Reopening of ductus arteriosus in idiopathic premature constriction or closure of ductus arteriosus: A case series

BACKGROUND

There is no consensus on managing pregnancy when the fetus is diagnosed with idiopathic premature constriction or closure of the ductus arteriosus (PCDA). Knowing whether the ductus reopens is valuable information for managing idiopathic PCDA. We conducted a case-series study to investigate the natural perinatal course of idiopathic PCDA and examined factors associated with ductal reopening.

METHODS

We retrospectively collected information about the perinatal course and echocardiographic findings at our institution, which, on principle, does not determine delivery timing based on fetal echocardiographic results. We also examined perinatal factors related to the reopening of the ductus arteriosus.

RESULTS

Thirteen cases of idiopathic PCDA were included in the analysis. The ductus reopened in 38% of cases. Among cases diagnosed in <  37 weeks of gestation, 71% reopened, which was confirmed seven days after diagnosis (interquartile range 4-7). Diagnosis earlier in gestation was associated with ductal reopening (p = 0.006). Two cases (15%) developed persistent pulmonary hypertension. No fetal hydrops or death occurred.

CONCLUSIONS

The ductus is likely to reopen when prenatally diagnosed before 37 weeks gestation. There were no complications due to our pregnancy management policy. In idiopathic PCDA, especially if the prenatal diagnosis is made before 37 weeks of gestational age, continuing the pregnancy with careful monitoring of the fetus's well-being is recommended.

The clinical outcome of fractional flow reserve based coronary revascularization strategy of the patients on hemodialysis

Background

The optimal coronary revascularization strategy for the patients on hemodialysis is yet to be determined. In the real-world practice, we sometimes encounter the rapid deterioration after percutaneous coronary intervention (PCI) to angiographically intermediate but functionally significant stenosis. According to the fractional flow reserve (FFR) based revascularization strategy, the clinical outcome of the deferred lesions is reported to be almost equivalent to that of the lesions received PCI. However, whether the relationship also applies to hemodialysis patients is unclear.

Purpose

To assess the clinical outcome of the lesions for which revascularization strategy was determined by FFR in patients with hemodialysis.

Methods

Consecutive 147 vessels in 120 patients with hemodialysis whose revascularization strategy was decided according to the FFR were enrolled in this study. We compared the clinical outcomes of the deferred group (FFR ≥0.80, 87 vessels, 78 patients) with the PCI group (FFR&lt;0.80, 60 vessels, 42 patients). The primary endpoint of this study was target vessel failure (TVF) defined as a composite of TV revascularization and myocardial infarction evaluated by per-vessel analysis. The secondary endpoint was major adverse cardiovascular events (MACE) defined as all cause death, myocardial infarction, urgent revascularization evaluated by per-patient analysis.

Results

The median follow-up period was 2.3 years (interquartile range, 1.5–4.0 years). The beseline characteristics of the lesions and patients were well balanced between the 2 treatment groups except for the distribution of target vessels and FFR value. The cumulative TVF rate was not significantly different between the deferred group and PCI group (2-year event rate 26.7% vs. 17.7%; Log-rank p=0.23). The risk of MACE was also not significantly different between two groups (2-year event rate 35% vs. 30%; Log-rank p=0.48).

Conclusion

The clinical outcome of the lesions/patients for which received revascularization based on FFR was equivalent to the deferred lesions/patients even in the patients on hemodialysis (2,129/3,000).

Funding Acknowledgement

Type of funding sources: None. Table 1Figure 1

Aggressive lipid lowering therapy with pitavastatin and ezetimibe improve cardiovascular outcomes in patients with ST segment elevation myocardial infarction: insights from the HIJ-PROPER Study

Aims

The purpose of this study was to evaluate the effect of aggressive lipid-lowering therapy with pitavastatin and ezetimibe in patients with ST-segment elevation myocardial infarction (STEMI) as compared with those with other classification of an acute coronary syndrome (ACS) including non-STEMI (NSTEMI) and unstable angina pectoris (UA).

Methods

This is a post hoc sub-analysis of the HIJ-PROPER study. In the original study, ACS patients with dyslipidemia were randomized to either pitavastatin + ezetimibe therapy or pitavastatin monotherapy. In the present analysis, we divided HIJ-PROPER participants into the STEMI group (n=880) and NSTEMI + UA group (n=841). Cardiovascular events were analyzed between the two groups. The primary endpoint was a composite of major advanced cardiovascular events (MACE; all-cause death, non-fatal myocardial infarction, non-fatal stroke, unstable angina pectoris, and ischemia-driven revascularization)

Result

During median follow-up period of 3.4 years, the cumulative incidence of the primary endpoint in STEMI group was 31.9% in the pitavastatin+ezetimibe therapy, compared with 39.7% in the pitavastatin-monotherapy (HR, 0.77; 95% CI, 0.62–0.97; p=0.02). However, there was no effect of pitavastatin+ezetimibe therapy on the primary endpoint in the NSTEMI + UA group. Concerning the individual components of the primary endpoint in STEMI group, the percentage of occurrence of all-cause death was significantly lower in the pitavastatin+ezetimibe therapy compared to pitavastatin mono-therapy (14 patients (3.2%) vs. 31 patients (6.9%), respectively; HR, 0.45; 95% CI, 0.23–1.84, p=0.01). Multivariate analysis revealed that use of ezetimibe and prevalence of diabetes mellitus at baseline were independent predictors of primary endpoints in STEMI group (HR, 0.79; 95% CI, 0.63–0.99; p=0.04 for use of ezetimibe, HR 1.54; 95% CI, 1.22–1.94, p=0.0003 for diabetes mellitus).

