Heparanase expression in endometrial cancer: analysis of immunohistochemistry

The human enzyme heparanase has been shown to function in tumour progression, metastatic spread and tumour angiogenesis. The aim of the present study was to assess heparanase expression assessed by immunohistochemical staining (IHC) in endometrial cancer in correlation with clinicopathological factors. A total of 52 endometrial cancers were obtained from previously untreated patients (median age, 56 years, range, 35-80 years). The expression of heparanase was evaluated by using IHC with anti-heparanase polyclonal antibody. This antibody was raised by immunising a rabbit with a peptide containing the amino acid residues from 238 to 250 of the heparanase. The IHC data were used to determine the relationship between heparanase expression, and clinicopathological parameters. IHC showed that the heparanase was expressed in 23 of 52 (44.2%) endometrial cancers. Heparanase was abundantly and equally expressed in both the cytoplasm and the cell membrane of the cells in endometrial cancer. Strong heparanase-positive staining was also seen at the invasive front of the tumour into myometrium. The expression was significantly related to lymph-vascular space involvement (p = 0.0028), depth of myometrial invasion (p = 0.0026), and histological tumour grade (p = 0.0135). In six tumours with positive lymph nodes, the heparanase expression was observed as being higher compared with tumours with negative lymph nodes, which was not significant (p = 0.2349). In terms of peritoneal cytology, ovarian metastasis, and cervical invasion, we observed no significant difference in the heparanase expression assessed by IHC. These results suggest that the expression of heparanase may promote tumour invasion into myometrium and lymph vascular space in endometrial cancer.

Quantized hyperfine field at an implanted micro+ site in PrPb3: interplay between localized f electrons and an interstitial charged particle

The local effect of an interstitial hydrogenlike particle on localized f electrons was studied in PrPb3 by means of micro+ spin rotation and relaxation. Spontaneous micro+ spin precession with harmonic frequencies was observed for the first time in f electron compounds. We demonstrate that the signal is derived from a coupling between the micro+ spin and the hyperfine-enhanced nuclear spin of nearest neighbor (NN) 141Pr with Ising-like anisotropy. The signal also suggests a marked suppression of spin dynamics of the NN 141Pr in comparison with that of the bulk 141Pr. These facts strongly indicate modification of the f electronic state due to the interstitial charged particle.

Visceral obesity is associated with the metabolic syndrome and elevated plasma retinol binding protein-4 level in obstructive sleep apnea syndrome

Obstructive sleep apnea syndrome (OSAS) is related to the increased prevalence of cardiovascular disease and metabolic syndrome (MS). A novel adipokine, retinol binding protein-4 (RBP4), was reported to be associated with insulin resistance and the prevalence of type 2 diabetes. To examine whether plasma RBP4 is associated with insulin resistance and MS development in OSAS, we measured plasma RBP4 levels in 181 Japanese men (24 healthy controls and 40 mild, 64 moderate, and 53 severe OSAS) of whom 26 had mild glucose intolerance with HbA1c < or = 6.0%. After a full polysomnography, blood was collected between 06:00 and 07:00 AM. Plasma RBP4 levels in moderate/severe OSAS patients were higher than in control subjects. Plasma RBP4 was not correlated with apnea variables, HOMA-IR, or blood pressure. However, it was positively correlated with visceral fat areas and plasma triglyceride levels. The prevalence of MS was higher in severe OSAS patients than in mild/moderate OSAS and control subjects. Plasma RBP4 was higher in OSAS patients with MS than in those without MS. This study indicates that plasma RBP4 is associated with dyslipidemia, but not with insulin resistance, glucose intolerance, or hypertension in patients with OSAS. Visceral obesity may play key roles in increasing the plasma RBP4 level and MS development in OSAS.

Repeated intracyclic clomiphene citrate therapy can be more effective than hMG therapy in inducing ovulation: case report

PURPOSE OF INVESTIGATION

When clomiphene citrate is ineffective in the treatment of anovulation, hMG administration is typically selected. However, high-dose hMG therapy is associated with a variety of adverse events. We describe the use of a modified clomiphene citrate regimen that was successful in increasing the effectiveness of ovulation induction.

CASE REPORT

A patient who did not initially respond to clomiphene citrate therapy required a total dose of 2400 IU hMG to prodeuce mature follicles. However, because of the physical and emotional burdens on the patient, and the possibility of multiple pregnancy and ovarian hyperstimulation syndrome, re-treatment with clomiphene citrate was then selected. Two courses of clomiphene citrate administered at a fixed interval during the same cycle safely induced ovulation. After initial induction of ovulation, her ovulatory failure improved and natural ovulation occurred.

