Expression and biologic significance of adiponectin receptors in papillary thyroid carcinoma

Obesity is associated with a higher incidence of thyroid cancer. Adiponectin is one of the most abundant adipokines with a pleiotropic role in metabolism and in the development and progression of cancer. It has been shown that circulating adiponectin level is inversely associated with the risk of thyroid cancer. This study aimed to investigate the possible association between the expression of adiponectin receptors (AdipoR1 and AdipoR2) and clinicopathological variables in papillary thyroid cancer. We found that protein levels of AdipoR1 and AdipoR2 were increased in some thyroid cancer specimens compared with adjacent normal thyroid tissues. Thyroid cancer cells expressed AdipoR1 and AdipoR2, which were attenuated by histone deacetylase inhibitors valproic acid and trichostatin A. Adiponectin stimulated AMP-activated protein kinase phosphorylation in thyroid cancer cells. We further determined the expression of AdipoR1 and AdipoR2 by immunohistochemical staining in primary tumor samples and metastatic lymph nodes. AdipoR1 was expressed in 27 % of primary tumors and AdipoR2 in 47 %. Negative expression of both adiponectin receptors was significantly associated with extrathyroidal invasion, multicentricity, and higher TNM stage. There was a trend toward decreased disease-free survival in patients with negative tumor expression of AdipoR1 and AdipoR2 (log-rank P = 0.051). Collectively, overexpression of adiponectin receptors was observed in some tumor tissues of papillary thyroid cancer and was associated with a better prognosis.

A comparison of the BURP and conventional and modified jaw thrust manoeuvres for orotracheal intubation using the Clarus Video System

We evaluated the effects of three airway manipulation manoeuvres: (a) conventional (single-handed chin lift); (b) backward, upward and right-sided pressure (BURP) manoeuvre; and (c) modified jaw thrust manoeuvre (two-handed aided by an assistant) on laryngeal view and intubation time using the Clarus Video System in 215 patients undergoing general anaesthesia with orotracheal intubation. In the first part of this study, the laryngeal view was recorded as a modified Cormack-Lehane grade with each manoeuvre. In the second part, intubation was performed using the assigned airway manipulation. The primary outcome was the time to intubation, and the secondary outcomes were the modified Cormack-Lehane grade, the number of attempts and the overall success rate. There were significant differences in modified Cormack-Lehane grade between the three airway manipulations (p < 0.0001). Post-hoc analysis indicated that the modified jaw thrust improved the laryngeal view compared with the conventional (p < 0.0001) and the BURP manoeuvres (p < 0.0001). The BURP worsened the laryngeal view compared with the conventional manoeuvre (p = 0.0132). The time to intubation in the modified jaw thrust group was shorter than with the conventional manoeuvre (p = 0.0004) and the BURP group (p < 0.0001). We conclude that the modified jaw thrust is the most effective manoeuvre at improving the laryngeal view and shortening intubation time with the Clarus Video System.

Cryoprotection of fibroblasts by carboxylated poly-L-lysine upon repeated freeze/thaw cycles

The cryoprotection of carboxylated h-poly-L-lysine (COOH-PLL) was investigated on fibroblasts [L-929 cells and human dermal fibroblasts (HDFs)] during multiple freeze/thaw cycles. COOH-PLL was not toxic to two fibroblast cell types even at 25% (w/v) concentration, whereas dimethylsulphoxide (DMSO) was highly toxic over 3.13% (v/v). When L-929 cells were subjected to 5 freeze/thaw cycles, the media containing 7.5% (w/v) COOH-PLL maintained cell morphology and significantly suppressed growth inhibition as well as cell detachment (P < 0.05). The result was comparable to the media containing 10% (v/v) DMSO. For HDFs, COOH-PLL could effectively retain cell viability and proliferation against 3 freeze/thaw cycles. Cell viability of HDFs was decreased after 5 freeze/thaw cycles, but COOH-PLL exerted better cryoprotection. The cell type might account for the difference in the observations. The data demonstrated that COOH-PLL is a good cryoprotectant for mammalian cells against repeated freeze/thaw cycles, and may be used for cell preservation in fields of cell transplantation, tissue engineering and regenerative medicine.