Conclusion

Patients with pitavastatin+ezetimibe therapy as compared with pitavastatin-monotherapy had lower cardiovascular event in patients with ST-segment elevation myocardial infarction.

Kaplan-Meier curves for primary endpoint

Funding Acknowledgement

Type of funding source: None

Lower levels of high-density lipoprotein cholesterol are associated with increased cardiovascular events in patients with acute coronary syndrome receiving contemporary lipid-lowering therapy

Background

This study aimed to elucidate whether high-density lipoprotein cholesterol (HDL-C) at 3-month follow-up for patients receiving contemporary lipid-lowering therapy after acute coronary syndrome (ACS) could predict cardiac events.

Methods

The HIJ-PROPER study was a multicenter, prospective, randomized trial comparing intensive lipid-lowering therapy (pitavastatin + ezetimibe) and conventional lipid-lowering therapy (pitavastatin monotherapy) after ACS. For the present analysis, the entire cohort was divided into three groups according to HDL-C levels at 3-month follow-up (Group 1, HDL-C ≤43 mg/dL; Group 2, 43–53.6 mg/dL; Group 3; HDL-C ≥53.6 mg/dL). Baseline characteristics and the incidence of the primary endpoint (a composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, unstable angina pectoris, or ischemia-driven revascularization) were compared among the three groups.

Results

The primary endpoint was reported in 34.8%, 30.1%, and 24.6% of patients in Groups 1, 2, and 3, respectively. The incidence of the primary endpoint was significantly higher in Group 1 than in Group 3 (hazard ratio [HR], 1.5; 95% confidence interval [CI], 1.19–1.9; p=0.001). Irrespective of the treatment regimen, Group 1 had a significantly higher rate of the primary endpoint than Group 3 (pitavastatin + ezetimibe therapy: HR, 1.6; 95% CI, 1.12–2.22; p=0.01 and pitavastatin monotherapy: HR, 1.4; 95% CI, 1.05–1.98; p=0.02). These trends remained even after adjustment for baseline characteristics and lipid profiles.

Conclusions

Lower levels of HDL-C at 3-month follow-up are associated with higher incidence of the cardiovascular events in patients with acute coronary syndrome receiving contemporary lipid-lowering therapy.

HDL-C levels and Cardiovascular events

Funding Acknowledgement

Type of funding source: None

Nivolumab treatment beyond progressive disease in advanced non-small cell lung cancer

PURPOSE

This study evaluated the efficacy and safety of nivolumab treatment beyond progressive disease (PD) in non-small cell lung cancer (NSCLC).

PATIENTS/METHODS

Medical records of consecutive patients with advanced NSCLC who received nivolumab between December 2015 and December 2018 were reviewed. Clinical outcomes of three groups of eligible patients who received nivolumab as a second-line treatment after PD were compared based on Response Evaluation Criteria in Solid Tumors v1.1. We conducted subgroup analyses in patients with and without new lesions at first PD.

RESULTS

Twenty-eight patients continued nivolumab treatment beyond PD (TBP). Post PD, 46 patients switched to other anti-cancer treatment (OAT), and 21 received no further anti-cancer treatment (NAT). There were no significant differences in overall survival (OS) or survival post progression (SPP) between TBP and OAT groups (OS: 15.6 vs. 13.4 months, P = .40, SPP: 12.2 vs. 9.3 months, P = .42). Subgroup analyses indicated that among patients without new lesions at first PD, SPP was longer in the TBP than in the OAT groups (12.6 vs. 9.3 months, P = .22, HR: 0.64; 95% CI 0.31‒1.31). The frequency of immune-related adverse events leading to discontinuation during nivolumab beyond PD was equivalent to that for pre-PD (10.7 vs. 12.6%).

CONCLUSIONS

No significant benefits were associated with continuation of nivolumab for advanced NSCLC patients. Continuation of nivolumab beyond PD could be a more useful option in patients without new lesions at first PD. Treatment-related toxicities require attention during nivolumab treatment not only before PD but also beyond PD.

Correlation of histological and microbiological findings in septic and aseptic knee implant failure

INTRODUCTION

The Musculoskeletal Infection Society (MSIS) has defined specific clinical and laboratory criteria for the diagnosis of periprosthetic joint infection (PJI). In this study we assessed the diagnostic utility of MSIS microbiological and histological criteria for PJI in 138 cases of septic and aseptic knee implant failure.

MATERIALS AND METHODS

Intra-operative samples from 60 cases of knee septic implant failure (SIF) and 78 cases of aseptic implant failure (AIF), defined on the basis of clinical, laboratory and operative findings/surgical management, were analysed microbiologically and histologically. Findings were correlated with the final clinical diagnosis and the specificity, sensitivity, accuracy, positive and negative predictive value of MSIS microbiological and histological criteria for knee PJI were assessed.

RESULTS

80% of SIF cases showed culture of the same organism from two or more samples (ie MSIS microbiological criteria for definite PJI); 8.3% grew an organism from one sample, and 11.7% showed no growth from any sample. 23.1% of AIF cases grew an organism from one sample and 76.9% showed no growth from any sample. MSIS histological criteria for PJI identified 96.7% of SIF cases. The sensitivity, specificity, accuracy and positive and negative predictive value of MSIS histological criteria for PJI were 96.7%, 100%, 98.6%, 100% and 97.5%, respectively. MSIS microbiological and histological criteria identified all AIF cases.