CONCLUSIONS

Repeated intracycle clomiphene cirate therapy may be more effective than hMG therapy in inducing ovulation in some patients.

18 RELATIONSHIP BETWEEN MULTIPLE OVULATIONS AND CONCEPTION IN LACTATING DAIRY COWS

The relationship between multiple ovulations and various factors involved in conception in lactating Holstein cows was investigated in this study. A total of 53 AI cows housed in a free-stall barn were assigned to this study. They were offered a balanced TMR ad libitum during the experimental period. Cows were milked at 0830 and 1900 h. Milk yields were recorded at each milking. Estrus was detected by radiotelemetric pedometers (Yoshioka et al. 2007 Reprod. Fertil. Dev. 19, 129). The body condition score (BCS) of cows was recorded at estrus. Artificial insemination was performed according to the pedometry data. Pregnancy was diagnosed 42 days post-AI by transrectal ultrasonography. Ovulation was assessed by transrectal ultrasonography of the ovary every 3 h from the end of estrus. Ovulation time was measured from the onset of estrus to ovulation. Milk production of each cow was determined from 14 days before the day of estrus. Blood samples for estradiol-17β (E2) were collected at the peak of estrus, and for progesterone (P4), samples were collected on Days 0, 3, 6, 9, and 12 (estrus = Day 0). The E2 and P4 concentrations were measured by enzyme immunoassay. Preovulatory follicles at estrus and CL on Day 0, 3, 6, 9, and 12 were monitored by transrectal ultrasonography. The overall incidence of multiple ovulations was 28.3% (15/53). There was no difference in duration of estrus between cows with multiple ovulations and cows with single ovulations (10.2 h, n = 15 v. 9.8 h, n = 38). Ovulation time was longer for cows with multiple ovulations than that for cows with single ovulations (30.4 h, n = 10 v. 28.7 h, n = 26; P = 0.0545). In all cases of multiple ovulations, 2 follicles ovulated simultaneously. The milk production of cows with multiple ovulations was higher than that of cows with single ovulations (40.1, n = 15 v. 36.2 kg d–1, n = 38; P = 0.0515); however, BCS showed the opposite results (2.86, n = 15 v. 3.13, n = 38; P < 0.05). There was a significant inverse correlation between milk production and BCS in cows with multiple ovulations (r = –0.768; P < 0.01). The E2 concentrations showed no difference between cows with multiple and single ovulations (9.6 pg mL–1, n = 8 v. 8.2 pg mL–1, n = 23). The diameters of preovulatory dominant follicles and secondary follicles at estrus in cows with multiple ovulations were significantly smaller than those in cows with single ovulations (18.2 and 14.2 mm, n = 14 v. 19.9 mm, n = 38, respectively; P < 0.05). Cows with multiple ovulations showed a significantly higher P4 concentration and a larger CL than those with single ovulations from Day 3 to 12. The conception rate for AI was significantly higher for cows with multiple ovulations than for cows with single ovulations (73.3%, n = 15 v. 36.2%, n = 38; P < 0.05). Our results showed that high conception rates, high levels of milk production, and low BCS were associated with multiple ovulations.

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.

Recurrent juvenile granulosa cell tumor of the ovary managed by palliative radiotherapy

Prognosis in the few patients with advanced-stage juvenile granulosa cell tumor (JGCT) of the ovary has traditionally been unfavorable. We report a recurrent JGCT patient managed by palliative radiotherapy. A 37-year-old woman with recurrent JGCT received a combination of paclitaxel–carboplatin chemotherapy and then single-agent docetaxel, but her disease progressed with multiple abdominal masses and ascites. We chose palliative radiation therapy to relieve her complaints. Whole-abdominal external beam radiotherapy with pelvic boost was delivered. She tolerated the treatment well. After the completion of radiotherapy, ultrasonography showed shrinkage of the tumor, and the ascites disappeared. We should consider using radiation therapy in a palliative setting for such patients with recurrent JGCT suffering from abdominal complaints

New dissipation relaxation phenomenon in oscillating solid (4)He

We describe the first observations on the time-dependent dissipation when the drive level of a torsional oscillator containing solid (4)He is abruptly changed. The relaxation of dissipation in solid (4)He shows rich dynamical behavior including exponential and logarithmic time-dependent decays, hysteresis, and memory effects.

