OP0112 THE EVER-LARGEST ASIAN GWAS FOR SYSTEMIC SCLEROSIS AND TRANS-POPULATION META-ANALYSIS IDENTIFIED SEVEN NOVEL LOCI AND A CANDIDATE CAUSAL SNP IN A CIS-REGULATORY ELEMENT OF THE FCGR REGION

Background

Genome-wide association studies (GWASs) have identified 29 disease-associated single nucleotide polymorphisms (SNPs) for systemic sclerosis (SSc) in non-human leukocyte antigen (HLA) regions (1-7). While these GWASs have clarified genetic architectures of SSc, study subjects were mainly Caucasians limiting application of the findings to Asians.

Objectives

The study was conducted to identify novel causal variants for SSc specific to Japanese subjects as well as those shared with European population. We also aimed to clarify mechanistic effects of the variants on pathogenesis of SSc.

Methods

A total of 114,108 subjects comprising 1,499 cases and 112,609 controls were enrolled in the two-staged study leading to the ever-largest Asian GWAS for SSc. After applying a strict quality control both for genotype and samples, imputation was conducted using the reference panel of the phase 3v5 1,000 genome project data combined with a high-depth whole-genome sequence data of 3,256 Japanese subjects. We conducted logistic regression analyses and also combined the Japanese GWAS results with those of Europeans (6) by an inverse-variance fixed-effect model. Polygenicity and enrichment of functional annotations were evaluated by linkage disequilibrium score regression (LDSC), Haploreg and IMPACT programs. We also constructed polygenic risk score (PRS) to predict SSc development.

Results

We identified three (FCRLA-FCGR, TNFAIP3, PLD4) and four (EOMES, ESR1, SLC12A5, TPI1P2) novel loci in Japanese GWAS and a trans-population meta-analysis, respectively. One of Japanese novel risk SNPs, rs6697139, located within FCGR gene clusters had a strong effect size (OR 2.05, P=4.9×10-11). We also found the complete LD variant, rs10917688, was positioned in cis-regulatory element and binding motif for an immunomodulatory transcription factor IRF8 in B cells, another genome-wide significant locus in our trans-ethnic meta-analysis and the previous European GWAS. Notably, the association of risk allele of rs10917688 was significant only in the presence of the risk allele of the IRF8. Intriguingly, rs10917688 was annotated as one enhancer-related histone marks, H3K4me1, in B cells, implying that FCGR gene(s) in B cells may play an important role in the pathogenesis of SSc. Furhtermore, significant heritability enrichment of active histone marks and a transcription factor C-Myc were found in B cells both in European and Japanese populations by LDSC and IMPACT, highlighting a possibility of a shared disease mechanism where abnormal B-cell activation may be one of the key drivers for the disease development. Finally, PRS using effects sizes of European GWAS moderately fit in the development of Japanese SSc (AUC 0.593), paving a path to personalized medicine for SSc.

Conclusion

Our study identified seven novel susceptibility loci in SSc. Downstream analyses highlighted a novel disease mechanism of SSc where an interactive role of FCGR gene(s) and IRF8 may accelerate the disease development and B cells may play a key role on the pathogenesis of SSc.

References

[1]F. C. Arnett et al. Ann Rheum Dis, 2010.

[2]T. R. Radstake et al. Nat Genet, 2010.

[3]Y. Allanore et al. PLoS Genet, 2011.

[4]O. Gorlova et al. PLoS Genet, 2011.

[5]C. Terao et al. Ann Rheum Dis, 2017.

[6]E. López-Isac et al. Nat Commun, 2019.

[7]W. Pu et al. J Invest Dermatol, 2021.

Disclosure of Interests

None declared

A phase II trial of stereotactic body radiotherapy in 4 fractions for patients with localized prostate cancer

Purpose/objective(s)

To report results from our phase II study of stereotactic body radiotherapy (SBRT) delivering 36 Gy in 4 fractions for patients with localized prostate cancer.

