Clinical and epidemiological survey and analysis of the first case of human infection with avian influenza A(H7N9) virus in Hangzhou, China

To investigate and report on the clinical and epidemiological characteristics of the first case of human infection with avian influenza A(H7N9) virus in Hangzhou, China. A field epidemiological survey was used to study the first case in Hangzhou. The patient was a 39-year-old male chef with a history of exposure to a farm product market and to poultry prior to the onset of disease on 15 March 2013. He had diarrhea, chills, pyrexia, and intermittent cough with freshly red foamy bloody sputum early in his disease. His fever > 39 °C continued for a week with rapid progression. Computed tomography findings showed extensive bilateral consolidation, followed by multiorgan failure. The patient died on the morning of 27 March. His infection was eventually confirmed 1 week later on 3 April. Flu-like symptoms including fever and cough were found in 46 of his 138 close contacts. This was the first case of human infection with avian influenza A(H7N9) virus in Hangzhou. None of the close contacts had onset of the disease. The case patient’s condition progressed rapidly. The source of infection might be his exposure to the farm product market, but the mode of exposure remains unclear.

Measurement of J/ψ azimuthal anisotropy in Au+Au collisions at sqrt[s(NN)]=200 GeV

The measurement of J/ψ azimuthal anisotropy is presented as a function of transverse momentum for different centralities in Au+Au collisions at sqrt[s(NN)]=200 GeV. The measured J/ψ elliptic flow is consistent with zero within errors for transverse momentum between 2 and 10 GeV/c. Our measurement suggests that J/ψ particles with relatively large transverse momenta are not dominantly produced by coalescence from thermalized charm quarks, when comparing to model calculations.

An investigation of factors that influence general practitioners' referral of computed tomography scans in patients with headache

AIM

In assessing patients with headaches, general practitioners (GPs) play an important role in determining which patients require computed tomography (CT) scans. The purpose of this study was to identify factors that influence GPs' decisions to refer CT scans for patients with headaches.

MATERIALS AND METHODS

A self-administered survey was presented to GPs in Western Australia. One hundred and twenty-eight vignettes describing patients who may have required CT referral for headache were constructed encompassing six clinical variables. Nine vignettes, selected at random, were presented to each respondent. Respondents were asked if they would refer the patient for diagnostic imaging tests, if so, which imaging modalities would they request, how urgently and the perceived benefits of the requested imaging modality. Multinomial logistic regression was used for the multivariate analysis.

RESULTS

We received 105 completed questionnaires (21%). GPs were more likely to refer patients with headaches for diagnostic imaging and CT scans in the following clinical scenarios: patients with a history of colorectal cancer and epilepsy; and patients feeling unwell for the past 6 weeks and headache being exacerbated with valsalva manoeuvrers. Private health insurance and other respondent demographics such as GPs experience and site of care increased imaging referral.

CONCLUSION

GP's referral decisions of diagnostic imaging and CT examinations for patients with headaches are dependent on clinical scenarios and the likelihood of a significant pathology. Further research is required to identify the significant clinical findings with regard to the CT referrals and ensure that CT scans are not requested in patients who are unlikely to benefit.

Notch1 overexpression promotes cell growth and tumor angiogenesis in myeloma

Patients with multiple myeloma (MM) have increased bone marrow angiogenesis, but the angiogenic properties of myeloma cells and the mechanism of MM-induced angiogenesis have not been completely clarified. Notch1 signal has been identified as a critical factor in the regulation of vessel formation. However, the role of Notch1 in the angiogenesis of MM is unclear. We constitutively overexpressed active Notch1 in RPMI8226 cells to explore the effect of Notch1 signaling on cell growth and tumor angiogenesis in vivo and in vitro. We found that Notch1 overexpression promoted myeloma cells growth and increased drug resistance. Moreover, vascular endothelial growth factor (VEGF) expression was increased. Finally, our in vitro results were supported by the in vivo finding in human myeloma xenograft Nonobese diabetic/severe combined immunodeficient (NOD/SCID) models. Notch1 overexpression in MM cells resulted in up-regulation of VEGF expression, promotion of tumor growth, and increased microvessel density (MVD). Our study suggests that Notch1-induced angiogenesis is partly due to activation of VEGF pathway.

Differentiation of human dental stem cells reveals a role for microRNA-218

BACKGROUND

Regeneration of lost periodontium is the ultimate goal of periodontal therapy. Advances in tissue engineering have demonstrated the multilineage potential and plasticity of adult stem cells located in periodontal apparatus. However, it remains unclear how epigenetic mechanisms controlling signals determine tissue specification and cell lineage decisions. To date, no data are available on micro-RNA (miRNA) activity behind human-derived dental stem cells (DSCs).

MATERIAL AND METHODS

In this study, we isolated periodontal ligament stem cells, dental pulp stem cells and gingival stem cells from extracted third molars; human bone marrow stem cells were used as a positive control. The expression of OCT4A and NANOG was confirmed in these undifferentiated cells. All cells were cultured under osteogenic inductive conditions and RUNX2 expression was analyzed as a marker of mineralized tissue differentiation. The miRNA expression profile was obtained at baseline and after osteogenic induction in all cell types.

