Increased circulating CD3+/CD31+ T cells in patients with acute coronary syndrome

The number of circulating endothelial progenitor cells (EPCs) is considered to be a surrogate marker for coronary artery disease (CAD). Recent studies have identified a novel T-cell subset labeled with CD3(+)/CD31(+), which is necessary for EPC colony formation and constitutes the central cluster. However, the clinical relevance of the CD3(+)/CD31(+) T cells in CAD remains unclear. We sought to clarify whether circulating CD3(+)/CD31(+) T cells are increased in patients with acute coronary syndrome (ACS). Circulating CD3(+)/CD31(+) T cells were determined in 16 ACS patients undergoing emergency percutaneous coronary intervention (PCI) and in 16 control subjects with angiographically normal coronary arteries. Although no differences between the groups were found in baseline patient characteristics, the ratio of circulating CD3(+)/CD31(+) T cells before PCI was higher in ACS patients as compared with that in control subjects (51.8 % ± 7.8 % vs 31.8 % ± 9.6 %, respectively; P < 0.001). The increased ratio of CD3(+)/CD31(+) T cells in ACS patients was not altered 24 h after PCI, but became comparable with that in control subjects within 6 months after PCI. These results suggest that mobilization of CD3(+)/CD31(+) T cells occurs in ACS, but is no longer detectable at 6 months after PCI.

Molecular phylogeography and genetic diversity of East Asian goats

The domestic goat is one of the most important livestock species, but its origins and genetic diversity still remain uncertain. Multiple highly divergent maternal lineages of goat have been reported in previous studies. Although one of the mitochondrial DNA lineages, lineage B, was detected only in eastern and southern Asia, the geographic distribution of these lineages was previously unclear. Here, we examine the genetic diversity and phylogeographic structure of Asian goats by mitochondrial DNA sequences and morphological characteristics. The analyses of a total of 1661 Asian goats from 12 countries revealed a high frequency of lineage B in Southeast Asia. The frequency of this lineage tended to be higher in mountain areas than in plain areas in Southeast Asian countries, and there was a significant correlation between its frequency and morphological traits. The results suggest an original predominance of lineage B in Southeast Asia and the recent infiltration of lineage A into Southeast Asian goats.

Cathepsin K expression in basal cell carcinoma

BACKGROUND

Cathepsin K is a cysteine protease with strong collagenolytic and elastolytic properties. Recently, cathepsin K expression in tumour cells of malignant melanoma and in the stromal cells of squamous cell carcinoma of the skin has been reported to play an important role in tumour progression. However, its expression profile in basal cell carcinoma (BCC) has not yet been clarified.

OBJECTIVE

The aim of this study is to examine the expression profile of cathepsin K in both the tumour cells and the peritumoural stromal cells of BCC in comparison with its expression in normal skin.

METHODS

Fifty consecutive operative cases of BCC, 10 cases of actinic keratosis, 10 cases of Bowen's disease and five normal skin tissues were assessed for cathepsin K expression by immunohistochemical methods.

RESULTS

In normal skin, cathepsin K expression was observed in the stratum corneum, mature sebaceous cells and outer root sheath of the hair follicles. Cathepsin K was expressed in the tumour cells of all BCC cases, in which 90% showed diffuse expression (>51% of tumour cells), as well as in the peritumoural stromal cells in all BCC cases. Focal cathepsin K expression was observed in the tumour cells of Bowen's disease (2/10 cases), but not in any of actinic keratosis (0/10 cases).

CONCLUSION

Cathepsin K expression may contribute to tumour invasion and peculiar histopathological features, such as fibromucinous stroma around the tumour nests by mediating extracellular matrix degradation in BCC.

P5-13-21: Japanese Patients with Discordance in Estrogen Receptor between Primary Breast Cancer and Recurrent Tumor Have a Poorer Outcome

Background Decisions of systemic treatment for recurrent breast cancer are usually based on the estrogen receptor (ER), progesterone receptor (PR), and HER2 receptor status of the primary tumor. Recently, discordance in receptor status between primary and recurrent tumors has been reported. The objective of this study was to compare receptor status between the primary and recurrent tumor, and to evaluate overall survival (OS) after the diagnosis of recurrence between patients with discordant and concordant receptor status.

Material and Methods Patients with recurrent breast cancer treated at National Kyushu Cancer Center between January 2004 and May 2011 were reviewed retrospectively. Primary and recurrent lesions were analyzed for ER and PR by immunohistochemistry (IHC) and HER2 by IHC or fluorescence in situ hybridization (FISH). OS in discordant and concordant groups for each receptor was estimated by Kaplan-Meier method and compared by log-rank test.