CONCLUSIONS

Knee PJI is more often identified by current MSIS histological than microbiological criteria. A significant proportion of SIF cases show either no growth or growth of an organism from only one sample. AIF is identified by both MSIS microbiological and histological criteria. Correlation of clinical, radiological and laboratory findings is required for the diagnosis of knee PJI.

Peritoneal dialysis as therapy for electrolyte and acid base disorders

Peritoneal dialysis (PD) does not demand special equipment and its fluid composition can be easily changed according to the individual condition. Nine patients with chronic or acute renal failure presented severe metabolic alkalosis (MA). Hemodialysis (HD) proved virtually ineffective and the MA persisted. Physiological saline solution was adopted as the main component of the PD fluid for the treament of MA. By this method, CI– can be shifted from PD fluid to extracellular fluid (ECF) and HCO3– from ECF to PD fluid by ionic gradient. Therefore, pH and base excess (BE) of these patients both improved to the normal range after several fluid exchanges. The lowering effect of BE (ΔBE/L) ranged from 0.99 to 2.6. Hyposaline and normo-osmol solution (Na+ 70 mEq/L) were used for one patient with hypernatremia and consciousness disturbance. Serum (S)-Na decreased from 170 to 138 mEq/L, and consciousness became almost clear with the use of 15 L of PD fluid. Hypersaline solution (Na+ 190 mEq/L) was used for two patients with hyponatremia (S-Na 113 and 121 mEq/L). S-Na rose to within the normal range after 16 and 9 L in the two cases. A fluid mixed with distilled water, 10% NaCl and 7% NaHCO3 (HCO3– 34 - 68 mEq/L) was used to treat lactic acidosis in two patients. By this method, HCO3– can be shifted from PD fluid to ECF and lactic acid from ECF to PD fluid. Two patients recovered from prolonged shock, and pH was corrected by 10 L and 4 L, respectively. PD should be considered for application in other diseases besides renal failure.

Primary intraosseous meningioma: an osteosclerotic bone tumour mimicking malignancy

BACKGROUND

Sclerotic tumours of the calvarial bones are rare and may be due to primary and secondary bone tumours as well as extradural tumours of meningeal origin.

CASE PRESENTATION

We report a case of primary intraosseous meningioma (PIM) which arose in the frontal bone of a 63 year old woman who complained of progressive pain and thickening of the right skull. Radiology showed a large osteosclerotic lesion in the right frontal bone. Histology showed an intraosseous lesion containing dense fibrous tissue in which there were scattered cells that expressed epithelial membrane antigen and progesterone receptor. The tumour was partially resected and 3 years after operation has not recurred.

CONCLUSIONS

PIM is a rare tumour which needs to be distinguished from primary/secondary osteosclerotic calvarial bone tumours.

Dendritic and mast cell involvement in the inflammatory response to primary malignant bone tumours

Background

A chronic inflammatory cell infiltrate is commonly seen in response to primary malignant tumours of bone. This is known to contain tumour-associated macrophages (TAMs) and lymphocytes; dendritic cells (DCs) and mast cells (MCs) have also been identified but whether these and other inflammatory cells are seen commonly in specific types of bone sarcoma is uncertain.

Methods

In this study we determined the nature of the inflammatory cell infiltrate in 56 primary bone sarcomas. Immunohistochemistry using monoclonal antibodies was employed to assess semiquantitatively CD45+ leukocyte infiltration and the extent of the DC, MC, TAM and T and B lymphocyte infiltrate.

Results

The extent of the inflammatory infiltrate in individual sarcomas was very variable. A moderate or heavy leukocyte infiltrate was more commonly seen in conventional high-grade osteosarcoma, undifferentiated pleomorphic sarcoma and giant cell tumour of bone (GCTB) than in Ewing sarcoma, chordoma and chondrosarcoma. CD14+/CD68+ TAMs and CD3+ T lymphocytes were the major components of the inflammatory cell response but (DC-SIGN/CD11c+) DCs were also commonly noted when there was a significant TAM and T lymphocyte infiltrate. MCs were identified mainly at the periphery of sarcomas, including the osteolytic tumour-bone interface.

Discussion

Our findings indicate that, although variable, some malignant bone tumours (e.g. osteosarcoma, GCTB) are more commonly associated with a pronounced inflammatory cell infiltrate than others (e.g. chondrosarcoma. Ewing sarcoma); the infiltrate is composed mainly of TAMs but includes a significant DC, T lymphocyte and MC infiltrate.

Conclusion

Tumours that contain a heavy inflammatory cell response, which includes DCs, TAMs and T lymphocytes, may be more amenable to immunomodulatory therapy. MCs are present mainly at the tumour edge and are likely to contribute to osteolysis and tumour invasion.

