Reduction of hyaluronan and increased expression of HYBID (alias CEMIP and KIAA1199) correlate with clinical symptoms in photoaged skin

BACKGROUND

Hyaluronan (HA) metabolism in skin fibroblasts is mediated by HYBID (hyaluronan binding protein involved in hyaluronan depolymerization, alias CEMIP and KIAA1199) and the HA synthases HAS1 and HAS2. However, photoageing-dependent changes in HA and their molecular mechanisms, and the relationship between HA metabolism and clinical symptoms in photoaged skin remain elusive.

OBJECTIVES

We examined the amount, size and tissue distribution of HA and expression levels of HYBID, HAS1 and HAS2 in photoaged skin, and analysed their relationship with the degree of photoageing.

METHODS

Photoageing-dependent changes of HA were investigated by studying skin biopsies isolated from photoprotected and photoexposed areas of the same donors, and the relationships between HA and photoageing symptoms such as skin wrinkling and sagging were examined.

RESULTS

Skin biopsy specimens showed that the amount and size of HA are decreased in photoexposed skin compared with photoprotected skin, and this was accompanied by increased expression of HYBID and decreased expression of HAS1 and HAS2. Histologically, HA staining in the papillary dermis was decreased in photoexposed skin, showing reverse correlation with HYBID expression. HYBID expression in the photoexposed skin directly correlated with skin roughness and sagging parameters, and the reduced HA staining in the papillary dermis in the photoexposed skin positively correlated with these symptoms.

CONCLUSIONS

These data demonstrate that imbalance between HYBID-mediated HA degradation and HAS-mediated HA synthesis may contribute to enhanced HA catabolism in photoaged skin, and suggest that HYBID-mediated HA reduction in the papillary dermis is related to skin wrinkling and sagging of photoaged skin.

Preparation of Controlled-Release Particles Based on Spherical Porous Silica Used as the Drug Carrier by the Dry Coating Method

A controlled-release formulation is a dosage form that could improve a patient's quality of life by reducing the frequency of administration, while ensuring the continued effect of the medicine and reducing the side effects. To prepare these controlled-release particles, a wet coating method in which a drug is coated with a controlled-release material using water or an organic solvent is used, but with this method, the coating process is very time-consuming and requires large amounts of energy for the drying phase. In addition, contact with water or an organic solvent may cause problems such as alteration of the drug. Therefore, the use of a dry coating method has attracted attention as a means of overcoming these issues. However, since the drug is fixed to the surface of a core particle, it is necessary to further coat it with a water-soluble material. We used spherical porous silica (SPS) particles, considering that the drug fixation via a water-soluble material would not be necessary if the drug were to be placed in the pores of these particles. We used SPS filled with theophylline (TP), a model drug, as the core particles. To prepare controlled-release particles (CRP), a controlled-release layer consisting of hydrogenated castor oil (HCO) was applied to the core particle surface by a dry coating method. The paddle method using 1% w/v polysorbate 80 solution as the test medium was employed to estimate the TP dissolution rate of the resulting CRPs. The 50% dissolution time of TP extended from 14 to 405 min with increasing the amount of the coated HCO. The Korsmeyer-Peppas model applied to the TP dissolution behavior yielded an n value of around 1. Moreover, the K value was comparable with the case in which a zero-order model was applied. It is thought that the dissolution of TP from CRPs will conform to the zero-order model.

Relationship of hyaluronan and HYBID (KIAA1199) expression with roughness parameters of photoaged skin in Caucasian women

BACKGROUND

Hyaluronan (HA) is an important constituent of extracellular matrix (ECM) in the skin, and HA degradation mediated by HYBID (KIAA1199) is suggested to be implicated in facial skin wrinkling in Japanese women. Ethnic difference in skin wrinkle formation is known between Caucasian and Japanese women, but no information is available for the relations of HA and HYBID expression levels with skin wrinkling in Caucasian women.

METHODS

The skin surface roughness at the eye corner of the Caucasian female subjects was measured, and the skin specimens biopsied from the same areas were subjected to microarray gene analysis, HA staining, and immunohistochemistry for HYBID.