Materials/methods

We enrolled 55 patients treated with SBRT delivering 36 Gy in 4 fractions between 2015 to 2018. All patients were categorized as low-risk (n = 4), intermediate-risk (n = 31) or high-risk (n = 20) according to National Comprehensive Cancer Network criteria. Median age was 73 years (range 54–86 years). Two-thirds of patients (n = 37) had received androgen-deprivation therapy for 3–46 months (median, 31 months). Median duration of follow-up was 36 months (range 1–54 months). We used Radiation Therapy Oncology Group and National Cancer Institute—Common Toxicity Criteria version 4 for toxicity assessments. Quality of life (QOL) outcomes were also evaluated using the Expanded Prostate Cancer Index Composite (EPIC).

Results

Protocol treatments were completed for all patients. Six patients experienced biochemical failures. Among these six patients, three patients experienced clinical failure. One patient showed bone metastasis before biochemical failure. One patient died of gastric cancer. The 3-year biochemical control rate was 89.8%. Acute grade 2 genitourinary (GU) and gastrointestinal (GI) toxicities were observed in 5 patients (9%) and 6 patients (11%), respectively. No grade 3 or higher acute toxicities were observed. Late grade 2 GU and GI toxicities were observed in 7 patients (13%) and 4 patients (7%), respectively. Late grade 3 GU and GI toxicities were observed in 1 patient (1.8%) each. EPIC scores decreased slightly during the acute phase and recovered within 3 months after treatment.

Conclusion

Our phase II study showed that SBRT delivering 36 Gy in 4 fractions was safe and effective with favorable QOL outcomes, although this regimen showed slightly more severe toxicities compared to current standards.

Commercial Wet-Spun Singlewall and Dry-Spun Multiwall Carbon Nanotube Fiber Surface O-Functionalization by Ozone Treatment

In this work, we demonstrate controlled introduction of O-functional groups on commercial carbon nanotube fibers (CNTFs) with different nanotube morphologies obtained by dry- and wet-spinning by treatment with gaseous ozone (O₃(g)). Our test samples were (1) wet-spun fibers of smalldiameter (1-2 nm) singlewall (SW)-CNTs and (2) dry-spun fibers containing large-diameter (20 nm) multiwall (MW)-CNTs. Our results indicate that SW-CNTFs undergo oxygenation to a higher extent than MW-CNTFs due to the higher reactivity of SW-CNTs with a larger curvature strain. Oxygenation resulting from O₃ exposure was evidenced as increase in surface O atomic% (at% by X-ray photoelectron spectroscopy, XPS) and as reductions in G/D (by Raman spectroscopy) as well as electrical conductivities due to changes in nanotube graphitic structure. By XPS, we identified the emergence of various types of O-functionalities on the fiber surfaces. After long duration O3 exposure (>300 s for SW-CNTFs and >600 s for MW-CNTFs), both sp² C═O (carbonyl) and sp³ C-O moieties (ether/hydroxy) were observed on fiber surfaces. Whereas, only sp³ C-O (ether/hydroxy) components were observed after shorter exposure times. O₃ treatment led to only changes in surface chemistry, while the fiber morphology, microstructure and dimensions remained unaltered. We believe the surface chemistry controllability demonstrated here on commercial fibers spun by different methods containing nanotubes of different structures is of significance in aiding the practical application development of CNTFs.

Valproate-Induced Polycystic Ovary Syndrome in a Girl with Epilepsy: A Case Study

BACKGROUND

Polycystic ovary syndrome (PCOS) is a common ovulatory disorder that can be induced by sodium valproate (VPA).

PATIENT

We report a case of PCOS that developed in a 15-year-old girl with idiopathic epilepsy after she took VPA. VPA administration stopped her seizures, but it also led to weight gain and amenorrhea, and the patient was diagnosed with PCOS on the basis of diagnostic imaging and serological examination results. Cessation of VPA administration led to reduced weight gain and restored menstruation.

