (amino acid, 32.1-47.9%) in DNA polymerase gene, and showed the closest relationship with turkey adenovirus 3 (TAdV-3) in phylogenetic analysis. During the 2008-2013 study period, the penguin adenoviruses were annually detected in 22 of 78 penguins (28.2%), and the molecular epidemiological study of the penguin adenovirus indicates a predominant infection in Chinstrap penguin population (12/30, 40%). Interestingly, the genome of penguin adenovirus could be detected in several internal samples, except the lymph node and brain. In conclusion, an analysis of the entire adenoviral genomes from Antarctic penguins was conducted, and the penguin adenoviruses, containing unique genetic character, were identified as a new species within the genus Siadenovirus. Moreover, it was annually detected in Antarctic penguins, suggesting its circulation within the penguin population.

Radiofrequency turbinoplasty for nonallergic rhinitis in geriatric patients

BACKGROUND AND OBJECTIVE

Radiofrequency (RF) turbinoplasty may be effective in treating nonallergic rhinitis in elderly patients. The present study evaluated the efficacy of nasal turbinate surgery with RF for the treatment of nonallergic rhinitis in elderly patients refractory to medical therapy.

METHODS

A total of 35 consecutive patients older than 65 years of age (mean subject age, 75.5 ± 9.6 [standard deviation] years) with nonallergic rhinitis refractory to medical therapy who underwent RF turbinate surgery were enrolled in this study. The efficacy of RF turbinoplasty in treating nonallergic rhinitis in elderly patients was evaluated by using rhinoscopy and a visual analog scale score of nasal symptoms.

RESULTS

The response rate of primary RF turbinate surgery for nonallergic rhinitis refractory to medical therapy was 68.6%. Postoperative symptom scores for rhinorrhea and nasal obstruction were significantly improved. Persistent crust formation developed in seven patients (20.0%). No patient experienced major complications (e.g., septal hematoma, abscess, septal perforation), but partial bone necrosis was observed in one patient.

CONCLUSION

RF turbinoplasty appeared to be effective for treating some nonallergic rhinitis symptoms in elderly patients, including rhinorrhea and nasal obstruction. These preliminary results are encouraging and warrant further investigation.

Abstract P1-10-25: Intrathoracic paclitaxel chemotherapy for malignant pleural effusion in breast cancer

Background: Malignant pleural effusion in breast cancer has been associated with poor prognosis which median survival rate is 5–16 months. The response rate of local treatment has been very low and in some case, complications have resulted in death.

Patients and methods: We investigated the efficacy and safety of paclitaxel, as an intrapleural chemotherapeutic agent. From January 2006 to June 2015, total 35 times of intrapleural chemothepapy were performed in 26 breast cancer patients who had developed malignant pleural effusion. They were infused 120mg/m2 of paclitaxel through a chest tube, which was clamped for 48 hours. The chest tube was maintained until drainage was reduced to less than 50-100 mL/day.

Results: Mean follow up period after intrapleural chemotherapy was 11 months.The average time of indwelling with a chest tube after intrapleural chemotherapy was 9.7 days.

Mean progression free survival was 7.8 Months. During the follow-up period, 5 patients had no progression of pleural effusion and 2 of them were free from progression for more than 36 months. In 26 attempts, there were effective and could remove chest tube otherwise In 9 attempts, there were no improvement after intrapleural chemotherapy. 1 patients received a second round of ipsilateral intrapleural chemotherapy and had no response unlike earlier attempts. There were 3 severe adverse effect related death caused by respiratory failure with or without G4 neutropenia.

Conclusion: Intrapleural paclitaxel chemotherapy is helpful for some cases of uncontrolled pleural effusion in that reduce the duration of hospital stay and improve quality of life. But it will be determined carefully, considering the side effects and response rate of treatment.

Citation Format: Yeu KJ, Park J, Choi JE, Kang SH, Lee SJ. Intrathoracic paclitaxel chemotherapy for malignant pleural effusion in breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-10-25.

Abstract P5-01-10: Correlation of apparent diffusion coefficient with standardized uptake value in invasive lobular carcinoma of breast using in hybrid 18F-FDG PET/MR

Purpose: To compare the apparent diffusion coefficient (ADC) with maximum standardized uptake values (SUV) derived from combined 18F-FDG PET/MRI in invasive lobular carcinoma (ILC) patients.