RESULTS

The expression of RUNX2 demonstrated successful osteogenic induction of all cell types, which was confirmed by alizarin red stain. The analysis of 765 miRNAs demonstrated a shift in miRNA expression that occurred in all four stem cell types, including a decrease in hsa-mir-218 across all differentiated cell populations. Hsa-mir-218 targets RUNX2 and decreases RUNX2 expression in undifferentiated human DSCs. DSC mineralized tissue type differentiation is associated with a decrease in hsa-mir-218 expression.

CONCLUSION

These data reveal a miRNA-regulated pathway for the differentiation of human DSCs and a select network of human miRNAs that control DSC osteogenic differentiation.

Assessment of coronary microvascular dysfunction in hypertrophic cardiomyopathy: first-pass myocardial perfusion cardiovascular magnetic resonance imaging at 1.5 T

AIM

To evaluate the integrity of the coronary microvasculature in patients with hypertrophic cardiomyopathy (HCM) using first-pass magnetic resonance perfusion imaging.

MATERIALS AND METHODS

Twenty-two patients with HCM and 13 healthy volunteers underwent cardiac magnetic resonance imaging (CMR) at rest. Imaging protocols included short axis cine, first-pass myocardial perfusion, and late-phase contrast-enhanced imaging. Left ventricular end-diastolic wall thickness (EDTH), myocardial thickening, maximal upslope of time-intensity curve (slopemax), and late myocardial gadolinium enhancement (LGE) were assessed for each myocardial segment. The differences in slopemax, myocardial thickening, and EDTH between healthy volunteers and HCM patients were evaluated as were differences among hypertrophic segments of different severities (mild, moderate, and severe hypertrophy) in a one-way analysis of variance analysis. The differences in slopemax, myocardial thickening, and EDTH between the segments with and without LGE were compared by independent-sample t-test. A Pearson correlation test was used to determine the relationships between slopemax, EDTH, and myocardial thickening.

RESULTS

Slopemax was statistically significantly less in HCM patients; the degree of myocardial thickening was also significantly reduced (p < 0.001). Slopemax and the degree of thickening statistically significantly decreased with increasing degrees of myocardial hypertrophy (p < 0.05). Differences in slopemax, myocardial thickening, and EDTH were observed between segments with and without LGE (p < 0.05). Slopemax and myocardial thickening were negatively correlated with EDTH.

CONCLUSION

First-pass myocardial perfusion CMR with slopemax measurements demonstrates microvascular coronary dysfunction in patients with HCM, a determination that may aid in risk stratification, therapeutic planning, and determination of prognosis for HCM.

Observation of an energy-dependent difference in elliptic flow between particles and antiparticles in relativistic heavy ion collisions

Elliptic flow (v(2)) values for identified particles at midrapidity in Au + Au collisions, measured by the STAR experiment in the beam energy scan at RHIC at sqrt[s(NN)] = 7.7-62.4 GeV, are presented. A beam-energy-dependent difference of the values of v(2) between particles and corresponding antiparticles was observed. The difference increases with decreasing beam energy and is larger for baryons compared to mesons. This implies that, at lower energies, particles and antiparticles are not consistent with the universal number-of-constituent-quark scaling of v(2) that was observed at sqrt[s(NN)] = 200 GeV.

Pathways of phosphate uptake from aqueous solution by ZnAl layered double hydroxides

ZnAl layered double hydroxides (LDHs) were prepared by urea hydrolysis-based coprecipitation for removing phosphate from aqueous solutions. The chemical formula of the product was determined as Zn5.54Al3.02(OH)8.73(CO3)0.57Cl5.66·7.84H2O. Chloride ion was the major interlayer anion of the ZnAl LDHs. Adsorption of phosphate onto the ZnAl sorbent over the entire study period was not in close agreement with pseudo-first-order or pseudo-second-order models. The adsorption can be divided into two steps. A fast adsorption was observed during the first 10 h with a marked increase in the concentration of Cl(-) in the bulk solution. This indicated that the adsorption of phosphate was largely attributed to the ion exchange between phosphate and the interlayer Cl(-). A second fast adsorption of phosphate occurred after 10 h. During this period, the pH increased slowly, whereas the Cl(-) concentration was stable. The uptake of phosphate was likely attributed to OH(-)-H2PO4(-)/HPO4(2-) ion exchange as well as surface adsorption/complexation. Acidic conditions favored adsorption of phosphate by ZnAl LDHs, which is consistent with the pH increases during the adsorption. Coexisting anions, e.g., SO4(2-) and CO3(2-), are competitive ions for the adsorption of phosphate. The results verify the contribution of ion exchange and surface adsorption/complexation in the removal of phosphate by ZnAl LDHs.