Results Among 283 recurrent breast cancer patients both primary and recurrent tumor information for ER, PR, and HER2 was available in 69. Among these, recurrent biopsy specimens were obtained from locoregional recurrence in 72.5% and from distant metastases in 27.5%. Discordant rate in receptor status between the primary and recurrent tumor was 36.2%. Discordant rate in ER, PR, and HER2 was 14.4%, 23.1%, and 4.3%, respectively. Two-year OS after the diagnosis of recurrence in discordant and concordant ER group was 66.7% and 84.7%, respectively. The discordant ER group had significantly worse OS than the concordant ER group (P = 0.040). There was no significant difference in OS between the discordant and concordant PR group (P = 0.950).

Conclusions Because discordance of receptor status between primary and recurrent tumors may exist, tissue confirmation of receptor status of recurrent tumor should be considered. Japanese patients with discordant ER between primary and recurrent tumor had a poorer outcome.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-13-21.

Unusual presentation of multiple recurrent cardiac sarcomas as acute acalculous cholecystitis caused by rapid expansion into the right cardiac chamber: report of a case

Sarcomas are rare malignant cardiac tumors and their prognosis is extremely poor, with a high recurrence rate despite extensive initial surgical resection. The development of therapeutic alternatives looks bleak for recurrent sarcomas, however, and complete surgical resection is crucial for any hope of survival even for the recurrent patients. We herein report the case of a 38-year-old male patient with multiple recurrent cardiac sarcomas causing acute acalculous cholecystitis 20 months after the resection of the primary tumor.

Transumbilical laparo-endoscopic single site surgery for adrenal cortical adenoma inducing primary aldosteronism: initial experience

BACKGROUND

We have started using laparo-endoscopic single-site surgery (LESS) in urologic surgery, although its use has not gained momentum due to its level of difficulty. We here report our initial experience with transumbilical LESS for adrenal cortical adenoma by using a single port with a multichannel cannula (SILS port) and bent laparoscopic instrumentation.

FINDINGS

A multichannel port (SILS port), bent laparoscopic instrument (Roticulator Endo Mini-Shears) and Opti4 laparoscopic electrodes were used in all cases. The intraperitoneal space was approached through the umbilicus. The SILS port was placed through a 2 cm incision at the inner edge of the umbilicus. A 5 mm flexible laparoscope was introduced to keep the laparoscope outside, and surgical specimens were extracted using an Endocatch bag. In addition, as a case control study, we compared perioperative data of LESS adrenalectomy (LESS-A) with that of conventional laparoscopic adrenalectomy (LA). We performed transumbilical LESS-A for adrenal cortical adenoma in 12 cases, beginning in December, 2009. All procedures were successfully completed, with only one incision through the umbilicus, and without conversion to a standard laparoscopic approach. Mean operative time for LESS-A was 121.2 ± 7.8 min, which was slightly longer than LA (110.2 ± 7.3 min). For right adrenal tumors, we used a miniport (2 mm port) in addition to a SILS port, and were able to successfully perform adrenalectomy "with no visible scaring". Tumor laterality and patient BMI did not affect surgical morbidity in these procedures. Moreover, there was no significant difference between LESS-A and LA in blood loss, analgesic requirement, hospital stay, and scar satisfaction.

CONCLUSIONS

The transumbilical approach in LESS for adrenalectomy is safe and feasible and also improves cosmetic outcome compared with standard laparoscopic procedures. Improvements in surgical devices may aid the further development of this approach.

Surfactant protein C G100S mutation causes familial pulmonary fibrosis in Japanese kindred

Several mutations in the surfactant protein C (SP-C) gene (SFTPC) have been reported as causing familial pulmonary fibrosis (FPF). However, the genetic background and clinical features of FPF are still not fully understood. We identified one Japanese kindred, in which at least six individuals over three generations were diagnosed with pulmonary fibrosis. We examined the patients radiologically and histopathologically and sequenced their SFTPC and ABCA3 genes. We also established a cell line stably expressing the mutant gene. All the patients had similar radiological and histopathological characteristics. Their histopathological pattern was that of usual interstitial pneumonia, showing numerous fibroblastic foci even in areas without abnormal radiological findings on chest high-resolution computed tomography. No child had respiratory symptoms in the kindred. Sequencing of SFTPC showed a novel heterozygous mutation, c.298G>A (G100S), in the BRICHOS domain of proSP-C, which co-segregated with the disease. However, in the ABCA3 gene, no mutation was found. In vitro expression of the mutant gene revealed that several endoplasmic reticulum stress-related proteins were strongly expressed. The mutation increases endoplasmic reticulum stress and induces apoptotic cell death compared with wild-type SP-C in alveolar type II cells, supporting the significance of this mutation in the pathogenesis of pulmonary fibrosis.