RESULTS

Among the ECM genes and those related to ECM metabolism, only HYBID expression levels positively correlated with the skin roughness parameters. When the skin sample groups with high expression of HYBID or low expression of HYBID were compared, the HA staining intensity and the ratio of HYBID-immunoreactive cells to total cells in the superficial dermis were significantly reduced and increased in the high-HYBID-expression group compared with the low-HYBID-expression group, respectively.

CONCLUSION

Our data suggest that like Japanese women, HYBID-mediated reduction of HA in the superficial dermis is involved in the formation of wrinkles in Caucasian women.

Effects of fermented soymilk with Lactobacillus casei Shirota on skin condition and the gut microbiota: a randomised clinical pilot trial

Several clinical studies have shown that isoflavones and Lactobacillus casei Shirota (LcS) have beneficial effects on skin condition and the gut microbiota, respectively. Thus, we investigated the effects of consecutive intake of fermented soymilk (FSM) with LcS on skin condition and the gut microbiota, as well as isoflavone bioavailability, in a randomised, double-blind, placebo-controlled trial as a pilot study. Sixty healthy premenopausal Japanese women received FSM containing a moderate level of isoflavone aglycones and a probiotic LcS, or soymilk (SM) containing neither of them, twice a day for 8 weeks. Skin condition was assessed by a subjective questionnaire for face and morphological analysis of the stratum corneum on the inner forearm. Faecal microbiota and urinary isoflavone were analysed by 16S rRNA gene amplicon sequencing and high-performance liquid chromatography tandem mass spectrometry, respectively. Both the FSM and SM groups had improved skin condition as assessed from scores of overall satisfaction, dryness, moisture, elasticity, coarseness, pigmentation and/or stratum corneum morphology, as well as significantly increased levels of urinary isoflavones during the intake period compared with the pre-intake period, although there were no significant differences between the two groups. There was a significant positive correlation between urinary isoflavone levels and skin questionnaire scores. In contrast, the relative abundance levels of Lactobacillaceae significantly increased and those of Bifidobacteriaceae tended to increase during the intake period compared with the pre-intake period. For the after-intake period they only decreased significantly in the FSM group. The levels of Enterobacteriaceae and Porphyromonadaceae significantly decreased during the intake period in the FSM group. These findings suggest that daily intake of FSM, as well as SM, provides health benefits that improve skin condition via increased levels of isoflavone absorption in the body, and that only FSM beneficially modifies the gut microbiota in premenopausal healthy women.

Abstract P3-01-03: The loss of lymph node metastasis after neoadjuvant chemotherapy in patients with cytologically proven node-positive primary breast cancer

Purpose:While the sensitivity to neoadjuvant chemotherapy (NAC) depends on breast cancer subtype, it has been reported that over 30% of patients with node-positive breast cancer achieved an axillary pathologic complete response (pCR) after NAC. However, axillary lymph node dissection (ALND) still remains as a standard treatment because of the difficulty of assessment of lymph node (LN) status after NAC. ALND will be omitted if axillary LN status is accurately assessed. Our purpose of this study was to predict the loss of axillary LN metastasis after NAC in primary breast cancer patients.

Patients and Methods: Among 997 consecutive patients who underwent surgery after NAC from January 2006, to December 2016, 279 patients with cytologically proven node-positive were included in this analysis. All patients were assessed using CT or PET-CT, and ultrasonography (US) before NAC. LN status after NAC was assessed by US. Patients with cT4 tumor, and supra/subclavicular and parasternal LN metastasis were excluded. Clinical LN status after NAC (ycN) was compared to pathological LN status (ypN) on surgical specimen. The association between LN status and clinicopathological factors including nuclear grade (NG), tumor size, the use of trastuzumab, and breast cancer subtypes, was assessed.

