The association between metabolic syndrome or chronic kidney disease and hearing thresholds in Koreans: the Korean National Health and Nutrition Examination Survey 2009-2012

BACKGROUND

The aim of this study was to determine whether metabolic syndrome (MetS) or chronic kidney disease (CKD) is associated with hearing thresholds in the general Korean population.

PATIENTS AND METHODS

A total of 16,554 participants were included in this study. MetS was defined using the National Cholesterol Education Program Adult Treatment Panel III guidelines, and CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2 or a dipstick proteinuria result of ≥1+. The hearing thresholds were measured at 0.5, 1, 2, 3, 4, and 6 kHz. Low-frequency (Freq) was defined as pure-tone averages at 0.5 and 1 kHz, while Mid-Freq and High-Freq were defined as the average thresholds at mid-frequency (2 and 3 kHz) and high frequency (4 and 6 kHz), respectively.

RESULTS

In men, the hearing thresholds were 15.1 ± 14.5 dB, 22.2 ± 21.3 dB, and 37.3 ± 26.5 dB for Low-, Mid-, and High-Freq, respectively. In women, the hearing thresholds were 14.9 ± 15.3 dB, 16.6 ± 18.0 dB, and 26.1 ± 21.5 dB for Low-, Mid-, and High-Freq, respectively. The hearing thresholds for men were significantly higher than the hearing thresholds for women in all 3 threshold categories. Male and female subjects with MetS or CKD had higher hearing thresholds than the subjects that did not have these disorders. In the multivariate analysis, MetS was associated with increased hearing thresholds in women, and CKD was associated with increased hearing thresholds in men and women.

CONCLUSION

MetS is associated with hearing thresholds in women, and CKD is associated with hearing thresholds in men and women. Therefore, patients with MetS or CKD should be closely monitored for hearing impairment.

Association between low-grade albuminuria and hearing impairment in a non-diabetic Korean population: The Korea National Health and Nutrition Examination Survey (2011-2013)

INTRODUCTION

The objective of the present study was to examine the association between low-grade albuminuria and hearing impairment in the non-diabetic population.

MATERIALS AND METHODS

Data from the Korean National Health and Nutrition Examination Survey 2011-2013 were used in the analyses. Participants were excluded from this study if they were younger than 19 years old, or had urine albumin/creatinine ratio (UACR) ≥ 30 mg/g or diabetes mellitus. There were 10,608 participants included in this study. The participants were divided into three groups according to their UACR tertiles.

RESULTS

There were 1560; 1561; and 1552 male and 1982; 1975; and 1978, female participants in the low, middle, and high tertile groups, respectively. The results indicated the association between low-grade albuminuria and the numbers of metabolic syndrome (MetS) components or Framingham risk score, and the presence of MetS or the proportions of participants at high cardiovascular risk. Univariate and multivariate linear regression analyses demonstrated an association between the UACR and average hearing threshold (AHT) that was observed in both sexes. Multivariate analyses showed that mean AHTs in the low, middle, and high tertile groups were, respectively, 16.127 dB, 17.139 dB, and 18.604 dB for men, and 14.842 dB, 15.100 dB, and 16.353 dB, respectively, for women. Low-frequency, mid-frequency, and high-frequency hearing thresholds according to UACR tertiles showed similar trends. In both sexes, multivariate logistic regression analyses revealed that participants in the low and middle tertile groups had a decreased risk for hearing loss compared to participants in the high tertile group.

CONCLUSION

Low-grade albuminuria was associated with hearing impairment in the non-diabetic participants of this study.

A new pH sensitive fluorescent and white light emissive material through controlled intermolecular charge transfer

A new, pH dependent and water-soluble, conjugated oligomer (amino, trimethylammonium oligophenylene vinylene, ATAOPV) was synthesized with a quaternary ammonium salt and an aromatic amine at the two ends of a π-conjugated oligomer, thus creating a strong dipole across the molecule. A unique white light LED is successfully fabricated from a stimuli responsive organic molecule whose emission properties are dominated by the pH value of the solution through controlled intermolecular charge transfer.

Visceral Fat Area Determined Using Bioimpedance Analysis Is Associated with Hearing Loss

BACKGROUND

Visceral fat area (VFA) using bioimpedance analysis (BIA) as a simple analyzer can be used to assess VFA, which may be associated with HL. The aim of the present study was to evaluate the clinical relevance and usefulness of VFA using BIA as a predictor of HL.

PATIENTS AND METHODS

In total, 18,415 patients were recruited into our study. VFAs were measured using multi-frequency BIA. VFAs were normalized by body mass index (BMI). Participants were divided into 3 tertiles based on their VFA/BMI for both sexes. For both ears of each participant, the low-frequency (Low-Freq), mid-frequency (Mid-Freq), and high-frequency (High-Freq) values were obtained calculating the pure tone averages at 0.5 and 1 kHz, 2 and 3 kHz, and 4 and 6 kHz, respectively. The average hearing threshold (AHT) was calculated as the pure tone average at the 4 frequencies (i.e., 0.5, 1, 2, and 3 kHz). HL was defined as AHT >40 dB.

RESULTS

The VFA/BMI had the greatest AUROC among VFA, BMI, and VFA/BMI in both sexes in this study. In both univariate and multivariate analyses, VFA/BMI tertiles were associated with all 4 hearing thresholds (i.e., Low-Freq, Mid-Freq, High-Freq, and AHT). The 4 hearing thresholds were positively correlated with VFA/BMI as a continuous variable. The odds ratio for HL increased as the VFA/BMI tertile increased.

CONCLUSION

VFA/BMI was associated with hearing impairment in the Asian population. The participants with high VFA/BMI should be closely monitored for hearing impairment.

Withaferin A induces apoptosis through the generation of thiol oxidation in human head and neck cancer cells

Withaferin A is a steroidal lactone purified from the Indian medicinal plant, Withania somnifera. Withaferin A has been shown to inhibit the proliferation, metastasis, invasion and angiogenesis of cancer cells. In the present study, we investigated whether withaferin A induces apoptosis in the human head and neck cancer cells, AMC-HN4. Withaferin A markedly increased the sub-G1 cell population and the cleavage of poly(ADP-ribose) polymerase (PARP), which are markers of apoptosis. Pan-caspase inhibitor, z-VAD-fmk (z-VAD), markedly inhibited the withaferin A-induced apoptosis. However, the withaferin A-induced increase in the expression of COX-2 was not affected by treatment with z-VAD. Furthermore, withaferin A upregulated cyclooxygenase-2 (COX-2) expression. The COX-2 inhibitor, NS-398, reduced the withaferin A-induced production of prostaglandin E2. However, treatment with NS-398 did not affect the sub-G1 population and the cleavage of PARP. In addition, the withaferin A-induced apoptosis was independent of reactive oxygen species production. Thiol donors [N-acetylcysteine (NAC) and dithiothreitol (DTT)] reversed withaferin A-induced apoptosis. Therefore, our data suggest that withaferin A induces apoptosis through the mechanism of thiol oxidation in head and neck carcinoma cells.