Primary synovial chondromatosis: a reassessment of malignant potential in 155 cases

OBJECTIVE

Primary synovial chondromatosis (PSC) is a rare disorder characterised by cartilage formation in synovium-lined joints, tendon sheaths and bursae. It is thought that PSC cartilage arises from the proliferation of mesenchymal cells, which exhibit cartilaginous metaplasia in subintimal connective tissue. There are reports of transformation of PSC to chondrosarcoma, although the precise incidence and nature of this complication is uncertain. In this study we carried out a retrospective review PSC to determine the incidence of sarcomatous change in this condition, in addition to the clinical, radiological and pathological features that characterise this complication

MATERIALS AND METHODS

We reviewed 155 cases of PSC and identified 4 cases (3 in the hip joint; 1 in the elbow joint) of aggressive behaviour and chondrosarcoma-like histology.

RESULTS

Radiologically, these cases were all reported as showing features consistent with PSC and aggressive extra-articular soft tissue/bone involvement. Histologically, in addition to typical features of PSC, there was morphological evidence of peri-articular soft tissue and, in 2 cases, bone involvement by an infiltrating cartilaginous tumour. These tumours all behaved as locally aggressive neoplasms and did not give rise to metastasis.

CONCLUSION

Our findings show that chondrosarcoma arises infrequently in PSC (approximately 2.5 %), and that this complication occurs most commonly in the hip joint (approximately 11 % of cases of hip PSC). These tumours behaved mainly as low-grade, locally aggressive tumours analogous to atypical cartilaginous tumour of bone/grade 1 chondrosarcoma of bone.

Carvedilol Suppresses Apoptosis and Ion Channel Remodelling of HL-1 Cardiac Myocytes Expressing E334K cMyBPC

BACKGROUND

Besides its antiarrhythmic action, carvedilol has an activity to suppress cardiac tissue damage. However, it is unknown whether it has any effect on cellular apoptosis and ion channel remodelling.

PURPOSE

To know whether carvedilol has any effect on apoptosis and ion channel remodeling of HL-1 cells expressing E334K MyBPC, and comparing it with bisoprolol.

METHOD

We examined effects of carvedilol and bisoprolol on the levels of pro- and anti-apoptotic proteins and ion channels as well as apoptosis of HL-1 cells transfected with E334K MyBPC using Western blot and flow cytometry.

RESULTS

Carvedilol decreased the protein levels of p53, Bax and cytochrome c and increased that of Bcl-2 in HL-1 cells expressing E334K MyBPC. Bisoprolol failed to affect the protein levels. Both carvedilol and bisoprolol increased the protein levels of Cav1.2 but not that of Nav1.5. Carvedilol was stronger than bisoprolol at decreasing the number of annexin-V positive cells in HL-1 cells expressing E334K MyBPC.

CONCLUSION

Carvedilol suppressed apoptosis of HL-1 cells expressing E334K MyBPC through modification of pro- and anti-apoptotic proteins, whose was associated with an increase of Cav 1.2 protein expression.

YKL-40 level in gingival crevicular fluid from patients with periodontitis and type 2 diabetes

OBJECTIVE

YKL-40 is a chitin-binding glycoprotein, the level of which increases in inflammatory diseases, diabetes mellitus (DM), cardiovascular diseases, and tumors. Gingival crevicular fluid (GCF) contains many proteins and markers of periodontitis. The purpose of this study was to investigate YKL-40 level in GCF from patients with periodontitis and DM and the association between YKL-40 level and chronic periodontitis (CP) or DM.

SUBJECTS AND METHODS

The subjects were 121 patients with DM, CP, DM and periodontitis (DM-P), and healthy subjects (H). GCF was collected using paper strips after the sites for GCF collection were clinically evaluated for probing depth (PD), gingival index (GI), and bleeding on probing (BOP). YKL-40 in GCF was identified by Western blotting, and its level was determined by ELISA.

RESULTS

YKL-40 was contained in GCF samples from H, DM, CP, and DM-P sites, and its levels (amount and concentration) in CP and DM-P were significantly higher than those in H and DM. GCF YKL-40 level significantly correlated with PD and GI, and its level in BOP-positive sites was significantly higher than that in BOP-negative ones.

CONCLUSIONS

GCF YKL-40 level was elevated in periodontitis, but not DM. YKL-40 in GCF may be an inflammatory marker for periodontitis.

Advanced glycation end products increase expression of S100A8 and A9 via RAGE-MAPK in rat dental pulp cells

OBJECTIVE

Advanced glycation end products (AGE) are involved in the progression of diabetic complications. Although our previous reports show that AGE increased dental pulp calcification, AGE accumulation is also associated with inflammation. This study examined AGE effect on the expression of inflammation factors using rat dental pulp tissues and cell cultures.

MATERIALS AND METHODS

Receptor for AGE (RAGE), S100A8, S100A9, and interleukin (IL)-1β were selected as inflammation parameters. Rat dental pulp cells were cultured and treated with AGE, and the effects were determined by real-time PCR. An anti-RAGE antibody or MAPK pathway inhibitors (PD98059, SB203580, and SP60012) were used to investigate AGE signaling pathway.

RESULTS

The mRNA levels of RAGE, S100A8, S100A9, and IL-1β were higher in diabetic pulp tissues. AGE increased mRNA expressions of S100A8, S100A9, and IL-1β in cultured dental pulp cells. In the presence of anti-RAGE antibody, AGE did not increase in S100A8 or S100A9 expressions. The AGE-induced increases in S100A8 and S100A9 were inhibited by PD98059 and SB203580, respectively.

CONCLUSIONS

Advanced glycation end products increased mRNA expression of S100A8, S100A9, and IL-1β under diabetic pulp conditions, and AGE-induced increases in S100A8 and S100A9 expressions may be associated with the RAGE-MAPK signaling pathway.