CONCLUSIONS

The risk of PCOS developing in patients with epilepsy is known to be high, and the association of VPA with PCOS is well established, so if physicians feel this is the best drug to prescribe for female patients with epilepsy, they should carefully monitor the patients' weight and menstruation, and immediately perform ovarian imaging and hormonal examinations if any abnormalities are observed.

Copper/carbon nanotube composites: research trends and outlook

We present research progress made in developing copper/carbon nanotube composites (Cu/CNT) to fulfil a growing demand for lighter copper substitutes with superior electrical, thermal and mechanical performances. Lighter alternatives to heavy copper electrical and data wiring are needed in automobiles and aircrafts to enhance fuel efficiencies. In electronics, better interconnects and thermal management components than copper with higher current- and heat-stabilities are required to enable device miniaturization with increased functionality. Our literature survey encouragingly indicates that Cu/CNT performances (electrical, thermal and mechanical) reported so far rival that of Cu, proving the material's viability as a Cu alternative. We identify two grand challenges to be solved for Cu/CNT to replace copper in real-life applications. The first grand challenge is to fabricate Cu/CNT with overall performances exceeding that of copper. To address this challenge, we propose research directions to fabricate Cu/CNT closer to ideal composites theoretically predicted to surpass Cu performances (i.e. those containing uniformly distributed Cu and individually aligned CNTs with beneficial CNT-Cu interactions). The second grand challenge is to industrialize and transfer Cu/CNT from lab bench to real-life use. Toward this, we identify and propose strategies to address market-dependent issues for niche/mainstream applications. The current best Cu/CNT performances already qualify for application in niche electronic device markets as high-end interconnects. However, mainstream Cu/CNT application as copper replacements in conventional electronics and in electrical/data wires are long-term goals, needing inexpensive mass-production by methods aligned with existing industrial practices. Mainstream electronics require cheap CNT template-making and electrodeposition procedures, while data/electrical cables require manufacture protocols based on co-electrodeposition or melt-processing. We note (with examples) that initiatives devoted to Cu/CNT manufacturing for both types of mainstream applications are underway. With sustained research on Cu/CNT and accelerating its real-life application, we expect the successful evolution of highly functional, efficient, and sustainable next-generation electrical and electronics systems.

Cervical Dilatation Curves of Spontaneous Deliveries in Pregnant Japanese Females

Background: Although cervical dilatation curves are crucial for appropriate management of labor progression, abnormal labor progression and obstetric interventions were included in previous and widely-used cervical dilatation curves. We aimed to describe the cervical dilatation curves of normal labor progression in pregnant Japanese females without abnormal labor progression and obstetric interventions. Methods: We completed retrospective obstetric record reviews on 3172 pregnant Japanese females (parity = 0, n = 1047; parity = 1, n = 1083; parity ≥ 2, n = 1042), aged 20 to 39 years old at delivery, with pregravid body mass indices of less than 30. All patients underwent spontaneous deliveries with term, singleton, cephalic and live newborns of appropriate-for-gestational age birthweight, without adverse neonatal outcomes. We characterized labor progression patterns by examining the relationship between elapsed times from the full dilatation and cervical dilatation stages, and labor durations by examining the distribution of time intervals from one cervical dilatation stage, to the next, and ultimately to the full dilatation. Results: Fastest cervical changes occurred at 6 cm (primiparas) and 5 cm (multiparas) of dilatation. The 95%tile of labor progression took over 3 hours to progress from 6 cm to 7 cm (primiparas), and over 2 hours to progress from 5 cm to 6 cm (multiparas). The 5%tile of traverse time to the full dilatation, during the active phase, was less than 1 hour (primiparas) and 0.5 hours (multiparas). At the end of the active phase, no deceleration phase was observed. Conclusions: Active labor may not start until 5 cm of dilatation. At the beginning of the active phase, cervical dilatation was slower than previously described. These results may reduce opportunities for obstetric interventions during labor progression.