New method of diagnosis for chronic ankle instability: comparison of manual anterior drawer test, stress radiography and stress ultrasound

PURPOSE

To diagnose chronic ankle instability, clinicians frequently use manual anterior drawer test and stress radiography. However, both exams can yield incorrect results and do not reveal the extent of ankle instability. The use of stress ultrasound during a manual anterior drawer stress procedure might enable the diagnosis of chronic ankle instability.

METHODS

Seventy-three patients with chronic ankle pain or laxity after remote ankle sprain were included. The study population included 41 males and 32 females. The mean age of the patients at the time of the operation was 29 years. A standardized physical examination (manual anterior drawer test), stress radiography and stress ultrasonography were performed to assess the anterior talofibular ligament (ATFL). Ultrasound images were taken in the resting position and the maximal anterior drawer position. The statistical significance of stress ultrasound among the three groups according to manual anterior drawer test and a specific degree (5 mm) of anterior translation of stress radiography were analysed. Correlation coefficients between stress ultrasound, stress radiography and manual anterior drawer test were calculated.

RESULTS

There was a significant difference for ATFL length (ATFL stress) and ATFL ratio (ATFL stress/ATFL resting) among the three groups (both p < 0.001). However, there was no significant difference for anterior translation of stress radiography among three groups according to manual anterior drawer test (p = 0.159). There was a significant difference for ATFL length (ATFL stress) and ATFL ratio between two groups with 5-mm anterior translation of stress radiography (p = 0.002 and p = 0.011, respectively). The mean value of grade of manual anterior drawer test between the two groups also differed (p = 0.021). There was a moderately positive linear relationship between stress ultrasound and manual anterior drawer test. Also, there was a positive linear relationship between stress ultrasound and stress radiography.

CONCLUSION

The results suggest that the value of ATFL length (ATFL stress) and ATFL ratio of stress ultrasound could be used for diagnosis of chronic ankle instability in addition to manual anterior drawer test and stress radiography.

Does procurement technique affect posttransplant graft function in deceased donor liver transplantation?

INTRODUCTION

Various techniques have been described deceased donor liver transplantation (DDLT) procurement. One is a technique whereby almost total dissection is done in the porta hepatis and perihepatic detachment is carried out before cross-clamping the donor aorta. In another approach, after the donor aorta is cross-clamped, rapid and minimal en bloc dissection is performed with minimal manipulation. We evaluated early posttransplant graft function among liver procurement techniques.

METHOD

Between January 2008 and August 2012, we performed 45 consecutive adult DDLTs. One patient was excluded from this analysis due to early death from sepsis after transplantation. The 44 included patients were divided into two cohorts according to the procurement technique: A warm dissection (n = 23; 52%) and a cold dissection group (n = 21; 48%). We compared early posttransplant graft function using the aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (T-bil), and prothrombin time (PT) values of the two groups from the first to seventh postoperative day.

RESULT

The AST values in the warm group were significantly greater than those in the cold group on postoperative days 3 and 5. In addition, the ALT values in the warm group were greater than those in the cold group on postoperative days 4, 5, and 6. Moreover, the T-bil values in the warm group were greater than those in the cold group on postoperative days 2, 3, 4, 5, 6, and 7. However, there were no differences in PT values.

CONCLUSION

During liver procurement for DDLT, rapid en bloc procurement with minimal manipulation after clamping the donor aorta achieved better early graft function posttransplantation.

Bone marrow analysis of immune cells and apoptosis in patients with systemic lupus erythematosus

OBJECTIVES

To examine the immune cell profile in the bone marrow of systemic lupus erythematosus (SLE) patients and to assess its clinical relevance.

METHODS

Sixteen bone marrow samples from 14 SLE patients were compared with seven healthy control samples. The numbers of immune cells and apoptotic cells in the bone marrow were examined by immunohistochemistry. The association between immune cell subsets and clinical features was investigated.

RESULTS

CD4+ T cells, macrophages and plasma cells were more common in the bone marrow of SLE patients than in healthy controls (p=0.001, p=0.004 and p<0.001, respectively). Greater numbers of CD4+ T cells and macrophages were associated with high-grade bone marrow damage. The percentage of apoptotic cells in bone marrow of SLE patients was significantly higher than that in controls (p<0.001) and was positively correlated with the number of plasmacytoid dendritic cells (p=0.013). Increased number of plasma cells along with high interleukin-6 expression was correlated with anti-double stranded DNA antibody levels and the SLE disease activity index (p=0.031 and 0.013, respectively).

CONCLUSION

Bone marrow from SLE patients showed a distinct immune cell profile and increased apoptosis. This, coupled with a correlation with disease activity, suggests that the bone marrow may play a critical role in the pathogenesis of SLE.

Observation of a charged charmoniumlike structure in e+ e- → (D* D*)± π∓ at √s = 4.26 GeV

We study the process e+ e- →(D* D*)± π∓ at a center-of-mass energy of 4.26 GeV using a 827  pb(-1) data sample obtained with the BESIII detector at the Beijing Electron Positron Collider. Based on a partial reconstruction technique, the Born cross section is measured to be (137±9±15)  pb. We observe a structure near the (D* D*)± threshold in the π∓ recoil mass spectrum, which we denote as the Zc±(4025). The measured mass and width of the structure are (4026.3±2.6±3.7)  MeV/c2 and (24.8±5.6±7.7)  MeV, respectively. Its production ratio σ(e+ e- → Zc±(4025)π∓ → (D* D*)± π∓)/σ(e+ e- → (D* D*)± π∓) is determined to be 0.65±0.09±0.06. The first uncertainties are statistical and the second are systematic.

High-resolution impedance manometry facilitates assessment of pharyngeal residue and oropharyngeal dysphagic mechanisms

The utility of high-resolution impedance manometry (HRIM) for evaluating oropharyngeal dysphagia (OPD) has been investigated. These approaches are limited because of the sophisticated methodology. A method of transforming HRIM into a simple and useful diagnostic tool for evaluating OPD is needed. A videofluoroscopic swallowing study (VFSS) and HRIM were performed by independent blinded examiners in 26 consecutive healthy volunteers (12 men; median age, 56.5 years) and 10 OPD patients (five men; median age, 59.5 years). Upper esophageal sphincter (UES) relaxation parameters were measured using a standard HRIM protocol. Peristalsis and bolus transit of the pharyngoesophageal (PE) segment were assessed using an HRIM-modified protocol in which the catheter was pulled back 10 cm. PE bolus transits were evaluated with an impedance contour pattern (linear vs. stasis) method. A significant difference was observed between the manometric measures of healthy volunteers and OPD patients for only the duration of pharyngeal contraction (0.49 ± 0.19 vs. 0.76 ± 0.33 s, P = 0.04). The percentage agreement and kappa value for detecting pharyngeal residue between the VFSS and the impedance analysis were 100% and 1.00, respectively. HRIM allowed for comprehensive assessment of abnormal pharyngeal components that caused pharyngeal residue on VFSS in two patients; reduced base of the tongue versus weak pharyngeal contraction in one, and reduced relaxation of the UES versus reduced laryngeal elevation in the remaining patient. Our findings demonstrated that HRIM using a simple methodology (i.e., pull-back of the catheter) detected pharyngeal residue through a simple analysis of the impedance contour pattern (linear vs. stasis). Furthermore, HRIM facilitated a comprehensive assessment of OPD mechanisms and recognition of subtle abnormalities not yet visible to the naked eye on VFSS.

