Drug-resistance gene expression and progression of astrocytic tumors

To clarify the influence of biochemotherapy on the progression of astrocytic tumors, the expression of O6-methylguanine DNA-methyltransferase (MGMT) mRNA, as well as of other drug-resistance- and drug-sensitivity-related genes such as multidrug resistance gene 1, multidrug resistance-associated protein, glutathione S-transferase-pi, DNA topoisomerase II, and interferon receptor mRNA, and the interferon regulatory factor (IRF)-1 and -2 ratios in gliomas were investigated by quantitative reverse transcription-polymerase chain reaction (RT-PCR). The mean MGMT/beta2-microglobulin (beta2-MG) ratio for 130 neuroepithelial tumors was 8.2 +/- 17.8. The mean ratio of 45 glioblastomas was significantly higher than that for the other 85 tumors. In contrast, the mean of 26 low-grade gliomas was significantly lower than that of other tumors. The mean IRF-1/IRF-2 ratio of 16 other brain tumors that mainly consisted of medulloblastomas was significantly greater than that of the other 114 tumors. Almost no significant differences were observed between primary and recurrent tumors in the expression of any gene, and before and after therapy with corresponding drugs. The mean MGMT/beta2-MG ratio in primary glioblastomas was significantly higher than that in secondary tumors. These findings suggest that native drug resistance is more important than acquired resistance when glioma therapy is considered.

Effect of landiolol hydrochloride, an ultra-short-acting beta 1-selective blocker, on supraventricular tachycardia, atrial fibrillation and flutter after pulmonary resection

WHAT IS KNOWN AND OBJECTIVE

Supraventricular tachycardia is a common complication after pulmonary resection. The objective of this study was to investigate the efficacy of landiolol hydrochloride, an ultra-short-acting β1-blocker, in patients with post-operative supraventricular tachycardia after pulmonary resection.

METHODS

The response to continuous intravenous infusion of landiolol was evaluated in 25 patients who developed post-operative atrial fibrillation or atrial flutter after major pulmonary resection. Four patients had preoperative rate-controlled chronic atrial fibrillation. The heart rate and blood pressure were compared before and after infusion of landiolol. Side effects and recurrence of supraventricular tachycardia after termination of landiolol infusion were also monitored.

RESULTS AND DISCUSSION

The heart rate was reduced from 135±24 bpm before landiolol infusion to a plateau rate of 85±19 bpm during infusion (P<0·0001). Heart rate reduction occurred in all but two patients. Conversion to normal sinus rhythm from supraventricular tachycardia occurred in 14 patients (56%). Recurrence of supraventricular tachycardia after stopping landiolol infusion was observed in 17 patients (68%), but all patients without preoperative AF were cured of post-operative AF. There were no detectable side effects, including no adverse influence on the circulatory and respiratory systems.

WHAT IS NEW AND CONCLUSION

Continuous intravenous infusion of landiolol was found to be effective and safe for supraventricular tachycardia after pulmonary resection.

Systemic lupus erythematosus and Sjögren's syndrome induced in a case by interferon-α used for the treatment of hepatitis C

A 57-year-old Japanese woman developed skin eruption, pleuritis, pancytopenia, parotid gland swelling and glomerulonephritis after 7-month treatment with pegylated interferon-α and ribavirin for chronic hepatitis C. Disease-specific autoantibodies such as anti-SSA, anti-SSB, anti-Sm and anti-dsDNA antibodies became positive. The diagnosis of systemic lupus erythematosus and Sjögren’s syndrome was made and treatment with glucocorticoid pulse followed by oral glucocorticoid was started. It is highly probable that interferon-α-induced systemic lupus erythematosus and Sjögren’s syndrome in this case. Interferon-α might be important pathogenically in these diseases. Lupus (2010) 19, 753—755.

Brillouin gain-coefficient measurement for bismuth-oxide-based photonic crystal fiber under significant beam reflection at splicing points

We investigate a six-air-hole bismuth-oxide-based photonic crystal fiber (Bi-PCF) in terms of Brillouin characteristics. One huge challenge in measuring the Brillouin properties of the Bi-PCF is the nonnegligible beam reflection at the splicing points, which can be attributed to the mirroring effect caused by different refractive indices of silica and bismuth fibers. To solve the problem we propose a method that is based on the combination of a pump-probe beat lock-in scheme and a normalized gain curve-fitting technique. Using this method, successful characterization of Brillouin properties for a 1.16-m-long Bi-PCF is experimentally demonstrated. With the measured Brillouin gain coefficient and the known chi((3)) nonlinearity parameters, the Kerr nonlinearity figure-of-merit (F(nl-SBS)), including the stimulated Brillouin scattering-caused pump-power limit, is also estimated for the Bi-PCF.