Fine mapping of porcine SSC14 QTL and SCD gene effects on fatty acid composition and melting point of fat in a Duroc purebred population

The stearoyl-CoA desaturase (delta-9-desaturase; SCD) gene is a candidate gene for fatty acid composition. It is located on pig SSC14 in a region where quantitative trait loci (QTL) for fatty acid composition were previously detected in a Duroc purebred population. The objective of the present study was to fine map the QTL, to identify polymorphisms of the pig SCD gene and to examine the effects of SCD polymorphisms on fatty acid composition and melting point of fat in the population. The pigs were examined for fatty acid composition and melting point of inner and outer subcutaneous fat and inter- and intramuscular fat; the number of pigs examined was 479-521. Two SNPs (g.-353C>T and g.-233T>C) were identified in the promoter region of the SCD gene and were completely linked in the pigs from the base generation. In all pigs, 19 microsatellite markers and SCD haplotypes were then genotyped. Different statistical models were applied to evaluate the effects of QTL and the possible causality of the SCD gene variants with respect to the QTL. The results show that all significant QTL for C14:0, C18:0, C18:1 and melting point of fat were detected in the same region, located near the SCD gene. The results also show a significant association between SCD haplotypes and fatty acid composition and fat melting point in this population. These results indicate that the haplotype of the SCD gene has a strong effect on fatty acid composition and melting point of fat.

Successful bridge to recovery in a patient surviving fatal device-related complications after implantation of a Toyobo left ventricular assist system

Emergent left ventricular assist system (LVAS) removal due to device complication is associated with high morbidity and mortality. This report describes a case of a 51-year-old man with dilated cardiomyopathy who successfully underwent emergent LVAS removal after a device-related complication. Although the patient's left ventricular function was still compromised, LVAS removal was indicated secondary to cerebral hemorrhage. Fortunately, the patient had an uneventful course over the ensuing 8 months and maintained good quality of life.

Low mean corpuscular hemoglobin level is a predictor of discontinuation of antiplatelet therapy in patients with acute coronary syndrome

OBJECTIVE

Premature discontinuation of antiplatelet therapy (APT) increases the risk of thrombosis in patients who have undergone placement of a drug-eluting stent for acute coronary syndrome (ACS). The goal of the present study was to identify predictors of patients who would prematurely discontinue APT following stent implantation.

METHODS

One-hundred and sixty-one ACS patients who underwent percutaneous coronary intervention in our institution between November 2004 and September 2008 were enrolled in this study.

RESULTS

Over the 12-month follow-up period, 18 patients (11.2%) discontinued APT. Among baseline demographic and laboratory variables, multivariate analysis revealed that mean corpuscular hemoglobin (MCH) level was an independent risk factor for APT discontinuation (OR: 0.738, p=0.017). Kaplan-Meier survival analysis showed that the incidence of APT discontinuation was significantly higher in patients with low MCH (<30.0 pg) than in patients with high MCH (≥30.0 pg) (p=0.0006).

CONCLUSION

Low baseline MCH level was a predictor of APT discontinuation in ACS patients. Thus, careful consideration should be made before employing a drug-eluting stent in patients with low MCH levels.

Technical difficulties of transumbilical laparoendoscopic single-site adrenalectomy: comparison with conventional laparoscopic adrenalectomy

PURPOSE

Interest in laparoendoscopic single-site (LESS) surgery has increased in recent years. The aim of this study was to evaluate the feasibility and safety of transumbilical LESS adrenalectomy and to elucidate the technical differences between LESS and conventional laparoscopic surgery.

METHODS

This study was comparing 10 consecutive transumbilical LESS adrenalectomies and 10 conventional laparoscopic adrenalectomies performed between March 2006 and April 2010 for benign adrenal tumors. Perioperative parameters were compared, and we reviewed our surgical videos and analyzed technical characteristics of the surgeries.