Electrical and optical properties of indium zinc oxide (IZO) thin films by continuous composition spread

Indium zinc oxide (IZO) films were deposited on glass substrate at room temperature using off-axis RF sputtering-continuous composition spread (CCS) system. The full range composition of IZO films were controlled by the deposition rate and thickness profiles of In2O3 and ZnO target. The structural, electrical and optical properties of IZO thin films were measured as functions of position. IZO thin film had the lowest resistivity and highest carrier concentration at the position of 15 mm (5.02 x 10(-4) omega cm, 3.9 x 10(20)/cm3). And IZO thin film had high transmittance in visible region at measured all positions. This study has investigated to explore the new composition of IZO films using CCS system.

A method to remove residual signals in fibre optic luminescence dosimeters

Whenever a fibre optic is used to convey a light signal through a radiation field, it is likely that an unwanted background signal will arise from Cerenkov or fluorescent light which will contaminate the signal. In luminescence dosimetry of high energy beams, when a fibre optic is used to convey the signal from the radiation field to the detector, Cerenkov light is the dominant contributor to the background signal and must be corrected for. In this work, a novel method is demonstrated to separate the signal from the unwanted background. A remotely operated shutter is used to block the signal, allowing the residual background in the fibre optic to be quantified. This background is subtracted from the total measurement acquired in a subsequent irradiation, enabling the luminescence signal to be extracted. Two types of shutter mechanism are considered: an electro-mechanical device to intercept the light path and an LCD device to block the light by cross-polarization. Both shutters were characterized and incorporated into a fibre optic dosimetry system used to measure the radiation dose produced by external beam radiation linear accelerators. The dosimeter using each of the shutters in turn was exposed to a 6 MV photon beam to determine their performance, including the measurement of field size dependent output factors. The mechanical shutter determined the output factors to within 0.29% of those measured with an ionization chamber, whereas the LCD shutter gave results that deviated by up to 2.4%. The switching precision of both shutters was good with standard deviations of less than 0.25% and both were able to completely block the light signal when closed. The use of shutters could therefore be applied to any fibre optic based system to quantify and remove a reproducible background arising from any source including ambient, fluorescent and Cerenkov light.

Arthroscopic shoulder surgery under general anesthesia with brachial plexus block: postoperative respiratory dysfunction of combined obstructive and restrictive pathology

OBJECTIVE

Changes in respiratory parameters and pulmonary function tests were evaluated after shoulder arthroscopic surgery with brachial plexus block (BPB). The purpose of this study was to identify the mechanism of respiratory dysfunction after this type of surgery.

METHODS

Patients undergoing arthroscopic rotator cuff repair under general anesthesia (GA) with BPB were enrolled in the arthroscopy group (n = 30) while those undergoing open reduction of a clavicle or humerus fracture under GA were enrolled in the control group (n = 30). Forced vital capacity (FVC) and forced expiratory volume 1 s (FEV(1)) were measured at the outpatient clinic stage (#1) before (#2) and 20 min after BPB (#3) and 1 h after extubation (#4). Respiratory variable measurements along with the cuff leak test were performed 5 min after surgical positioning (T1) and at the start of skin closure (T2). Respiratory discomfort was evaluated after extubation. The upper airway diameters and soft tissue depth of chest wall were also measured by ultrasonography at stages #3 and #4.

RESULTS

Static compliance decreased significantly at T2 in the arthroscopy group (50 ± 11 at T1 vs. 44 ± 9 ml/cm H(2)O at T2, p =0.035) but not in the control group. The incidence of positive cuff leak tests at T2 was significantly higher in the arthroscopy group than in the control group (47% in the arthroscopy group vs. 17% in controls, p =0.010). While FEV(1) and FVC remained stable at stages #1 and #2, FVC and FEV(1) decreased at stages #3 and #4 only in the arthroscopy group (FVC in arthroscopy group, #2: 3.26 ± 0.77 l; #3: 2.55 ± 0.63 l, p =0.015 vs. #2; #4: 2.66 ± 0.41 l, p =0.040 vs. #2). The subglottic diameter decreased at #4 in the arthroscopy group, while no changes occurred in the control group (0.70 ± 0.21 cm vs. 0.85 ± 0.23 cm in the arthroscopy and control groups, respectively, p =0.011). Depth of skin to pleura increased at both intercostal spaces 1-2 and 3-4 in the arthroscopy group. There were three cases of hypoxia (S(p)O(2) < 95%) with room air in the arthroscopy group while none occurred in the controls.

CONCLUSION

Shoulder arthroscopic surgery under GA with BPB induced both restrictive and obstructive pathologies. It is important to maintain a high level of awareness for the potential negative respiratory effects of this surgery especially for subjects with pre-existing cardiopulmonary disease. The measurements in this study would be useful to monitor the risk of respiratory dysfunction in these patients.