Aggressive and invasive growth of tectal glioma after surgical intervention and chemoradiotherapy

A tectal glioma presenting with late-onset aqueduct stenosis and obstructive hydrocephalus is usually categorized as a benign glioma. Apparent clinical or radiological progression justifies biopsy of the tumour. In this case, an unusual tumour shows aggressive and invasive growth after surgical intervention and chemoradiotherapy.

Massive intractable pericardial effusion in a patient with systemic lupus erythematosus treated successfully with pericardial fenestration alone

Systemic lupus erythematosus (SLE) is often complicated by pericarditis with effusion, which generally responds well to glucocorticoid. We report herein a Japanese patient with SLE who showed a sign of cardiac tamponade and severe chest and back pain because of massive intractable pericardial effusion. Pulse glucocorticoid and pulse cyclophosphamide gained marginal effects. Pericardial effusion accumulated again soon after ultrasound-guided pericardiocentesis and drainage. Pericardial fenestration performed surgically as a last resort, for draining pericardial fluid into the pleural space, was very effective, and only a much smaller amount of fluid was observed in the space thereafter in comparison with the volume before the surgery. Pathological examination of the retrieved pericardium unfolded intense hyperplasia of small vessels and capillaries. Levels of IL-6 and TNF-α in pericardial effusion were extremely higher than those in serum. Pericardial effusion with extensive capillary hyperplasia in SLE would be resistant to medical treatment and require surgical fenestration.

Tonsillar crypt epithelium of palmoplantar pustulosis secretes interleukin-6 to support B-cell development via p63/p73 transcription factors

Palmoplantar pustulosis (PPP) is an autoimmune disease characterized by psoriasis-like erythematous lesions on palms and/or soles due to an abnormal humoral immune response. Tonsillectomy is effectively employed for the treatment of PPP; however, how tonsils are involved in the aetiology of PPP remains unclear. Here we analysed surgically resected palatine tonsils from 36 cases of PPP as well as usual recurrent tonsillitis (RT) as a control. Histological examination revealed that a unique lesion, with lymphoid follicles surrounded by reticular crypt epithelial cells, was more frequently observed in tonsils of patients with PPP than in those with RT (p < 0.0001; PPP vs RT). Interestingly, crypt epithelial cells in primary cultures derived from PPP tonsils showed marked production of interleukin-6 (IL-6). Moreover, these epithelial cells from PPP tonsils expressed p53-related transcription factors in their nuclei that were found to contribute to the up-regulation of IL-6 gene expression. These findings suggest that, at least in part, the specialized lymphoepithelial symbiosis of PPP tonsils, under the control of p53-related factors, may be relevant to the generation of the impaired micro-environment underlying the aberrant production of autoantibodies.

Frequency of rate of body temperature chart at mid cycle in pregnant women and the subsequent effect on pregnancy

PURPOSE OF INVESTIGATION

To determine if changes in basal body temperature (BBT) during the ovuratory phase are related to subsequent effects on pregnancy.

METHODS

BBT records from 216 pregnant women in a spontaneous cycle or a clomiphene citrate cycle during a recent 6-year period were studied. The last day of low phase (LDLP) and the number of days until high phase (NDHP) were determined for all subjects.

RESULTS

In the spontaneous cycle group, medium-cycle cases were most frequent and long-cycle cases were most frequent in the clomiphene cycle group. The NDHP ranged between one and three days in 82.8% of the subjects in the spontaneous cycle group and in 86.1% of the subjects in the clomiphene cycle group.

CONCLUSIONS

Our findings demonstrate the importance of properly evaluating an NDPH of two or even three days in a BBT-based assessment of ovarian function in the ovulatory phase.

Four-wave mixing based widely tunable wavelength conversion using 1-m dispersion-shifted bismuth-oxide photonic crystal fiber

We demonstrate widely tunable wavelength conversion based on four-wave mixing using a dispersion-shifted bismuth-oxide photonic crystal fiber (Bi-PCF). A 1-meter-long Bi-PCF is used as the nonlinear medium for wavelength conversion of a 10 Gb/s non-return-to-zero (NRZ) signal. A 3- dB working range of the converted signal over 35 nm is obtained with around 1-dB power penalty in the bit-error-rate measurements.

