The generation of genuine quadripartite Einstein-Podolsky-Rosen steering in an optical superlattice

Einstein-Podolsky-Rosen (EPR) steering is a quantum effect based on quantum entanglement and it is the key resource for building quantum networks because of its useful properties. Based on the criterion for genuine multipartite EPR steering, the genuine quadripartite EPR steering is confirmed and it can be generated by a spontaneous parametric down-conversion cascaded process with two sum-frequency generations in an optical superlattice. This occurs either below the oscillation threshold and without oscillation threshold. The influence of the parameters of cascaded nonlinear process on the quadripartite EPR steering among signal, idler, and two sum-frequency beams are also discussed. Choosing appropriate nonlinear parameters can achieve good quadripartite quantum steering. This scheme of the generation of genuine quadripartite EPR steering has potential applications in quantum communication and computing.

Cardiopulmonary Protection for Bilateral Breast Irradiation: A Dosimetric Comparison between Proton and Photon Plans

PURPOSE/OBJECTIVE(S)

Recent advances in cancer treatment improve cancer survivorship. Cardiovascular disease has become the leading cause of non-cancer death in breast cancer survivors. Therefore, risk of cardiopulmonary toxicities during multimodality treatment should be assessed carefully. It remains to be defined the best scenario for proton therapy to confer meaningful cardiovascular protection in the setting of breast irradiation. We hypothesized proton therapy plan provides optimal cardiopulmonary protection during bilateral breast irradiation. The study aimed to compare cardiopulmonary dosimetric parameters of proton and photon radiotherapy plans.

MATERIALS/METHODS

We conducted a retrospective study and patients with bilateral breast cancer indicated for radiotherapy between January 01, 2010 and December 31, 2020 were included. All patients received whole breast or chest wall irradiation with or without regional nodal irradiation. The dose scheme was 50-50.4 Gy in 25-28 fractions. Boost was allowed if patients receiving breast conserving surgery or known risk factors. The dosimetric parameters included planning target volume, mean dose to the heart, the volume of whole lung receiving 5 Gy, 10 Gy, and 20 Gy. For photon therapy, volumetric modulated arc therapy using double partial arc plans was generated with Pinnacle 9.8, Elekta Synergy and tomotherapy helical plan was generated with Tomo Hi-Art planning system. For proton therapy, treatment planning was generated with Ray station 9A. All data was managed using SAS v.9.4 software. Analysis of variance (α = 0.05) was used to compute the dosimetry of different treatment modalities. The statistical significance was considered with a p-value <0.05.

RESULTS

Thirty-one patients with bilateral breast cancer were included, including 12 bilateral breast irradiation patients and 6 bilateral chest wall irradiation patients. The mean dose of heart was 53.0±43.3 cGy in proton therapy while 736.6±225.1 cGy and 869.67±241.0 cGy in Tomotherapy and volumetric modulated arc therapy respectively. The volume of whole lung receiving 5 Gy was 15.4±7.91% in proton therapy while 46.1±10.8% and 46.3±2.5% in Tomotherapy and volumetric modulated arc therapy respectively. The volume of whole lung receiving 20 Gy was 7.7±4.3% in proton therapy while 15.4±5.6% and 19±3.5% in Tomotherapy and volumetric modulated arc therapy respectively. The effects of cardiopulmonary protection were more significant for chest wall irradiation over breast irradiation.

CONCLUSION

Proton radiotherapy provided significant dose reduction for bilateral breast irradiation. The benefit is more significant is patients receiving bilateral chest wall irradiation. Further clinical validations will be warranted to confirm the clinical relevance of the finding.

Analysis of Skin Dose and Position Stability for a New Personalized Device for Breast Radiotherapy

PURPOSE/OBJECTIVE(S)

Whole breast irradiation is the standard treatment for patients with early-stage breast cancer. We previously developed a personalized breast support device (PERSBRA) that reduced heart and lung radiation exposure. However, the skin dose was concerned for the device due to its thickness. In this study, we designed the new honeycomb structures to reduce the dose to the skin and maintain stable breast position with this device.

MATERIALS/METHODS

Three different structures of PERSBRA were designed. They were solid structure, honeycomb structures with 3.5 mm wall thickness and honeycomb structures with 4.5 mm wall thickness respectively. Those patients who scheduled to receive whole breast irradiation were enrolled for anthropometric breast position analysis. Stability of breast position in supine with PERSBRA were analyzed by scanning with a 3D infrared scanner. The distances between the nipples, between the nipple and the xiphoid process, and between the nipple and the inframammary fold were used to be the index. 32 patients were enrolled for anthropometric breast position analysis. The skin dose was simulated using the thermoluminescent dosimeter (TLD) positioned on the phantom with PERSBRA in the treatment scenario.

RESULTS

The displacements between two nipples, the nipple and the infra mammary point, and the nipple and the xiphoid process were 1.4%, 1.2%, and 0.4% for 3.5 mm honeycomb structure. Meanwhile, these displacements were 0.8%, 0.7% and 0.2% for solid 10% structure. Compared to these results, there were no significant difference for the two designations. The surface dose simulating the treatment scenario were 78.27%, 89.39% and 91.9% of prescribed dose for the 3.5mm, 4.5 mm honeycomb structure and the solid 10% filled structure, respectively. The 3.5 mm honeycomb structure reduce the surface dose significantly compared to another two designations.

CONCLUSION

The honeycomb structures do not jeopardize mechanical properties of PERSBRA or the breast positional stability support. Moreover, honeycomb structure with 3.5 mm thickness effectively reduces skin surface dose on a breast phantom. These data encourage further clinical studies to investigate the effects of such design on radiation dermatitis during whole breast irradiation.

Using Body Composition Analysis for Improved Nutritional Intervention in Septic Patients: A Prospective Interventional Study

The study aimed to determine whether using body composition data acquired through bio-electrical impedance analysis (BIA) to adjust diet formulas could improve outcomes in septic patients. There were 132 septic patients in medical intensive care units enrolled in the prospective, randomized, double-blind, interventional study. For the intervention group, dietitians had access to BIA data for adjusting diet formulas according to body composition variables on days 1, 3, and 8. The patients were also stratified based on nutritional risk using the modified Nutrition Risk in Critically ill (mNUTRIC) score. Patients with intervention were more likely to achieve caloric and protein intake goals compared to the control group, especially in the low-risk group. The intervention did not significantly affect mortality, but the survival curves suggested potential benefits. The high-risk group had longer ICU stays and mechanical ventilation duration, which were mitigated by the intervention. Certain body composition variables (e.g., extracellular water to total body water ratio and phase angle) showed differences between high-risk and low-risk groups and may be related to patient outcomes. Non-invasive body composition assessment using BIA can help dietitians adjust diet formulas for critically ill septic patients. Body composition variables may be associated with sepsis outcomes, but further research with larger patient numbers is needed to confirm these findings.