Type 1 Pili Enhance the Invasion ofSalmonella braenderupandSalmonella typhimuriumto HeLa Cells

The relationship between type 1 pili-associated adhesion and invasion to HeLa cells by Salmonella braenderup and S. typhimurium was studied. When the clinical isolates of these strains were grown in L-broth, they showed both type 1 pili formation and mannose-sensitive adhesion to HeLa cells. On the other hand, the type 1 pili-defective mutants, which were obtained either by repeated subcultures on L-agar plates or by the transposon Tn1-insertion mutagenesis of the S. braenderup and S. typhimurium strains, concomitantly lost mannose-sensitive adhesion to HeLa cells. When the HeLa cells were incubated with Salmonella, the type 1 piliated strains invaded the HeLa cells with much higher infection rate than did the type 1 pili-defective strains. The invasion of type 1 piliated strains to HeLa cells was markedly inhibited in the presence of D-mannose. The infectivity of the strain, which lost type 1 pili but still had mannose-resistant adhesion, was slightly higher than that of the strains defective in both mannose-sensitive and mannose-resistant adhesion. These results suggested that type 1 pili have a role in enhancing the invasion of S. braenderup and S. typhimurium to HeLa cells.

Flavonoids as potential anti-hepatocellular carcinoma agents: recent approaches using HepG2 cell line

Numerous studies have documented that in cancer therapy flavonoids extracted from traditional Chinese medicine have anti-tumor activity or can enhance efficiency of chemotherapy in combination with chemotherapeutics. Thus, an awareness of flavonoids is needed by physicians and medical researchers. This review provides evidence about anti-hepatocellular carcinoma activity of flavonoids. First, as a common employed in vitro model, profile of HepG2 is shown. Second, the intracellular signaling pathways induced by flavonoids which inhibit the HepG2 cell line are summarized. Third, study situation of anti-HBV/HCV activity of flavonoids is shown. Our review is aimed at providing an understanding of anti-HBV/HCV activity and anti-HCC mechanisms of flavonoids, and an outlook on flavonoids application on cancer therapy.

Efficacy and immunomodulatory actions of ONO-4641, a novel selective agonist for sphingosine 1-phosphate receptors 1 and 5, in preclinical models of multiple sclerosis

ONO-4641 is a next-generation sphingosine 1-phosphate (S1P) receptor agonist selective for S1P receptors 1 and 5. The objective of the study was to characterize the immunomodulatory effects of ONO-4641 using preclinical data. ONO-4641 was tested in both in-vitro pharmacological studies as well as in-vivo models of transient or relapsing-remitting experimental autoimmune encephalomyelitis (EAE). In vitro, ONO-4641 showed highly potent agonistic activities versus S1P receptors 1 and 5 [half maximal effective concentration (EC(50) ) values of 0·0273 and 0·334 nM, respectively], and had profound S1P receptor 1 down-regulating effects on the cell membrane. ONO-4641 decreased peripheral blood lymphocyte counts in rats by inhibiting lymphocyte egress from secondary lymphoid tissues. In a rat experimental autoimmune encephalomyelitis (EAE) model, ONO-4641 suppressed the onset of disease and inhibited lymphocyte infiltration into the spinal cord in a dose-dependent manner at doses of 0·03 and 0·1 mg/kg. Furthermore, ONO-4641 prevented relapse of disease in a non-obese diabetic mouse model of relapsing-remitting EAE. These observations suggest that ONO-4641 may provide therapeutic benefits in the treatment of multiple sclerosis.

c-Met: A potential therapeutic target for hepatocellular carcinoma

The approval of receptor tyrosine kinase (RTK) targeted agent sorafenib as the first effective drug for the systemic treatment of advanced hepatocellular carcinoma (HCC) represents a milestone in the treatment of this disease. A better understanding of HCC pathogenesis will lead to development of novel targeted treatments. As a typical member of the RTK family, c-Met represents an intriguing target for cancer therapy. The c-Met signaling pathway has been shown to be deregulated and to correlate with poor prognosis in a number of major human cancers. This review discusses the possibility of c-Met as a target in HCC treatment from the following respects: i) c-Met expression and activation profile in HCC, ii) relationship between c-Met and clinicopathologic state and prognosis of HCC, iii) role of c-Met signaling activity in HCC genesis and progression, and iv) strategy of c-Met pathway targeting therapy in HCC treatment.

Diffusion of Technetium in Compacted Bentonites in the Reducing Condition with Corrosion Products of Iron

In the vicinity of a high-level waste repository, corrosion of carbon steel overpacks will create a reducing environment. Reducing conditions are expected to retard the migration of redox-sensitive radionuclides such as technetium.

The apparent diffusion coefficients of technetium were measured in compacted bentonites (Kunigel VI® and Kunipia F®, JAPAN) in contact with carbon steel and its corrosion products under reducing conditions or without carbon steel under oxidizing conditions for comparison. The apparent diffusion coefficients measured were 10-12 to 10-13 m2/s under oxidizing conditions and 10-12 to 10-13 m2/s under reducing conditions. There were significant effects of redox condition, dry density (0.2 to 2.3 g / cm3) and montmorillonite content (50% for Kunigel VI or 100% for Kunipia F) on the apparent diffusion coefficients. Montmorillonite density could be a good index to explain density dependence of the diffusion coefficients under both reducing and oxidizing conditions.