Electrical performance of lightweight CNT-Cu composite wires impacted by surface and internal Cu spatial distribution

We report ultralong conducting lightweight multiwall carbon nanotube (MWCNT)-Cu composite wires with MWCNTs uniformly distributed in a continuous Cu matrix throughout. With a high MWCNT vol% (40-45%), the MWCNT-Cu wire density was 2/3rd that of Cu. Our composite wires show manufacturing potential because we used industrially compatible Cu electrodeposition protocols on commercial CNT wires. Further, we systematically varied Cu spatial distribution on the composite wire surface and bulk and measured the associated electrical performance, including resistivity (ρ), temperature dependence of resistance, and stability to current (measured as current carrying capacity, CCC in vacuum). We find that a continuous Cu matrix with homogeneous MWCNT distribution, i.e., maximum internal Cu filling within MWCNT wires, is critical to high overall electrical performances. Wires with maximum internal Cu filling exhibit (i) low room temperature ρ, 1/100th of the starting MWCNT wires, (ii) suppressed resistance-rise with temperature-increase and temperature coefficient of resistance (TCR) ½ that of Cu, and (iii) vacuum-CCC 28% higher than Cu. Further, the wires showed real-world applicability and were easily soldered into practical circuits. Hence, our MWCNT-Cu wires are promising lightweight alternatives to Cu wiring for weight-reducing applications. The low TCR is specifically advantageous for stable high-temperature operation, e.g., in motor windings.

A Report on the Positive Response to an Outdoor Nature Challenge of a Snow Camp for Young Liver Transplant Patients

OBJECTIVES

More than two decades have passed since the first living donor liver transplantation was performed in Japan in 1989. There are many reports about problems in adherence to taking medication and medical follow-ups in children who received liver transplants, because there is no transition strategy for those children and parents or guardians. The objective of this study is to measure the effect of nature and outdoor activity to improve children's medical adherence.

METHODS

We recruited participants from 9-year-old children who are attending the outpatient liver transplant clinic in a stable condition (no event such as rejection or surgical procedure within 6 months). We took participants to a snow camp and measured its effect by using the IKIRU CHIKARA (IKR) tool, which contain 28 items divided into 3 categories: psychosocial ability, moral fitness, and physical ability. Children were tested on three occasions, before, just after, and 1 month after the camp.

RESULTS

Eight patients participated in the snow camp and 7 patients were eligible for the study. The average age was 12.6 with a range 10 to 17 years. There were 3 girls and 4 boys. The average IKR scores before, just after, and 1 month after the camp were 127.9, 131.5, and 126.6, respectively.

CONCLUSION

An outdoor activity such as a snow camp can be safely conducted, and it is an acceptable option to incorporate within a pediatric liver transplant program. There were no significant changes in IKR scores during this short observation. Longer observation is needed to measure the effect of nature and outdoor activities.

Pregnancy-associated Deaths: 31-year Experience

AIM

The aim of the present study was to elucidate the clinical characteristics of pregnancy-associated maternal deaths.

METHODS

We performed a retrospective analysis with medical records and autopsy reports of cases of pregnancy-associated deaths. We collected information on all maternal deaths related to pregnancy that occurred in 3 hospitals affiliated with Nippon Medical School in Japan from January 1, 1984, to December 31, 2014. Data analyzed were maternal age, past medical history, parity, gestational age, clinical signs and symptoms, cause of death, and maternal autopsy findings.

RESULTS

A total of 26 maternal deaths occurred during the 31-year study period. Autopsies were performed for 16 patients (61.5%). The 26 deaths included 19 (73.1%) classified as direct maternal deaths and 7 (26.9%) classified as indirect maternal deaths. The mean maternal age at death was 33.1±4.3 years (range, 26-41 years). The highest percentage of women was aged 35 to 39 years (38.5%). Of the 26 maternal deaths, 69% occurred at 32 to 41 weeks of gestation. In cases of direct maternal death, the leading causes were amniotic fluid embolism (7 cases, 27.0% of all deaths) and hemorrhage (6 cases, 23.1% of all deaths). In cases of indirect obstetric deaths, the causes included cardiovascular disorders, cerebrovascular disorders, sepsis due to group A streptococcal infection, and hepatic failure of unknown etiology.

