[The preliminary application of vonoprazan fumarate on laryngopharyngeal reflux disease]

Objective: To evaluate the clinical effect of vonoprazan fumarate on laryngopharyngeal reflux disease (LPRD). Methods: The clinical data of 89 patients from June 2020 to January 2022, including 45 males and 44 females, aged 18-77 (45.54±13.53) years old, were retrospectively analyzed. All the patients were diagnosed as suspected LPRD according to reflux symptom index (RSI) and reflux finding score (RFS). Patients of the Vonoprazan Fumarate group were prescribed Vonoprazan Fumarate orally (20 mg, qd) for 8 weeks.Patients of the Esomeprazole group were prescribed Esomeprazole orally (20 mg, bid) for 8 weeks. RSI and RFS of all the patients before and after treatment were compared. SPSS 18.0 was used for statistics analysis. Results: Before treatment, gender, age, RSI and RFS of the two groups had no obvious differences. After treatment, RSI and RFS in both groups were alleviated significantly. In the vonorazan fumarate group, the RSI before treatment was 12.62±7.18, and after treatment was 4.74±3.87(t=6.91, P<0.001), the RFS was 10.78±2.29 before treatment and 8.24±2.45 after treatment (t=7.06, P<0.001). While in the esomeprazole group, the RSI was 13.27±6.95 before treatment and 6.02±4.28 after treatment (t=7.50, P<0.001), the RFS was 10.59±3.14 before treatment and 8.14±3.30 after treatment (t=5.41, P<0.001). There was no significant difference in the effective rate between the two groups (86.7% in the vonoprazan fumarate group and 77.3% in the esomeprazole group, χ²=1.443, P=0.486). Conclusion: Vonoprazan fumarate could effectively alleviate the symptoms and signs of LPRD patients. The effect of vonoprazan fumarate on LPRD is not inferior to Esomeprazole. It can be used as a supplement to PPI.

[The role of continuous 48 h oropharyngeal pH monitoring in the diagnosis of laryngopharyngeal reflux disease]

Objective: To investigate the daily variation of LPR and the significance of 48-hour oropharyngeal pH monitoring in the diagnosis of LPRD. Methods: 72 subjects with suspected LPRD who were treated in our department from June 2018 to June 2021 were included. All patients were hospitalized to complete continuous 48-hour oropharyngeal Dx-pH monitoring. The consistency of Ryan index and W index and the correlation of various reflux parameters between the first and second 24-hour were compared. SPSS 24.0 was used for statistical analysis. Results: All 72 subjects successfully completed 48-hour oropharyngeal Dx-pH monitoring. Ryan index was positive in 11 cases (15.2%) in the first 24-hour, in 17 cases (23.6%) in the second 24-hour, in 5 cases (6.9%) both first and second, and in 23 cases (31.9%) in either 24-hour, Kappa=0.211 (P=0.064), 18 cases (25%) had inconsistent results of the first 24-hour and the second 24-hour, and there was no significant difference in the positive rate between the first and second (P=0.234). The number of positive cases in 48-hour monitoring increased by 109.1% compared with 24-hour monitoring.For W index, 49 cases (68.1%) were positive in the first 24-hourf 53 cases (73.6%) were positive in the second 24-hour, 42 cases (58.3%) were positive both first and second, and 58 cases (80.6%) were positive in either 24-hour, Kappa=0.477 (P<0.001), 16 cases (22.2%) had inconsistent results of the first and second, and there was no significant difference in the positive rate between the first and second (P=0.804). The number of positive cases in 48-hour monitoring increased by 18.4% compared with 24-hour monitoring. There was no significant difference in all the reflux parameters of first and second (P>0.05). The correlation comparison showed that the correlation of various reflux parameters in the upright position was lower than that in the supine position. Conclusion: Laryngeal reflux has daily variability. Extending the monitoring time of Dx-pH to 48-hour can help reduce the missed diagnosis caused by daily variability; the use of W index can reduce the influence of daily variability on the diagnostic results of LPRD.

[Evaluation of reliability and validity of the Chinese version of a new symptom score of laryngopharyngeal reflux disease]

Objective: To produce the Chinese version of a new reflux symptom score (RSS) of laryngopharyngeal reflux disease (LPRD) and to evaluate its reliability, validity and clinical value. Methods: This was a retrospective study which contained 42 healthy volunteers and 135 possible LPRD patients. RSI,RFS,oropharyngeal pH monitoring (Dx-pH monitoring) and RSS of each patient were performed. RSS was performed again after 1 week. Confirmed LPRD patients were treated with proton pump inhibitor for 8 week. And RSS was performed again after treatment. Reliability and validity of RSS were evaluated. Results: The Cronbach's α coefficient of RSS was 0.77, which indicated good internal reliability of the new score. The results of test-retest found all P values were less than 0.05, which supported good external reliability. Comparing RSS with laryngopharyngeal reflux test results, the diagnostic coincidence rate was 84.44% (114/135), and the positive predictive value was 85.71% (114/133), which showed good criterion validity. After 8 weeks treatment of PPI, RSS decreased significantly (pretreatment 84.79±42.50,posttreatment 20.11±22.82,t=-10.54, P<0.001), indicating good reactivity of RSS. The score of quality of life impact (Qol) in possible LPRD patients was obviously higher than that of healthy volunteers (t=7.15,P<0.001). All patients and volunteers believed that RSS was a good way to evaluate their symptoms. Conclusions: The new score RSS have good internal and external reliability, criterion validity and reactivity. RSS can be one of the important reference indexes to evaluate LPRD.