Whole blood versus serum ionized calcium concentrations in dialysis patients

BACKGROUND/AIMS

The aim of this study is to measure the difference of ionized calcium between heparinized whole blood and serum.

METHODS

We recruited 107 maintenance hemodialysis (HD) patients from our hospital HD unit. The clinical and laboratory data included ionized calcium in serum and in whole blood (reference, 4.07 to 5.17 mg/dL).

RESULTS

The level of ionized calcium in serum was higher than that in whole blood (p < 0.001). Bland-Altman analysis showed that difference for ionized calcium was 0.5027. For the difference, the nonstandardized β was -0.4389 (p < 0.001) and the intercept was 2.2418 (p < 0.001). There was a significant difference in the distribution of categories of ionized calcium level between two methods (κ, 0.279; p < 0.001).

CONCLUSIONS

This study demonstrates that whole blood ionized calcium is underestimated compared with serum ionized calcium. Positive difference increases as whole blood ionized calcium decreases. Therefore, significant hypocalcemia in whole blood ionized calcium should be verified by serum ionized calcium.

Paricalcitol ameliorates epithelial-to-mesenchymal transition in the peritoneal mesothelium

BACKGROUND

The purpose of the present study was to examine the effectiveness of paricalcitol for the prevention of epithelial-to-mesenchymal transition (EMT).

MATERIALS AND METHODS

Human peritoneal mesothelial cells (HPMCs) were cultured in media containing transforming growth factor β1 (TGF-β1) with or without paricalcitol. Forty-two male Sprague-Dawley rats were divided into three groups. In the control group, the catheter was inserted but no dialysate was infused. The peritoneal dialysis (PD) group was infused with a conventional 4.25% dialysis solution. The paricalcitol group was infused with 4.25% dialysis solution and cotreated with paricalcitol.

RESULTS

Exposure of HPMCs to TGF-β1 decreased the protein level of the epithelial cell marker and increased the expression levels of the mesenchymal markers. Cotreatment with paricalcitol increased the protein levels of the epithelial cell marker and decreased those of mesenchymal markers compared with their levels in cells treated with TGF-β1 alone. Exposure of HPMCs to TGF-β1 significantly increased the phosphorylation of Smad2 and Smad3. Cotreatment with paricalcitol significantly decreased the phosphorylation of Smad2 and Smad3 compared with that of cells treated with TGF-β1 alone. After 8 weeks of experimental PD in rats, the thickness of the peritoneal membrane in the PD group was significantly increased compared with that of the control group. Cotreatment with paricalcitol decreased peritoneal thickness.

CONCLUSION

The present study showed that paricalcitol attenuates the TGF-β1-induced EMT in peritoneal mesothelial cells. We suggest that paricalcitol may preserve peritoneal mesothelial cells during PD and could thus be of value for the success of long-term PD.

Observation of a charged (DD*)± mass peak in e+ e- → πDD* at sqrt[s] = 4.26 GeV

We report on a study of the process e+ e- → π± (DD*)∓ at sqrt[s] = 4.26  GeV using a 525 pb(-1) data sample collected with the BESIII detector at the BEPCII storage ring. A distinct charged structure is observed in the (DD*)∓ invariant mass distribution. When fitted to a mass-dependent-width Breit-Wigner line shape, the pole mass and width are determined to be Mpole = (3883.9±1.5(stat)±4.2(syst))  MeV/c2 and Γpole = (24.8±3.3(stat)±11.0(syst))  MeV. The mass and width of the structure, which we refer to as Zc(3885), are 2σ and 1σ, respectively, below those of the Zc(3900) → π± J/ψ peak observed by BESIII and Belle in π+ π- J/ψ final states produced at the same center-of-mass energy. The angular distribution of the πZc(3885) system favors a JP = 1+ quantum number assignment for the structure and disfavors 1- or 0-. The Born cross section times the DD* branching fraction of the Zc(3885) is measured to be σ(e+ e- → π± Zc(3885)∓)×B(Zc(3885)∓ → (DD*)∓) = (83.5±6.6(stat)±22.0(syst))   pb. Assuming the Zc(3885) → DD* signal reported here and the Zc(3900) → πJ/ψ signal are from the same source, the partial width ratio (Γ(Zc(3885) → DD*)/Γ(Zc(3900) → πJ/ψ)) = 6.2±1.1(stat)±2.7(syst) is determined.

Effects of low-glucose degradation product solution on peritoneal membrane characteristics in peritoneal dialysis patients: a 3-year follow-up study

INTRODUCTION

Changes in peritoneal membrane characteristics including epithelial-mesenchymal transition are an important problem in the maintenance of peritoneal dialysis (PD). This study reports a 3-year follow-up assessment of the effects of low-glucose degradation products (GDP) solution, including epithelial-mesenchymal transition.

MATERIALS AND METHODS

Adult patients who received continuous ambulatory PD between April 2001 and March 2007 were identified, and those who maintained on PD with the same solution for more than 3 years were included. Patients with an initial effluent score of 3 (fibroblastoid cells dominant in overnight effluent dialysate) were excluded. The patients were divided into two groups according to the dialysate: standard and low-GDP. The following were measured: cancer antigen-125, cell score, normalized protein equivalent of nitrogen appearance, dialysate-plasma creatinine and sodium ratios, and residual renal function. Cell score and peritoneal equilibration test were measured at 1, 6, 12, 18, and 24 months after the initiation of PD.

RESULTS

Fifty patients were in the standard group and 76 in the low-GDP group. No significant difference in dialysate-plasma creatinine ratio was detected at baseline and at the end-point of follow-up between the two groups. Dialysate-plasma sodium ratio decreased significantly at the end-point of follow-up in the low-GDP group. Initial and follow-up cancer antigen-125 levels were higher in the low-GDP group. Multivariable analysis showed that low-GDP was associated with a higher cell score 3-free survival rate.

CONCLUSIONS

The present study shows that a low-GDP solution may be associated with preserving the mesothelial cell and peritoneal membrane characteristics.

Abstract PD6-8: Prognostic value of disseminated tumor cells according to ER/PR and HER2 status in non-metastatic breast cancer

Background: Disseminated tumor cells (DTCs) in the bone marrow from breast cancer patients have been reported as a prognostic factor. We evaluated prognostic value of DTCs in non-metastatic breast cancer according to ER/PR and HER2 status.

Methods: Bone marrow aspirates were obtained from 607 non-metastatic breast cancer patients at the time of primary surgery between 1999 and 2012. DTCs were identified via immunomagnetic enrichment followed by flow cytometry (IE/FC) using anti-EpCAM monoclonal antibody (mAb). The relation between high DTC count and clinical outcome was analyzed with ER/PR and HER2 status. Patients whose DTC count is in the above 80th percentile were considered as higher DTCs.

Results: Median and mean DTC count were 7.2 and 24.5 cells/mL and 80th percentile was 18.5 cells/mL. Higher DTC group (&gt; = 18.5 cells/mL) showed impaired disease free survival (DFS; P = .019, log-rank) after median follow-up of 59 months. This poorer outcome in higher DTC group was observed mainly in ER(-) patients and triple negative patients with lower DFS (P = .002 and 018) and overall survival (OS; P = .004 and .012). There was no significant survival difference in ER(+), HER2(+), or ER(+)/HER2(-) patients.