Result: Of the 279 patients with LN-positive before NAC, 166 patients (59.5%) had ER+/HER2- tumor, 51 patients (18.3%) had ER+/HER2+ tumor, 33 patients (11.8%) had ER-/HER2- tumor, and 29 patients (10.4%) had ER-/HER2+ tumor. 179 patients (64.2%) had ycN0 and 102 patients (36.6%)had ypN0. There was significant difference of rate of the loss of LN metastasis after NAC; 37 of 166 patients (22.3%) with ER+/HER2- tumor, 24 of 51 patients (47.1%) with ER+HER2+ tumor, 19 of 33 patients (57.6%) with ER-HER2- tumor, and 22 of 29 patients (75.9%) with ER-HER2+ tumor, (p<0.01).The accuracy of assessment of the loss of LN metastasis by US (ycN0/ypN0) was high in 20 of 25 patients (80.0%) with ER-/HER2+ tumor and in 14 of 19 patients (73.4%) ER-/HER2- tumor compared to ER+ tumor; 21 of 39 patients (53.8%) with ER+/HER2+ tumor and 34 of 96 patients (35.4%) with ER+/HER2- tumor (p<0.01). For patients with ycN0/ypN+, the median number of residual LN metastasis was 1 in ER-/HER2+ tumor (range:1-2) and ER-/HER2- tumor (range:1-3), and 2 in ER+/HER2+ tumor (range:1-6) and ER+/HER2- tumor (range:1-14). Among patients with ER-/HER2+ tumor, there was association between the loss of LN metastasis and the use of trastuzumab (p<0.01). There was no association between the loss of LN metastasis and NG or tumor size.

Conclusion: Our results showed patients with ER-/HER2+ tumor and cytologically proven LN metastasis who received NAC with trastuzumab might have the loss of LN metastasis if assessed as ycN0 by US after NAC, whereas, the patients in ER+ tumor have a high risk to have residual LN metastases after NAC even if assessed as ycN0. Further studies are warranted the prognostic impact of the omission of ALND for these populations.

Citation Format: Namura M, Hayashi N, Tsunoda H, Yoshida A, Takei J, Suzuki K, Nakamura S, Yamauchi H. The loss of lymph node metastasis after neoadjuvant chemotherapy in patients with cytologically proven node-positive primary breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-01-03.

Abstract P3-05-17: The numbers of Foxp3 positive cells in simultaneous bilateral breast cancer

Background

Evasion of the immune system is one of the hallmarks of malignant tumors, and recently blocking of such evasion has been used in clinical practice for the treatment of some types of cancers. Recruitment of regulatory T cells (Tregs), which express the specific marker Foxp3, is an established mechanism of escaping from the immune system. In breast cancer, it has been reported that the number of Tregs differs widely among breast cancer subtypes, and that patients who have many Tregs around the tumor tend to have a poor prognosis. However, the factors that are important for the recruitment of Tregs are not well known. Thus, factors that depend on the host (e.g., age or comorbidity), on the tumor (e.g., subtype, grade, or stage), or on measurement error might be the cause of the observed differences in the number of Tregs. In this study, we investigated the numbers of Tregs in simultaneous bilateral breast cancer patients in order to determine the factors that influence the recruitment of Tregs, while excluding differences in individuals as much as possible.

Material and methods

Patients who had breast cancer in both breasts and who underwent simultaneous surgery between January 2005 and September 2015 at two institutions were enrolled in this study. Patients who underwent primary systemic therapy who were diagnosed with ductal carcinoma in situ, or who were stage IV were excluded. The average numbers of Foxp3-positive (Foxp3+cells) were determined from scores of five high-power fields (HPFs). The association between the difference in Foxp3+ cell number between each breast in a single individual and clinicopathological features was examined.

Results

Seventy patients were included in this study. Their ages ranged from 39-85 (median 54) years old. Ninety five percent of the tumors were invasive ductal carcinoma non-special type. Eighty eight (62.9%), 43 (30.7%), and 9 (6.4%) of the tumors were T1, T2, and ≥T3, respectively, and 102 (72.9%) of the tumors were node-negative. Regarding nuclear grade (NG), 104 (74.3%), 21 (22.1%), and 7 (5%) of the tumors were NG1, 2, and 3, respectively. As for subtype, 124 (88.6%), 9 (6.4%), and 7 (5%) were ER-positive and HER2-negative(ER+/HER2-), ER-positive or negative and HER2-negative(ER±/HER2+), and ER-negative and HER2-negative(ER-/HER2-), respectively. The numbers of Foxp3+ cells ranged from 0 to 39.8 (median 3.3)/HPF, and difference in Foxp3+ cell number between each breast in a single individual ranged from 0 to 34 (median 3.9)/HPF.