Effects of taurine on growth performance, antioxidant capacity, and lipid metabolism in broiler chickens

To investigate the effects of dietary taurine supplementation on growth performance, antioxidant status, and lipid metabolism in broilers, 384 male broilers (Arbor Acres, 1 D of age) were randomly allocated into 4 groups with 8 replicates of 8 birds. Dietary treatments were supplemented with taurine at the level of 0.00, 2.50, 5.00, and 7.50 g/kg of the diet (denoted as CON, TAU1, TAU2, TAU3, respectively). The BW gain from 1 to 21 D and from 22 to 42 D were all increased linearly (linear, P < 0.001) by taurine supplementation. Throughout the trial period, the highest BW gain and favorable gain-to-feed ratio were observed in the TAU2 group. Taurine supplementation increased the antioxidant enzyme activities and decreased (linear, P < 0.001) the content of malondialdehyde in both serum and the liver of broilers and alleviated oxidative damage through enhancing (P < 0.05) the hepatic genes expression of nuclear factor erythroid-2-related factor 2 (NRF2), glutathione peroxidase (GPX), and heme oxygenase-1 (HO-1). Correspondingly, in serum, the activities of hepatic lipase and total lipase were decreased linearly and quadratically (linear and quadratic, P < 0.001) with the increasing inclusion of taurine in the diet. Meanwhile, in serum, the content of triglycerides was significantly decreased (P < 0.05), and except for TAU3, the total cholesterol content was also significantly decreased (P < 0.05) by taurine supplementation. In addition, the hepatic content of triglycerides was significantly decreased (P < 0.05) in the TAU1 and TAU2 groups. Compared with the CON group, the hepatic genes expression of adenosine monophosphate-activated protein kinase alpha (AMPKα), silent 1, (SIRT1) and carnitine palmitoyltransferase 1 (CPT-1) were all increased (P < 0.05), and sterol regulatory element-binding protein-1 (SREBP-1) expression was decreased (P < 0.05) in the TAU2 group. These results indicated that taurine supplementation improved the growth performance, antioxidant capacity, and lipid metabolism of broilers.

Effects of bamboo leaf extract on growth performance, meat quality, and meat oxidative stability in broiler chickens

This study was conducted to investigate the effects of dietary bamboo leaf extract (BLE) on growth performance, meat quality, oxidative stability, and nuclear factor erythroid 2-related factor 2 (Nrf2) related gene expression of breast meat in broilers. A total of 576 one-day-old male Arbor Acres broilers were divided into 6 groups. The control group (CTR) was fed basal diet, while BLE1, BLE2, BLE3, BLE4, and BLE5 were fed basal diet supplemented with 1.0, 2.0, 3.0, 4.0, and 5.0 g BLE per kg feed, respectively. Compared with the CTR group, BLE2 and BLE5 increased average daily feed intake from 1 to 21 D and 22 to 42 D (P < 0.05), BLE1 and BLE2 improved average daily gain (ADG) and feed to gain ratio from 22 to 42 D (P < 0.05). Throughout the trial period, the highest body weight and favorable ADG and feed to gain ratio were observed in the BLE2 group. The drip loss at 24 h and pH at 45 min postmortem of breast meat were linearly improved by BLE supplementation (P < 0.05). Shear force was significantly lower in BLE2 and BLE3 than that in CTR group. Increasing supplementation of BLE linearly improved free radical scavenging capacity and decreased malondialdehyde content of breast meat during 12 D of storage (P < 0.05). Total antioxidant capacity and glutathione peroxidase activity were linearly increased by BLE supplementation (P < 0.05). Compared with the CTR group, the mRNA expression of Nrf2 and glutathione peroxidase in BLE3, BLE4, and BLE5 groups was significantly promoted, and glutathione S-transferase gene expression was increased in BLE2, BLE4, and BLE5 (P < 0.05). The highest (P < 0.05) heme oxygennase-1 gene expression was observed in BLE5. In conclusion, broiler supplemented with BLE improved growth performance and meat quality, BLE supplementation might activate Nrf2 pathway to alleviate lipid oxidation and increase antioxidant capacity of breast meat. The dosage of 2.0 to 3.0 g/kg BLE in broiler diet was recommanded.

New species of Donda Moore, 1882 and new data on Pantheinae species. Revision of Pantheinae, contribution XIV (Lepidoptera, Noctuidae: Pantheinae)

This paper supplements earlier revisions and descriptions of the subfamily Pantheinae (Behounek et al. 2012a, 2012b, 2015a, 2015b; Behounek and Kononenko 2012a, 2012b. It contains the description of Donda hunana sp. n., description of the male of Anabelcia thai Behounek Kononenko, 2012 which was described from a small series of females, and new data on distribution of Xizanga mysterica Behounek, Han Kononenko, 2012b and Pantheaforma ihlei Behounek, Han Kononenko, 2015a.