Conclusion: High DTCs in non-metastatic breast cancer is associated with poor clinical outcome, especially in ER(-) or triple negative patients. However, DTCs is not related with prognosis in other ER/HER2 status groups.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr PD6-8.

Abstract P3-11-01: Prospective study of cognitive function in women with early stage breast cancer: Predictors of cognitive decline and relationship to cognitive complaints

Background: Cognitive complaints are common among women receiving adjuvant therapy (Rx) for early stage breast cancer (ESBC). Longitudinal prospective data is needed to understand cognitive complaints and decline. We conducted a prospective trial to evaluate the effects of chemotherapy (CTX) and hormone therapy (HRx) on brain and cognitive function in patients with ESBC using objective & subjective tests as well as MRI/PET imaging.

Methods: Eligibility included female patients planning to receive adjuvant Rx for ESBC. Patients were enrolled in 3 treatment groups: CTX, CTX and HRx, and HRx, with a 4th no disease age and education matched control group. Patients underwent a battery of objective and subjective cognitive tests before start of Rx, 1 month after CTX or 5 months after start of HRx (FU1), then 9 months (FU2) and 18 months (FU3) after Rx. Brain MRI, PET & serum estradiol (E) were performed at baseline, FU1 & FU3.

Results: 81 patients were enrolled as follows: 14 CTX, 33 CTX & HRx, 22 HRx, and 12 control. 90% completed FU1, 72% FU2, & 62% FU3, with 29 patients waiting to complete testing. Demographics were similar between groups: median age 54, 78% Caucasian. At each FU, approximately 25% of patients showed cognitive decline using a reliable change index; 51% showed decline at ≥ 1 time point, primarily in tests of executive function & verbal memory. 62 - 77% of patients who declined later stabilized or improved. Compared to controls, receipt of HRx (OR 4.94, p = .004) but not serum E, menopausal status, CTX, demographic factors, depression, or fatigue, were significant predictors of decline at any time point. Rx group did not predict cognitive complaints (FACT-Cog). At FUP1, depression, fatigue, and decline in letter fluency predicted overall cognitive complaints, but HRx did not. Cognitive complaints were predicted by domain-specific cognitive decline: memory decline predicted memory complaints, and verbal fluency decline predicted verbal fluency complaints, even after controlling for depression and fatigue. Additional analyses will be presented as more patients complete follow-up testing.

Conclusion: Decline in cognitive function is common in patients receiving adjuvant Rx for ESBC. Ongoing HRx was a risk factor for worse cognitive function, but not for perceived cognitive problems. Other Rx and patient related factors did not predict decline. Perceived cognitive problems were predicted by depression, fatigue, and letter fluency decline, with specific cognitive complaints predicted by domain-specific declines. Patients should be aware that HRx may be a risk factor for cognitive decline, while depression, fatigue, and cognitive decline predicted cognitive complaints. Intervention studies, including assessment for depression and fatigue, should be offered to patients who complain of cognitive changes and particularly to patients treated with HRx.

Funding: NIH R01 1AG025303-01A2.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-11-01.

Observation of a charged charmoniumlike structure Zc(4020) and search for the Zc(3900) in e+e-→π+π-hc

We study e+e-→π+π-hc at center-of-mass energies from 3.90 to 4.42 GeV by using data samples collected with the BESIII detector operating at the Beijing Electron Positron Collider. The Born cross sections are measured at 13 energies and are found to be of the same order of magnitude as those of e+e-→π+π-J/ψ but with a different line shape. In the π±hc mass spectrum, a distinct structure, referred to as Zc(4020), is observed at 4.02  GeV/c2. The Zc(4020) carries an electric charge and couples to charmonium. A fit to the π±hc invariant mass spectrum, neglecting possible interferences, results in a mass of (4022.9±0.8±2.7)  MeV/c2 and a width of (7.9±2.7±2.6)  MeV for the Zc(4020), where the first errors are statistical and the second systematic. The difference between the parameters of this structure and the Zc(4025) observed in the D*D[over ¯]* final state is within 1.5σ, but whether they are the same state needs further investigation. No significant Zc(3900) signal is observed, and upper limits on the Zc(3900) production cross sections in π±hc at center-of-mass energies of 4.23 and 4.26 GeV are set.

Study of the electronic structure of the interfaces between 2-TNATA and MoOx

In order to understand the characteristics of ohmic hole-contacts for the inverted/conventional organic light emitting devices, a hole-only device with all ohmic contacts, which is composed of glass/ITO/MoOx/4,4,4-tris[2-naphthyl-phenyl-amino]triphenylamine (2-TNATA)/MoOx/Al, the elements of the electronic structures of MoOx-on-2-TNATA interface and 2-TNATA-on-MoOx interface were investigated by photoemission spectroscopy, with regards to interface energetics, formative mechanism, and a potential charge carrier injection. The electronic structures revealed that the behavior of the interface between MoOx and 2-TNATA was different whether MoOx was deposited on (2-TNATA) or vice versa. The bottom interfaces of 2-TNATA-on-MoOx in this hole-only devices showed no hole-injecting barrier height (Phi(h)B) when the thickness of 2-TNATA was deposited in the range of 0.1 to 5.0 nm on the 10.0 nm-thick MoOx thin films. This has been explained to be attributed to both metal-induced gap states and a chemical reaction at the interfaces. The top interfaces of MoOx-on-2-TNATA in this hole-only device structure also showed no Phi(h)B when a hole was injected from the MoOx-on-2-TNATA interfaces to cathode. The hole-ohmic property in the top interfaces depends on interface dipole by the formation of charge transfer complexes as well as interdiffusion of MoOx into the 2-TNATA film in these interfaces.

A phase 1 trial of imatinib, bevacizumab, and metronomic cyclophosphamide in advanced colorectal cancer

Background:

This phase 1 clinical trial was conducted to determine the safety, maximum-tolerated dose (MTD), and pharmacokinetics of imatinib, bevacizumab, and metronomic cyclophosphamide in patients with advanced colorectal cancer (CRC).

Methods:

Patients with refractory stage IV CRC were treated with bevacizumab 5 mg kg⁻¹ i.v. every 2 weeks (fixed dose) plus oral cyclophosphamide q.d. and imatinib q.d. or b.i.d. in 28-day cycles with 3+3 dose escalation. Response was assessed every two cycles. Pharmacokinetics of imatinib and cyclophosphamide and circulating tumour, endothelial, and immune cell subsets were measured.

Results:

Thirty-five patients were enrolled. Maximum-tolerated doses were cyclophosphamide 50 mg q.d., imatinib 400 mg q.d., and bevacizumab 5 mg kg⁻¹ i.v. every 2 weeks. Dose-limiting toxicities (DLTs) included nausea/vomiting, neutropaenia, hyponatraemia, fistula, and haematuria. The DLT window required expansion to 42 days (1.5 cycles) to capture delayed toxicities. Imatinib exposure increased insignificantly after adding cyclophosphamide. Seven patients (20%) experienced stable disease for >6 months. Circulating tumour, endothelial, or immune cells were not associated with progression-free survival.

Conclusion:

The combination of metronomic cyclophosphamide, imatinib, and bevacizumab is safe and tolerable without significant drug interactions. A subset of patients experienced prolonged stable disease independent of dose level.