Methods: From 2012 Aug to 2015 Feb, 53 women with histologically proven ILC (mean age, 50.3 ± 7.7 y-o) underwent hybrid 18F-FDG PET/MR (Siemens Biograph mMR) scan for preoperative assessment. During PET acquisition, simultaneous diffusion-weighted imaging (DWI, b values: 0, 400, 800 s/mm2) was performed using breast coil. ILC over than 2 Cm in size were analyzed. Regions of interest (ROI) were drawn covering the entire ILC on the attenuation-corrected PET-image and the monoexponential ADC-map on PET/MR workstation. All the patients were received surgical treatment within 3 weeks after scan. Spearman rank correlation coefficient (ρ) was calculated to examine the correlation between SUVmax and ADC value.

Results: Total 25 ILC (5.4±1.3 cm; 2.1-6.3 cm) of 22 women were enrolled. 24 ILC showed ER (+)/PR (+) and all ILC showed HER2 (-). 15 patients were confirmed metastatic axillary lymph nodes. The mean of SUVmax was 2.14 ± 2.2 (0.91-11.9) and mean of ADC was 1.02 ×10-3 (0.82 -1.31 ×10-3) mm2/s. Higher histologic grade was correlated with higher SUV (ρ = -0.6, p=0.001). And SUV showed inverse correlation with ADC (ρ = -0.48, p=0.016).

Conclusion: The present data show inverse correlation between increased glucose-metabolism and cellularity in ILC patients. 18F-FDG PET and DWI thus may offer complementary information for the evaluation of treatment response in ILC.

Citation Format: Choi JE, Kang SH, Lee SJ, Kong EJ. Correlation of apparent diffusion coefficient with standardized uptake value in invasive lobular carcinoma of breast using in hybrid 18F-FDG PET/MR. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-01-10.

Abstract P3-13-06: The efficacy and long term results of intraoperative frozen section analysis to access resection margin in ductal carcinoma in situ

Introduction

Breast conserving surgery (BCS) is a standard procedure for early breast cancer and resection margin state is the most important risk factor of local recurrence. Re-operation is generally conducted in 20∼40% after initial BCS to achieve negative margins, especially in breast cancer with carcinoma in situ components. In this study, we analyzed the long-term follow up results and efficacy of BCS using intraoperative frozen section analysis to access resection margin in ductal carcinoma in situ (DCIS) patients.

Methods

Between 2004 and 2006, 1016 patients were diagnosed with primary breast cancer and received breast cancer surgery. Among them, BCS was attempted as an initial operation for 523 patients. Superior, inferior, medial and lateral margin of resected specimen were evaluated according to the intraoperative frozen section analysis. If tumor cells existed less than 2mm from resected specimen margin, intraoperative further resection was done and if the further resection was impossible, initial BCS was converted to mastectomy. All medical records and pathologic reports were reviewed retrospectively.

Results

Of the 523 patients who had to undergo BCS, 13.3% (70/523) were converted to mastectomy during initial BCS. The number of the patients who had either only DCIS or invasive carcinoma c carcinoma in situ component was 372 (71.1%, 372/523) and 17.2% (64/372) were converted to mastectomy. One hundred fifty one (28.9%, 151/523) patients had only invasive carcinoma and 3.97% (6/151) were converted to mastectomy. In this study, we analyzed 94 patients who had to undergo BCS with DCIS. The rate of intraoperative conversion to mastectomy was 13.8% (13/94) and 81 patients had successful BCS with 0∼3 times of intraoperative frozen section analysis. There were no differences between patients who had BCS and final mastectomy in clinicopathologic characteristics such as physical examination of tumor, age of patients, DCIS subtypes, nuclear polymorphism, presence of necrosis, ER, PR, HER2 and Ki67. After permanent biopsy was reported, in 5 patients, resected specimen had tumor cells within less than 2mm from resected margin, not inked margin. They had no reoperations and no recurrences. Mean follow up period was 76.6 months. One locoregional and 3 local recurrences in BCS patients and 1 local recurrence in mastectomy patients were found. There was no difference in disease free survival between two groups (95.1% vs 92.3%, p=0.659). In these DCIS patients, reoperation rate was 0%.