[The correlation between gastric bubble size and laryngopharyngeal reflux pattern in patients with laryngopharyngeal reflux disease]

Objective: To investigate the correlation between gastric bubble size and laryngopharyngeal reflux pattern in patients with laryngopharyngeal reflux disease(LPRD). Methods: A total of 52 LPRD patients who underwent Dx-pH monitoring and anteroposterior chest radiography at the same time from February 2016 to November 2018 were retrospectively studied. Patients were devided into three position-related groups according to the Ryan score of upright and supine: isolated upright reflux(IUR), isolated supine reflux(ISR) and bipositional reflux(BR) groups. In addition, 13 healthy volunteers with negative pH monitoring were selected as the control group. Gastric bubble size and pH monitoring data among the four groups were compared. SPSS 24.0 was used for statistical analysis. Results: In all the 52 patients, 35 cases (67.3%) were classified as IUR, 9 cases (17.3%) as ISR, and 8 cases (15.4%) as BR. The height of gastric bubbles in the four groups were: IUR (26±14) mm, ISR (9±8) mm, BR (20±13) mm, control (17±15) mm, and statistical difference was found among the four groups(P=0.004). Post Hoc Multiple Comparisons found that IUR group had statistical difference between ISR group and control group (P=0.001, P=0.034 respectively). There was no statistical difference of gastric bubble width and area among the four groups(P=0.340, P=0.186 respectively). The ROC curve of the gastric bubble height with isolated upright and supine reflux patterns was obtained, and the optimal cutoff value of the gastric bubble height was 11 mm. Accordingly, we divided the patiens into two groups with high and low gastric bubble. LPRD reflux pattern distribution was significantly different between the two groups(P<0.001). The comparison of reflux parameters in pH monitoring also showed that the supine reflux parameters in the lower group were significantly higher than those in the higher group, and the upright reflux parameters in the higher group were significantly higher than those in the lower group(P<0.001). Conclusions: The height of gastric bubble is significantly correlated with the reflux patterns in LPRD patients. The gastric bubble of patients with IUR is significantly higher than that of patients with ISR. Taking 11 mm as the cutoff value, patients with higher gastric bubble are more prone to upright laryngopharyngeal reflux, while those with lower gastric bubble are more prone to supine laryngopharyngeal reflux.

[Present status of the treatment for olfactory dysfunction]

Olfactory dysfunction is defined as decrease or loss of smell perception.This review systematically summarizes classification, etiology and diagnosis progress of olfactory dysfunction, and focuses on advancement in management of olfactory dysfunction, including pharmaceutical remedy, surgical treatment as well as olfactory training.Glucocorticoids play an important role in the treatment of olfactory dysfunction. Sodium citrate, vitamin A, and nonspecific phosphodiesterase inhibitors (theophylline, pentoxifylline) are promising drugs.Endoscopic paranasal sinuses surgery can improve the olfactory dysfunction caused by chronic sinusitis to some extent.Olfactory training has been proven to be effective for a variety of causes of olfactory dysfunction.

Twelve new species and four new records of Stenoloba Staudinger 1892 from China (Lepidoptera, Noctuidae: Bryophilinae)

Twelve new species of the genus Stenoloba Staudinger, 1892 (S. gaoligonga sp. n., S. huanxipoa sp. n., S. chlorobrunnea sp. n., S. ochraceola sp. n., S. plumbeoviridis sp. n., S. plumbeobrunnea sp. n., S. cucullata sp. n., S. asymmetrica sp. n., S. acontioides sp. n., S. rectilinoides sp. n., S. uncata sp. n. and S. assimilina sp. n.) are described from China. Four species (S. albistriata Kononenko Ronkay, S. glaucescens (Hampson), S. rectilinea Yoshimoto, and S. brunnescens Kononenko Ronkay) are reported to China for the first time; S. nora Kononenko Ronkay is firstly reported for the continental China. The female genitalia of five species (S. albistriata, S. brunnescens, S. plumbeoculata Pekarsky, Dvořák G. Ronkay, S. motuoensis Han Lu and S. acutivalva Han Kononenko) are described and illustrated for the first time. New data on distribution in China for four species are provided. All treated species are illustrated in colour with black and white photographs of their genitalia in 56 figures. The updated global checklist of the genus Stenoloba with marking of Chinese species is presented.