RESULTS

There was no open conversion in laparoscopic group, no additional port placement in LESS group, and no perioperative complications in either group. No significant differences in operative time, estimated blood loss, or resumption of oral intake were observed between two groups. Pneumoperitoneum time did not differ between LESS and laparoscopic groups (91.2 vs. 74.3 min, P = 0.257). In LESS group only, time was needed for adjustment of roticulator (14.5 ± 8.1 min). After subtracting the time needed for adjustment, operative time between two groups was more comparable (76.7 vs. 74.3 min, P = 0.880). One-handed manipulation time in LESS group decreased in a time-dependent manner (r = -0.806, P < 0.0049). Tissue re-grasping during operation was more frequently observed in LESS group (16.2 vs. 2.2 times, P < 0.001).

CONCLUSIONS

Transumbilical LESS adrenalectomy is feasible and comparable to conventional laparoscopic adrenalectomy. There are still obvious technical difficulties associated with LESS surgery, and it is essential that these be overcome in order to improve this surgical technique.

Expression of snail in upper urinary tract urothelial carcinoma: prognostic significance and implications for tumor invasion

PURPOSE

There are few molecular markers known to predict upper urinary tract urothelial carcinomas (UTUC) prognosis. Snail, which contributes to epithelial-mesenchymal transition (EMT), has been documented in cancer progression, but not clear yet in UTUC. We therefore addressed the expression and biological significance of Snail in UTUC.

EXPERIMENTAL DESIGN

To elucidate the biological significance of Snail in UTUC, we examined the immunohistochemical expression of snail in UTUC and analyzed its clinical significance in 150 patients with UTUC. Biological effects of Snail in EMT and invasion were evaluated by using small interfering RNA (siRNA) specific for Snail in urothelial carcinoma cell lines and the Matrigel invasion assay.

RESULTS

Nuclear Snail staining was very weak in superficial UTUC. In contrast, strong Snail staining was observed in many of the nucleus of invasive UTUC. Snail expression was significantly higher in the high tumor stage, high grade, and in tumors showing lymphovascular invasion (LVI). Multivariate Cox regression analysis revealed that elevated Snail expression was a significant and an independent prognostic predictor of recurrence-free survival and cancer-specific survival. Patients with positive LVI and high Snail expression showed the worse outcome. Targeting of Snail mRNA expression in UMUC-3 cells with Snail-specific siRNA downregulated the mRNA expression of Snail, Vimentin, MMP2, and MMP9. Furthermore, the cells with siRNA for Snail showed decreased invasion activity in comparison with the cells transfected with a nontargeting siRNA.

CONCLUSION

Snail-induced EMT represents a clinically relevant mechanism of UTUC progression and an attractive target for the treatment of patients with UTUC.

First-principles study of blue silicate phosphors

First-principles calculations were performed to investigate the optical property of blue silicate phosphor, CMS:Eu. The optical absorption property is discussed based on electronic band structure and density of states. Our calculation results indicate that hybridization of the wavefunction plays an important role for nonradiative migration of electrons and holes. The calculated optical absorption spectrum could reproduce the optical features of the experimental excitation spectrum. It is also demonstrated that a practical approach using computational materials screening is effective in phosphor materials development.

Are predictive models for cancer volume clinically useful in localized prostate cancer?

OBJECTIVES

To evaluate the correlation between preoperatively predicted and pathologically measured prostate cancer volumes and to investigate the clinical use of preoperatively predicted cancer volume in predicting pathological stage.

METHODS

Correlations between pathological findings and various preoperative parameters, including the cancer volumes as predicted by using two methods (Vca and estimated PCvol), were analyzed in 196 patients who underwent radical prostatectomy for clinically localized prostate cancer.

RESULTS

Pathologically measured prostate cancer volume was significantly correlated with the Vca and estimated PCvol, but the correlation coefficients were respectively only 0.46 and 0.35. Prostate-specific antigen (PSA), PSA density (PSAD), primary Gleason score, Vca, Vca fraction (Vcafx), and estimated PCvol were significantly higher in 82 patients with extraprostatic cancer than in 114 patients with organ-confined cancer. Magnetic resonance imaging (MRI) findings were significantly correlated with pathological stage. Multivariate logistic regression analysis indicated that the Vcafx and MRI findings were significant predictors of extraprostatic cancer, but receiver operating characteristic analysis revealed that the combination of Vcafx and MRI findings had no advantage over the combination of Gleason score, PSAD, and MRI findings.

CONCLUSIONS

Vca and estimated PCvol are significantly correlated with the pathologically measured cancer volume but their ability to accurately predict cancer volume is limited. Vcafx and MRI findings were statistically significant predictors of extraprostatic cancer but their combination was not superior to the combination of Gleason score, PSAD, and MRI findings.