[A case of malignant peritoneal mesothelioma]

Malignant mesothelioma is a highly malignant disease that most often occurs in the pleural cavity, followed by the peritoneum and pericardium. Malignant peritoneal mesothelioma (MPM) accounts for 10%-15% of all mesothelioma. The most important risk factor for MPM is exposure to asbestos. MPM has no specific clinical symptoms, imaging and histopathology are critical for the diagnosis. There are currently no generally accepted guidelines for curative treatment of MPM. The patient mainly presented with abdominal pain, abdominal distension and discomfort. Due to extensive omentum metastasis, no further surgical treatment was performed. Pemetrexed combined with cisplatin chemotherapy was given for 2 cycles, and the patient is still alive.

[Blood pressure control and influencing factors in hypertension patients with metabolic syndrome]

Objective: To investigate the blood pressure control and its influencing factors in hypertension patients with MS. Methods: Between January 2017 and December 2018, more than 78 000 residents aged 35-75 years selected through convenient sampling were invited to participant in China Patient-Centered Evaluative Assessment of Cardiac Event Million Persons Project in Fujian province, physical and laboratory tests were conducted for them, and their basic information were recorded. A total of 5 281 hypertension patients with MS were included in the study. Results: The treatment rate of hypertension patients with MS was 55.5%, and the control rate was 7.2%. The control rate was higher in patients who were older, women, had advanced education level, had history or family history of cardiovascular disease. The results of multivariate analysis indicated that living area (urban or rural), cardiovascular history, diabetes, urine protein, BMI had impacts on both treatment and control of hypertension. Family history of cardiovascular disease, age, self-management of hypertension, dyslipidemia, waist circumference and drinking had impacts on the treatments, and gender had effects on the control. Conclusions: The treatment rate of hypertension patients with MS was unsatisfactory and the control rate was low. Intervention should be strengthened in rural area, males and young age groups, and activity of self-management group of hypertension should be conducted regularly.

Multicentre study of the prognostic impact of preoperative bodyweight on long-term prognosis of hepatocellular carcinoma

BACKGROUND

Whether preoperative bodyweight is associated with long-term prognosis in patients after liver resection for hepatocellular carcinoma (HCC) is controversial. This study aimed to investigate the relationship of patient weight with long-term recurrence and overall survival (OS) after curative liver resection for HCC.

METHODS

Data for patients with HCC who underwent curative liver resection between 2000 and 2015 in five centres in China were analysed retrospectively in three groups according to their preoperative BMI: underweight (BMI 18·4 kg/m² or less), normal weight (BMI 18·5-24·9 kg/m² ) and overweight (BMI 25·0 kg/m² or above). Patients' baseline characteristics, operative variables and long-term survival outcomes were compared. Univariable and multivariable Cox regression analyses were performed to identify risk factors for OS and recurrence-free survival (RFS) after resection.

RESULTS

Of 1524 patients, 107 (7·0 per cent) were underweight, 891 (58·5 per cent) were of normal weight and 526 (34·5 per cent) were overweight. Univariable analyses showed that underweight and overweight patients had poorer OS (both P < 0·001) and RFS (both P < 0·001) than patients of normal weight. Multivariable Cox regression analysis also identified both underweight and overweight to be independent risk factors for OS (hazard ratio (HR) 1·22, 95 per cent c.i. 1·19 to 1·56, P = 0·019; and HR 1·57, 1·36 to 1·81, P < 0·001, respectively) and RFS (HR 1·28, 1·16 to 1·53, P = 0·028; and HR 1·34, 1·17 to 1·54, P < 0·001).

CONCLUSION

Underweight and overweight patients appear to have a worse prognosis than those of normal weight following liver resection for HCC.

[Clinical effects of pediatric penetrating keratoplasty for congenital corneal opacity]

Objective: To report the clinical results of pediatric penetrating keratoplasty (PKP) in patients under 3 years old with congenital corneal opacity. Methods: Retrospective study. Sixteen eyes of 12 patients who were treated with PKP in Aier Eye Hospital Group from June 2009 to December 2016 were enrolled in this study. All the patients were diagnosed as congenital corneal opacities: 8 cases (11 eyes) with Peter's anomaly I, 2 cases (3 eyes) with sclerocornea, and 2 cases (2 eyes) with corneal dermoid tumor combined with iris synechia. Seven cases (7 eyes) were under 1 year old. Eight cases (10 eyes) could not follow the light. Only 1 case (2 eyes) received PKP with extracapsular cataract extraction, and the others only had PKP. Postoperative examinations were performed more frequently than in adults, and sometimes general anesthesia was needed. Results: The follow-up period was from 8 months to 6 years (33.17±22.60 months). The postoperative visual acuity improvement was found in all eyes from 1 week to 1 month after surgery except a 3-year-old patient with corneal dermoid tumor with serious esotropia. All the surgeries were successful without intraoperative complications. Graft rejection occurred in 4 cases (4 eyes). The graft of a 33-month-old patient became semitransparent. The grafts of 2 cases under 1 year old were clear after drug therapy. And the vision of a 3-year-old patient with Peter anomaly improved obviously, but immune rejection occurred 2 years after surgery. The second PKP was performed, but rejection occurred again. Secondary glaucoma was found in the other eye early after operation; anti-glaucoma surgery failed, and the graft became cloudy. Graft infection associated with loosened sutures was observed in one case (2 eyes) of sclerocornea, and the second PKP failed. Conclusions: For the patients with congenital corneal opacities, there is often a noticeable visual improvement after PKP. Good postoperative care, appropriate amblyopia treatment and timely examination are the keys to success. (Chin J Ophthalmol, 2017, 53: 941-946).

[Estimation of underreporting rate of death cases in disease surveillance system of Fujian province using propensity score weighting method, 2012-2014]

Objective: To understand the underreporting of death cases and related factors in disease surveillance system of Fujian province. Methods: We carried out a field underreporting survey in 20 disease surveillance sites selected through stratified cluster random sampling during 2012-2014. The related factors of underreporting were analyzed by using logistic regression method. Propensity score weighting method was used to calculate the underreporting rate in different groups classified by year, urban/rural areas, gender, age and death cause variables. Results: The overall underreporting rate was 9.21%(95%CI: 9.06%-9.39%) after adjusting by propensity score weighting method. The underreporting rate was higher in rural area (11.55%, 95%CI: 11.30%-11.81%) than in urban area (6.64%, 95%CI: 6.50%-6.78%). The underreporting rate was highest in age group 0-14 years (36.29%, 95% CI: 34.23%-38.67%) and lowest in age group ≥65 years (7.91%, 95% CI: 7.78%-8.03%). The underreporting rate was higher in people died of perinatal disease, congenital anomalies and injury. Conclusion: The underreporting rates were different between different groups classified by urban/rural areas, age and death cause variables. Propensity score weighting method can be used to adjust underreporting rate of death cases in mortality surveillance in Fujian.

The effects of cleanroom noise intensity and frequency on physiological measures and subjective responses

BACKGROUND

Workplace noise exposure gains growing attention in high tech industry.