[Ryan index for detection of laryngopharyngeal reflux diseases]

Objective: To explore the utility of pharyngeal pH monitoring which positive standard is Ryan index in diagnosis of laryngopharyngeal reflux disease. Methods: In a retrospective study, clinical data of 590 patients who had symptoms laryngopharyngeal reflux disease from February 2016 to March 2017 were analyzed. All patients were received electronic laryngoscopy, assessment of reflux symptom index(RSI) and reflux finding score(RFS), and pharyngeal pH monitoring. SPSS 19.0 software was used to analyze the date. Results: There were 94 patients whose Ryan index were positive(15.93%). Among the 94 patients, 70 were positive during upright, 12 during supine and 12 during both upright and supine. There were 40 patients(6.78%)with pH decline events related to symptoms, while those Ryan index were normal. There were 536(90.85%), 417(70.68%), 233(39.49%) and 117(19.83%) patients with pH<6.5, pH<6.0, pH<5.5 and pH<5.0 events respectively. The positive rate of RSI, RFS, RSI and RFS, RSI or RFS were 44.24%, 16.78%, 7.12%, 53.90% respectively. The RFS score in Ryan index positive group was higher than that in Ryan index negative group[(8.2±2.4) vs (4.0±2.9), u=5.424, P<0.05], while the RSI score in Ryan index positive group was not statistically different from that in Ryan index negative group[(11.3±6.2) vs (12.7±5.8), t=1.247, P=0.167]. Conclusions: Pharyngeal pH monitoring is an objective and non-invasive method which can reflect laryngopharyngeal reflux directly. However, with the Ryan index as a criterion for the diagnosis of laryngopharyngeal reflux disease, partial patients may be missed. Further studies are needed to obtain more accurate and objective laryngopharyngeal pH statistical index for diagnosis of laryngopharyngeal reflux disease.

[PM2.5 and polluted gas exposure induced acute injury in rats'larynx membrane]

Objective:To study acute injury of rat's larynx membrane which were exposured to PM2.5 and polluted gas in serious air pollution. Method:Rats were divided into 3 groups of 5 animals each, the normal control group, gas exposured group, PM2.5 +gas exposured group. The control group served as the normal healthy control, rats of the gas exposured group had been exposured polluted gas in the A cabin, rats of PM2.5 +gas exposured group had been exposured PM2.5 and polluted gas in the B cabin. The total exposure time was six days. We collected specimen from 3 groups immediately after exposure. Histopathological changes in the rat's larynx membrane were assessed using hematoxylin and eosin staining(HE), the expression of IL-1β in laryngeal mucous membrane were assessed using immunohistochemical staining(IHC), and the ultrastructure changes were observed under TEM. Result:HE staining showed the rat's laryngeal mucosa cells in the normal control group had no obvious abnormalities, laryngeal mucosa of rats in the two experimental group had different degrees of cell proliferation, cell polarity change, etc. IHC staining showed that there's no obvious expression of IL-1β in laryngeal mucous membrane in the normal control group, and positive expression in the two experimental group. TEM showed the control group had no obvious abnormalities, the laryngeal mucosa cells in the two groups of experimental groups had been found irregular nucleus and damaged mitochondria. Conclusion:Exposed to PM2.5 and polluted gas in severe atmospheric pollution 6 days, the acute damage in rats laryngeal mucosa can be observed.

A replacement name for <i>Flavala</i> Behounek, Han &amp; Kononenko, 2012 (Lepidoptera: Noctuidae: Pantheinae)

The genus name Flavala Behounek, Han & Kononenko, 2012 (homonym nov.) must be replaced by Mooreia nomen nov. because Flavala is preoccupied by Flavala Berio, 1966, the junior synonym of Thioptera Franclemont, 1950, the Nearctic Eustrotiinae genus (Lepidoptera, Noctuidae, Eustrortiinae). The name Mooreia is dedicated to Frederic Moore, the famous British lepidopterologist of the nineteenth century, the explorer of the Oriental fauna, described many Lepidoptera taxa including Acronycta flavala Moore, 1867.

A review of the genus Atrovirensis Kononenko, 2001 with description of four new species from China (Lepidoptera, Noctuidae: Xyleninae, Apameini)

The genus Atrovirensis Kononenko, 2001 is reviewed. Four new species (Atrovirensis parannamita sp. n., Atrovirensis furcatus sp. n., Atrovirensis sacculatus sp. n. and Atrovirensis miraculosus sp. n.) are described from China. A new combination Atrovirensis euplexina (Draudt, 1950), comb. n. [Valeria] is proposed. Two taxa of uncertain status (Atrovirensis sp. cf. parannamita and Atrovirensis sp. cf. furcatus) are included to the review. The updated checklist of the genus is presented. All taxa of the genus Atrovirensis are illustrated in colour with black and white photographs of their genitalia in 48 figures.

A revision of the genus Tambana Moore, 1882 with description of eight new species and one subspecies (Lepidoptera, Noctuidae: Pantheinae). Revision of Pantheinae, contribution XIII

The oriental Pantheinae genus Tambana Moore, 1882 (type-species Tambana variegata Moore, 1882) with 16 previously described species is revised. Eight new species and one subspecies (T. tibetica sp. n., T. xilinga sp. n., T. mekonga sp. n., T. helmuti sp. n., T. fansipana sp. n., T. laura sp. n., T. indeterminata sp. n., T. annamica sp. n., T. annamica stumpfi ssp. n.) are described from China, Vietnam and Myanmar. One unrecognized taxon is included to the revision. Three new synonyms and one new combination are introduced (Trisuloides klapperichii Mell 1958, syn. n. of Tambana entoxantha (Hampson, 1894); Tambana behouneki Speidel & Kononenko, 1998, syn. n. of Tambana glauca (Hampson, 1898); Trichosea gerryi Thöny, 1996, syn. n. of Tambana funebris (Berio, 1973), comb. n. (Trichosea). The updated checklist of 26 taxa of Tambana is presented. Short diagnoses are given for the described species. In addition the related genus Xanthomantis Warren, 1909 with two species X. cornelia (Staudinger, 1888) and X. contaminata (Draudt, 1937) is reviewed.