Conclusion

Intraoperative frozen section analysis during BCS to access resection margin helps to avoid reoperations and increase intraoperative success rate of BCS in DCIS. It also shows oncological safe long term results. Further studies are needed to resolve the problem with cost-effectiveness of intraoperative frozen section analysis.

Citation Format: Choi JE, Yeu KJ, Park JY, Kang SH, Lee SJ, Bae YK. The efficacy and long term results of intraoperative frozen section analysis to access resection margin in ductal carcinoma in situ. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-13-06.

Aureimonas glaciistagni sp. nov., isolated from a melt pond on Arctic sea ice

A Gram-staining-negative, motile, aerobic and rod-shaped bacterial strain, PAMC 27157T, was isolated from a melt pond on sea ice in the Chukchi Sea. Phylogenetic analysis of the 16S rRNA gene sequence of strain PAMC 27157T revealed an affiliation to the genus Aureimonas with the closest sequence similarity (96.2 %) to that of Aureimonas phyllosphaerae. Strain PAMC 27157T grew optimally at 30 °C and pH 7.0 in the presence of 3.5 % (w/v) NaCl. The major polar lipids were diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, phosphatidylcholine, phosphatidylmonomethylethanolamine, sulfoquinovosyldiacylglycerol and an unidentified aminolipid. The major cellular fatty acid was summed feature 8 (C18 : 1ω7c and/or C18 : 1ω6c, 83.1 %) and the major respiratory quinone was Q-10. The genomic DNA G+C content was 69.1 mol%. The combined phylogenetic, phenotypic and chemotaxonomic data showed that strain PAMC 27157T could be clearly distinguished from species of the genus Aureimonas with validly published names. Thus, strain PAMC 27157T should be classified as representing a novel species in the genus Aureimonas, for which the name Aureimonas glaciistagni sp. nov. is proposed. The type strain is PAMC 27157T ( = KCCM 43049T = JCM 30183T).

Combined use of scoring incisions and 2-octylcyanoacrylate adhesive during endonasal septoplasty to correct cartilaginous deviations

BACKGROUND

Applying 2-octylcyanoacrylate (2-OCA) tissue adhesive onto scoring incisions may increase efficacy and prevent concavity recurrence after septal deviation treatment. The present study evaluates the utility of 2-OCA adhesive application during endonasal septoplasty.

METHODS

The postoperative outcomes were compared between two consecutive periods in a single surgical department. Between March 2011 and March 2012, 23 consecutive patients underwent septoplasty using scoring incisions without 2-OCA application (scoring alone group), and between April 2012 and April 2013, the scoring incision gaps were filled with 2-OCA in 27 patients (scoring + CA group). The patients were followed up for more than six months.

RESULTS

A straight septum was achieved in 37.0% of patients in the scoring alone group versus 58.3% in the scoring + CA group. The postoperative symptom score for nasal obstruction was significantly improved in both groups. Persistent septal swelling developed in three (12.5%) patients in the scoring + CA group. Neither group experienced major complications such as septal hematoma, abscess, or septal perforation.

CONCLUSIONS

Application of 2-OCA adhesive onto scoring incisions appears to be a reliable and effective technique to correct deviated cartilage during endonasal septoplasty. However, the volume of 2-OCA applied onto the septum should be minimized to avoid potential foreign body reaction. A long-term follow-up study is warranted.

An assessment of phytoplankton primary productivity in the Arctic Ocean from satellite ocean color/in situ chlorophyll-a based models

We investigated 32 net primary productivity (NPP) models by assessing skills to reproduce integrated NPP in the Arctic Ocean. The models were provided with two sources each of surface chlorophyll-a concentration (chlorophyll), photosynthetically available radiation (PAR), sea surface temperature (SST), and mixed-layer depth (MLD). The models were most sensitive to uncertainties in surface chlorophyll, generally performing better with in situ chlorophyll than with satellite-derived values. They were much less sensitive to uncertainties in PAR, SST, and MLD, possibly due to relatively narrow ranges of input data and/or relatively little difference between input data sources. Regardless of type or complexity, most of the models were not able to fully reproduce the variability of in situ NPP, whereas some of them exhibited almost no bias (i.e., reproduced the mean of in situ NPP). The models performed relatively well in low-productivity seasons as well as in sea ice-covered/deep-water regions. Depth-resolved models correlated more with in situ NPP than other model types, but had a greater tendency to overestimate mean NPP whereas absorption-based models exhibited the lowest bias associated with weaker correlation. The models performed better when a subsurface chlorophyll-a maximum (SCM) was absent. As a group, the models overestimated mean NPP, however this was partly offset by some models underestimating NPP when a SCM was present. Our study suggests that NPP models need to be carefully tuned for the Arctic Ocean because most of the models performing relatively well were those that used Arctic-relevant parameters.