OBJECTIVE

This study investigated the noise effect on physiological and subjective responses in semiconductor manufacturing clean room environment.

METHODS

Twenty subjects including 10 males and 10 females completed all phases of the experiment. Each subject was asked to participate in four treatment combinations of two noise intensities [65 dB(A) and 80 dB(A)] × two frequency levels [high and low]. For each treatment condition, the subject was exposed to the specified noise condition in a sound proof cabin for one hour. The physiological measures included blood pressure and heart rate. The subjective measures included noise sensitivity, fatigue and annoyance.

RESULTS

The ANOVA results indicate that long-time noise exposure caused significant increase in blood pressure (p< 0.001). Furthermore, the noise intensity by time interaction effect was found to be significant on annoyance and fatigue.

CONCLUSIONS

The findings suggest that prolonged exposure to noise intensity at 80 dB(A) would result in a significant increase in physiological cost and subjective discomfort feeling. Thus, some countermeasures should be taken to reduce noise exposure and to promote health, and quality of working life.

The Topoisomerase 1 Inhibitor Austrobailignan-1 Isolated from Koelreuteria henryi Induces a G2/M-Phase Arrest and Cell Death Independently of p53 in Non-Small Cell Lung Cancer Cells

Koelreuteria henryi Dummer, an endemic plant of Taiwan, has been used as a folk medicine for the treatment of hepatitis, enteritis, cough, pharyngitis, allergy, hypertension, hyperlipidemia, and cancer. Austrobailignan-1, a natural lignan derivative isolated from Koelreuteria henryi Dummer, has anti-oxidative and anti-cancer properties. However, the effects of austrobailignan-1 on human cancer cells have not been studied yet. Here, we showed that austrobailignan-1 inhibited cell growth of human non-small cell lung cancer A549 and H1299 cell lines in both dose- and time-dependent manners, the IC₅₀ value (48 h) of austrobailignan-1 were 41 and 22 nM, respectively. Data from flow cytometric analysis indicated that treatment with austrobailignan-1 for 24 h retarded the cell cycle at the G2/M phase. The molecular event of austrobailignan-1-mediated G2/M phase arrest was associated with the increase of p21^Waf1/Cip1 and p27^Kip1 expression, and decrease of Cdc25C expression. Moreover, treatment with 100 nM austrobailignan-1 for 48 h resulted in a pronounced release of cytochrome c followed by the activation of caspase-2, -3, and -9, and consequently induced apoptosis. These events were accompanied by the increase of PUMA and Bax, and the decrease of Mcl-1 and Bcl-2. Furthermore, our study also showed that austrobailignan-1 was a topoisomerase 1 inhibitor, as evidenced by a relaxation assay and induction of a DNA damage response signaling pathway, including ATM, and Chk1, Chk2, γH2AX phosphorylated activation. Overall, our results suggest that austrobailignan-1 is a novel DNA damaging agent and displays a topoisomerase I inhibitory activity, causes DNA strand breaks, and consequently induces DNA damage response signaling for cell cycle G2/M arrest and apoptosis in a p53 independent manner.

Abstract 2726: RET fusions identified in colorectal cancer PDX models are sensitive to the potent RET inhibitor ponatinib

Background: Chromosomal translocations resulting in formation of activating RET fusion genes have been identified in papillary thyroid cancer and 1-2% of NSCLC. We have previously shown that ponatinib, a pan-BCR-ABL and multi-targeted tyrosine kinase inhibitor (TKI), potently inhibits the most common NSCLC fusion variant, KIF5B-RET, at clinically-achievable concentrations. Here we used patient-derived (PDX) tumor models to explore the potential involvement of RET fusions, and the efficacy of ponatinib, in other cancers.

Results: To identify potential RET fusion-positive PDX tumor models, we examined RET mRNA levels in 273 PDX tumors (Crown Bioscience) from various cancer types, looking for models with outlier RET expression. To search for RET fusions, we performed RNAseq on 4 tumors that had the highest RET levels. Interestingly, RET fusions were detected in tumors from 2 colorectal cancer (CRC) patients (pts) and not in tumors from 2 NSCLC pts that expressed similar levels of RET. The fusions detected in CRC pts, NCOA4-RET and CCDC6-RET, had previously been observed in NSCLC pts. Both CRC tumors were negative for other major hotspot mutations, including KRAS, BRAF and PI3K, suggesting that these RET-fusions might be primary oncogenic drivers in these tumors. To evaluate the cellular activity of ponatinib, we generated cell lines that were dependent on the activity of these fusions. Ponatinib potently inhibited the viability of Ba/F3 cells expressing NCOA4-RET and CCD6-RET with IC50s of 6 and 22 nM, respectively. Consistent with these effects being due to inhibition of RET, ponatinib inhibited RET phosphorylation with similar potency. Other TKIs with RET activity, vandetanib (IC50s: 564-1000 nM), cabozantinib (60-386 nM), sunitinib (277-584 nM), sorafenib (105-494 nM), and lenvatinib (68-257 nM), also inhibited viability of the Ba/F3 lines, but with potencies substantially reduced compared to ponatinib. Finally, we examined the efficacy of ponatinib in the RET fusion positive PDX colorectal models, compared to 2 RET fusion negative colorectal models. In the RET-negative models, daily oral dosing of ponatinib (20 mg/kg) inhibited tumor growth by 24-41%. In contrast, ponatinib exhibited much greater efficacy in the RET-fusion positive models, inhibiting tumor growth by 79% in the NCOA4-RET model and inducing near complete regression in the CCDC6-RET model.

Conclusion: We identified, for the first time, oncogenic RET fusions in CRC patient samples, suggesting RET may be a driver in a subset of CRC patients. Ponatinib effectively inhibited these fusions with potency substantially exceeding that of other RET inhibitors and demonstrated significant anti-tumor activity in PDX models. These results provide strong support for the clinical evaluation of ponatinib in patients with RET-fusion positive cancers, including colorectal cancer.

Citation Format: Joe M. Gozgit, Tzu-Hsiu Chen, Tim Clackson, Victor M. Rivera. RET fusions identified in colorectal cancer PDX models are sensitive to the potent RET inhibitor ponatinib. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2726. doi:10.1158/1538-7445.AM2014-2726

Changes in graves' ophthalmopathy after radioiodine and anti-thyroid drug treatment of Graves' disease from 2 prospective, randomized, open-label, blinded end point studies

AIMS

A significant association between radioiodine therapy (RIT) and the development or the worsening of pre-existing Graves' ophthalmopathy (GO) has been reported. This post-hoc analysis of 2 studies attempted to describe the changes observed in pre-existing or new-onset GO following RIT with the goal of euthyroidism rather than hypothyroidism and to describe the relationship GO changes and the final outcome.