Patellar resurfacing in primary total knee replacement: a meta-analysis

BACKGROUND

Treatment of the patella during total knee replacement is an area of continuing debate. We performed a meta-analysis of randomized controlled trials to address the hypothesis that patellar resurfacing in primary total knee replacement improved patient outcome.

METHODS

Randomized controlled trials comparing patellar resurfacing with nonresurfacing in primary total knee replacement were included. The primary outcomes analyzed were knee scores, anterior knee pain, and patient satisfaction. We also investigated the prevalence of complications, revision surgery related specifically to the patellofemoral joint, the infection rate, operative time, and radiographic appearance.

RESULTS

Sixteen randomized controlled trials assessing 3465 knee replacements were eligible; 1710 procedures included patellar resurfacing and 1755 did not. The knee component of the Knee Society Score was significantly higher in the resurfacing group (p = 0.005); however, no significant difference was observed for the function component of the Knee Society Score or for any other reported knee score. Anterior knee pain was reported in 13% of resurfaced knees and in 24% of nonresurfaced knees; this difference was not significant (p = 0.1). Patients were satisfied with the outcome after 485 (90%) of 539 procedures that included patellar resurfacing compared with 488 (89%) of 548 that did not; this difference was not significant. There were ninety-three reported patellofemoral complications in the resurfacing group and 205 in the nonresurfacing group; this difference was significant (p = 0.02) in a random-effect model. The rate of reoperation because of anterior knee pain (p &lt; 0.00001) and the rate of reoperation because of any patellofemoral complication (p = 0.002) were significantly higher in the nonresurfaced group. No differences were found in the analyses of infection rate, operative time, or radiographic appearance.

CONCLUSIONS

Patients who underwent patellar resurfacing experienced anterior knee pain and satisfaction with the arthroplasty procedure that were equivalent to those experienced by patients whose patella was not resurfaced; however, these patients underwent significantly fewer additional surgical procedures. Further long-term follow-up of modern prostheses in randomized studies measuring outcome with a patella-specific score is needed.

Abstract P1-05-24: Pharmacologic reversion of epigenetic silencing of the PRKD1 promoter blocks breast tumor cell invasion and metastasis

Epigenetic silencing of tumor suppressing genes by promoter-specific DNA methylation is common in many types of cancer. As an early event, this process has been well shown to promote tumor initiation and progression; however little is known how such epigenetic silencing can contribute to tumor metastasis. The PRKD1 gene encodes Protein Kinase D1 (PKD1), a serine/threonine kinase expressed in epithelial cells of the normal mammary gland that maintains the epithelial phenotype of normal breast cells and prevents epithelial-to-mesenchymal transition (EMT). PKD1 is also a critical suppressor of tumor cell invasion and is silenced in expression and activity during breast tumor progression. Here, we show that aberrant methylation of PRKD1 promoter region is not only correlated with the silencing of its expression but is also associated with invasiveness of breast cancer cell lines and with aggressiveness of breast tumors. Using the highly invasive MDA-MB-231 cells, we show that the inhibition of PRKD1 promoter methylation with the DNA methyltransferase inhibitor decitabine restores PKD1 expression and significantly decreases their invasive abilities in vitro. More importantly, in a tumor xenograft model it dramatically blocks tumor spread and metastasis to the lung in a PKD1-dependent fashion. Our data suggest that the status of epigenetic regulation of the PRKD1 promoter can provide valid information on the invasiveness of breast tumors, and therefore could serve as an early diagnostic marker. Moreover, targeted upregulation of PKD1 expression may be used as a therapeutic approach to reverse the invasive phenotype of breast cancer cells.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P1-05-24.

Therapeutic and preventive effects of an epidermal growth factor receptor inhibitor on oral squamous cell carcinoma

OBJECTIVE

Oral squamous cell carcinoma (OSCC) is the sixth most common human neoplasm worldwide. Epidermal growth factor receptor (EGFR) is a receptor tyrosine kinase that is highly expressed in human OSCC and is a target for cancer therapy and prevention. This study investigated the therapeutic and preventive effects of an inhibitor of EGFR (PD153035) on OSCC.

METHODS

The effects of PD153035 were examined in human cancer cell lines in vitro, in an athymic nude mouse xenograft model in vivo, and in the 7,12-dimethyl benz[a]anthracene (DMBA)-induced hamster cheek pouch tumour model in vivo.

RESULTS

PD153035 significantly inhibited cell growth, delayed cell cycle progression and induced apoptosis in human OSCC cells in vitro. In vivo, PD153035 inhibited xenograft tumour growth in nude mice in a dose-dependent manner and prevented the development of OSCC at the postinitiation stage in the DMBA-induced hamster cheek pouch tumour model. PD153035 inhibited the DMBA-induced increases in cell proliferation and in levels of phosphorylated EGFR and phosphorylated signal transducer and activator of transcription 3 (STAT3) protein in the hamster cheek pouch.

CONCLUSIONS

Inhibitors of EGFR, such as PD153035, have potential value in the treatment and prevention of OSCC.