Double transgenic mice crossed GFP-LC3 transgenic mice with alphaMyHC-mCherry-LC3 transgenic mice are a new and useful tool to examine the role of autophagy in the heart

BACKGROUND

The involvement of autophagy in heart disease has been reported. Transgenic mice expressing GFP-LC3 have been a useful tool in detecting autophagosomes systemically. It is difficult to differentiate increased formation of autophagosomes from decreased clearance of autophagosomes in the heart using GFP-LC3 mice.

METHODS AND RESULTS

We generated transgenic mice expressing mCherry-LC3 under alphaMyHC promoter and crossed the mice with transgenic mice expressing GFP-LC3. The deference of resistance to acidic conditions between GFP and mCherry overcame the limitation.

CONCLUSIONS

This method is an innovative approach to examine the role of autophagy and to analyze autophagosome maturation in cardiomyocytes. (Circ J 2010; 74: 203 - 206).

Activation of the aryl hydrocarbon receptor pathway enhances cancer cell invasion by upregulating the MMP expression and is associated with poor prognosis in upper urinary tract urothelial cancer

Aryl hydrocarbon receptor (AhR) and the activation of the AhR pathway are involved in xenobiotic-induced toxicity and carcinogenesis. Although xenobiotics, such as cigarette smoke, contribute to the development of urothelial carcinoma (UC), the relationship between AhR and UC is unclear. In the present study, we investigated AhR expression in 209 patients with upper urinary tract UC. The nuclear expression of AhR was significantly associated with histological grade, pathological T stage, lymphovascular invasion and lymph node involvement. A multivariate Cox analysis revealed that nuclear AhR expression was a significant and independent predictor for disease-specific survival (hazard ratio = 2.469, P = 0.013). To determine whether the AhR pathway can be activated in the T24 UC cell line, we examined the expression of cytochrome P450 (CYP) 1A1 and CYP1B1, which are target genes of the AhR pathway, following exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), a ligand of AhR. TCDD treatment upregulated the expression levels of AhR, CYP1A1 and CYP1B1. TCDD enhanced T24 cell invasion associated with the upregulation of matrix metalloproteinase (MMP)-1 and MMP-9. Furthermore, targeting AhR messenger RNA (mRNA) expression in T24 cells with small interfering RNA (siRNA) downregulated the mRNA expression of AhR, CYP1A1, CYP1B1, MMP-1, MMP-2 and MMP-9; furthermore, the cells transfected with siRNA for AhR showed decreased invasion activity in comparison with the cells transfected with a non-targeting siRNA. Our results therefore suggest that AhR plays a role in the invasiveness of UC cells and can serve as a marker for the prognosis of upper urinary tract UC.

Diaroyl tellurides: synthesis, structure and NBO analysis of (2-MeOC6H4CO)2Te--comparison with its sulfur and selenium isologues. The first observation of [MgBr][R(C=Te)O] salts

A series of aromatic diacyl tellurides were prepared in moderate to good yields by the reactions of sodium or potassium arenecarbotelluroates with acyl chlorides in acetonitrile. X-ray structure analyses and theoretical calculations of 2-methoxybenzoic anhydride and bis(2-methoxybenzoyl) sulfide, selenide and telluride were carried out. The two 2-MeOC₆H₄CO moieties of bis(2-methoxybenzoyl) telluride are nearly planar and the two methoxy oxygen atoms intramolecularly coordinate to the central tellurium atom from both side of C(11)-Te(11)-C(22) plane. In contrast, the oxygen and sulfur isologues (2-MeOC₆H₄CO)₂E (E = O, S), show that one of the two methoxy oxygen atoms contacts with the oxygen atom of the carbonyl group connected to the same benzene ring. The structure of di(2-methoxybenzoyl) selenide which was obtained by MO calculation resembles that of tellurium isologues rather than the corresponding oxygen and sulfur isologues. The reactions of di(aroyl) tellurides with Grignard reagents lead to the formation of tellurocarboxylato magnesium complexes [MgBr][R(C=Te)O].

π-Facial Selectivity of Diels-Alder Reactions

Diels-Alder reaction is one of the most fundamental and important reactions for organic synthesis. In this chapter we review the studies of the π-facial selectivity in the Diels-Alder reactions of the dienes having unsymmetrical π-plane. The theories proposed as the origin of the selectivity are discussed.