CONCLUSIONS

Amniotic fluid embolism was the leading cause of maternal deaths and was followed by obstetric hemorrhage. To prevent and reduce the number of maternal deaths in Japan, further basic and clinical research on amniotic fluid embolism is required.

Nano-scale, planar and multi-tiered current pathways from a carbon nanotube-copper composite with high conductivity, ampacity and stability

New lithographically processable materials with high ampacity are in demand to meet the increasing requirement for high operational current density at high temperatures existing in current pathways within electronic devices. To meet this demand, we report an approach to fabricate a high ampacity (∼100 times higher than Cu) carbon nanotube-copper (CNT-Cu) composite into a variety of complex nano-scale, planar and multi-tiered current pathways. The approach involved the use of a two-stage electrodeposition of copper into a pre-patterned template of porous, thin CNT sheets acting as the electrode. The versatility of this approach enabled the realization of completely suspended multi-tier, dielectric-less 'air-gap' CNT-Cu circuits that could be electrically isolated from each other and are challenging to fabricate with pure Cu or any metal. Importantly, all such complex structures, ranging from 500 nm to 20 μm in width, exhibited ∼100-times higher ampacity than any known metal, with comparable electrical conductivity as Cu. In addition, CNT-Cu structures also exhibited a superior temperature stability compared to the ∼10-times wider Cu counterparts. We believe that the combination of our approach and the properties demonstrated here are vital achievements for the future development of efficient and powerful electrical devices.

A phenomenological model for selective growth of semiconducting single-walled carbon nanotubes based on catalyst deactivation

A method for the selective semiconducting single-walled carbon nanotube (SWCNT) growth over a continuous range from 67% to 98%, within the diameter range of 0.8-1.2 nm, by the use of a "catalyst conditioning process" prior to growth is reported. Continuous control revealed an inverse relationship between the selectivity and the yield as evidenced by a 1000-times difference in yield between the highest selectivity and non-selectivity. Further, these results show that the selectivity is highly sensitive to the presence of a precise concentration of oxidative and reductive gases (i.e. water and hydrogen), and the highest selectivity occurred along the border between the conditions suitable for high yield and no-growth. Through these results, a phenomenological model has been constructed to explain the inverse relationship between yield and selectivity based on catalyst deactivation. We believe our model to be general, as the fundamental mechanisms limiting selective semiconducting SWCNT growth are common to the previous reports of limited yield.

Consecutive cervical length measurements as a predictor of preterm cesarean section in complete placenta previa

BACKGROUND

To evaluate whether consecutive cervical length measurements can predict preterm cesarean section in women with complete placenta previa.

METHODS

Seventy-one women with complete placenta previa were retrospectively categorized into women who delivered preterm due to massive hemorrhage (the preterm cesarean section group, n = 28) and those delivered at term (the control group, n = 43). Maternal characteristics, delivery outcomes, and cervical lengths serially measured at least every 2 weeks from 24 weeks' gestation until delivery were compared. The relationship between cervical length and preterm cesarean section was analyzed.

RESULTS

Cervical length gradually decreased with advancing gestational age. After 26 weeks' gestation, this decrease was significantly more rapid in the preterm cesarean section group. Cervical length before cesarean section in the preterm cesarean section group was significantly shorter than that in the control group. Just before cesarean section, 71.4% of the preterm cesarean section group presented with cervical lengths of ≤35 mm, whereas only 34.9% of the control group had cervical lengths of ≤35 mm (odds ratio 4.67, 95% confidence interval 1.66-13.10, p = 0.006).

CONCLUSIONS

In women with complete placenta previa, decrease in cervical length to ≤35 mm was associated with increased risk of preterm cesarean section due to massive hemorrhage.

Safety of induced abortions at less than 12 weeks of pregnancy in Japan

OBJECTIVE

To assess the safety of various methods of induced abortion when used before 12 weeks of pregnancy in Japan.