Differences in tumor size and node status in individuals did not impact on the number of Foxp3+ cells. However, the number of Foxp3+ cells in tumors that were NG3 (P=0.00098) or ER±/HER2+ or ER-/HER2- type (P=0.00586) were statistically significantly increased compared with tumors that were NG1/2 or ER+/HER2- type in the same host.

Furthermore, the difference of Foxp3+ cells between each tumor in a single individual were quite small regarding tumor size and node status in 53 patients who had similar NG and subtype tumors in both breasts.

Conclusions

The number of Foxp3+ cells showed no relationship with tumor size, or lymph node status in simultaneous bilateral breast cancer patients. High NG, ER±/HER2+ or ER-/HER2- type of the tumor were involved with enhancement of the recruitment of Tregs.

Citation Format: Goto R, Hirota Y, Aruga T, Horiguchi S, Tazawa S, Nakamura S, Takimoto M. The numbers of Foxp3 positive cells in simultaneous bilateral breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-05-17.

Abstract P2-11-11: Role of postmastectomy radiotherapy after neoadjuvant chemotherapy in breast cancer patients: A study from the Japanese breast cancer registry

Background:

Postmastectomy radiotherapy (PMRT) has been shown to be beneficial in node-positive breast cancer patients. However, the role of PMRT for patients receiving modern neoadjuvant chemotherapy (NAC) are controversial. We aimed to evaluate the efficacy of radiotherapy for breast cancer patients treated with NAC and mastectomy in the Japanese Breast Cancer Registry.

Methods:

Patients who received NAC and mastectomy for cT1-4 cN0-2 M0 breast cancer were included in this analysis. We assessed locoregional recurrence (LRR), distant disease-free survival (DDFS), and overall survival (OS) using the Kaplan-Meier method and compared them between the groups with and without PMRT by nodal status after NAC; ypN0, ypN1, and ypN2-3. We also performed multivariable cox regression analysis to evaluate the association of radiotherapy and these outcomes adjusting for baseline patient and cancer characteristics.

Results:

Of the 145,530 patients registered from 2004 to 2009, we identified 3,226 patients who met our inclusion criteria with the 5-year follow-up information including 1,299 ypN0, 1,036 ypN1, and 879 ypN2-3 cases. PMRT was performed in 185 patients (14.2%) with ypN0, 265 patients (25.6%) with ypN1, and 543 patients (61.8%) with ypN2-3. There was no difference in LRR, DDFS, and OS between the groups with and without radiotherapy for ypN1 patients who received NAC (P=0.72, P=0.29, and P=0.36, respectively). For patients with ypN2-3 breast cancer, radiotherapy significantly improved LRR (P<0.001), DDFS (P=0.01), and OS (P<0.001) on univariate analysis. No difference in LRR, DDFS, and OS was observed for ypN0 patients (P=0.81, P=0.15, and P=0.05, respectively). In multivariable analysis, the use of radiotherapy was independently associated with improved LRR [hazard ratio (HR): 0.608, 95% confidence interval (CI): 0.452–0.818, P=0.001] and OS [HR: 0.685, 95% CI: 0.531–0.885, P=0.004] for ypN2-3 patients.

Effect of PMRT on locoregional recurrence by the ypN subgroupsypN subgroupHazard ratio95%CI Low95%CI HighP valueypN00.8550.4581.5960.623ypN10.8320.5491.2620.387ypN2-30.6080.4520.8180.001

Abstract PD1-09: High incidence rate of occult cancer in risk reducing mastectomy specimens despite thorough assessment with breast MRI and ultrasound-findings from the hereditary breast and ovarian cancer registration 2016 in Japan

Introduction:One of the preemptive strategies for Hereditary Breast and Ovarian Cancer (HBOC) is prophylactic surgery. Data for risk reducing mastectomy (RRM) clearly showed a risk reduction of more than 90% for breast cancer.

Method: We report here the statistical results of the HBOC registration up to 2016. The subjects of this study were those who underwent BRCA1/2 genetic testing during the study period, at 7 medical institutions.