PATIENTS AND METHODS

In 2 prospective, randomized open-label blinded endpoint trials, patients received radioiodine alone; or, patients received radioiodine or antithyroid drug therapy (ATD). The severity and activity of GO were assessed during a 9-12-year follow-up. The study end points in study 1 were euthyroidism, hyperthyroidism, hypothyroidism, and changes in GO. In study 2, the end points were euthyroidism, hyperthyroidism, hypothyroidism, relapse, and changes in GO.

RESULTS

Both RIT and ATD were associated with worsening GO and new-onset GO. Both RIT and ATD led to similar aggravation of pre-existing GO or the development to new-onset GO. After RIT or ATD, the euthyroid patients (without levothyroxine substitution) demonstrated an improvement in GO, with 78-89% patients with preexisting GO exhibiting improvement, whereas hyperthyroid, hypothyroid and relapsed patients had worsening or new-onset GO.

CONCLUSIONS

Thyroid function is a dominant risk factor. Thyroid function may be the most important determinant in worsening or new-onset GO in both the natural disease course and in treated patients, independent of the kind of treatment. Therefore, we recommend euthyroidism as a goal of treatment.

Abstract B266: Ponatinib, a potent KIT inhibitor, suppresses the emergence of secondary resistance mutations in a gastrointestinal stromal tumor (GIST) model system

Background: Approximately 80% of GISTs contain primary activating mutations in KIT, the majority of which cluster in exon 11. Imatinib is approved for treatment of metastatic and/or unresectable GIST; however patients often relapse due to the acquisition of secondary resistance mutations in KIT, typically located in the ATP-binding pocket or activation loop (A-loop). Sunitinib is approved for 2nd line treatment, but does not effectively inhibit A-loop mutants. Ponatinib is a multi-targeted tyrosine kinase inhibitor (TKI) with potent activity against BCR-ABL that has been approved for treatment of CML and Ph+ ALL patients resistant or intolerant to prior TKIs. We have previously shown that ponatinib also potently inhibits both activated KIT and KIT containing imatinib- or sunitinib-resistance mutations, including those at the gatekeeper residue and within the A-loop. V654A was identified as the most recalcitrant mutant, although ponatinib was still capable of significantly inhibiting tumor growth in a V654A mouse model. To survey more broadly for mutations that might confer substantial resistance to ponatinib, an accelerated KIT mutagenesis screen was performed.

Results: Ba/F3 cells dependent on exon 11 mutant KIT (Δ557-8) were chemically mutagenized to introduce random mutations and grown in the presence of TKIs to identify secondary resistance mutations. Importantly, resistant clones that grew in the presence of imatinib or sunitinib recapitulated the spectrum of mutations observed clinically. In the presence of imatinib, mutations in the ATP pocket and A-loop were observed, with the T670I gatekeeper mutation conferring the highest level of resistance. In the presence of sunitinib, mutations were observed primarily in the A-loop (D816, D820, N822 and Y823), but not the ATP pocket. In contrast, in the presence of 40 nM ponatinib, only the V654A mutation persisted, in a small number of clones. In the presence of 80 nM ponatinib the development of resistance mutations was completely suppressed. Importantly, levels of ponatinib achieved in patients dosed once daily with 45 mg ponatinib (145 nM peak; 64 nM trough) exceed these target levels. The results of mutagenesis studies using other primary mutant backgrounds, and the newly approved TKI regorafenib, will also be described.

Conclusion: Preclinical analysis suggests that, in an exon 11 mutant KIT background, ponatinib can inhibit development of a broad spectrum of potential resistance mutations, including multiple problematic mutations within the A-loop. Thus far, the only secondary mutation identified that is not completely suppressed at clinically achievable trough concentrations is V654A. These studies provide further support for an ongoing phase 2 study of ponatinib in patients with TKI-resistant GIST (NCT01874665).

Citation Information: Mol Cancer Ther 2013;12(11 Suppl):B266.

Citation Format: Alexa B. Schrock, Tzu-Hsiu Chen, Victor M. Rivera, Joseph M. Gozgit. Ponatinib, a potent KIT inhibitor, suppresses the emergence of secondary resistance mutations in a gastrointestinal stromal tumor (GIST) model system. [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2013 Oct 19-23; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2013;12(11 Suppl):Abstract nr B266.

Luteolin attenuates TGF-β1-induced epithelial-mesenchymal transition of lung cancer cells by interfering in the PI3K/Akt-NF-κB-Snail pathway

AIMS

Luteolin is a natural flavonoid that possesses a variety of pharmacological activities, such as anti-inflammatory and anti-cancer abilities. Whether luteolin regulates the transformation ability of lung cancer cells remains unclear. The current study aims to uncover the effects and underlying mechanisms of luteolin in regulation of and epithelial-mesenchymal transition of lung cancer cells.

MAIN METHODS

The lung adenocarcinoma A549 cells were used in this experiment; the cells were pretreated with luteolin followed by administration with TGF-β1. The expression levels of various cadherin and related upstream regulatory modules were examined.

KEY FINDINGS

Pretreatment of luteolin prevented the morphological change and downregulation of E-cadherin of A549 cells induced by TGF-β1. In addition, the activation of PI3K-Akt-IκBa-NF-κB-Snail pathway which leads to the decline of E-cadherin induced by TGF-β1 was also attenuated under the pretreatment of luteolin.

SIGNIFICANCE

We provide the mechanisms about how luteolin attenuated the epithelial-mesenchymal transition of A549 lung cancer cells induced by TGF-β1. This finding will strengthen the anti-cancer effects of flavonoid compounds via the regulation of migration/invasion and EMT ability of various cancer cells.

Interleukin-6 upregulates paraoxonase 1 gene expression via an AKT/NF-κB-dependent pathway

The aim of this study is to investigate the relationship between paraoxonase 1 (PON1) and atherosclerosis-related inflammation. In this study, human hepatoma HepG2 cell line was used as a hepatocyte model to examine the effects of the pro-inflammatory cytokines on PON1 expression. The results showed that IL-6, but not TNF-α and IL-1β, significantly increased both the function and protein level of PON1; data from real-time RT-PCR analysis revealed that the IL-6-induced PON1 expression occurred at the transcriptional level. Increase of IκB kinase activity and IκB phosphorylation, and reduction of IκB protein level were also observed in IL-6-treated HepG2 cells compared with untreated culture. This event was accompanied by increase of NF-κB-p50 and -p65 nuclear translocation. Moreover, treatment with IL-6 augmented the DNA binding activity of NF-κB. Furthermore, pharmacological inhibition of NF-κB activation by PDTC and BAY 11-7082, markedly suppressed the IL-6-mediated PON1 expression. In addition, IL-6 increased the levels of phosphorylated protein kinase B (PKB, AKT). An AKT inhibitor LY294002 effectively suppressed IKK/IκB/NF-κB signaling and PON1 gene expression induced by IL-6. Our findings demonstrate that IL-6 upregulates PON1 gene expression through an AKT/NF-κB signaling axis in human hepatocyte-derived HepG2 cell line.