A new species and two new combinations in the genus Strotihypera Kononenko & Han, 2011 (Lepidoptera, Noctuidae, Noctuinae: Elaphriini). A postscript to the description of the genus Strotihypera

Elaphriini is a small tribe of the subfamily Noctuinae with predominantly New World distribution. Only three genera, Elaphria Hübner, 1818 with four species, Galgula Guenée, 1852 with one species (Fibiger & Hacker 2010) and Strotihypera Kononenko & Han, 2011 with one species are known from the Eurasia. The majority of species occurs in tropical and subtropical regions. The review of Eurasian Elaphriini with description of the new genus Strotihypera has recently been published by Kononenko & Han (2011). In the subsequent years in the result of intensive collecting in South West China we found a new species allied to Strotihypera flavipuncta (Leech, 1889) and two related species Strotihypera ochreipuncta (Wileman, 1914), comb. n. and "Hyperstrotia" macroplaga (Hampson, 1907), comb. n. The description of a new species and the review of two of its allies are presented here as a postscript to the description of the genus Strotihypera (Kononenko & Han 2011).

A revision of the genus Belciana Walker, 1862 with description of three new species (Lepidoptera, Noctuidae: Pantheinae) from East and South East Asia. Revision of Pantheinae, contribution XII

The Oriental Pantheinae genus Belciana Walker, 1862 is revised. Three new species, B. hreblayi sp. n., B. sulawesiana sp. n., B. pinratanai sp. n., from Taiwan, Indonesia and Thailand, are described. Five new combinations in the genus Diphteroides Bethune-Baker, 1906 are proposed: Diphteroides caerulea (Hampson, 1926) comb. n., D. habroscia (Prout, 1924) comb. n., D. patricolor (Prout, 1924) comb. n., D. serrata Bethune-Baker, 1906, D. subserrata (Prout, 1924) comb. n. and D. sophronia (Prout, 1924) comb. n. The extensive diagnoses of known species of Belciana are given. The imagines, male and female genitalia are illustrated. The checklist of the genus Belciana in East Asia is presented.

Two new genera and one new species of Pantheinae from East Asia (Lepidoptera, Noctuidae: Pantheinae). Revision of Pantheinae, contribution XI

Two new genera, Pantheaforma gen. n. (Type-species Pantheaforma ihlei sp. n.) and Chrisotea gen. n. (Type-species Trichosea zhangi Chen, 1990) from East Asia and a new species Pantheaforma ihlei sp. n. from Thailand and Myanmar are described. New combination Chrisotea zhangi (Chen, 1990), comb. n. is proposed. New taxa are illustrated with imagines in colour and male and female genitalia. The little-known species Pantheana yangzisherpana Hreblay, 1998, formerly only known from Nepal is reported for China for the first time. 

Revision of the Old World genera Panthea Hübner, [1820] 1816 and Pantheana Hreblay, 1998 with description two new species from China (Lepidoptera, Noctuidae: Pantheinae). Revision of Pantheinae, contribution IX

The Old World species of the genus Panthea Hübner [1820] 1816 are revised. The article contains the description of two new species Panthea fuscogrisea sp. n. and Panthea florianii sp. n. from continental China and re-description of two species P. roberti Joannis 1928 and P. grisea Wileman, 1919 with illustration of male and female genitalia. Diphthera hoenei Draudt, 1950 (syn. n.) is synonymised with P. roberti Joannis 1928. The species Panthea ronnyi Thony, 1996 is excluded from the genus Panthea. Lectotypes for Diphthera hoenei and Panthea roberti are designated. The genus includes five species in the Old World, distributed mainly in Sino-Himalayan subregion of the Palaearctic. A checklist of species of the genus Panthea is presented. The little-known genus Pantheana Hreblay, 1998 with the sole species Pantheana yangzisherpana Hreblay, 1998 is reviewed. The imagines, male and female genitalia of all Old World species of Panthea and Pantheana are illustrated.