Expression of Apoptotic vs Antiapoptotic Proteins in Middle Ear Cholesteatoma

Objectives

To explore the role of antiapoptotic and apoptotic processes in the development of cholesteatoma by investigating the expression of an antiapoptotic (c-FLIP) and apoptotic (p53) protein relative to the expression of a proliferation marker (Ki-67).

Study Design

Basic science study.

Setting

Tertiary referral center.

Subjects and Methods

An immunohistochemical investigation was performed on 35 cholesteatoma specimens (21 acquired, 14 congenital) and 10 normal retroauricular skins to evaluate the expression of c-FLIP, p53, and Ki-67. The expression rate of each marker was measured to assess the difference between retroauricular skin and cholesteatoma, as well as between congenital and acquired cholesteatoma.

Results

c-FLIP expression was significantly higher in the cholesteatoma specimens than in retroauricular skin ( P < .05), while the expression of p53 did not significantly differ between the two. Ki-67 expression in cholesteatoma was significantly higher than in retroauricular skin ( P < .001). The c-FLIP expression rate was positively correlated with that of Ki-67 ( r = 0.47, P = .001), and there was no significant correlation between the expression level of p53 and that of Ki-67 ( r = 0.152, P = .319). In addition, no differences in c-FLIP, p53, and Ki-67 expression rates were evident between congenital and acquired cholesteatoma.

Conclusions

The upregulation of c-FLIP together with unchanged p53 suggests an altered equilibrium between apoptosis and antiapoptosis, favoring antiapoptosis, and may play a role in the pathogenesis of cholesteatoma.

Effect of aerosolized fibrin sealant on hemostasis and wound healing after endoscopic sinus surgery: a prospective randomized study

BACKGROUND

The purpose of this study was to investigate the effect of aerosolized fibrin sealant (FS) compared with that of polyvinyl acetal sponge packing on hemostasis and wound healing after functional endoscopic sinus surgery (FESS).

METHODS

We conducted a prospective randomized controlled trial of the use of aerosolized FS in 41 consecutive patients who underwent bilateral FESS between February 2011 and March 2012. The patients were randomized to receive FS applied via an aerosol spray in one nasal cavity and polyvinyl acetal sponge packing in the opposite cavity. The patients were followed up at 1, 2, 4, 8, and 12 weeks postoperatively. Crusting, adhesion, bleeding, granulation tissue formation, infection, and frontal sinus ostium stenosis after endoscopic surgery were assessed using a grading scale. Subjective symptoms related to nasal packing were evaluated using questionnaires quantified by visual analog scales.

RESULTS

The degree of granulation and crusting was significantly reduced in the side treated with FS compared with the polyvinyl acetal sponge side, as were bleeding and pain during nasal packing removal (p < 0.05). In addition, general satisfaction and willingness to reuse the material were significantly higher for the FS-treated side than for the polyvinyl acetal sponge-packed side (p < 0.001).

CONCLUSIONS

Compared with polyvinyl acetal sponge, aerosolized FS shows beneficial effects on hemostasis and wound healing after FESS. The application of FS resulted in a high degree of patient satisfaction without additional morbidity.

Clinical results of treatment of garden type 1 and 2 femoral neck fractures in patients over 70-year old

INTRODUCTION

We retrospectively analyzed the clinical results of treatment of impacted or undisplaced femoral neck fractures (Garden types 1 and 2) by osteosynthesis in elderly patients >70-year old.