Abstract 2084: Ponatinib is a highly potent inhibitor of activated variants of RET found in MTC and NSCLC

Background: RET kinase is dysregulated by activating mutations or fusion gene formation in multiple cancers, including medullary thyroid cancer (MTC) and non-small cell lung cancer (NSCLC). RET mutations are found in 50-95% of MTCs, with mutations at C634R (extracellular domain) and M918T (kinase domain) predominating. Recently, a translocation that results in formation of a KIF5B-RET fusion gene has been identified in 1-2% of NSCLCs. Ponatinib (AP24534) is a multi-targeted tyrosine kinase inhibitor (TKI) with potent activity against BCR-ABL being investigated in patients with chronic myeloid leukemia. Previously, ponatinib has been shown to potently inhibit the in vitro kinase activity of RET and the viability of Ba/F3 cells transformed to IL-3 independence through expression of a RET kinase domain artificially-activated via fusion to the TEL dimerization domain. Here, the activity of ponatinib was examined in Ba/F3 cells transformed with the most common, naturally-occurring activated variants of RET found in MTC and NSCLC. In addition, the activity of ponatinib was compared to that of 4 other multi-targeted TKIs with anti-RET activity in clinical development: vandetanib, cabozantinib, sunitinib and sorafenib.

Results: Ponatinib potently inhibited viability of Ba/F3 cells expressing RETC634R, RETM918T and KIF5B-RET, with IC50s of 2, 3, and 11 nM, respectively. Consistent with these effects being due to inhibition of RET, ponatinib inhibited RET phosphorylation with similar potency in each respective cell line (IC50s of 4, 2, and 9 nM). The TKIs vandetanib (IC50: 448, 357 and 773 nM, respectively), cabozantinib (226, 100 and 292 nM), sunitinib (299, 312 and 570 nM) and sorafenib (&gt;1000, 372 and 861 nM) also inhibited viability of Ba/F3 cells expressing RETC634R, RETM918T and KIF5B-RET, however the potency of all 4 TKIs was substantially reduced compared to that of ponatinib. Importantly, trough ponatinib concentrations (64 nM) observed in patients treated once daily with ponatinib (45 mg) substantially exceed IC50s for inhibition of each of the mutationally-activated RET variants. Additional studies to further evaluate the anti-RET activity of ponatinib and other TKIs, including their susceptibility to mutation-based resistance, are ongoing and will be presented.

Conclusion: Ponatinib is a highly potent inhibitor of activated variants of RET found in MTC and NSCLC. The potency of ponatinib substantially exceeds that of other TKIs with anti-RET activity that are being evaluated in clinical trials. These results provide strong support for the clinical evaluation of ponatinib in patients with RET-driven cancers.

Citation Format: Joseph M. Gozgit, Tzu-Hsiu Chen, Tim Clackson, Victor Rivera. Ponatinib is a highly potent inhibitor of activated variants of RET found in MTC and NSCLC . [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 2084. doi:10.1158/1538-7445.AM2013-2084

Mental health status and factors that influence the course of Graves' disease and antithyroid treatments

AIMS

Biological, psychological and social factors may interact with the mental health status of Graves' disease (GD) patients before and after antithyroid drug (ATD) treatment. Our aim was to quantify the impact of supportive and risk factors after recovery from GD which may enhance cure rates.

PATIENTS AND METHODS

300 patients were recruited for a 6-year prospective cohort study. Before and after treatment, we assessed the impact of biopsychosocial factors on the success of ATD treatment and mental health using the Symptom Checklist 90, the Eysenck Personality Questionnaire, the Life Event Scale, Simplified Coping Styles and the Perceived Social Support Scale. The patients routinely received ATD at least over 18 months. End-point was defined as cured (at least 2 years without a relapse after the withdrawal of ATD), otherwise as not cured.

RESULTS

Regression analysis explained 80.5% of the influences affecting mental health. The odds ratios (OR) revealed positive coping styles (OR: 2.90, 95% CI, 1.09-7.68), negative events (OR: 1.04, 95% CI, 1.01-1.07) and social support (OR: 5.10, 95% CI, 2.77-9.40) as protective factors, predicting a cure for GD patients. These variables explained 61.7% of the influences leading to a cure or no cure. Large thyroid volume was a risk factor, predicting failure (OR: 0.865, 95% CI, 0.83-0.90, P<0.000).

CONCLUSIONS

Enhancing positive coping strategies and social support is important to improve mental health in GD patients, to avoid compromising work-related performance and endangering a patient's social status.

Quantitative trait loci on barley (Hordeum vulgare L.) chromosome 7 associated with components of winterhardiness

Quantitative trait loci (QTL) controlling traits associated with winterhardiness in barley (field survival, LT50, growth habit, and crown fructan content) were mapped to chromosome 7 in a population of 100 F1-derived doubled haploid lines. The largest QTL effects for all traits were detected in a 21% recombination interval on the long arm of chromosome 7. QTL in this region accounted for 37-68% of the variation for three measures of cold tolerance, 47% of the variation for growth habit, and 28% of the variation in crown fructan content. Trait association may be due to linkage rather than pleiotropy.

Adherence to phosphate binder therapy is the primary determinant of hyperphosphatemia incidence in patients receiving peritoneal dialysis

We investigated the major determinant of hyperphosphatemia incidence among patients receiving peritoneal dialysis. Seventy-six patients aged 25-55 years who had received peritoneal dialysis for more than 3 months were recruited. The patients were divided into three groups according to their serum phosphorus levels (Group 1, ≥ 6 mg/dL; Group 2, 5.9-4.8 mg/dL; and Group 3, <4.8 mg/dL). Renal dietitians interviewed the patients to determine their phosphate intake and adherence to phosphate binder therapy. No statistical differences in demographics or phosphate intake were identified among the groups. However, adherence to phosphate binders was greater in Group 3 than in Groups 1 and 2 (96.3% vs. 21.4% and 52.4%, respectively; P < 0.001). Multivariate analysis showed that adherence to phosphate binder therapy was the only significant contributor to serum phosphorus levels (P= 0.0001). Adherence to diet was better than adherence to phosphate binder therapy among patients receiving peritoneal dialysis, and the latter determined the incidence of hyperphosphatemia.

Combined ventriculoperitoneal shunt blockage, viscus perforation and migration into urethra, presenting with repeated urinary tract infection

We present an extremely rare case of delayed and combined ventriculoperitoneal shunt blockage, viscus perforation and migration into the urethra manifested by a repeated urinary tract infection. This was discovered six months after the shunt was inserted. Although there were various other transient symptoms, the patient did not show obvious peritoneal signs. This complication could have been lethal if the discovery had been delayed. One of the best ways of preventing such migration is possibly the use of a softer catheter. However, making sure of appropriate redundancy for the abdominal part of the catheter may be of equal importance.