Invasion of carcinoma cells into reconstituted type I collagen gels: visual real-time analysis by time-lapse microscopy

Stromal-epithelial interactions play a critical role in promoting tumorigenesis and invasion. To obtain detailed information on cancer cell behaviors on the stroma and kinetics of cell migration, which cannot be observed by conventionally-used Boyden chamber assays, this study was aimed at analyzing the cell invasion process in vitro using time-lapse microscopic observation. Serum-free conditions and reconstituted type I collagen gels which provided a basal membrane-stroma-like microenvironment were used to first establish a basal condition. Time-lapse microscopic observation for 30 h of cell invasion into the collagen gel revealed kinetic parameters and individualistic behavior of cancer cells. Of breast cancer MDA-MB-231 or MCF-7 cells and colon cancer LS180 or HT29 cells examined, MDA-MB-231 cells most rapidly disappeared from the collagen gel surface under basal conditions. Estrogen-dependent MCF-7 cells disappeared at a rate approximately two times slower than that of MDA-MB-231 cells under serum- and phenol red-free conditions. By the addition of 10 nM β-estradiol to the basal medium, MCF-7 cell invasion was facilitated to a rate similar to that of MDA-MB-231 cells. Microscopic analyses of collagen gel-sections demonstrated that most of the MDA-MB-231 and MCF-7 cells remained within 60 μm from the gel top under basal conditions, which is consistent with the observation obtained using Boyden chambers that no cells could cross the collagen I gel barrier unless 1% fetal calf serum was added to basal conditions. In summary, this study demonstrated future applicability of this method to understand the initial phase of cancer cell invasion processes.

Microstructure of Simulated High-Level Waste Glass Doped with Short-Lived Actinides, 238Pu and 244Cm

The microstructural changes of a simulated waste glass irradiated with doping of 238pu and 244Cm were observed by use of a preshadowed carbon replica technique in combination with scanning electron microscopy (SEM). The irradiated glass was annealed and its microstructural changes after annealing were observed by use of the sametechnique.

In the glass irradiated at a dose of 2.75x1025 α-decays/m3, bubbles with a radius from 0.15μrm to 0.35μm were observed. The average bubble radius and the bubble density were 0.23μm and 1x1017 bubbles/m3, respectively. Using these observed values, the volume change of the glass resulting from the bubble formation was estimated to be + 0.51 %. This valuoof + 0.51 % was close to the volume change of the irradiated glass measured in our previous study, which suggests a large portion of the volume change by α-irradiation results from bubble formation. In the glass annealed after irradiation the average bubbleradius was observed to decrease with annealing time. The bubble radius as a function of annealing time was analyzed on the basis of the helium diffusion model with two chemicalprocesses, i.e. trapping at bubbles and re-solution from bubbles into glass matrix. The values of the diffusion coefficient of helium, the trapping parameter and the re-solution parameter, which had been obtained experimentally in our previous study on the helium release, were applied to the calculation. The calculated curve was in good agreement with the observed data.

Diffusion of Uranium in Compacted Bentonite in the Presence of Carbon Steel

In a high-level waste repository, a carbon steel overpack will be corroded by consuming oxygen trapped in the repository after closure. This will create a reducing environment in the vicinity of repository. Reducing conditions are expected to retard the migration of redox-sensitive radionuclides such as uranium.

The apparent diffusivities of uranium were measured in compacted bentonite (Kunigel VI®, Japan) in contact with carbon steel under reducing conditions or without carbon steel under oxidizing conditions for comparison. The apparent diffusivities of uranium were 3.5 × 10-14 to 1.1 × 10-13 m2/s under reducing conditions and 9.0 × 10-13 to 1.4 × 10-12 m2/s under oxidizing conditions. There was no significant effect of dry density (1.6 to 1.8 g/cm3) and silica sand (0 or 40%) on the apparent diffusivities.

Since the bentonite pore water would be buffered at a pH between 8 and 9, uranium in the bentonite pore water would probably exist as a neutral hydroxide complex under reducing conditions and as an anioníc carbonate or hydroxide complex under oxidizing conditions. The anion exclusion theory cannot explain the difference of diffusivities between the two conditions. The uranium concentrations in bentonite under oxidizing conditions were one order of magnitude higher than those under the reducing conditions. The uranium concentration in the bentonite pore water under the reducing condition is estimated to be two orders of magnitude lower than that under the oxidizing conditions under the assumption of diffusion in porous media.

Diffusion of Uranium in Compacted Bentonites in the Reducing Condition with Corrosion Products of Iron

In high-level waste repository, a carbon steel overpack will be corroded after closure. This will create a reducing environment in the vicinity of the repository. Reducing conditions are expected to retard the migration of redox-sensitive radionuclides such as uranium.

The apparent diffusion coefficients of uranium were measured in compacted bentonites (Kunigel VI® and Kunipia F®, JAPAN) in contact with carbon steel and its corrosion products under reducing conditions or without carbon steel under oxidizing conditions for comparison. The apparent diffusion coefficients measured were 10-12 to 10-14 m2/s under oxidizing conditions and 10-13 to 10-14 m2/s under reducing conditions. There were significant effects of redox conditions, dry density (0.8 to 2.0 g/cm3) and montmorillonite contents (60% for Kunigel VI or 100% for Kunipia F) on the apparent diffusion coefficients. The sorption of uranium on corrosion products of iron was smaller than that on montmorillonite. Montmorillonite density could be a good index to explain density dependence of the diffusion coefficients under the reducing conditions. Uranium would diffuse in free pore water with diffusion coefficients greater than 10-13 m2/s in low density bentonites under both redox conditions because the diffusion coefficients depended on sorption coefficients. Since diffusion coefficients were independent of sorption coefficients in high density bentonites where free pore water is scarce, surface diffusion might occur with coefficients were of about 10-13 m2/s.