Mammographic densities and the prevalence and incidence of histological types of benign breast disease. Reference Pathologists of the Canadian National Breast Screening Study

There is now a large amount of evidence indicating that women with extensive areas of mammographic densities are 4-6 times more likely to develop breast cancer than those with little or no density in the mammogram. We have examined one potential biological explanation for this association by estimating the incidence of various histological types of benign breast disease in relation to mammographic density. We studied the large cohort of women taking part in the National Breast Screening Study (NBSS), a randomized trial of screening with mammography. Mammograms from subjects with biopsies (n = 423) and from a comparison group of subjects randomly selected from the NBSS (n = 465) were included. Histological slides from biopsied subjects (n = 353) were classified independently by the pathologists of the NBSS and by a review pathologist (H.M.J.). Mammographic density in more than 75% of the breast area was associated with an increased risk of incidence of hyperplasia without atypia, and of atypical hyperplasia and/or carcinoma in situ. The classifications of the review pathologist showed that, compared to women with no density, the relative risk of incident lesions for women with density in more than 75% of breast was 13.85 (95% CI 2.65-72.49) for hyperplasia, and 9.23 (95% CI 1.66-51.48) for atypical hyperplasia and/or carcinoma in situ. These findings suggest that the association between extensive mammographic density and breast cancer risk may, at least in part, be attributable to biological processes in the breast that give rise to these histological features that are known to be related to breast cancer risk.

Distinct selectin ligands on colon carcinoma mucins can mediate pathological interactions among platelets, leukocytes, and endothelium

Selectins are adhesion molecules that mediate calcium-dependent cell-cell interactions among leukocytes, platelets, and endothelial cells. The naturally occurring vascular ligands for the selectins are mostly mucin-type glycoproteins. Increased expression and altered glycosylation of mucins are known to be prominent features of carcinoma progression. We have previously shown that all three selectins bind to colon carcinoma cell lines in a calcium-dependent fashion and that carcinoma growth and metastasis formation are attenuated in P-selectin-deficient mice. Here we show that the three recombinant soluble selectins recognize ligands within primary colon carcinoma tissue samples. Affinity chromatography showed that the ligands for all three selectins are O-sialoglycoprotease-sensitive mucins that are recognized in a calcium- and sialic acid-dependent manner. Furthermore, there are separate binding sites on the mucins for each selectin, allowing cross-binding of a single mucin molecule by more than one selectin. We also show that the selectin ligands on purified carcinoma mucins can mediate at least four different pathological interactions among platelets, leukocytes, and endothelial cells. These findings could explain some of the adhesive events of blood-borne tumor cells reported to occur with leukocytes, platelets, and endothelial cells, which are believed to play a part in modulating some early events in tumor metastases.

Inhibition of L- and P-selectin by a rationally synthesized novel core 2-like branched structure containing GalNAc-Lewisx and Neu5Acalpha2-3Galbeta1-3GalNAc sequences

The selectins interact in important normal and pathological situations with certain sialylated, fucosylated glycoconjugate ligands containing sialyl Lewisx(Neu5Acalpha2-3Galbeta1-4(Fucalpha1-3)GlcN Ac). Much effort has gone into the synthesis of sialylated and sulfated Lewisxanalogs as competitive ligands for the selectins. Since the natural selectin ligands GlyCAM-1 and PSGL-1 carry sialyl Lewisxas part of a branched Core 2 O-linked structure, we recently synthesized Galbeta1-4(Fucalpha1-3)GlcNAcbeta1-6(SE-3Galbeta1++ +-3)GalNAc1alphaOMe and found it to be a moderately superior ligand for L and P-selectin (Koenig et al. , Glycobiology 7, 79-93, 1997). Other studies have shown that sulfate esters can replace sialic acid in some selectin ligands (Yeun et al. , Biochemistry, 31, 9126-9131, 1992; Imai et al. , Nature, 361, 555, 1993). Based upon these observations, we hypothesized that Neu5Acalpha2-3Galbeta1-3GalNAc might have the capability of interacting with L- and P-selectin. To examine this hypothesis, we synthesized Galbeta1-4(Fucalpha1-3)GlcNAcbeta1-6(Neu5Acalpha2++ +-3Galbeta1-3)-GalNAc alpha1-OB, which was found to be 2- to 3-fold better than sialyl Lexfor P and L selectin, respectively. We also report the synthesis of an unusual structure GalNAcbeta1-4(Fucalpha1- 3)GlcNAcbeta1-OMe (GalNAc-Lewisx-O-methyl glycoside), which also proved to be a better inhibitor of L- and P-selectin than sialyl Lewisx-OMe. Combining this with our knowledge of Core 2 branched structures, we have synthesized a molecule that is 5- to 6-fold better at inhibiting L- and P-selectin than sialyl Lewisx-OMe, By contrast to unbranched structures, substitution of a sulfate ester group for a sialic acid residue in such a molecule resulted in a considerable loss of inhibition ability. Thus, the combination of a sialic acid residue on the primary (beta1-3) arm, and a modified Lexunit on the branched (beta1-6) arm on an O-linked Core 2 structure generated a monovalent synthetic oliogosaccharide inhibitor superior to SLexfor both L- and P-selectin.