Sudden infant death syndrome in infants of cocaine using mothers

A study of Sudden Infant Death Syndrome (SIDS) with maternal cocaine exposure was undertaken using the perinatal medical records at the University of Miami/Jackson Memorial Medical Center and case files of the Metropolitan Dade County Medical Examiner Department, Miami, Florida USA from 1988-1992. 78 SIDS cases were analysed. 18 infants were classified as cocaine-exposed SIDS infants with positive history of maternal cocaine abuse and/or positive urine toxicology; 50 infants were classified as cocaine-negative SIDS infants without the history and with negative toxicology. The incidence of SIDS among cocaine-exposed infants was estimated to be higher than that of cocaine-negative infants overall (p < 0.025), but statistical significance between the groups was not confirmed when controlled for ethnicity. No significant differences of birth weight, estimated gestational age, body and brain weights were observed at autopsy between the two groups. Cocaine-exposed SIDS cases included 6 infants born small for gestational age (p < 0.05). 10 of 18 cocaine-exposed SIDS infants had a positive result for urine toxicology at birth and died younger aged than cocaine-negative infants (p < 0.05). Toxicology tests of the specimens obtained from cadavers were all negative for cocaine metabolites.

Nucleon axial charge in (2+1)-flavor dynamical-lattice QCD with domain-wall fermions

We present results for the nucleon axial charge g{A} at a fixed lattice spacing of 1/a=1.73(3) GeV using 2+1 flavors of domain wall fermions on size 16;{3} x 32 and 24;{3} x 64 lattices (L=1.8 and 2.7 fm) with length 16 in the fifth dimension. The length of the Monte Carlo trajectory at the lightest m_{pi} is 7360 units, including 900 for thermalization. We find finite volume effects are larger than the pion mass dependence at m{pi}=330 MeV. We also find a scaling with the single variable m{pi}L which can also be seen in previous two-flavor domain wall and Wilson fermion calculations. Using this scaling to eliminate the finite-volume effect, we obtain g{A}=1.20(6)(4) at the physical pion mass, m_{pi}=135 MeV, where the first and second errors are statistical and systematic. The observed finite-volume scaling also appears in similar quenched simulations, but disappear when V>or=(2.4 fm);{3}. We argue this is a dynamical quark effect.

Neoadjuvant chemotherapy followed by extended-field concurrent chemoradiotherapy in squamous cell carcinoma of the cervix with positive paraaortic lymph nodes: two cases

PURPOSE

To report the feasibility of neoadjuvant chemotherapy (NAC) followed by extended-field concurrent chemoradiotherapy (EF-CCRT) for squamous cell carcinoma of the cervix (CC) with paraaortic lymph node (PAN) metastasis.

METHODS

Two patients were diagnosed with CC with positive PAN, and received two courses of cisplatin (120 mg/m2) in a neoadjuvant setting. They then received extended-field, external-beam radiotherapy (50.4 Gy) followed by intracavitary brachytherapy concurrently with cisplatin (20 mg/m2 x 5 days) at 21-day intervals.

RESULTS

EF-CCRT was interrupted in one patient for five days because of grade 4 neutropenia. No severe late toxicities were observed. The two patients are alive with no evidence of recurrence at present.

CONCLUSIONS

NAC followed by EF-CCRT is feasible and may improve the survival outcome of patients with CC with positive PAN.

Oscillation frequency dependence of nonclassical rotation inertia of solid 4He

The nonclassical rotational inertia fraction of the identical cylindrical solid 4He below 300 mK is studied at 496 and 1173 Hz by a double resonance torsional oscillator. Below 35 mK, the fractions are the same at sufficiently low rim velocities. Above 35 mK, the fraction is greater for the higher than the lower mode. The dissipation peak of the lower mode occurs at a temperature approximately 4 mK lower than that of the higher mode. The drive dependence of the two modes shows that the reduction of the fraction is characterized by critical velocity, not amplitude or acceleration.

Comparison of Swedish interactive threshold algorithm and full threshold algorithm for glaucomatous visual field loss

PURPOSE

To compare the prevalence of visual field loss, the sensitivity distribution, and the size and depth of glaucomatous visual field defects using the standard full threshold (FT) and the Swedish interactive threshold algorithm (SITA) standard (SS) procedures in patients with early or suspected glaucoma.

METHODS

Automated perimetry findings were retrospectively evaluated in 53 patients (105 eyes) with early or suspected glaucoma.