Results: A total of 1527 probands underwent BRCA testing; 1125 cases (73.7%) were negative for BRCA1/2 mutation, and 297 cases (19.5%) were positive, while 105 cases (6.9%) had uncertain results. Among the 297 cases with positive results, 157 cases (10.3%) were positive for BRCA1, 139 cases (9.1%) for BRCA2, and 1 case (0.1%) was positive for both.The mean age at breast cancer diagnosis was 41.7 years in BRCA1/2 mutation positive and 45.8 years in negative cases. In comparison to the National Registration for Breast Cancer Incidence 2011 in Japan (n=72,472), breast cancer with BRCA mutations occurred at a younger age. Among 359 cases of triple negative breast cancer, 101 cases (28.3%) were BRCA1 mutation positive while 18 cases (5.0%) were BRCA2 mutation positive.

Three hundred seventy cases underwent genetic testing prior to surgery, as a deciding factor for the surgical procedure. Among BRCA mutation positive cases, 58 cases (87.9%) chose to undergo total mastectomy, and 8 cases (12.1%) chose breast conserving surgery (BCS); on the other hand, 141 cases (46.4%) of BRCA mutation negative cases chose total mastectomy and 158 cases (52.0%) chose BCS.

Four cases of new onset breast cancers were observed among the 55 cases of previvors (mean observation period: 2.5 years; incidence rate: 2.9%/Y). Among the 73 BRCA1/2 mutation positive women who underwent BCS, 3 ipsilateral breast cancer cases were observed (mean observation period: 3.5 years; incidence rate: 1.2%/Y), while 2 cases were noted among 477 cases of BRCA1/2 mutation negative cases (mean observation period: 2.2 years; incidence rate: 0.2%/Y). Of 189 BRCA1/2 mutation positive cases with unilateral breast cancer, 8 contralateral breast cancer cases were noted (mean observation period: 3.0 years; incidence rate: 1.4%/Y), while 4 cases of contralateral breast cancer were observed among 892 cases of BRCA1/2 mutation negative cases (mean observation period: 2.2 years; incidence rate: 0.2%/Y).

Fifty-one patients had undergone RRM.Six cases (11.8%) of occult breast cancer were noted in the RRM specimens, among which 2 were BRCA1 positive cases and 4 were BRCA2 positive cases. All of these six cases had undergone extensive imaging work-up prior to surgery by using mammography, ultrasound and breast MRI.

Conclusions: The incidence rate of occult cancer after risk-reducing mastectomy was reported to be about 5% in the high-risk population. Our report showed a relatively higher incidence rate of occult cancer at 11.8% among BRCA mutation positive cases, despite thorough pre-operative radiological evaluations, which included a breast MRI. These results suggest the limitations in the use of MRI for the surveillance of patients with BRCA mutations.

Citation Format: Yamauchi H, Okawa M, Yokoyama S, Nakamura S, Arai M. High incidence rate of occult cancer in risk reducing mastectomy specimens despite thorough assessment with breast MRI and ultrasound-findings from the hereditary breast and ovarian cancer registration 2016 in Japan [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD1-09.

Significant association of increased PD-L1 and PD-1 expression with nodal metastasis and a poor prognosis in oral squamous cell carcinoma

Programmed cell death ligand 1 (PD-L1) and its receptor PD-1 are immune checkpoint molecules that attenuate the immune response. Blockade of PD-L1 enhances the immune response in a variety of tumours and thus serves as an effective anti-cancer treatment. However, the biological and prognostic roles of PD-L1/PD-1 signalling in oral squamous cell carcinoma (OSCC) remain to be elucidated. The purpose of this study was to examine the correlation of PD-L1/PD-1 signalling with the prognosis of OSCC patients to assess its potential therapeutic relevance. The expression of PD-L1 and of PD-1 was determined immunohistochemically in 97 patients with OSCC and the association of this expression with clinicopathological characteristics was examined. Increased expression of PD-L1 was found in 64.9% of OSCC cases and increased expression of PD-1 was found in 61.9%. Univariate and multivariate analysis revealed that increased expression of PD-L1 and PD-1 positively correlated with cervical lymph node metastasis. The expression of CD25, an activated T-cell marker, was negatively correlated with the labelling index of PD-L1 and PD-1. Moreover, the patient group with PD-L1-positive and PD-1-positive expression showed a more unfavourable prognosis than the group with PD-L1-negative and PD-1-negative expression. These data suggest that increased PD-L1 and PD-1 expression is predictive of nodal metastasis and a poor prognosis and is possibly involved in cancer progression via attenuating the immune response.