Sorption Behavior of Uranium(VI) on a Biotite Mineral

Biotite has the most important role for the sorption of radionuclides in granitic rocks. Experiments on the sorption of uranium (VI) on biotite were conducted to understand the fundamental controls on uranium sorption on biotite mineral, including the effects of pH and uranium concentration in solution. Biotite powder (mesh 32 – 60) were washed with 1N HC1 for a week and were rinsed twice with deionized water for a week. This HC1 treatment was necessary to avoid the effects by other minerals. The agreement between surface adsorption coefficient, Ka, of both biotites with and without HC1 treatment was within one order of magnitude. The peak Ka value was in the range of 0.1 to 0.01 cm3/cm2 around pH 6. A comparison of aqueous uranium speciations and sorption results indicates that neutral uranyl hydroxide could be an important species sorbed on the biotite.

Sequential desorption experiments with KC1 and HC1 solutions were also carried out after sorption experiments to investigate sorption forms of uranium. Approximately 20 % of uranium in solution were sorbed on the biotite as an exchangeable ion. The fraction of exchangeable uranium had a little dependence on pH. The other uranium could not be extracted even by 6N HC1 solution. It is possible that most of the uranium could be precipitated as U(IV) via Fe(II) reduction on the biotite surface.

Measurement of initial dissolution rate of P0798 simulated HLW glass by using micro-reactor flow-through test method

We applied a new type of flow-through test method using micro-reactor consisting of a simple test apparatus with compact size to measurement of the dissolution rate of a Japanese type of simulated waste glass (P0798 glass). In this test method, a solution flows through a micro-channel (20 mm length, 2 mm width, 0.16 mm depth) in contact with a face of coupon shaped glass specimen, and the output solution is retrieved at certain intervals to be analyzed for determination of the glass dissolution rate. By using this test method the initial dissolution rate of glass matrix or forward dissolution rate was measured as a function of pH (3 to 11) and temperature (25°C to 90°C). The present test results indicated that the initial dissolution rate has ‘V-shaped’ pH dependence, and the effect of pH on the dissolution rate decreases with increase in temperature similar to the results measured by using the Single-pass flow-through (SPFT) method. The present test results also indicated that the dissolution of B is controlled by diffusion process and that of Si is controlled by surface reaction process.

Diffusion of Cs and Sr in Compacted Bentonites Under Reducing Conditions and in the Presence of Corrosion Products of Iron

In high-level waste repositories, a carbon steel overpack will be corroded by consuming oxygen trapped in the repository after closure. Iron corrosion products are expected to interfere with migration of radionuclides by filling the pore in bentonite and sorbing radionuclides. In this study the apparent diffusion coefficients of cesium and strontium were measured in compacted Na-bentonites (Kunigel VI® and Kunipia F®, JAPAN) contacted with carbon steel and its corrosion products under reducing conditions or without carbon steel under oxidizing conditions for comparison. The apparent diffusion coefficients of cesium with and without corrosion product were 2.2 to 13 × 10−12 m2/s. The apparent diffusion coefficients of strontium with and without corrosion product were 3.1 to 25 × 10−12 m2/s. There were significant effects of dry density (0.8 to 2.0 g/cm3) and montmorillonite contents (50% for Kunigel V1 or 100% for Kunipia F). The presence of corrosion product decreased the apparent diffusion coefficients of Cs in both bentonites and that of Sr in Kunigel V1, especially at low dry density. This may be due to corrosion product filling the pore in the bentonite, decreasing the free pore size and density for diffusion.

Effects of Water Redox Conditions and Presence of Magnetite on Leaching of Pu and Np From HLW Glass

The objective of this study is to evaluate the effects of water redox conditions and of the presence of iron corrosion products (magnetite) on the release of actinides from HLW glasses. Static corrosion tests were performed on a simulated HLW glass doped with Pu and Np in deionized water in the presence of magnetite under oxidizing and reducing conditions. The tests under oxidizing conditions were performed in air, while the tests under reducing conditions were performed in mixed gas (Ar+5%H2) atmosphere.

The following results were obtained: (1) The presence of magnetite enhances formation of colloids containing Pu and Np in the leachates under both redox conditions. (2) Redox conditions have no remarkable influence on the release of Pu. (3) The reducing conditions combined with the presence of magnetite cause a decrease in the concentrations of Np dissolved species, which is probably the result of the reduction of Np(V) to Np(IV) at the magnetite surface.

Expression of KL-6 mucin, a human MUC1 mucin, in intrahepatic cholangiocarcinoma and its potential involvement in tumor cell adhesion and invasion

AIMS

Aberrant expressions of KL-6 mucin were proved to be associated with worse tumor behaviors of many carcinomas. This study was to evaluate the expression KL-6 mucin, a human MUC1 mucin, in intrahepatic cholangiocarcinoma (CC) and its significance in tumor progression.