RESULTS

The number of eyes judged to have glaucomatous visual field loss by SS (48 eyes) was significantly larger than what was found with FT (35 eyes), and 70 eyes were classified as pre-perimetric glaucoma. In these 70 eyes, there were many locations where the sensitivity was significantly higher with SS than with FT (intrasubject difference), and SS had less intersubject variability than FT at most locations. The cumulative decibel scores at the region of glaucomatous defects were larger with SS (206.2+/-103.3 dB) than with FT (162.1+/-87.5 dB) (p=0.02), which indicated that the depth of defects measured by SS was shallower than that by FT. The sizes of defects were significantly larger with SS (11.2+/-5.6) than with FT (9.7+/-5.1) (p<0.05).

CONCLUSIONS

Glaucomatous defects were measured as being significantly shallower and larger with SS than with FT. In addition, the prevalence of visual field defect was higher with SS according to some of the criteria for glaucomatous visual field defects. These results might be related to the fact that SS strategy has a lower variability and to the Bayesian statistical properties of the SITA algorithm.

Concurrent chemoradiotherapy for locally advanced cervical cancer: Analysis of a single institutional 10-year experience

16056

Background: The purpose of this study was to report the feasibility and efficacy of concurrent chemoradiotherapy (CCRT) for the locally advanced cervical cancer in our institute. Methods: We retrospectively reviewed 147 patients (stage Ib: 9, II: 82, III: 80, and IVa: 7) with squamous cell carcinoma of the cervix treated with CCRT. Cisplatin (20mg/m2/day) was administered for 5 days every 3 weeks for a median of three courses (range: 1–5 courses) during radiotherapy (RT). The patients with paraaortic and/or common iliac lymphadenopathy were excluded. RT consisted of pelvic external beam RT (EBRT) with 40Gy/20 fractions followed by high-dose rate brachytherapy (HDR-BT) with 18Gy/3 fractions and pelvic EBRT with 10Gy/5 fractions using a midline block. Late complications were graded by the RTOG/EORTC criteria. Results: The 5-year actuarial overall survival (OS), disease-free survival (DFS), and pelvic relapse-free survival were 78.5%, 70.7%, and 78.0%, respectively. The 5-year OS by the disease stage was as follows: stage Ib 100%, II 82.0%, III 62.3%, and IVa 35.7%. Multivariate analysis identified pelvic lymphadenopathy, tumor diameter > 7cm, and pretreatment hemoglobin < 9.0g/dl as an independent prognostic factor for both OS and DFS. Only one patient suffered from grade 3 enterocolitis, but no grade 4 complication developed. Conclusions: Our experience suggests that CCRT using HDR-BT for locally advanced cervical cancer could achieve favorable local control without suffering from severe late complications.

No significant financial relationships to disclose.

Pelvic node control in patients with locally advanced uterine cervical cancer treated with concurrent chemoradiotherapy

16018

Background: To evaluate pelvic node control in cervical cancer patients treated with concurrent chemoradiotherapy (CCRT) without surgical resection. Methods: Ninety-six patients (stage IB2, 3; IIA, 2; IIB, 49; IIIA, 1; IIIB, 40; IVA, 1) with uterine cervical squamous cell carcinoma treated with CCRT were analyzed. Cervical tumor diameter and pelvic node status were assessed by MRI. The median maximum tumor diameter was 58 mm (range, 36–86 mm). Thirty-four patients had positive pelvic nodes (= 10 mm in shortest diameter). The largest diameter of the positive nodes ranged from 10–50 mm (median, 18 mm). All patients received CDDP (20 mg/m2 for 5 days every 21 days), pelvic external beam RT (PERT), and high-dose-rate intracavitary brachytherapy (HDR-ICBT). The planned RT schedule consisted of PERT with 40 Gy/20 fractions (frs) followed by HDR-ICBT with 18–24 Gy/3–4 frs and PERT with 10 Gy/5 frs using a midline block. Thirty of thirty-four node-positive patients received boost RT (6–10 Gy/3–5 frs) to involved nodes. The dose from HDR-ICBT to the pelvic nodes was estimated at a point 6 cm lateral to the midline at the level of the vaginal fornix. Doses of ERT and HDR-ICBT were simply summed and used for pelvic node dose-response analysis. The median total dose was 60 Gy (range, 52–64 Gy) for positive nodes and 54 Gy (range, 51–55 Gy) for negative nodes. Median follow-up of the surviving 79 patients was 41 months (range, 8–98 months). Results: Four-year overall survival (OAS), pelvic control (PC), and distant metastasis-free (DMF) rates for all 96 patients were 79%, 90%, and 79%, respectively. Four-year OAS, PC, and DMF rates for node-positive/node-negative patients were 60%/89% (P=0.002), 82%/95% (P=0.08), and 66%/86% (P=0.008), respectively. Pelvic nodal recurrence was observed in 4 patients. One patient developed isolated pelvic node recurrence while the other 3 had concurrent recurrences at other sites, including 1 with a cervical tumor and 2 with cervical tumor and distant metastases. Nodal recurrence rates by largest diameter were 1/62 for node-negative patients, 1/14 for nodes 10–14 mm, 0/13 for nodes 15–29 mm, and 2/7 for nodes = 30 mm. Conclusions: Pelvic nodal metastases < 30 mm were well controlled by CCRT without surgical resections using RT dose delivered.