Sorafenib induces autophagy and suppresses activation of human macrophage

Background

Sorafenib, a multi-kinase inhibitor approved for treatment of advanced renal cell carcinoma and other malignancies, has been shown as a modulator for dendritic cells. This study was designed to examine the effects of sorafenib on macrophages, the major ontogeny of innate immunity.

Materials and methods

Macrophages were derived from sorted CD14⁺ monocytes of human peripheral blood mononuclear cells. Cell viability and surface antigens were examined by trypan blue analysis. Autophagy was characterized by light microscopy and transmission electron microscopy for morphology, Western blotting for microtubule associated light chain protein 3B (LC-3B) I lipidation, and acridine orange staining for acidic component vacuoles. Soluble factors contained in culture medium and serum were measured by ELISA.

Results

We found that sorafenib inhibited the viability of macrophages accompanied by morphological changes characteristic of autophagy. This autophagy-inducing effect was validated by LC3B-I lipidation and autophagosome accumulation. The surface antigen expression and the function of activated macrophages were inhibited by sorafenib, including the expression of co-stimulatory molecule CD80, phagocytosis, and the production of reactive oxygen species. The secretion of IL-10, but not IL-6, TNF-α nor TGF-β, was reduced by sorafenib.

Conclusion

Sorafenib, in addition to being a cancer targeted therapeutic agent, can induce autophagy and modulate the function of human macrophages.

Vertebrobasilar dolichoectasia as a risk factor for cerebral microbleeds

BACKGROUND

Both vertebrobasilar dolichoectasia (VBD) and cerebral microbleeds (CMBs) are related with the risk of intracerebral hemorrhage. We aimed to examine the relationship between the VBD and CMB in ischaemic stroke patients.

METHODS

A consecutive series of 182 patients hospitalized because of ischaemic stroke or transient ischaemic attack (TIA), and who underwent gradient echo brain magnetic resonance imaging were retrospectively recruited from a prospective stroke registry. CMB locations were categorized into anterior and posterior circulation. Ectasia was defined as basilar artery (BA) diameter > 4.5 mm, and dolichosis, as either BA bifurcation above the suprasellar cistern or lateral to the margin of the clivus or dorsum sellae. Whether VBD is associated with CMB anywhere in the brain or in anterior or posterior circulation territories was analysed using binary and multinomial logistic regression models.

RESULTS

Twenty-four subjects (13.2%) had VBD and 48 (26.4%) had CMBs. CMBs were more frequently observed in patients with VBD than without (66.7% vs. 20.3%, P < 0.001). VBD was significantly associated with CMBs in any location (crude odds ratio, 7.88; 95% confidence interval, 3.10-20.02), in the posterior circulation territory only (9.63; 2.60-34.94), and in both territories (9.25; 3.40-26.29), but not in the anterior circulation only (1.14; 0.009-11.20). These associations remained unchanged after adjusting for age, gender, hypertension, leukoaraiosis and stroke subtype.

CONCLUSIONS

VBD in patients with ischaemic stroke or TIA is independently associated with CMBs, especially in the posterior circulation territory.

Abstract P1-01-24: Which combinations are helpful to predict axillary lymph node metastasis in T1 breast cancer with ultrasonography and contrast-enhanced MRI and contrast-enhanced 18F-FDG PET-CT?

Backgrounds: Axillary lymph node(ALN) status has been important factor of treatment and prognosis for patients with breast cancer. Even though the better ultrasonographic instruments have been developed, it is still difficult to predict axillary lymh node metastasis (ALNM) with only ultrasonography(US) in T1 breast cancers which most of newly diagnosed breast cancers are recently since T1 breast cancers have low rate and less tumor burden of ALNM. This study evaluated the accuracy of prediction of ALNM in T1 breast cancer with US, contrast-enhanced MRI (cMRI) and contrast-enhanced 18F-FDG PET/CT (cPET/CT) and found out adequate combinations of these modalities.

Method: Retrospectively, we reviewed 351 breast cancer patients with tumors(T1) ≤2cm in size between January 2008 and December 2011 who were preoperatively examined with US, cMRI, and cPET/CT and underwent pathologic evaluation of axillary lymph nodes acquired by sentinel lymph node biopsy or axillary dissection.

