Changes in Target Coverage and Dose to the Normal Brain during Fractionated Stereotactic Radiotherapy for Metastatic Brain Tumors

PURPOSE/OBJECTIVE(S)

Fractionated stereotactic radiotherapy (SRT) has been applied to large brain metastases to reduce the risk of radiation necrosis. For fractionated SRT, potential of interfractional tumor changes during the treatment period, such as tumor size, shape, and geometry, must be considered to improve the tumor local control. Our center performs adaptive re-planning for large brain metastases based on repeat MRI verification with a contrast agent in the middle of the treatment period. Purpose of this study is to evaluate the dosimetric impact of the changes in tumor size, shape, and geometry on the doses to the targets and normal brain in patients with brain metastases undergoing fractionated SRT.

MATERIALS/METHODS

Fifteen solitary large intracranial metastatic lesions treated with fractionated SRT were investigated. Standardized planning MRI (MRI-1) and repeat verification MRI (MRI-2) were performed during the middle of the irradiation period. The GTV on the MRI-1 and MRI-2 scans was contoured by the same oncologist. The PTV was created by adding an isotropic margin of 1 mm from the GTV in all directions. Volumetric modulated arc therapy (VMAT) with beam energies of 6 MV (flattening filter-free mode) was used and plans were normalized such that PTV D95% or D98% was equal to the prescribed dose. Beam configuration and intensity on the initial VMAT plan were used to evaluate the dose to the tumor and the normal brain on MRI-2. We evaluated the impact of D98% on the GTV using the plans on the MRI-1 and MRI-2 scans. For the normal brain, the V90%, V80%, and V50% were investigated.

RESULTS

The median GTV changed from 9.8 cc (range of 3.2-33.0 cc) to 9.7 cc (range of 2.8-36.5 cc) (p = 0.482). Three and four tumors exhibited volume shrinkage and enlargement changes of >10%. Five tumors exhibited volume shrinkage and enlargement changes of <10%. Three tumors showed no volume changes. Of the 15 large brain metastases, 12 tumors required treatment plan modification. The dosimetric parameters of the GTV, PTV, and normal brain did not significantly differ between the MRI-1 and MRI-2 scans. Regarding the tumor dose, the D98% to the GTV increased in patients with tumor shrinkage because of dose inhomogeneity and decreased in patients with tumor enlargement. The V90%, V80%, and V50% increase with decreasing tumor volumes and were linearly related to the tumor volume difference, with a coefficient of determination of 0.97, 0.98, and 0.97, respectively.

CONCLUSION

Our study demonstrated the usefulness of repeat verification MRI for adaptive radiotherapy in the middle of the treatment period due to changes in tumor size, shape, and geometry in patients with brain metastases. Repeated MRI should be considered to evaluate the dose to the target and normal brain, which improves tumor local control and reduces brain necrosis, to reduce the magnitude of underdosing to the target or overdosing to the normal brain during the treatment period.

Transarterial ethiodised oil marking before CT-guided renal cryoablation: evaluation of tumour visibility in various renal cell carcinoma subtypes

AIM

To evaluate ethiodised oil retention of transarterial embolisation using ethiodised oil (ethiodised oil marking) before computed tomography (CT)-guided percutaneous cryoablation (PCA) according to renal cell carcinoma (RCC) subtype.

MATERIALS AND METHODS

Ethiodised oil marking was performed 1-3 days before PCA in 99 patients with 99 RCCs from 2016 to 2020. Ethiodised oil retention on CT images was evaluated retrospectively and CT attenuation values in the tumour were measured. Regions of interest (ROI) were placed on the tumours to calculate: average (ROI-average), maximal (ROI-max), minimum (ROI-min), and standard deviation (ROI-SD). Qualitative scores comprising a five-point scale (5, excellent; 1, poor) were evaluated for the retention scores (RS) of ethiodised oil in the tumour (ethiodised oil-RS) and the visualisation scores (VS) of the boundary between the tumour and renal parenchyma (boundary-VS).

RESULTS

The histological subtypes comprised clear cell (ccRCC; n=85), papillary (pRCC; n=6), and chromophobe/oncocytoma renal cell carcinoma (chrRCC; n=8). The mean ROI-average, ROI-max, and ROI-SD were significantly higher in ccRCCs than in chrRCCs and pRCCs (p<0.05). The mean ethiodised oil-RS was significantly lower in pRCCs than in ccRCCs (p=0.039), and the mean boundary-VS was >4 in all subtypes. Even with poor intratumour ethiodised oil retention (n=6), sufficient boundary-VS was obtained due to "inverted marking." All PCA procedures were completed without additional intravenous contrast material injection at the time of PCA.