Predicting residual renal function in peritoneal dialysis patients using an estimated glomerular filtration rate based on serum creatinine levels

BACKGROUND

The aim of this study was to evaluate regression equations correcting estimated glomerular filtration rate (eGFR) and the clinical significance of the corrected eGFRs calculated using these equations.

PATIENTS AND METHODS

The authors determined how well corrected eGFR values calculated using regression equations predict residual renal function (RRF).

RESULTS

RRF values were correlated with all eGFR values of nonanuric patients of both genders. Peritoneal creatinine clearance values were not correlated with eGFRs in anuric patients of either gender. In males, eGFR biases ranged from -5.66 to -3.25, and in females, from -5.96 to -3.21. However, these biases decreased when eGFR values were transformed to corrected eGFR values. The area under the curve of the corrected eGFR values was acceptable for a diagnosis of RRF loss.

CONCLUSION

Corrected eGFR values obtained using these methods may provide an alternative means of predicting RRF without 24-hour urine collection.

Clinical validity of tissue carcinoembryonic antigen expression as ancillary to serum carcinoembryonic antigen concentration in patients curatively resected for colorectal cancer

AIM

Although serum carcinoembryonic antigen (CEA) level is prognostic in colorectal cancer, the prognostic role of tumour CEA expression is unclear. The aim of this study is to identify the prognostic and surveillance roles of tissue CEA expression along with serum CEA concentration in patients curatively resected for colorectal cancer.

METHOD

Between January and December 2003, 294 patients who underwent curative resection for colorectal cancer were included in the study. Correlation of tissue CEA expression with overall survival (OS), disease-free survival (DFS) and elevated serum CEA concentration at tumour recurrence were analysed.

RESULTS

Tissue CEA expression was positive in 215 patients (73.1%). CEA expression was an independent prognostic factor for OS [hazard ratio (HR) = 2.537, 95% confidence interval (CI) = 1.065-6.042, P = 0.035] and DFS (HR = 3.090, 95% CI = 1.405-6.795, P = 0.005). Elevation of serum CEA at tumour recurrence was significantly lower in patients without than with tissue CEA expression (14.3 vs 57.6%, P = 0.045). Moreover, when patients were grouped according to a combination of serum CEA elevation and tissue CEA expression, those with tissue CEA expression and elevated serum CEA (group 3) had significantly poorer OS and DFS (P < 0.001 each) than those without CEA expression and elevated serum CEA (group 1) and those with either tissue CEA expression or elevated serum CEA (group 2). OS (P = 0.006) and DFS (P = 0.027) were both significantly greater in group 1 than in group 2.

CONCLUSION

Tissue CEA expression is a prognostic factor in patients with colorectal cancer. Analysis of tissue CEA expression may be helpful in determining the clinical utility of serial measurements of serum CEA as surveillance in patients with curatively resected colorectal cancer.

Regio-selectively reduced streptogramin A analogue, 5,6-dihydrovirginiamycin M1 exhibits improved potency against MRSA

A newly reduced macrocyclic lactone antibiotic streptogramin A, 5,6-dihydrovirginiamycin M1 was created by feeding virginiamycin M1 into a culture of recombinant Streptomyces venezuelae. Its chemical structure was spectroscopically elucidated, and this streptogramin A analogue showed twofold higher antibacterial activities against methicillin-resistant Staphylococcus aureus (MRSA) compared with its parent molecule virginiamycin M1. Docking studies using the model of streptogramin A acetyltransferase (VatA) suggested that the newly generated analogue binds tighter with overall lower free energy compared with the parent molecule virginiamycin M1. This hypothesis was validated experimentally through the improvement of efficacy of the new analogue against MRSA strains. The biotransformation approach presented herein could have a broad application in the production of reduced macrocyclic molecules.

Characteristics and clinical outcomes of hyponatraemia in peritoneal dialysis patients

AIM

There are few reports on the incidence, aetiology, and mortality of peritoneal dialysis (PD) patients with hyponatraemia.

METHODS

We identified all adults (>18-years-of-age) who received PD between May 2001 and March 2010. The patients were divided into two groups according to the presence of hyponatraemia (<135 mmol/L) during follow-up. Total body water (TBW) was obtained from bioimpedance analysis. Appropriate water gain was defined as a more than 3.6% increase of the mean TBW during normonatraemia in the same patient. Aetiologies of hyponatraemia were divided into two classes according to TBW.

RESULTS

Three hundred and eighty seven patients were enrolled in this study. Ninety nine had normonatraemia and 288 developed hyponatraemia during follow-up. Among 241 episodes with simultaneous bioelectrical impedance analysis measurement, there were 71 cases with appropriate water gain and 170 cases with non-appropriate water gain. Low residual renal function and long duration of PD were associated with development of hyponatraemia by appropriate water gain. On multivariate analysis, old age (≥65-years-of-age), hypoalbuminaemia (<35 g/L), low residual renal function (<2 mL/min per 1.73(2) ) and a high comorbid condition were associated with mortality in the PD patients. The patients with intermediate and high Davies index had an odds ratio of 3.25 for development of hyponatraemia during the follow-up period (95% confidence interval, 2.025-5.215; P < 0.001).

CONCLUSION

The prevalence of hyponatraemia increases along with the increased comorbidity status. The comorbidity conditions may be more important than hyponatraemia per se for predicting mortality. Additionally, the preservation of residual renal function may play a role in preventing hyponatraemia.

Change in body composition in accordance with residual renal function in patients on peritoneal dialysis

OBJECTIVES

The aim of this study is to evaluate changes in body composition in accordance with residual renal function (RRF).

SUBJECTS AND METHODS

Two hundred forty-four patients with more than 1 year of follow-up were enrolled. The mean value of RRF at peritoneal dialysis (PD) initiation and 1 year after PD initiation was used as an indicator of the time-averaged RRF (TA-RRF). The patients were divided into 3 groups with respect to the tertile of the TA-RRF level: low tertile (n = 81), middle tertile (n = 82), and high tertile (n = 81). Body composition measurement was determined from dual-energy X-ray absorptiometry and bioimpedance analysis. This analysis was performed at PD initiation and 1 year after PD initiation.

RESULTS

Multivariate analysis showed that the high TA-RRF tertile was associated with an increase in lean mass index. Fat mass index in all tertiles and bone mineral content index in the middle and high TA-RRF tertiles were increased, but no significant difference were observed in these changes among the 3 tertiles. The edema index decreased over the 1-year PD period. The high TA-RRF tertile was associated with a lower edema index. Although there was no statistical significance, the increase in fat mass/lean mass ratio (FM/LM) attenuated as the grade of TA-RRF tertile increased. The increase in fat mass index was similar to the trend in FM/LM.

CONCLUSION

TA-RRF was associated with an increase in total lean mass and a decrease in edema index.