High performance imaging streak camera for the National Ignition Facility

An x-ray streak camera platform has been characterized and implemented for use at the National Ignition Facility. The camera has been modified to meet the experiment requirements of the National Ignition Campaign and to perform reliably in conditions that produce high electromagnetic interference. A train of temporal ultra-violet timing markers has been added to the diagnostic in order to calibrate the temporal axis of the instrument and the detector efficiency of the streak camera was improved by using a CsI photocathode. The performance of the streak camera has been characterized and is summarized in this paper. The detector efficiency and cathode measurements are also presented.

Platelet protease-activated receptor (PAR)4, but not PAR1, associated with neutral sphingomyelinase responsible for thrombin-stimulated ceramide-NF-κB signaling in human platelets

Thrombin activates platelets mainly through protease-activated receptor (PAR)1 and PAR4. However, downstream platelet signaling between PAR1 and PAR4 is not yet well understood. This study investigated the relationship between nSMase/ceramide and the NF-κB signaling pathway in PARs-mediated human platelet activation. The LC-MS/MS, aggregometry, flow cytometry, immunoprecipitation, and mesenteric microvessels of mice were used in this study. Human platelets stimulated by thrombin, 3-OMS (a neutral sphingomyelinase [nSMase] inhibitor) and Bay11-7082 (an NF-κB inhibitor) significantly inhibited platelet activation such as P-selectin expression. Thrombin also activated IκB kinase (IKK)β and IκBα phosphorylation; such phosphorylation was inhibited by 3-OMS and SB203580 (a p38 MAPK inhibitor). Moreover, 3-OMS abolished platelet aggregation, IKKβ, and p38 MAPK phosphorylation stimulated by PAR4-AP (a PAR4 agonist) but not by PAR1-AP (a PAR1 agonist). Immunoprecipitation revealed that nSMase was directly associated with PAR4 but not PAR1 in resting platelets. In human platelets, C24:0-ceramide is the predominant form of ceramides in the LC/MS-MS assay; C24:0-ceramide increases after stimulation by thrombin or PAR4-AP, but not after stimulation by PAR1-AP. We also found that C2-ceramide (a cell-permeable ceramide analog) activated p38 MAPK and IKKβ phosphorylation in platelets and markedly shortened the occlusion time of platelet plug formation in vivo. This study demonstrated that thrombin activated nSMase by binding to PAR4, but not to PAR1, to increase the C24:0-ceramide level, followed by the activation of p38 MAPK-NF-κB signaling. Our results showed a novel physiological significance of PAR4-nSMase/ceramide-p38 MAPK-NF-κB cascade in platelet activation.

The Kety-Schmidt technique for quantitative perfusion and oxygen metabolism measurements in the MR imaging environment

SUMMARY

The Kety-Schmidt technique provides quantitative measurement of whole-brain CBF. CBF is measured as the area between the arterial and venous washout curves of a diffusible tracer. Oxygen extraction and metabolism may be calculated from arterial and venous samples. In this report, we present a method for performing these measurements in an MR imaging environment. This technique could be useful for validation of MR imaging methods of hemodynamic and metabolic measurements in humans.

Blood neutrophil-to-lymphocyte ratio correlates with tumor size in patients with differentiated thyroid cancer

BACKGROUND AND OBJECTIVES

Inflammation has been implicated in the initiation and progression of thyroid cancer. Neutrophil-to-lymphocyte ratio (NLR) is a simple index of systemic inflammatory response, and has been shown to be a prognostic indicator in some types of cancer. The aim of this study was to examine the relationship between NLR and clinicopathological features in patients with differentiated thyroid cancer.

METHODS

Total white blood cell and differential counts of 159 patients with differentiated thyroid cancer were compared to those of 318 age- and sex-matched controls undergoing thyroidectomy for benign thyroid nodules. Clinicopathological variables, stratified by NLR tertiles, were analyzed.

RESULTS

There was no difference in NLR between patients having benign and malignant thyroid nodules (P = 0.293). Cancer patients in the higher NLR tertile had significantly larger tumor size (P = 0.004). Higher NLR was observed in patients with high American Thyroid Association (ATA) risk of recurrence.

CONCLUSIONS

High preoperative NLR was associated with increased tumor size and high ATA risk of recurrence in patients with differentiated thyroid cancer.

Blood neutrophil-to-lymphocyte ratio correlates with tumor size in patients with differentiated thyroid cancer

BACKGROUND AND OBJECTIVES

Inflammation has been implicated in the initiation and progression of thyroid cancer. Neutrophil-to-lymphocyte ratio (NLR) is a simple index of systemic inflammatory response, and has been shown to be a prognostic indicator in some types of cancer. The aim of this study was to examine the relationship between NLR and clinicopathological features in patients with differentiated thyroid cancer.