MAIN METHODS

KL-6 mucin expressions in 21 patients with CC, 12 with combined hepatocellular and cholangiocarcinoma (cHCC-CC), and 78 with hepatocellular carcinoma (HCC) were detected by immunohistochemical staining. The effects of two glycosylation inhibitors (tunicamycin and benzyl-alpha-N-acetylgalactosamine (BAG)) on CC cell proliferations were assessed by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl-tetrazolium bromide (MTT) assays. KL-6 mucin expressions were detected by immunocytochemical staining and western blotting after tunicamycin or BAG treatment. Cell adhesive and invasive properties were evaluated by adhesion tests and transwell chamber assays after tunicamycin or BAG treatment.

KEY FINDINGS

Positive KL-6 mucin staining was observed in all CC tissues and CC areas of cHCC-CC tissues. Immunocytochemical staining and western blotting showed that KL-6 mucin expressions were significantly reduced after both inhibitors treatment. Cell adhesive properties were significantly decreased after both inhibitors treatment, while cell invasive abilities were significantly decreased after BAG but not tunicamycin treatment.

SIGNIFICANCE

This study indicated that KL-6 mucin might be a specific tumor target for CC. Therapeutic strategies that target glycosylation of KL-6 mucin may be useful to control aggressive behaviors of CC.

Shosaikoto increases calprotectin expression in human oral epithelial cells

BACKGROUND AND OBJECTIVE

Oral epithelial cells help to prevent against bacterial infection in the oral cavity by producing antimicrobial peptides (AMPs). A broad-spectrum AMP, calprotectin (a complex of S100A8 and S100A9 proteins), is expressed by oral epithelial cells and is up-regulated by interleukin-1alpha (IL-1alpha). Shosaikoto (SST) is a traditional Japanese herbal medicine that has immunomodulatory effects and is reported to enhance the levels of IL-1alpha in epithelial cells. The purpose of this study was to investigate the effect of SST on the expression of calprotectin and other AMPs through the regulation of IL-1alpha in oral epithelial cells.

MATERIAL AND METHODS

Human oral epithelial cells (TR146) were cultured with SST (at concentrations ranging from 10 to 250 microg/mL) in the presence or absence of anti-IL-1alpha or IL-1 receptor antagonist. The expression of S100A8- and S100A9-specific mRNAs was examined by northern blotting. Calprotectin expression and IL-1alpha secretion were investigated by immunofluorescent staining or ELISA. The expression of other AMPs and IL-1alpha was analyzed by RT-PCR and by quantitative real-time PCR.

RESULTS

Shosaikoto (25 microg/mL) significantly increased the expression of S100A8- and S100A9-specific mRNAs and calprotectin protein. Shosaikoto increased S100A7 expression, but had no effect on the expression of other AMPs. The expression of IL-1alpha-specific mRNA and its protein were slightly increased by SST. A neutralizing antibody against IL-1alpha or IL-1 receptor antagonist inhibited SST up-regulated S100A8/S100A9 mRNA expression.

CONCLUSION

These results suggest that SST increases the expression of calprotectin and S100A7 in oral epithelial cells. In response to SST, up-regulation of calprotectin may be partially induced via IL-1alpha.

Development of pressure cell for specific heat measurement at low temperature and high Magnetic field

We report the performance of Ag-Pd-Cu alloy as the material of a pressure cell to carry out specific heat measurements at low temperatures and high magnetic fields. The Ag-Pd-Cu alloy is advantageous to reduce the background due to the nuclear specific heat in the pressure cell growing at low temperatures and high magnetic fields. We prepared 70-20-10 alloy composed of 70 mass % of Ag, 20 mass % of Pd, and 10 mass % of Cu. The maximum hardness over 100 HRB (Rockwell-B scale) is achieved by the heat treatment. The magnetization and susceptibility results show that the alloy includes a small amount of magnetic ions, whose concentration is smaller than that in the Be-Cu alloy. We confirm that the specific heat of a piston cylinder cell made of the 70-20-10 alloy increases smoothly from 0.2 to 9 K and the nuclear specific heat decreases drastically in magnetic field compared to that expected in the Be-Cu alloy. The pressure value in the cell at low temperature increases almost linearly up to P=0.4 GPa, which is nearly the limit of the inner piston made of the 70-20-10 alloy, with increasing of the load applied at room temperature.

Effect of benzyl-N-acetyl-α-galactosaminide on KL-6 mucin expression and invasive properties of a human pancreatic carcinoma cell line

KL-6 mucin is a type of MUC1 mucin and its aberrant expression has been shown to be associated with aggressive metastasis and poor clinical outcome in tumors. The present study is to investigate the effects of benzyl-N-acetyl-α-galactosaminide (GalNAc-O-bn), an O-glycosylation inhibitor, on KL-6 mucin expression and invasive properties of a human pancreatic carcinoma cell line, Suit-2 cells. Expression profiles of KL-6 mucin in the cells pretreated with or without 5 mM GalNAc-O-bn for 48 h were examined by Western blotting and immunocytochemical staining and invasive properties were examined by transwell chamber assay. Western blotting and immunocytochemical staining showed that the expression profiles of KL-6 mucin changed significantly after GalNAc-O-bn treatment. Meanwhile, the invasive ability of Suit-2 cells decreased significantly after GalNAc-O-bn treatment (p < 0.05). These results suggest that glycosylation of KL-6 mucin may be closely related to aggressive behaviors of pancreatic cancer cells like metastasis and invasion.