No significant financial relationships to disclose.

Outbreak of human metapneumovirus detected by use of the Vero E6 cell line in isolates collected in Yamagata, Japan, in 2004 and 2005

A number of epidemiological studies have shown human metapneumovirus (hMPV) to be one of the most important viral agents associated with acute respiratory infections in humans. However, due to the difficulty in growing the virus, all epidemiological studies of hMPV infection have been performed on the basis of the molecular method. Thus, the development of a cell line suitable for the isolation of hMPV from clinical specimens is a crucial step for further research. Using the Vero E6 cell line, which could be stably maintained for 1 month without passage or medium change, we succeeded in isolating 79 strains from 4,112 specimens obtained in Yamagata, Japan, in 2004 and 2005. The total isolation rate was 1.9% (79/4,112). The monthly distribution revealed that hMPV infections occurred between February and April in 2004 and throughout most of the year in 2005. Phylogenetic analysis indicated that subgenogroup B2 was predominant in 2004, whereas three subgenogroups, A2, B1, and B2, had cocirculated in 2005. Although multiple subgenogroups cocirculated in 2005, each individual subgenogroup strain was found to predominate at specific sites. An infectivity assay of hMPV strains also indicated that the infection efficiency in Vero E6 cells was better than that in LLC-MK2 cells. Finally, we found that Vero E6 cells are useful for the isolation of hMPVs and that this utility might aid further research into hMPVs beyond the epidemiological data shown in this study.

Macrofilaricidal and microfilaricidal effects of Neurolaena lobata, a Guatemalan medicinal plant, on Brugia pahangi

Twelve extracts of 11 Guatemalan medicinal plants were initially screened in vitro for potential macrofilaricidal activity against Brugia pahangi, a lymphatic dwelling filarial worm, using concentrations from 125 to 1000 μg ml−1 of each extract that could be dissolved in the culture medium. Of 12 extracts used, the ethanol extract of leaves of Neurolaena lobata showed the strongest activity against the motility of adult worms. Subsequently, the extract of N. lobata was extensively examined in vitro for macro- and micro-filaricidal effects using a series of concentrations of 500, 250, 100, 50 and 10 μg ml−1. The effects were assessed by worm motility, microfilarial release by female worms and a MTT assay. The effect on the motility of adult worms was observed in a concentration- and time-dependent manner. The time required to stop motility of both sexes of adult worms was 6 h at 500 μg ml−1, 24 h at 250 μg ml−1, and 3 days for females and 4 days for males at 100 μg ml−1. The movement of females ceased at 4 days at a concentration of 50 μg ml−1 whereas the motility of males was only reduced. The loss of worm's viability was confirmed by the MTT assay and was similar to the motility results. These concentrations, including 10 μg ml−1, prevented microfilarial release by females in a concentration- and time-dependent manner. Concentrations higher than 100 μg ml−1 even induced mortality of the microfilariae. The present study suggested that the ethanol extract of Neurolaena lobata has potential macro- and micro-filaricidal activities.

Delayed macrofilaricidal activity of diethylcarbamazine against Brugia pahangi in Mongolian jirds

The macrofilaricidal activity of diethylcarbamazine (DEC) was confirmed in jirds infected with Brugia pahangi. Seventy jirds were inoculated subcutaneously with 100 infective larvae. At 20 weeks post-infection, the microfilaraemic jirds were divided into two groups, untreated and treated. For the treated group, 200 mg kg−1 of DEC was injected intraperitoneally for 5 consecutive days. One, 4, 8, 12, 16 and 27 weeks after the final treatment, 4–7 jirds in each group were sacrificed to measure adult worm burdens. The number of adult worms recovered from treated jirds was comparable to controls at earlier necropsy (1 and 4 weeks post-treatment). However, at late necropsy (8 weeks and later) the recovery rate of adult worms in treated jirds was significantly lower than that in untreated controls, indicating an adultcidal effect of DEC. The present study demonstrates that DEC requires 8 weeks to kill B. pahangi adult worms in jirds and that the Mongolian jird is a useful model for screening antifilarial activity.