Forensic Science in Support of Wildlife Conservation Efforts - Developments in Morphological and Chemical Approaches in Taiwan

Parts from animals that are now endangered species (such as bear bile, rhino horn, and tiger bone) have long been important ingredients of traditional Chinese medicine (TCM). Deeply believing in the potency of these ingredients and coupled with substantial gains in wealth of the population in Taiwan in the 1980s, ugly scenarios came to light. Taiwan quickly became the target of investigation pursued by international wildlife conservationists. To provide scientific bases for the government's investigation efforts, morphological, chemical/physical, and genetic methods were developed to characterize TCM products. This review focuses on Taiwanese scientists' efforts on the following topic matters: (a) morphological approach to identify CITES-listed species from the turtle shells traded in the TCM market; (b) chromatographic and spectrophotometric methods for the identification and differentiation of bile products of different animal origins; and (c) gas chromatography-mass spectrometry method for the analysis of deer musk components and alleged musk products.

Dietary supplements usage among elderly Taiwanese during 2005-2008

This study describes dietary supplement consumption practices among the Taiwanese population over the age of 65. Data for the analyses were derived from the 2005-2008 Nutrition and Health Survey in Taiwan. Data from a total of 914 participants (456 men and 458 women) was collected in the study to delineate patterns of supplement usage. The results indicated that the percentage of individuals taking supplements was 45.7% for men and 52.2% for women. There were no significant differences in supplement use by gender, age group, geographic stratum, current employment status, household monthly income, self-reported health status or marital status, except for higher education and adequate perceived financial resources. Half of both men and women chose to take only one supplement. In addition, as the number of supplements taken increased, the number of people decreased. The elderly with higher education levels were more likely to take two kinds of supplements. The top five supplements consumed from highest to lowest were: glucosamine, multivitamins and minerals, calcium, fish oil and vitamin B complex. The major reason for supplements use for men was to supplement an unbalanced diet, and that for women was to prevent joint degeneration. The main factor influencing choice of supplements in the elderly was receiving the supplement as a gift from another person. Note that mean intakes of vitamins A, C, E, B-1, B-2, B-6, B-12, biotin, niacin, and pantothenic acid from supplements over-exceeded DRIs in Taiwan.

Abstract A199: Oncogenic and drug-sensitive ERBB2 mutations in glioblastoma

The Cancer Genome Atlas (TCGA) Consortium recently completed a multidimensional analysis of glioblastoma, characterizing somatic alterations across a large sample set, and identifying genetic lesions that likely contribute to tumor fitness (TCGA Network, Nature, 2008). However, functional experiments are required to determine whether significantly altered genes are in fact oncogenes or tumor suppressor genes in glioblastoma. We experimentally analyzed mutations in one of the significantly mutated genes, ERBB2. Unlike ERBB2 mutations in lung adenocarcinoma, ERBB2 mutations in glioblastoma are primarily located in the extracellular region, clustering around the domain that mediates receptor dimerization. We have determined that a subset of the reported mutations are gain-of-function and oncogenic, require kinase activity for oncogenic transformation, and are sensitive to specific small molecule kinase inhibitors. This discovery has therapeutic implications for glioblastoma patients who harbor somatic ERBB2 mutations.

Citation Information: Mol Cancer Ther 2009;8(12 Suppl):A199.

Abstract A2: Oncogenic and drug-sensitive ERBB2 mutations in glioblastoma

The Cancer Genome Atlas (TCGA) Consortium recently completed a multidimensional analysis of glioblastoma, characterizing somatic alterations across a large sample set, and identifying genetic lesions that likely contribute to tumor fitness (TCGA Network, Nature, 2008). However, functional experiments are required to determine whether significantly altered genes are in fact oncogenes or tumor suppressor genes in glioblastoma. We experimentally analyzed mutations in one of the significantly mutated genes, ERBB2. Unlike ERBB2 mutations in lung adenocarcinoma, ERBB2 mutations in glioblastoma are primarily located in the extracellular region, clustering around the domain that mediates receptor dimerization. We have determined that a subset of the reported mutations are gain-of-function and oncogenic, require kinase activity for oncogenic transformation, and are sensitive to specific small molecule kinase inhibitors. This discovery has therapeutic implications for glioblastoma patients who harbor somatic ERBB2 mutations.

Citation Information: Cancer Res 2009;69(23 Suppl):A2.

Genetic evaluation and management of fetal chylothorax: review and insights from a case of Noonan syndrome

Fetal chylothorax is one of a very few syndromes that can be treated in utero with thoracoamniotic shunting or pleurodesis by OK-432 as two major therapeutic modalities. We report on a fetus with Noonan syndrome and a missense mutation c.182A > C (p.Asp61Ala) of PTPN11 who responded poorly to antenatal pleurodesis by OK-432. Based on our previous publication and this case study, we propose that fetal chylothorax of a distinct genetic origin may respond poorly to OK-432 pleurodesis.

Predicting drug susceptibility of non-small cell lung cancers based on genetic lesions

Somatic genetic alterations in cancers have been linked with response to targeted therapeutics by creation of specific dependency on activated oncogenic signaling pathways. However, no tools currently exist to systematically connect such genetic lesions to therapeutic vulnerability. We have therefore developed a genomics approach to identify lesions associated with therapeutically relevant oncogene dependency. Using integrated genomic profiling, we have demonstrated that the genomes of a large panel of human non-small cell lung cancer (NSCLC) cell lines are highly representative of those of primary NSCLC tumors. Using cell-based compound screening coupled with diverse computational approaches to integrate orthogonal genomic and biochemical data sets, we identified molecular and genomic predictors of therapeutic response to clinically relevant compounds. Using this approach, we showed that v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog (KRAS) mutations confer enhanced Hsp90 dependency and validated this finding in mice with KRAS-driven lung adenocarcinoma, as these mice exhibited dramatic tumor regression when treated with an Hsp90 inhibitor. In addition, we found that cells with copy number enhancement of v-abl Abelson murine leukemia viral oncogene homolog 2 (ABL2) and ephrin receptor kinase and v-src sarcoma (Schmidt-Ruppin A-2) viral oncogene homolog (avian) (SRC) kinase family genes were exquisitely sensitive to treatment with the SRC/ABL inhibitor dasatinib, both in vitro and when it xenografted into mice. Thus, genomically annotated cell-line collections may help translate cancer genomics information into clinical practice by defining critical pathway dependencies amenable to therapeutic inhibition.

Self-limited febrile syndromes temporally associated with the use of propofol for sedation in gastrointestinal endoscopic procedures

PURPOSE

To investigate cases of febrile illnesses in patients who received propofol for sedation during gastrointestinal endoscopy.

METHODS

Active case finding for patients who underwent endoscopy between 1 April and 30 May 2007 and suffered unexplained fever, chills, or myalgia within 48 hour after the procedure. We reviewed medications and clinical practices to find factors associated with the reactions.