Observation of a charged charmoniumlike structure in e+ e- → π+ π- J/ψ at sqrt[s] = 4.26 GeV

We study the process ee+ e- → π+ π- J/ψ at a center-of-mass energy of 4.260 GeV using a 525  pb(-1) data sample collected with the BESIII detector operating at the Beijing Electron Positron Collider. The Born cross section is measured to be (62.9±1.9±3.7)  pb, consistent with the production of the Y(4260). We observe a structure at around 3.9  GeV/c2 in the π(±)J/ψ mass spectrum, which we refer to as the Z(c)(3900). If interpreted as a new particle, it is unusual in that it carries an electric charge and couples to charmonium. A fit to the π(±)J/ψ invariant mass spectrum, neglecting interference, results in a mass of (3899.0±3.6±4.9)  MeV/c2 and a width of (46±10±20)  MeV. Its production ratio is measured to be R = (σ(e+ e- → π(±)Z(c)(3900)(∓) → π+ π- J/ψ)/σ(e+ e- → π+ π- J/ψ)) = (21.5±3.3±7.5)%. In all measurements the first errors are statistical and the second are systematic.

Proteinuria as a risk factor for decline in residual renal function in non-diabetic peritoneal dialysis patients

BACKGROUND

Preservation of residual renal function (RRF) is a major issue for patients on peritoneal dialysis (PD). Whether proteinuria is associated with a decline in RRF in patients on PD remains unclear.

PATIENTS AND METHODS

We reviewed the medical records at the Yeungnam University Hospital in Korea and identified patients who started PD between June 1995 and August 2011. A total of 147 non-diabetic patients were enrolled in the study. The patients were divided into 3 groups with respect to the tertile of initial proteinuria level: Low (n = 49; <320 mg/day), Middle (n = 49; 320-822 mg/day), and High groups (n = 49; >822 mg/day).

RESULTS

The mean patient age was 50.2 ± 15.0 years in the Low tertile, 50.2 ± 15.4 years in the Middle tertile, and 49.0 ± 15.1 years in the High tertile. Decline in RRF during follow-up period was greater in the High tertile than that in the other tertiles (P = 0.001). The proportion of patients with RRF >50% of baseline at 24 months after the initiation of PD was 83% in the Low tertile, 66% in the Middle tertile, and 40% in the High tertile (P < 0.001). The multivariate analysis after adjusting for initial RRF, age, gender, underlying disease of end-stage renal disease except diabetes mellitus, PD modality, use of icodextrin, PD-associated peritonitis, and tertile of the initial proteinuria level revealed that High tertile of the initial proteinuria level was associated with a decline in RRF (hazard ratios: 2.442 for the Middle tertile, P = 0.007 ; 3.713 for the Low tertile, P < 0.001).

CONCLUSION

The present study demonstrates that proteinuria may be is associated with a rapid decline in RRF in non-diabetic patients on PD, although the potential role of additional factors should be further investigated in prospective studies.

Chronic chorioamnionitis is the most common placental lesion in late preterm birth

OBJECTIVES

The pathogenesis of late preterm birth remains elusive for the mechanisms of disease responsible. Placental examination can often provide important clues for the pathogenesis of pregnancy complications. This study was conducted to determine placental pathologic findings according to the gestational age and the clinical circumstances of preterm birth.

STUDY DESIGN

Placental pathologic findings and obstetrical and neonatal outcomes were reviewed in a consecutive preterm birth cohort from a single tertiary center (N = 1206). Placentas of term births (N = 300) were used as normal controls.

RESULTS

Acute chorioamnionitis (22.7% vs. 16.7%), maternal vascular underperfusion (6.4% vs. 0.5%), and chronic chorioamnionitis (20.8% vs. 10.5%) were significantly more frequent in preterm births than in term births (P < 0.05, for each). Among preterm births, chronic chorioamnionitis was the most common pathology of late preterm birth (gestational age <37 and ≥34 weeks), while acute chorioamnionitis was the most common lesion of extremely preterm birth (gestational age <28 weeks). While the frequency of acute chorioamnionitis decreased with advancing gestation, that of chronic chorioamnionitis increased (P < 0.001, for each). The upward trend of the frequency of chronic chorioamnionitis was related to advancing gestation in both spontaneous and indicated preterm births (P < 0.001, for each).

CONCLUSIONS

Chronic chorioamnionitis is a common pathology of late preterm birth. It is suggested that chronic chorioamnionitis, a feature of maternal anti-fetal rejection, is an important etiology of preterm birth, especially of late preterm birth.

Prognostic classification of fifth metatarsal stress fracture using plantar gap

BACKGROUND

There have been diverse results even in same Torg type of fifth metatarsal stress fractures.

METHODS

Eighty-six cases with a fifth metatarsal stress fracture that were treated with modified tension band wiring from January 2003 to May 2009 were evaluated retrospectively. Each case was classified according to Torg's classification and a new classification. Using the new proposed classification, cases were subdivided into complete fracture and incomplete fracture. The cases of incomplete fracture were subdivided based on presence or absence of plantar gap more than 1 mm. After surgery, bone union was determined by CT. Statistical analysis of the Torg classification and time for bone union as well as the proposed new classification and time for bone union was performed.

RESULTS

There was a significant difference in the time for bone union among the three Torg types (P = 0.004). The mean time for bone union in group A (complete fracture, n = 32) was 67.5 ± 28.8, and it was 103.2 ± 47.7 for group B (incomplete fracture, n = 54). There was a significant difference in time for bone union between them (P < 0.001). The mean time for bone union in group B1 (incomplete fracture, plantar gap less than 1 mm, n = 16) was 73.9 ± 26.7, and it was 115.5 ± 45.4 for group B2 (incomplete fracture, plantar gap 1 mm or more, n = 38). There was a significant difference in time for bone union between them (P < 0.001).

CONCLUSION

The results of this study suggest that the classification incorporating the plantar gap might be used for classification of fifth metatarsal stress fractures.

LEVEL OF EVIDENCE

Level III, retrospective comparative series.

Effects of pancreatectomy on nutritional state, pancreatic function and quality of life

Background

There are concerns about the extent of impaired endocrine and exocrine pancreatic function and poor quality of life (QoL) after pancreatectomy, but there is little information from large prospective follow-up studies.

Methods

Consecutive patients undergoing pancreaticoduodenectomy or distal pancreatectomy between 2007 and 2011 were included. Relative bodyweight (RBW), triceps skinfold thickness (TSFT), serum protein, albumin, transferrin, fasting blood glucose, postprandial 2-h glucose (PP2), glycosylated haemoglobin A1c and stool elastase measurements, and European Organization for Research and Treatment of Cancer QLQ-C30 questionnaires were collected serially for 1 year.

Results

Some 136 patients undergoing pancreatic resection completed the study. RBW and TSFT recovered to over 90 per cent of the preoperative value by 12 months, whereas transferrin, albumin and protein had returned to preoperative levels by 3 months. Diabetes mellitus, impaired fasting glucose or raised PP2 was present in 42 of 76 patients at 6 months and 36 of 76 at 12 months. Although steatorrhoea and diarrhoea had mainly resolved by 3 months, stool elastase level decreased after operation and showed no recovery. Nutritional status, pancreatic endocrine function and QoL returned to preoperative levels in 63 (46·3 per cent), 72 (52·9 per cent) and 77 (56·6 per cent) of 136 patients within 6 months of pancreatectomy. Multivariable analysis revealed that age 60 years or more, operation type, chronic pancreatitis and malignant disease had a significant impact on nutritional index, pancreatic function and QoL.