METHODS

A retrospective study was undertaken of induced abortions conducted between January 1 and December 31, 2012. Questionnaires were sent to 4154 institutions that employed doctors who were licensed to conduct induced abortions. Information was obtained about the numbers of induced abortions performed before 12 weeks, methods, complications, and routine management.

RESULTS

Completed questionnaires from 2434 institutions showed that 100 851 induced abortions had been performed. Vacuum aspiration (VA) was used in 20 458 (20.3%) abortions, VA with sharp curettage in 47 148 (46.8%), dilatation and curettage (D&C) in 32 958 (32.7%), and medical abortion in 287 (0.3%). Overall, 358 complications were reported (355.0 per 100000 procedures). The rate of complications was significantly higher after D&C than after VA and after VA with sharp curettage (P<0.001 for both). However, incomplete abortion requiring repeat procedures was the only complication that was significantly associated with D&C (P<0.001).

CONCLUSION

D&C can be safely used for induced abortion before 12 weeks of pregnancy, but changing from D&C to VA could reduce incomplete abortions and improve the safety of induced abortions before 12 weeks of pregnancy in Japan.

Multi-drug-resistant Staphylococcus aureus and future chemotherapy

Staphylococcus (S.) aureus silently stays as our natural flora, and yet sometimes threatens our life as a tenacious pathogen. In addition to its ability to outwit our immune system, its multi-drug resistance phenotype makes it one of the most intractable pathogenic bacteria in the history of antibiotic chemotherapy. It conquered practically all the antibiotics that have been developed since 1940s. In 1961, the first MRSA was found among S. aureus clinical isolates. Then MRSA prevailed throughout the world as a multi-resistant hospital pathogen. In 1997, MRSA strain Mu50 with reduced susceptibility to vancomycin was isolated. Vancomycin-intermediate S. aureus (VISA), so named according to the CLSI criteria, was the product of adaptive mutation of S. aureus against vancomycin that had long been the last resort to MRSA infection. Here, we describe the genetic basis for the remarkable ability of S. aureus to acquire multi-antibiotic resistance, and propose a novel paradigm for future chemotherapy against the multi-resistant pathogens.

Fetal heart rate classification proposed by the perinatology committee of the Japan Society of Obstetrics and Gynecology: reproducibility and clinical usefulness

AIM

Intrapartum management guidelines based on fetal heart rate classification comprising a 5-tier system (Levels 1-5) was proposed by the Perinatology Committee of the Japan Society of Obstetrics and Gynecology (JSOG). This study aimed to assess the reproducibility and clinical usefulness of this classification.

METHODS

For assessing intraobserver and interobserver reproducibility in the interpretation of fetal heart rate tracing, 2 obstetricians reviewed 247 fetal heart rate tracings using the JSOG classification (Level 1, normal; Level 2, benign variant; Level 3, mild variant; Level 4, moderate variant; and Level 5, severe variant) and a subjective 3-tier classification (normal, equivocal, and ominous). In a separate series, we investigated whether the JSOG classification is related to early neonatal outcome and the delivery mode in 96 deliveries.

RESULTS

Weighted kappa coefficients of intraobserver and interobserver reproducibility in the interpretation of fetal heart rate tracings based on the JSOG classification were 0.73 to 0.77 and 0.70, respectively. In the subjective classification, these values were 0.69 to 0.72 and 0.59. There was a progressive increase in the rate of instrumental or cesarean deliveries across the 5 levels of the JSOG classification (P<0.001). Although, level 5 of the JSOG classification had a lower Apgar score and umbilical artery pH than did the other 4 levels (p<0.05), there were no significant differences among the other levels in regard to early neonatal outcome.

CONCLUSIONS

This study demonstrated that both intraobserver reproducibility and interobserver reproducibility of the JSOG classification for interpreting FHR tracings were clinically acceptable. The results also suggest that the intervention according to the JSOG classification is useful for avoiding worsening early neonatal outcomes.