RESULTS

Seventy-four cases at eight facilities in five states were identified yielding a rate of 36 reactions per 1000 procedures, compared with a baseline rate of 0.6 per 1000. The majority of patients experienced self-limited fever (89.2%), chills (73.0%), or myalgia (63.5%). Blood samples from five patients were collected for culture; no organisms grew. All health care facilities that reported cases and fully participated in the investigation (n = 7) had received a common lot of propofol just before recognition of the first case. Bacterial endotoxin and sterility testing on unopened vials from this lot of propofol showed no abnormalities. Cases terminated after facilities stopped using the associated lot of propofol.

CONCLUSIONS

We found a temporal association between a particular lot of propofol and an outbreak of febrile illnesses at several healthcare facilities performing endoscopy. When propofol is used to sedate patients for endoscopy, fever is a rare outcome and healthcare professionals should investigate clusters of these reactions. Post-procedure surveillance is important to identify possible medication reactions.

YC-1 induces apoptosis of human renal carcinoma A498 cells in vitro and in vivo through activation of the JNK pathway

BACKGROUND AND PURPOSE

The aim of this study was to elucidate the mechanism of YC-1{3-(5'-hydroxy methyl-2'-furyl)-1-benzylindazole}-induced human renal carcinoma cells apoptosis and to evaluate the potency of YC-1 in models of tumour growth in mice.

EXPERIMENTAL APPROACH

YC-1-mediated apoptosis was assessed by analysis of MTT, SRB, DAPI staining and flow cytometry analysis. Knockdown of JNK protein was achieved by transient transfection using siRNA. The mechanisms of action of YC-1 on different signalling pathways involved were studied using western blot. Fas clustering was analysed by confocal microscopy and in vivo efficacy was examined in a A498 xenograft model.

KEY RESULTS

YC-1 displayed cytotoxicity in renal carcinoma cells at 10(-7)-10(-8) M. Increased condensation of chromatin was observed and an increase in the cell population in subG1 phase. Moreover, YC-1 triggered mitochondria-mediated and caspase-dependent pathways. YC-1 significantly induced Fas ligand expression, but did not modify either the protein levels of death receptors or ligands. In addition, Fas clustering in cells responsive to YC-1 was observed, suggesting involvement of a Fas-mediated pathway. Furthermore, YC-1 markedly induced phosphorylation of JNK and a JNK inhibitor, SP600125, and siRNA JNK1/2 significantly reversed YC-1-induced cytotoxicity and protein expression. We suggest that YC-1 induced JNK phosphorylation, the upregulation of FasL and Fas receptor clustering to promote the activation of caspases 8 and 3, resulting in apoptosis. Finally, we demonstrated the antitumour effect of YC-1 in vivo.

CONCLUSIONS AND IMPLICATIONS

These data suggest that YC-1 is a good candidate for development as an anticancer drug.

Drug-sensitive FGFR2 mutations in endometrial carcinoma

Oncogenic activation of tyrosine kinases is a common mechanism of carcinogenesis and, given the druggable nature of these enzymes, an attractive target for anticancer therapy. Here, we show that somatic mutations of the fibroblast growth factor receptor 2 (FGFR2) tyrosine kinase gene, FGFR2, are present in 12% of endometrial carcinomas, with additional instances found in lung squamous cell carcinoma and cervical carcinoma. These FGFR2 mutations, many of which are identical to mutations associated with congenital craniofacial developmental disorders, are constitutively activated and oncogenic when ectopically expressed in NIH 3T3 cells. Inhibition of FGFR2 kinase activity in endometrial carcinoma cell lines bearing such FGFR2 mutations inhibits transformation and survival, implicating FGFR2 as a novel therapeutic target in endometrial carcinoma.

Allele-dependent variation in the relative cellular potency of distinct EGFR inhibitors

Targeted cancer therapies impede cancer cell growth by inhibiting the function of activated oncogene products. Patients with non-small cell lung cancer and somatic mutations of EGFR can have a dramatic response to treatment with erlotinib and gefitinib; different somatic mutations are associated with different times to progression and survival. In this study, the relative and absolute potencies of two distinct EGFR tyrosine kinase inhibitors, erlotinib and an investigational irreversible inhibitor, HKI-272, were found to vary significantly in a panel of Ba/F3 cells transformed by representative EGFR somatic mutations. HKI-272 more potently inhibited the primary exon 20 insertion mutants, the secondary erlotinib-resistance mutants including T790M and many erlotinib-sensitive mutants including L858R. In contrast, erlotinib is a more potent inhibitor of the major exon 19 deletion mutants than is HKI-272. Analyses of EGFR autophosphorylation patterns confirmed the mutation-specific variation in relative potency of these tyrosine kinase inhibitors. Our finding that distinct EGFR inhibitors are more effective in vitro for different mutant forms of the protein suggests that tyrosine kinase inhibitor treatment could be tailored to specific EGFR mutations. More broadly, these results imply that the development and deployment of targeted therapies should focus on inhibition of specific cancer-causing mutations, not only on the mutated target.

Sensitive mutation detection in heterogeneous cancer specimens by massively parallel picoliter reactor sequencing

The sensitivity of conventional DNA sequencing in tumor biopsies is limited by stromal contamination and by genetic heterogeneity within the cancer. Here, we show that microreactor-based pyrosequencing can detect rare cancer-associated sequence variations by independent and parallel sampling of multiple representatives of a given DNA fragment. This technology can thereby facilitate accurate molecular diagnosis of heterogeneous cancer specimens and enable patient selection for targeted cancer therapies.

Oncogenic transformation by inhibitor-sensitive and -resistant EGFR mutants

BACKGROUND

Somatic mutations in the kinase domain of the epidermal growth factor receptor tyrosine kinase gene EGFR are common in lung adenocarcinoma. The presence of mutations correlates with tumor sensitivity to the EGFR inhibitors erlotinib and gefitinib, but the transforming potential of specific mutations and their relationship to drug sensitivity have not been described.

METHODS AND FINDINGS

Here, we demonstrate that EGFR active site mutants are oncogenic. Mutant EGFR can transform both fibroblasts and lung epithelial cells in the absence of exogenous epidermal growth factor, as evidenced by anchorage-independent growth, focus formation, and tumor formation in immunocompromised mice. Transformation is associated with constitutive autophosphorylation of EGFR, Shc phosphorylation, and STAT pathway activation. Whereas transformation by most EGFR mutants confers on cells sensitivity to erlotinib and gefitinib, transformation by an exon 20 insertion makes cells resistant to these inhibitors but more sensitive to the irreversible inhibitor CL-387,785.

CONCLUSION

Oncogenic transformation of cells by different EGFR mutants causes differential sensitivity to gefitinib and erlotinib. Treatment of lung cancers harboring EGFR exon 20 insertions may therefore require the development of alternative kinase inhibition strategies.