Pathologic complete remission of cytologically proven axillary node metastases may be a strong prognostic factor in HER2-positive breast cancer

21149

Background: Preoperative chemotherapy has become one of the standard modes of treatment in patients with breast cancer, and pathologic complete remission (pCR) thus obtained has become an important prognostic factor. However, the number of cells in the main lesion is enormous and changes over time in a heterogeneous manner. Thus, time and individual differences in sensitivity influence the acquisition of pCR, and questions about the coincidence with the effects of metastatic lesions also remain. On the other hand, although pCR of axillary lymph node metastasis lesions with relatively lower numbers of the cells is considered one of the best surrogate prognostic markers, evaluation criteria have not yet been established because definitive preoperative diagnosis is difficult. In our department, preoperative axillary cytodiagnosis has been conducted in all surgical breast cancer cases. In this study, we investigated pCR of the axillary lymph nodes (ALN- pCR) in cytologically proven axillary node metastasis cases. Subjects and Methods: ALN-pCR, DFS, and OS were investigated in 52 surgical breast cancer cases (observation period: 15–52 months; medial level: 28 months) positive for cytological axillary metastasis and received preoperative chemotherapy (AC-Paclitaxel) during the period from 2002 to 2005. Results: ALN-pCR was found in 21 of 52 cases (40.4%). Rates of disease-free survival (DFS) at 36 months in ALN-pCR and non-ALN-pCR cases were 85.0% and 42.3% (P=0.031) and those of overall survival (OS; 48 months) were 100% and 87.9% (P=0.353), respectively. DFS (36 months) was very favorable 100% in ALN-pCR cases that obtained the effect of 1b or higher on evaluation of the main lesion effect and ALN-pCR cases with Her2-positive results on sub-type analysis. Conclusions: ALN-pCR of cytologically proven axillary node metastasis was indicated to be a prognostic factor in cases of breast cancer. Especially, its importance was demonstrated in HER2-positive breast cancer. From these findings, HER2-positive and cytologically axillary lymph node-positive cases were considered the best indications for preoperative chemotherapy.

No significant financial relationships to disclose.

Use of oblique supine magnetic resonance imaging in breast-conserving surgery following neoadjuvant chemotherapy

11064

Background: The success of breast-conserving surgery (BCS) after neoadjuvant chemotherapy (NAC) is dependent on accurate assessment of the extent of surgical excision of the original tumor bed (OTB). However the difficulty in locating microscopic residual disease often leads to a high re-excision rate (RER) and large excision specimen area (ESA). Methods: Magnetic resonance imaging (MRI) scans in the oblique supine position are performed with the patient in the same posture as that adopted during surgery. Maximum intensity projection (MIP) images of MR coronary section images of OTB are generated and used for surgery. OTB images are copied onto transparent sheets overlaid on the MIP images. These images are projected onto the breast before surgery, and used to determine the lines for surgical excision. In the conventional method (CM), OTB is determined by ultrasonography (US) and CT images. The oblique supine MRI method (SMM) has been used at our hospital since 2005. In this study, 14 patients treated prospectively with SMM (12/05- 12/06) were compared with a series of 19 consecutive patients treated with CM (04/03–11/05). ESA and RER were analyzed. Re-excision was performed in cases with a calcified lesion or tumor within 1 cm of the excised margin by X-ray or US during surgery, or invasive cancer was detected within 1 mm by pathological examination. ESA was analyzed using NIH Image. All patients received anthracycline/taxane-based chemotherapy. Results: There were no significant differences in characteristics of patients in the initial stages (T1, 2) or pathological chemotherapy responses between SMM and CM groups. There were four T3.4 cases in the SMM group, but none in the CM group. Clinical responses in CM and SMM were as follows (cases): CR 6, 7; PR 12, 7; SD 1, 0, respectively. RER was significantly greater in CM (36.8%, n=7) than in SMM (7.1%, n=1) (P<0.05). Average ESA in SMM were 19.0 cm2 (n=2) in T1, 33.6 cm2 (7) in T2, and 59.3 cm2 (5) in T3.4, while corresponding values in CM were 49.4 cm2 (4) and 65.5 cm2 (15), respectively; ESA was significantly improved in SMM. Conclusions: SMM, which has the benefits of decreased ESA and RER with superior cosmetic results, is a reliable technique for BCS following NAC.

No significant financial relationships to disclose.