DNA aptamers block L-selectin function in vivo. Inhibition of human lymphocyte trafficking in SCID mice

Selectins participate in the initial events leading to leukocyte extravasation from the blood into tissues. Thus the selectins have generated much interest as targets for antiinflammatory agents. Therapeutic molecules based on the monomeric carbohydrate ligand sialyl Lewis X (SLe(X)) have low affinities and are not specific for a given selectin. Using SELEX (Systematic Evolution of Ligands by EXponential Enrichment) technology, we have generated aptamers specific for L-selectin that require divalent cations for binding and have low nanomolar affinity. In vitro, the deoxyoligonucleotides inhibit L-selectin binding to immobilized SLe(X) in static assays and inhibit L-selectin-mediated rolling of human lymphocytes and neutrophils on cytokine-activated endothelial cells in flow-based assays. These aptamers also block L-selectin-dependent lymphocyte trafficking in vivo, indicating their potential utility as therapeutics.

Calcium-dependent oligonucleotide antagonists specific for L-selectin

The selectins are calcium-dependent C-type lectins that recognize complex anionic carbohydrate ligands, initiating many cell-cell interactions in the vascular system. Selectin blockade shows therapeutic promise in a variety of inflammatory and postischemic pathologies. However, the available oligosaccharide ligand mimetics have low affinities and show cross-reaction among the three selectins, precluding efficient and specific blockade. The SELEX (systematic evolution of ligands by exponential enrichment) process uses combinatorial chemistry and in vitro selection to yield high affinity oligonucleotides with unexpected binding specificities. Nuclease-stabilized randomized oligonucleotides subjected to SELEX against recombinant L-selectin yielded calcium-dependent antagonists with approximately 10(5) higher affinity than the conventional oligosaccharide ligand sialyl LewisX. Most of the isolated ligands shared a common consensus sequence. Unlike sialyl LewisX, these antagonists show little binding to E- or P-selectin. Moreover, they show calcium-dependent binding to native L-selectin on peripheral blood lymphocytes and block L-selectin-dependent interactions with the natural ligands on high endothelial venules.

The human sperm acrosome reaction does not depend on arachidonic acid metabolism via the cyclooxygenase and lipoxygenase pathways

The objective of this study was to determine whether the metabolism of arachidonic acid via the cyclooxygenase pathway, the lipoxygenase pathway, or both has a pivotal role in the human sperm acrosome reaction. To do so, the stimulatory effect of arachidonic acid and a number of its metabolites, as well as the inhibitory effect of cyclooxygenase and lipoxygenase inhibitors on the acrosome reaction, was evaluated. Arachidonic acid, prostaglandin E2, and prostacyclin (PGI2) induced the acrosome reaction when added to 3-hour preincubated (capacitated) spermatozoa. The arachidonic acid-induced acrosome reaction was dependent upon extracellular calcium. Leukotriene B4 and 15-HPETE only induced the acrosome reaction when present throughout the preincubation period, indicating that they may enhance the capacitation process rather than the acrosome reaction. Thromboxane did not affect the acrosome reaction under any of the conditions tested. Inhibitors of cyclooxygenase (indomethacin, phenylbutazone) and lipoxygenase (phenidone, nordihydroguiaretic acid) or FPL 55712 (a leukotriene antagonist) did not prevent the arachidonic acid-stimulated acrosome reaction. Furthermore, 5, 8, 11, 14-eicosatetraynoic acid (ETYA), the acetylenic analog of arachidonic acid that inhibits arachidonic acid metabolism, induced an acrosome reaction equivalent to that of arachidonic acid. These results strongly suggest that the acrosome reaction induced by exogenous arachidonic acid is not mediated via either the cyclooxygenase pathway or the lipoxygenase pathway.(ABSTRACT TRUNCATED AT 250 WORDS)

Relationship between mammographic and histological risk factors for breast cancer

BACKGROUND

Information on breast cancer risk can be obtained both from the histological appearance of the breast epithelium in biopsy specimens and from the pattern of parenchymal densities in the breast revealed by mammography. It is not understood, however, how parenchymal densities influence breast cancer risk or whether these densities are associated with histological risk factors.

PURPOSE

We have estimated, in a large cohort of women, the relative risk of detecting carcinoma in situ, atypical hyperplasia, hyperplasia without atypia, or nonproliferative disease in biopsy specimens from women with different extents of mammographic density. We also examined the association between these histological classifications and radiological features present specifically at the biopsy site.

METHODS

The source of study material was a population of women aged 40-49 years who were enrolled in the Canadian National Breast Screening Study (NBSS). Mammograms from women who had undergone a biopsy (n = 441) and from a comparison group of women (n = 501) randomly selected from the mammography arm of the NBSS were classified according to the extent of mammographic density. The corresponding histological slides were independently classified by a review pathologist.

RESULTS

Compared with women showing no mammographic densities, women with the most extensive densities (i.e., occupying greater than 75% of the breast volume) had a 9.7 times greater risk of developing carcinoma in situ or atypical hyperplasia (95% confidence interval [CI] = 1.75-53.97), a 12.2 times greater risk of developing hyperplasia without atypia (95% CI = 2.97-50.14), and a 3.1 times greater risk of developing non-proliferative disease (95% CI = 1.20-8.11). The gradients in risk were not monotonic across the five classifications of mammographic density. The association could not be explained by the presence of mammographic densities at the biopsy site, but calcification at the biopsy site was strongly associated with high-risk histological changes (relative risk = 24; 95% CI = 5.0-156.0).