Hypercalcemia and status epilepticus relates to salmon calcitonin administration in breast cancer

Calcitonin is currently used to treat hypercalcemia of many clinical types. However, we encountered a woman who suffered severe hypercalcemia and status epilepticus, both of which developed 8 days after the administration of salmon calcitonin for the treatment of breast cancer. When the patient first presented her serum calcium level was 15.5mg/dl, intact parathyroid hormone level 118 pg/ml, calcitonin <2 pg/ml, magnesium 1.2mg/dl, and phosphate 1mg/dl. Her serum calcium level returned to the reference range within 48 h after correction. At follow-up no hypercalcemia had developed, although the patient had received no further treatment for her breast cancer and multiple metastases were subsequently detected. Her hypercalcemia is ascribed to exogenous calcitonin supplementation. These conflicting events may be due to functionally heterogeneous calcitonin receptors or to activation of 1 alpha-hydroxylase by exogenous calcitonin.

Reconstruction after intercalary resection of malignant bone tumours

We reviewed 29 patients who had undergone intercalary resection for malignant tumours. Of these, 14 had received segmental allograft reconstruction and 15 extracorporeally-irradiated autograft.

At a mean follow-up of 71 months (24 to 132), 20 were free from disease, five had died and four were alive with pulmonary metastases. Two patients, one with an allograft and one with an irradiated autograft, had a local recurrence. Reconstruction with extracorporeally-irradiated autograft has a significantly lower rate of nonunion (7% vs 43%, p = 0.031) but an insignificantly higher rate of fracture (20% vs 14%, p = 0.535) than that with segmental allograft. Using the Enneking functional evaluation system, the mean postoperative score for the patients without local recurrence was 87% (80% to 96%) and was similar in both groups.

Extracorporeally-irradiated autograft could be an acceptable alternative for reconstruction after intercalary resection, especially in countries where it is difficult to obtain allografts.

An integrated view of copy number and allelic alterations in the cancer genome using single nucleotide polymorphism arrays

Changes in DNA copy number contribute to cancer pathogenesis. We now show that high-density single nucleotide polymorphism (SNP) arrays can detect copy number alterations. By hybridizing genomic representations of breast and lung carcinoma cell line and lung tumor DNA to SNP arrays, and measuring locus-specific hybridization intensity, we detected both known and novel genomic amplifications and homozygous deletions in these cancer samples. Moreover, by combining genotyping with SNP quantitation, we could distinguish loss of heterozygosity events caused by hemizygous deletion from those that occur by copy-neutral events. The simultaneous measurement of DNA copy number changes and loss of heterozygosity events by SNP arrays should strengthen our ability to discover cancer-causing genes and to refine cancer diagnosis.

High-resolution single-nucleotide polymorphism array and clustering analysis of loss of heterozygosity in human lung cancer cell lines

Chromosomal loss of heterozygosity (LOH) is a common mechanism for the inactivation of tumor suppressor genes in human epithelial cancers. Hybridization to single-nucleotide polymorphism (SNP) arrays is an efficient method to detect genome-wide cancer LOH. Here, we survey LOH patterns in a panel of 33 human lung cancer cell lines using SNP array hybridization containing 1500 SNPs. We compared the LOH patterns generated by SNP array hybridization to those previously obtained by 399 microsatellite markers and find a high degree of concordance between the two methods. A novel informatics platform, dChipSNP, was used to perform hierarchical tumor clustering based on genome-wide LOH patterns. We demonstrate that this method can separate non-small-cell and small-cell lung cancer samples based on their shared LOH. Furthermore, we analysed seven human lung cancer cell lines using a novel 10 000 SNP array and demonstrate that this is an efficient and reliable method of high-density allelotyping. Using this array, we identified small regions of LOH that were not detected by lower density SNP arrays or by standard microsatellite marker panels.

Missense mutations of the BRAF gene in human lung adenocarcinoma

Mutations of the BRAF protein serine/threonine kinase gene have recently been identified in a variety of human cancers, most notably melanomas. We sought to determine the frequency of BRAF mutations in human lung cancer pathogenesis. Analysis of BRAF sequence from 127 primary human lung adenocarcinomas revealed mutations in two tumor specimens, one in exon 11 (G465V), and a second in exon 15 (L596R). These specimens belong to the same adenocarcinoma subgroup as defined by clustering of gene expression data. BRAF may provide a target for anticancer chemotherapy in a subset of lung adenocarcinoma patients.

Treatment of malignant bone tumours by extracorporeally irradiated autograft-prosthetic composite arthroplasty

Autogenous bone graft which has been either autoclaved or irradiated is commonly used in oriental countries as an alternative to allograft. We started to use the technique of extracorporeal irradiation of the resected specimen and reimplantation (ECIR) in 1991. There was, however, a high incidence of fracture of the irradiated bone and loss of articular cartilage. In an attempt to reduce these complications, we combined the irradiated autograft with a conventional arthroplasty. Between 1995 and 1998, 14 patients underwent limb salvage by this method. Seven had an osteosarcoma, two bony metastases, three a chondrosarcoma, one a malignant fibrous histiocytoma, and one a leiomyosarcoma. Ten tumours were located in the proximal femur, two in the proximal humerus, and two in the distal femur. One patient who had a solitary metastasis in the proximal part of the left femur died from lung metastases 13 months after operation. The remaining 13 patients were alive and without evidence of local recurrence or distant metastases at a mean follow-up of 43 months (28 to 72). Postoperative palsy of the sciatic nerve occurred in one patient, but no complications such as wound infection, fracture, or nonunion were seen. All host-irradiated bone junctions healed uneventfully within eight months. Using the Enneking functional evaluation system, the mean postoperative score for all 14 patients was 80% (57 to 93). The use of irradiated autograft prosthesis composites reduces the complications of ECIR and gives good functional results. It may be a good alternative in limb-salvage surgery, especially in countries where it is difficult to obtain allografts.

PCR amplification of the Salmonella typhimurium fimY gene sequence to detect the Salmonella species

This study evaluated the suitability of fimY gene amplification by PCR as an effective means of detecting Salmonella species. Although fimY gene of Salmonella typhimurium is involved in regulating type 1 fimbrial expression, the amino acid sequence of FimY shares very little homology with other known prokaryotic proteins in the GenBank database. Therefore, fimY is a promising target gene to detect the presence of Salmonella species. Herein, two primers internal to the fimY gene of S. typhimurium are used to investigate the distribution of the fimY homologous sequence among 45 Salmonella serovars and 20 non-Salmonella species by using PCR. Experimental results indicated that only Salmonella species possessed the fimY homologous sequence, subsequently generating the specific 526-bp DNA fragments. The sensitivity of the fmY-specific primer set was demonstrated on a Salmonella-free swab sample from a pork carcass surface, which was then artificially contaminated with different concentrations of S. typhimurium. A combining of pre-enrichment step in buffered peptone water and PCR amplification of fimY allowed the detection of S. typhimurium at the concentration of 3.4 x 10(0) CFU/ml from the swab sample. With an additional enrichment step in Rappaport-Vassiliadis (RV) broth, this procedure can also detect pork carcass surface naturally contaminated with Salmonella species in a slaughterhouse. Results in this study demonstrate that fimY is unique to Salmonella species and is an appropriate PCR target for detecting these microorganisms.