MATERIALS AND METHODS

We retrospectively reviewed the radiological results of 52 patients who were followed up for at least 6 months from April 2002 to December 2008. The average age of the patients was 77.6 years (range 70-97 years), and 38 patients were females. The mean follow-up period was 11.7 months (range 6-19 months). Thirteen cases were Garden type 1 fractures, and 39 were Garden type 2 fractures. We assessed the relationships between the occurrence of complications and age, sex, Garden stage, bone mineral density (BMD), history of contralateral hip fracture, and any additional hip injury.

RESULTS

Major complications occurred in 18 cases (34.6 %), including nonunion (8 cases), osteonecrosis (6 cases), stress fracture of the subtrochanter (2 cases), excessive pull-out of a screw (1 case), and deep infection (1 case). The development of complications was associated with Garden stage 2, BMD, and additional hip injury. However, other factors were not associated with complications. Reoperations were performed in 16 cases (30.1 %), and 2 of the patients died during follow-up.

CONCLUSION

A relatively high rate of complications or reoperations developed after treatment of Garden 2 femoral neck fractures in senile patients >70 years of age with osteoporosis. Although internal fixation has been recommended in the literature for undisplaced femoral neck fractures, primary arthroplasty may be a better option for treatment of Garden type 2 fractures in elderly patients.

Feasibility of septal body volume reduction for patients with nasal obstruction

OBJECTIVE

Septal body hypertrophy, like inferior turbinate hypertrophy, can result in changes to the nasal cross-sectional area and resistance to airflow. The aim of this study is to evaluate the efficacy of septal body volume reduction (SBVR) for the treatment of septal body hypertrophy in patients with nasal obstruction.

STUDY DESIGN

Prospective randomized study.

METHODS

The study was conducted on two groups (51 patients) with symptoms and signs of nasal obstruction associated with septal body and inferior turbinate hypertrophy that were refractory to medical therapy. In the turbinoplasty only (ITR) group (n = 25), conventional turbinoplasty was only performed on the inferior turbinate. In the septal body reduction (SBR) group (n = 26), concurrent bilateral microdebrider-assisted SBVR was performed during the turbinate surgery.

RESULTS

The nasal symptoms, including nasal obstruction, rhinorrhea, itching, and sneezing, had significantly improved at 3 months after treatment in both groups (P < 0.001). Improvement of nasal obstruction in the SBR group was greater than that in the ITR group at 3 months (P < 0.05). Acoustic rhinometry demonstrated a significant increase in the cross-sectional area and nasal volume in both groups 3 months after surgery. The postoperative change in nasal volume was higher in the SBR group (P < 0.05). No adverse reactions such as bleeding, infection, adhesions, or olfactory changes were encountered in the SBR group.

CONCLUSIONS

Combined SBVR and turbinoplasty appears to be more effective than turbinoplasty alone for the treatment of nasal obstruction in patients with inferior turbinate and septal body hypertrophy.

Production rate estimation of mycosporine-like amino acids in two Arctic melt ponds by stable isotope probing with NAH(13) CO3

The net carbon uptake rate and net production rate of mycosporine-like amino acids (MAAs) were measured in phytoplankton from 2 different melt ponds (MPs; closed and open type pond) in the western Arctic Ocean using a (13) C stable isotope tracer technique. The Research Vessel Araon visited ice-covered western-central basins situated at 82°N and 173°E in the summer of 2012, when Arctic sea ice declined to a record minimum. The average net carbon uptake rate of the phytoplankton in polycarbonate (PC) bottles in the closed MP was 3.24 mg C · m(-3) · h(-1) (SD = ±1.12 mg C · m(-3) · h(-1) ), while that in the open MP was 1.3 mg C · m(-3) · h(-1) (SD = ±0.05 mg C · m(-3) · h(-1) ). The net production rate of total MAAs in incubated PC bottles was highest (1.44 (SD = ±0.24) ng C · L(-1) · h(-1) ) in the open MP and lowest (0.05 (SD = ±0.003) ng C · L(-1) · h(-1) ) in the closed MP. The net production rate of shinorine and palythine in incubated PC bottles at the open MP presented significantly high values 0.76 (SD = ±0.12) ng C · L(-1) · h(-1) and 0.53 (SD = ±0.06) ng C · L(-1) · h(-1) . Our results showed that high net production rate of MAAs in the open MP was enhanced by a combination of osmotic and UVR stress and that in situ net production rates of individual MAA can be determined using (13) C tracer in MPs in Arctic sea ice.