CONCLUSIONS

These results suggest that the radiological patterns referred to as mammographic dysplasia may influence breast cancer risk by virtue of their association with high-risk histological changes in the breast epithelium.

IMPLICATIONS

Identification of the factors responsible for high-risk histological changes may offer new insights into the etiology of breast cancer and potentially lead to the development of methods for its prevention.

Modulation of the human sperm acrosome reaction by effectors of the adenylate cyclase/cyclic AMP second-messenger pathway

The acrosome reaction of spermatozoa appears to be analogous to various somatic cell exocytotic events which involve cascade reactions, i.e., transmission of an external signal across the cell membrane resulting in activation of an "amplifier" enzyme and the generation of a second messenger. Using a synchronous acrosome reaction system (De Jonge et al., J. Androl., 10:232-239, '89a), it was found that analogues of the second-messenger cAMP, dibutyryl cAMP (dbcAMP) and 8-bromo cAMP, stimulated the acrosome reaction of capacitated spermatozoa. Additionally, treatment of spermatozoa with either xanthine or non-xanthine phosphodiesterase inhibitors induced a significant (P less than 0.05) increase in the percent acrosome reaction after a period of capacitation in comparison to untreated controls. These results indicate that analogues of cAMP or inhibitors which prevent cAMP hydrolysis can induce the human sperm acrosome reaction. Subsequent experiments were conducted to test whether the amplifier enzyme in the cascade reaction, adenylate cyclase, has a role in the acrosome reaction. Forskolin, an adenylate cyclase stimulator, caused a significant (P less than 0.01) increase in the percent acrosome reaction in comparison to controls. Modulators of adenylate cyclase--adenosine, 2'-0-methyladenosine, and 2',3'-dideoxyadenosine--significantly (P less than 0.01) inhibited the forskolin-induced acrosome reaction. dbcAMP was able to overcome the inhibition by adenosine. Two inhibitors of protein kinase A, the Walsh inhibitor and H-8, caused a significant (P less than 0.01) inhibition of the dbcAMP-induced acrosome reaction. Finally, in the absence of extracellular calcium, dbcAMP induced a significant (P less than 0.01) increase in the acrosome reaction in contrast to A23187. These results suggest that: 1) a molecular mechanism for the human sperm acrosome reaction involves the cAMP second-messenger system; i.e., activation of adenylate cyclase, the amplifier enzyme that produces cAMP, production of cAMP as a second messenger, and activation of cAMP-dependent kinase A; and that 2) activation of adenylate cyclase occurs after calcium influx.

Effect of phorbol diesters, synthetic diacylglycerols, and a protein kinase C inhibitor on the human sperm acrosome reaction

The acrosome reaction of spermatozoa may be analogous to various somatic cell exocytotic events that incorporate cascade reactions. One such cascade system involves the hydrolysis of a membrane-bound phospholipid; generation of the intracellular second messenger, diacylglycerol; and activation of protein kinase C, followed by the phosphorylation of a number of intracellular proteins. Stimulators of protein kinase C, phorbol diesters and synthetic diacylglycerols, were evaluated to determine if this system functions in the human sperm acrosome reaction. Phorbol 12-myristate 13-acetate and 4 beta-phorbol 12,13-didecanoate caused a significant (P less than 0.01) increase in the acrosome reaction of capacitated spermatozoa. Conversely, an inactive phorbol diester had no significant (P greater than 0.05) stimulatory effect on the acrosome reaction. The synthetic diacylglycerols, 1-oleoyl-2-acetyl-sn-glycerol, 1,2-dioctanoyl-sn-glycerol, and 1,2-dioleoyl-sn-glycerol caused a significant (P less than 0.01) increase in the acrosome reaction of capacitated spermatozoa, and to a similar extent as the phorbol diesters. A nonactivating isomer of 1,2-dioleoyl-sn-glycerol, 1,3-diolein, had no significant (P greater than 0.05) stimulatory effect on the acrosome reaction. Protein kinase C activation is a diacylglycerol-dependent and Ca2(+)-dependent process, and stimulation of the acrosome reaction by 1,2-dioctanoyl-sn-glycerol required the presence of calcium ions in the capacitation medium. An inhibitor of protein kinase C, 1-(5-isoquinolinylsulfonyl)-2-methylpiperazine (H-7), prevented the diacylglycerol-induced acrosome reaction (P less than 0.01). These results support the hypothesis that protein kinase C, via activation by the intracellular second messenger diacylglycerol, has a role in the human sperm acrosome reaction.

Inhibition of the human sperm acrosome reaction by a high molecular weight factor from human seminal plasma

Human seminal plasma possesses a factor (acrosome reaction-inhibitory factor) that is precipitated by high speed centrifugation and that inhibits the ionophore- and dbc AMP-induced acrosome reaction of capacitated human spermatozoa but only if it is added toward the end of the capacitation period. Acrosome reaction-inhibitory factor can be partially purified by cation exchange chromatography and appears to differ from another factor that can be obtained by ultracentrifugation of human seminal plasma and that prevents the fertilization of mouse gametes.