Conclusion

About half of all patients can expect recovery from pancreatectomy after 6 months, but those with risk factors need more careful follow-up and supportive management.

Electronic structure of Zn doped Fe3O4 thin films

We investigated the effect of Zn doping on the electronic property of magnetite by using optical spectroscopy. The (Zn(x)Fe(1-x))Fe2O4 (ZFFO) (x = 0, 0.2, 0.4, and 0.5) samples were prepared by PLD technique. The XRD measurement revealed that all the samples have an inverse spinel-type of crystalline structure. The M-H curves indicate that the saturation magnetization reduces with the increasing x. From the spectroscopic ellipsometry and infrared spectroscopy, we found that the doping of nonmagnetic Zn2+ ions leads to the dramatic change in the electronic structure of the ZFFO films. We discuss the correlation of our spectra with the electric and magnetic properties of the ZFFO films.

Synthesis and optical characterization of SrHfO3 nano-crystals synthesized by using the combustion method

We synthesized SrHfO3 nano-crystals (NCs) by using the combustion method, and investigated their emission property using 325 nm photo-excitation. The as-grown SrHfO3 NCs were annealed at different temperatures from 700 degrees C to 1450 degrees C. The X-ray diffraction analysis revealed that all the samples are of a single phase, and the grain size increases with the higher temperature annealing. Interestingly, it is found that in contrast to the bulk case, the SrHfO3 NCs show a strong blue emission even at room temperature. The strong dependence of the visible emission on annealing temperatures and grain sizes indicated that the effects of grain size and oxygen vacancies may play a role in forming the observed visible emission band for SrHfO3 NCs. We also compare our findings with the case of similar material, SrZrO3.

The impact of total antioxidant capacity on pulmonary function in asthma patients

BACKGROUND

Oxidative stress, mediated by an imbalance between oxidants and antioxidants, contributes significantly to the pathogenesis of asthma.

OBJECTIVE

To evaluate the impact of serum total antioxidant capacity (TAC) on the pulmonary function of Korean asthma patients.

METHOD

A total of 104 adult asthma patients enrolled from the COREA (Cohort for Reality and Evolution of Adult Asthma in Korea) programme participated in the study. Baseline clinical parameters at enrolment, and the results of pulmonary function tests at baseline and 1 and 2 years after enrolment were collected. TAC at baseline was measured using a Trolox-equivalent antioxidant capacity assay. Patients were divided into two groups based on TAC levels, and various clinical parameters were compared.

RESULT

Serum TAC levels correlated with forced expiratory volume in 1 second (FEV(1)) at baseline (r = 0.22, P = 0.03). The group with higher baseline TAC levels maintained greater mean FEV(1) both 1 and 2 years after enrolment, even after adjusting for sex, age, height, weight, body mass index and smoking status.

CONCLUSION

These results suggest an important link between serum TAC levels and pulmonary function, indicating that higher TAC levels may be a biomarker for favourable prognosis in asthma patients.

Atypical imaging features of Epstein-Barr virus-positive primary central nervous system lymphomas in patients without AIDS

BACKGROUND AND PURPOSE

Recent clinical experience with EBV-positive PCNSL in patients without acquired immune deficiency syndrome showed that they tended to have atypical features seen on conventional MR imaging. The purpose of our study was to evaluate the MR imaging features of EBV-positive PCNSL in patients without AIDS and to compare these imaging findings with those of EBV-negative PCNSL.

MATERIALS AND METHODS

MR images were obtained in 55 consecutive patients with pathologically proved EBV-positive (n = 10) or EBV-negative (n = 45) PCNSL. We statistically analyzed the differences between the patient groups regarding the occurrence of tumor necrosis or hemorrhage and ADC, rCBVmax, rCBVr, and the Cho/NAA ratio in the tumor area.

RESULTS

Tumor necrosis and hemorrhage were observed in 9 (90%) and 7 (70%), respectively, of the patients with EBV-positive PCNSL; necrosis was observed in 8 (18%), and hemorrhage, in 3 (7%) patients with EBV-negative PCNSL (P < .0001 each). The necrotic core was hyperintense relative to contralateral white matter, as seen on DWI in 4 patients with EBV-positive PCNSL, though the ADC between the 2 patient groups did not differ significantly. rCBVmax, rCBVr, and the Cho/NAA ratios did not differ significantly between the 2 groups. The sensitivity and specificity of necrosis and hemorrhage for differentiating the 2 groups were 89.2% and 81.7% and 78.5% and 94.1%, respectively.

CONCLUSIONS

Our initial clinical experience with a small number of patients suggests that EBV-positive PCNSL in patients without AIDS tends to present with atypical MR imaging features.

Geriatric Nutritional Risk Index as a prognostic factor in peritoneal dialysis patients

BACKGROUND

The Geriatric Nutritional Risk Index (GNRI) might be a useful screening tool for malnutrition in dialysis patients. However, data concerning the GNRI as a prognostic factor in peritoneal dialysis (PD) patients are scarce.

METHODS

We reviewed the medical records at Yeungnam University Hospital in Korea to identify all adults (>18 years) who received PD; 486 patients were enrolled in the study.

RESULTS

The initial low, middle, and high GNRI tertiles included 162, 166, and 158 patients respectively. Significant correlations were noted between the initial GNRI and body mass index, creatinine, albumin, arm circumference, fat mass index, and comorbidities. The cut-off value for the time-averaged GNRI over 1 year was 96.4, and the sensitivity and specificity for a diagnosis of a decline in lean mass were 77.1% and 40.0% respectively. A multivariate analysis adjusted for age, risk according to the Davies comorbidity index, and C-reactive protein showed that an low initial GNRI tertile was associated with mortality in PD patients.

CONCLUSIONS

The GNRI is a simple method for predicting nutrition status and clinical outcome in PD patients.

Observation of two new N* resonances in the decay ψ(3686)→ppπ0

Based on 106×10(6)ψ(3686) events collected with the BESIII detector at the BEPCII facility, a partial wave analysis of ψ(3686)→ppπ0 is performed. The branching fraction of this channel has been determined to be B(ψ(3686)→ppπ0)=(1.65±0.03±0.15)×10(-4). In this decay, 7 N* intermediate resonances are observed. Among these, two new resonances, N(2300) and N(2570) are significant, one 1/2+ resonance with a mass of 2300(-30-0)(+40+109)  MeV/c2 and width of 340(-30-58)(+30+110)  MeV/c2, and one 5/2- resonance with a mass of 2570(-10-10)(+19+34)  MeV/c2 and width of 250(-24-21)(+14+69)  MeV/c2. For the remaining 5 N* intermediate resonances [N(1440), N(1520), N(1535), N(1650) and N(1720)], the analysis yields mass and width values that are consistent with those from established resonances.

Allergenicity of recombinant profilins from Japanese hop, Humulus japonicus

BACKGROUND AND OBJECTIVE

Pollen from Japanese hop, Humulusjaponicus, is a major cause of pollinosis in Korea. Profilin (15 kDa) from Humulus scandens has been associated with strong allergenicity in allergic Chinese patients. Profilin has also been detected in pollen extract from Korean Japanese hop by proteomic analysis and immunoglobulin (Ig) E immunoblotting. However, the allergenicity of allergens isolated from Japanese hop has not been investigated in Korean individuals. This study was undertaken to produce recombinant profilin from Japanese hop and evaluate its allergenicity.