METHODS

Total white blood cell and differential counts of 159 patients with differentiated thyroid cancer were compared to those of 318 age- and sex-matched controls undergoing thyroidectomy for benign thyroid nodules. Clinicopathological variables, stratified by NLR tertiles, were analyzed.

RESULTS

There was no difference in NLR between patients having benign and malignant thyroid nodules (P = 0.293). Cancer patients in the higher NLR tertile had significantly larger tumor size (P = 0.004). Higher NLR was observed in patients with high American Thyroid Association (ATA) risk of recurrence.

CONCLUSIONS

High preoperative NLR was associated with increased tumor size and high ATA risk of recurrence in patients with differentiated thyroid cancer.

Zoledronic acid, an aminobisphosphonate, prolongs survival of skin allografts

Purpose: Zoledronic acid (ZOL), an effective nitrogen-containing bisphosphonate used to prevent excessive bone loss in clinical practice, has been shown to affect the development of dendritic cells by redirecting differentiation toward a state of atypical maturation. The study was aimed to examine whether ZOL can reduce acute rejection of skin allografts. Methods: A skin transplantation model using C57BL/6 to BALB/c mice was used. ZOL was injected intraperitoneally into transplant recipients post-surgically. Graft survival, body weight, leukocyte count, hepatic and renal functions were assessed. Results: ZOL treatment significantly prolonged skin allograft survival in mice. In terms of toxicity, there were no significant differences in body weight, leukocyte count, plasma alanine aminotransferase or creatinine levels between the ZOL-treated and control groups. Histopathology showed that the loss of skin integrity seen in control group was prevented by ZOL treatment. In draining lymph nodes and spleen, the number and clustering extent of mononuclear cells were markedly declined by ZOL treatment. The plasma IL-6 levels were reduced by treatment of ZOL. Conclusion: ZOL can prolong skin allograft survival without major toxicity.

Surgical management of benign gastric outlet obstruction in the elderly

BACKGROUND/AIMS

Surgical management of gastric outlet obstruction may associate with significant morbidity and mortality. Few studies have documented surgical outcomes in elderly patients. The aim of this study was to review recent operative results of benign gastric outlet obstruction in elderly patients compared with younger patients.

METHODOLOGY

Forty- seven consecutive patients from January 2000 through September 2008 were included. Preoperative, intraoperative data and early postoperative complications were analyzed.

RESULTS

Fifteen operations were performed in elderly patients and 32 in younger patients. More patients in the elderly group were assigned as ASA class 3 (p=0.037), but Charlson comorbidity index was similar. Procedure types included Finney or Jaboulay pyloroplasty (n=26), antrectomy (n=13) and gastrojejunostomy (n=8). The mean postoperative hospital stay was 14.9 days. A modest correlation between the length of stay and the patient's age (p=0.044; r=0.294) was observed. There were two in hospital mortalities and four patients had complications.

CONCLUSIONS

Surgery for benign gastric outlet obstruction is safe in the elderly population and is not associated with any increase in morbidity or mortality.

Abstract 5752: Expression and biological significance of adiponectin receptors in papillary thyroid carcinoma

Obesity is associated with a higher incidence of thyroid cancer. Adiponectin is one of the most abundant adipokines with pleiotropic roles in metabolism and in the development and progression of cancer. This study aimed to investigate the possible association between the expression of adiponectin receptors (AdipoR1 and AdipoR2) and clinicopathological variables in papillary thyroid cancer. We found that levels of AdipoR1 and AdipoR2 were commonly increased in thyroid cancer compared with adjacent normal thyroid tissues. Thyroid cancer cells expressed AdipoR1 and AdipoR2, which were attenuated by histone deacetylase inhibitor trichostatin A. We determined the expression of AdipoR1 and AdipoR2 by immunohistochemical staining in primary tumor samples and metastatic lymph nodes. AdipoR1 was expressed in 27% of primary tumors and AdipoR2 in 47%. AdipoR1 expression correlated with AdipoR2 expression in primary tumors and in metastatic lymph nodes. Tumor AdipoR1 expression was associated with larger tumor size, whereas negative AdipoR2 expression was significantly associated with extrathyroidal invasion and multicentricity. Patients in the high AMES risk group had negative tumor expression of AdipoR1 and AdipoR2. Collectively, altered expression of adiponectin receptors in thyroid cancer supports a potential role in the pathogenesis of thyroid cancer.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 5752. doi:1538-7445.AM2012-5752