Torsion-sensing material from aligned carbon nanotubes wound onto a rod demonstrating wide dynamic range

A rational torsion sensing material was fabricated by wrapping aligned single-walled carbon nanotube (SWCNT) thin films onto the surface of a rod with a predetermined and fixed wrapping angle without destroying the internal network of the SWCNTs within the film. When applied as a torsion sensor, torsion could be measured up to 400 rad/meter, that is, more than 4 times higher than conventional optical fiber torsion sensors, by monitoring increases in resistance due to fracturing of the aligned SWCNT thin films.

Type and location of placenta previa affect preterm delivery risk related to antepartum hemorrhage

PURPOSE

To evaluate whether type and location of placenta previa affect risk of antepartum hemorrhage-related preterm delivery.

METHODS

We retrospectively studied 162 women with singleton pregnancies presenting placenta previa. Through observation using transvaginal ultrasound the women were categorized into complete or incomplete placenta previa, and then assigned to anterior and posterior groups. Complete placenta previa was defined as a placenta that completely covered the internal cervical os, with the placental margin >2 cm from the os. Incomplete placenta previa comprised marginal placenta previa whose margin adjacent to the internal os and partial placenta previa which covered the os but the margin situated within 2 cm of the os. Maternal characteristics and perinatal outcomes in complete and incomplete placenta previa were compared, and the differences between the anterior and the posterior groups were evaluated.

RESULTS

Antepartum hemorrhage was more prevalent in women with complete placenta previa than in those with incomplete placenta previa (59.1% versus 17.6%), resulting in the higher incidence of preterm delivery in women with complete than in those with incomplete placenta previa [45.1% versus 8.8%; odds ratio (OR) 8.51; 95% confidence interval (CI) 3.59-20.18; p < 0.001]. In complete placenta previa, incidence of antepartum hemorrhage did not significantly differ between the anterior and the posterior groups. However, gestational age at bleeding onset was lower in the anterior group than in the posterior group, and the incidence of preterm delivery was higher in the anterior group than in the posterior group (76.2% versus 32.0%; OR 6.8; 95% CI 2.12-21.84; p = 0.002). In incomplete placenta previa, gestational age at delivery did not significantly differ between the anterior and posterior groups.

CONCLUSION

Obstetricians should be aware of the increased risk of preterm delivery related to antepartum hemorrhage in women with complete placenta previa, particularly when the placenta is located on the anterior wall.

Hierarchical three-dimensional layer-by-layer assembly of carbon nanotube wafers for integrated nanoelectronic devices

We report a general approach to overcome the enormous obstacle of the integration of CNTs into devices by bonding single-walled carbon nanotubes (SWNTs) films to arbitrary substrates and transferring them into densified and lithographically processable "CNT wafers". Our approach allows hierarchical layer-by-layer assembly of SWNTs into organized three-dimensional structures, for example, bidirectional islands, crossbar arrays with and without contacts on Si, and flexible substrates. These organized SWNT structures can be integrated with low-power resistive random-access memory.

The effect of regular exercise training during pregnancy on postpartum brachial-ankle pulse wave velocity, a measure of arterial stiffness

The aim of our study was to use brachial-ankle pulse wave velocity (baPWV) measurements to noninvasively assess the effect of exercise training on arterial stiffness in normal pregnant women. Arterial stiffness was assessed at the beginning of the early second trimester of pregnancy and 1 month after delivery in 17 women with normal singleton pregnancies who exercised regularly throughout pregnancy: 81 matched controls were used for comparison. No significant differences were observed in baPWV between the exercise and control groups at the beginning of the second trimester. BaPWV 1 month after delivery (1160.2 ± 109.1 cm·second(-1)) was signifi-cantly higher than that in the early second trimester (1116.7 ± 87.9 cm·second(-1)) in the control group (indicating increased arterial stiffness), but not in the exercise group (1145.9 ± 88.1 cm/second vs 1122.7 ± 100.2 cm·second(-1), respectively: not significant). The results indicated that regular maternal exercise training decreased arterial stiffness in normal pregnant women, which suggests that regular exercise may help prevent hypertensive disorders during pregnancy. Key pointsRegular maternal exercise training decreased arterial stiffness in normal pregnant women, which suggests that regular exercise may help prevent hypertensive disorders during pregnancy.Maternal exercise suggests that disturbances in arterial function during pregnancy may be prevented by regular exercise.