METHODS

Complementary DNA sequences encoding 2 isoallergens were cloned by reverse transcription polymerase chain reaction and their recombinant proteins expressed in Escherichia coli. The IgE-binding reactivities of the recombinant allergens were assessed by enzyme-linked immunosorbent assay.

RESULTS

The deduced amino acid sequences of the H. japonicus profilins were 68.7% to 80.2% homologous with profilins from mugwort (Art v 4), ragweed (Amb a 14), and birch (Bet v 2). Two isoallergens of profilin from H. japonicus were 78.2% identical. Notably, the cDNA sequences of these 2 isoallergens were 98.5% (AY268422) and 98.7% (AY268424) identical to those of H. scandens. Serum samples from Japanese hop-sensitized individuals showed 12.9% IgE reactivity to both of the recombinant profilin isoallergens from H. japonicus, indicating that profilin may not be an allergenically dominant component of Japanese hop pollen. The recombinant profilins showed only 0% to 9.3% inhibition of the crude extract.

CONCLUSIONS

Two isoallergens of profilin that are highly conserved with those of mugwort, ragweed, and birch were identified in H. japonicus. Profilins from Japanese hop pollen may play a minor role in the pathogenesis of pollinosis in Koreans.

Impact of heavy proteinuria on clinical outcomes in patients on incident peritoneal dialysis

Background

There are few reports on the nutritional status changes and residual renal function (RRF) according to proteinuria levels in patients on peritoneal dialysis (PD).

Methods

A total of 388 patients on PD were enrolled. The patients were divided into 3 groups with respect to initial proteinuria: the A (n = 119; <500 mg/day), B (n = 218; 500–3,500 mg/day), and C groups (n = 51; >3,500 mg/day).

Results

The patients with higher proteinuria levels had a higher incidence of male sex, diabetes mellitus, and icodextrin use than those with lower proteinuria levels. Although initial peritoneal albumin loss in C group was lower than that detected in the other groups, no significant difference was observed in peritoneal albumin loss among the 3 groups at the end of follow-up period. At the time of PD initiation, the Geriatric nutritional risk index (GNRI) was lower in the C group than in the other 2 groups. However, at the end of the follow-up period, there was no significant difference in GNRI between the 3 groups. The GNRI increased, and the proteinuria level or RRF decreased more in the C group than in the other 2 groups. There were no significant differences in lean mass index or fat mass index change from the time of PD initiation to the end of the follow-up period. However, fat mass index and nPNA showed greater increases in the C group. The multivariate analysis revealed that proteinuria was negatively correlated with GNRI at the time of PD initiation and at the end of the follow-up period. The initial RRF and proteinuria were negatively correlated with the RRF decline during the follow-up.

Conclusion

The attenuation of the nephrotic proteinuria, along with the RRF decline, was associated with the improvement of the malnutrition.

Abstract P2-01-05: Parallel DNA and RNA profiling of EpCAM-positive cells in blood of metastatic breast cancer (MBC) patients confirm their malignant nature

Background: Molecular studies of EpCAM-positive cells found in the blood of cancer patients have been limited to immuno-enriched samples containing a high background of leukocytes. We developed a process to isolate rare EpCAM-positive cells and subjected them to DNA and RNA profiling.

Methods: Blood was subjected to immunomagnetic enrichment using EpCAM beads followed by fluorescence activated cell sorting (IE/FACS) to isolate EpCAM-positive cells away from leukocytes (CD45+). Duplicate samples of 20 cells were isolated from the same enriched blood from 53 MBC patients and then subjected to DNA and RNA profiling in parallel. For DNA profiling, sorted cells were subjected to BAC array comparative genomic hybridization analysis following whole genome amplification. For RNA profiling, QPCR analysis was performed on sixty four (64) cancer-related genes using Taqman® low density arrays. For non-tumor controls, RNA profiling was performed on matched leukocytes (CD45+) isolated from the same enriched blood samples from 44 of the 53 patients.

Results: Differential gene expression analysis between EpCAM-positive cells and matched leukocytes confirmed the up-regulation of EPCAM and other genes including MUC1 and KRT19 (adjusted p &lt;0.05). In addition, EpCAM-positive cells showed a significant down-regulation of the leukocyte-specific marker PTPRC (encodes CD45) as well as CD44 and VIM, markers associated with stem cellness and epithelial to mesenchymal transition, respectively. Unsupervised hierarchical clustering analysis of RNA profiles showed that EpCAM-positive cells clustered away from the leukocytes. Genome-wide copy number analysis of EpCAM-expressing cells revealed gains (e.g. 1q and 8q), losses (e.g. 8p and 16q), and focal amplifications (e.g. on 8q and 11q including CCND1) frequently seen in primary breast cancers.

Discussion: We demonstrate the feasibility of isolation and molecular analysis of highly pure EpCAM-positive cells in the blood. Our results strongly suggest that epithelial cells captured from blood of MBC patients are malignant in nature and are therefore circulating tumor cells. This approach can serve as a non-invasive source of highly pure metastatic tumor tissue for further molecular characterization. This study was supported by CALGB and BCRF.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-01-05.

Abstract P6-01-05: Enhancement of18F-FDG uptake and glycolysis by epidermal growth factor via PI3K activation in T47D breast cancer cells

It is well known that the binding of epidermal growth factor (EGF) to EGF receptors (EGFR) stimulates proliferation of breast cancer cells via activation of mitogen-activated protein kinase (MAPK) and phosphatidylinositol 3-kinase (PI3K)-protein kinase B (Akt) signaling pathways. There was a report that glucose consumption and lactate production were increased in MDA-MB-468 breast cancer cells following EGF exposure. However, the effect of EGF in enhancing glucose uptake and signaling pathways that are involved have not been clearly revealed. We thus investigated the role of EGF in stimulation of18F-FDG uptake in T47D breast cancer cells, and further elucidated the molecular mechanisms that are involved.

Exposure of T47D cells to 100 ng/mL EGF for 24 h caused a substantial augmentation of18F-FDG uptake to even greater extents to 310.8% ± 30.1% of control cells (P &lt; 0.001), and this effect of EGF showed dose- and time-dependency. Increased glucose uptake by EGF occurred through enhanced membrane GLUT-1 expression as well as hexokinase activity. Inhibition experiments with cycloheximide showed that the metabolic effect by EGF required new protein biosynthesis. Stimulation of glucose uptake by EGF was dependent on sufficient EGFR expression because18F-FDG uptake in MCF-7 cells weakly expressing EGFR was not affected by EGF treatment. Although EGF was also a stimulator of T47D cell proliferation (137.3 ± 7.3% of basal levels at 24 h, P &lt; 0.001), the metabolic effect occurred in a manner that clearly preceded and surpassed the proliferative effect. EGF-stimulated proliferation was significantly inhibited by the EGFR inhibitor BIBX1382, the PI3K inhibitor LY294002 and the specific MAPK inhibitor PD98059. Unlike proliferation, the ability of EGF to augment18F-FDG uptake was found to be dependent on PI3K but not on MAPK activity.

These findings yield the insight into our understanding of the role of EGF and the molecular basis that are involved in glucose metabolism of breast cancer cells.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P6-01-05.