Next-generation sequencing for patients with non-obstructive azoospermia: implications for significant roles of monogenic/oligogenic mutations

Azoospermia affects up to 1% of adult men. Non-obstructive azoospermia is a multifactorial disorder whose molecular basis remains largely unknown. To date, mutations in several genes and multiple submicroscopic copy-number variations (CNVs) have been identified in patients with non-obstructive azoospermia. The aim of this study was to clarify the contribution of nucleotide substitutions in known causative genes and submicroscopic CNVs in the genome to the development of non-obstructive azoospermia. To this end, we conducted sequence analysis of 25 known disease-associated genes using next-generation sequencing and genome-wide copy-number analysis using array-based comparative genomic hybridization. We studied 40 Japanese patients with idiopathic non-obstructive azoospermia. Functional significance of molecular alterations was assessed by in silico analyses. As a result, we identified four putative pathogenic mutations, four rare polymorphisms possibly associated with disease risk, and four probable neutral variants in 10 patients. These sequence alterations included a heterozygous splice site mutation in SOHLH1 and a hemizygous missense substitution in TEX11, which have been reported as causes of non-obstructive azoospermia. Copy-number analysis detected five X chromosomal or autosomal CNVs of unknown clinical significance, in addition to one known pathogenic Y chromosomal microduplication. Five patients carried multiple molecular alterations. The results indicate that monogenic and oligogenic mutations, including those in SOHLH1 and TEX11, account for more than 10% of cases of idiopathic non-obstructive azoospermia. Furthermore, this study suggests possible contributions of substitutions in various genes as well as submicroscopic CNVs on the X chromosome and autosomes to non-obstructive azoospermia, which require further validation.

Postpartum infective endocarditis with Enterococcus faecalis in Japan: a case report

Background

The clinical characteristics of infective endocarditis include the presence of predisposing cardiac disease, a history of illegal drug use, and high morbidity in the elderly. Only a few cases of the disease after delivery have been reported in the literature. We describe here a first case of enterococcal postpartum infective endocarditis without underlying disease in Japan.

Case presentation

We report the case of a 31-year-old Japanese woman with postpartum infective endocarditis by Enterococcus faecalis. She had no significant medical history or any unusual social history. After emergency surgery for severe mitral regurgitation and antimicrobial treatment for 6 weeks, she was discharged from our hospital and is now being monitored at an out-patient clinic.

Conclusions

We encountered a case of Enterococcus faecalis infective endocarditis that occurred in the native valve of a postpartum healthy woman. Although the pathogenesis of this case remains unclear, it could be due to bacteremia arising from the administration of prophylactic broad-spectrum antibiotics used for cesarean section. Previous use of cefotiam and urinary catheter insertion may be risk factors for nosocomial enterococcal bacteremia in this case.

Setting Ideal Lubricant Mixing Time for Manufacturing Tablets by Evaluating Powder Flowability

We investigated the effectiveness of using Carr's flowability index (FI) and practical angle of internal friction (Φ) as indexes for setting the target Mg-St mixing time needed for preparing tablets with the target physical properties. We used FI as a measure of flowability under non-loaded conditions, and Φ as a measure of flowability under loaded conditions for pharmaceutical powders undergoing direct compression with varying concentrations of Mg-St and mixing times. We evaluated the relationship between Mg-St mixing conditions and pharmaceutical powder flowability, analyzed the correlation between the physical properties of the tablets (i.e., tablet weight variation, drug content uniformity, hardness, friability, and disintegration time of tablets prepared using the pharmaceutical powder), and studied the effect of Mg-St mixing conditions and pharmaceutical powder flowability on tablet properties. Mg-St mixing time highly correlated with pharmaceutical powder FI (R ² = 0.883) while Mg-St concentration has low correlation with FI, and FI highly correlated with the physical properties of the tablet (R ² values: weight variation 0.509, drug content variation 0.314, hardness 0.525, friability 0.477, and disintegration time 0.346). Therefore, using pharmaceutical powder FI as an index could enable prediction of the physical properties of a tablet without the need for tableting, and setting the Mg-St mixing time by using pharmaceutical powder FI could enable preparation of tablets with the target physical properties. Thus, the FI of the intermediate product (i.e., pharmaceutical powder) is an effective index for controlling the physical properties of the finished tablet.