Type I IFN-mediated enhancement of anti-leukemic cytotoxicity of gammadelta T cells expanded from peripheral blood cells by stimulation with zoledronate

BACKGROUND

In order to establish efficient gammadelta T-cell based tumor immunotherapy, we explored a method to enhance the cytotoxicity of gammadelta T cells against leukemia cells by stimulating gammadelta T cells with type I IFN.

METHODS

Gammadelta T cells were expanded from normal PBMC by culturing with zoledronate and a low concentration of IL-2 for 2 weeks. For the activation of gammadelta T cells, gammadelta T cells were cultured with type I IFN (HLBI, IFN-alpha2b and IFN-beta) for 1-3 days. The cytotoxicity of HLBI-activated gammadelta T cells against leukemia cell lines and fresh leukemia cells was evaluated by 51Cr-release assay.

RESULTS

Gammadelta T cells, which were expanded and purified with magnetic beads using an anti-gammadelta TCR MAb, were demonstrated to be cytotoxic against leukemia cell lines of both lymphoid and myeloid origin and fresh myeloid leukemia cells. By culturing expanded gammadelta T cells with type I IFN, the expression of the activation marker CD69 was increased and the cytometric bead array showed an elevated production of IFN-gamma by gammadelta T cells. In addition, the cytotoxicity of gammadelta T cells against leukemia cells was definitely enhanced by culturing gammadelta T cells with HLBI.

DISCUSSION

The present study has demonstrated that type I IFN could enhance the anti-leukemic cytotoxicity of expanded gammadelta T cells, which implies that in vitro bisphosphonate (such as zoledronate)-expanded and type I IFN-activated gammadelta T cells could be applied to immunotherapy for hematologic malignancies such as leukemia and lymphoma.

Prevalence of periodontal bacterial infection in non-obese Japanese type 2 diabetic patients: relationship with C-reactive protein and albuminuria

The aim of the present study was to investigate the relationship between periodontal bacteria infection ( Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Prevotella intermedius) and C-reactive protein (CRP) and albuminuria in non-obese Japanese type 2 diabetic patients. One hundred and thirty-four non-obese Japanese type 2 diabetic patients without evidence of current acute illness including clinically significant acute infectious disease were enrolled into the study. The degree of periodontal bacterial infection was evaluated using IgG titer against Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, or Prevotella intermedius. The bacterial sonic extracts were used as antigens. High-sensitivity CRP (hCRP), glucose, glycosylated hemoglobin (HbA (1c)), and lipids were also measured after an overnight fast. Urinary albumin excretion rate as a ratio of urinary albumin and urinary creatinine was assessed in a morning spot urine sample using a commercial enzymatic immunoassay. The prevalence of Porphyromonas gingivalis infection was 52.2 % and that of Actinobacillus actinomycetemcomitans and Prevotella intermedius was 7.5 and 14.2 %, respectively. IgG titer against Porphyromonas gingivalis significantly correlated with CRP (r = 0.225, p < 0.001) and albuminuria (r = 0.185, p < 0.05), while IgG titer against Actinobacillus actinomycetemcomitans or Prevotella intermedius was not associated with either parameter. These results suggest that among periodontal bacteria, Porphyromonas gingivalis infection is associated with atherosclerosis in non-obese Japanese type 2 diabetic patients.

A new pathway in the reaction of disilene with carbonyl compounds: an 'ene' reaction instead of cycloaddition

The 3H-disilagermirene, (tBu2MeSi)4GeSi2, reacts with alpha-hydrogen containing carbonyl compounds (acetophenone, butane-2,3-dione) by an 'ene'-reaction pathway followed by isomerization or insertion reactions, representing a new mode in the reaction of disilenes with carbonyl compounds.