CONCLUSION

Regardless of the tumour subtypes, ethiodised oil marking aids in visualising the boundary between the tumour and parenchyma on non-contrast CT in PCA.

Formation and evolution of carbonaceous asteroid Ryugu: Direct evidence from returned samples

Samples of the carbonaceous asteroid Ryugu were brought to Earth by the Hayabusa2 spacecraft. We analyzed 17 Ryugu samples measuring 1 to 8 millimeters. Carbon dioxide-bearing water inclusions are present within a pyrrhotite crystal, indicating that Ryugu's parent asteroid formed in the outer Solar System. The samples contain low abundances of materials that formed at high temperatures, such as chondrules and calcium- and aluminum-rich inclusions. The samples are rich in phyllosilicates and carbonates, which formed through aqueous alteration reactions at low temperature, high pH, and water/rock ratios of <1 (by mass). Less altered fragments contain olivine, pyroxene, amorphous silicates, calcite, and phosphide. Numerical simulations, based on the mineralogical and physical properties of the samples, indicate that Ryugu's parent body formed ~2 million years after the beginning of Solar System formation.

Effects of oral administration of timothy hay and psyllium on the growth performance and fecal microbiota of preweaning calves

The objective of this study was to evaluate the effects of oral administration of fiber from the first week of life on the growth and hindgut environment of preweaning calves. Twenty newborn female Holstein calves were divided into 2 groups as control and treatment. Calves in both groups were reared under the same feeding program except for oral fiber administration. Timothy hay and psyllium were mixed at a 50-to-6 ratio as a treatment diet for oral fiber administration. Calves in the treatment group were orally administered 50 g of fiber daily from 3 to 7 d of age and 100 g of fiber from 8 d of age until weaning. Feed intake and occurrence of diarrhea were recorded daily, and body weight (BW) was recorded weekly for the individual calf. Fresh feces were collected from calves at 7, 21, 35, 49, and 56 d of age to analyze fermentation parameters and microbiota to characterize the hindgut environment. Higher fiber intake in the treatment group due to oral administration of timothy and psyllium did not affect the starter intake and achieved higher BW at 21 d of age. The fecal pH, total volatile fatty acid, lactate, and ammonia nitrogen concentrations were not affected by oral fiber administration; meanwhile, the molar proportion of propionate was higher in the treatment group at 7 d of age. The difference in fecal microbiota in the calves subjected to the oral administration of fiber was observed within 21 d of life; Lactobacillus spp. and Prevotella spp. showed higher abundance, whereas that of Clostridium perfringens was decreased. These higher abundances of beneficial bacteria and lower abundance of pathogenic bacteria during early life may partly explain the higher BW of calves in the treatment group at 21 d of age. Furthermore, no adverse effect was observed for the BW and health status in the treatment group throughout the preweaning period. Therefore, early fiber feeding via oral administration potentially contributes to improving the hindgut environment in newborn calves, which leads to better growth of calves during the early stage of life.

Rumen microbiota and its relation to fermentation in lactose-fed calves

In our previous studies, we revealed the effect of lactose inclusion in calf starters on the growth performance and gut development of calves. We conducted the present study as a follow-up study to identify the shift in rumen microbiota and its relation to rumen fermentation when calves are fed a lactose-containing starter. Thirty Holstein bull calves were divided into 2 calf starter treatment groups: texturized calf starter (i.e., control; n = 15) or calf starter in which starch was replaced with lactose at 10% (i.e., LAC10; n = 15) on a dry matter basis. All calves were fed their respective treatment calf starter ad libitum from d 7, and kleingrass hay from d 35. Rumen digesta were collected on d 80 (i.e., 3 wk after weaning) and used to analyze rumen microbiota and fermentation products. There was no apparent effect of lactose feeding on the α-diversity and overall composition of rumen microbiota. Amplicon sequencing and real-time PCR quantification of the 16S rRNA gene confirmed that the abundance of butyrate-producing bacteria (i.e., Butyrivibrio group and Megasphaera elsdenii) did not differ between the control and LAC10 groups. Conversely, the relative abundance of Mitsuokella spp., which produce lactate, succinate, and acetate, was significantly higher in the rumen of calves that were fed lactose, whereas the lactate concentration did not differ between the control and LAC10 groups. These findings suggest that the lactate production can be elevated by an increase of Mitsuokella spp. and then converted into butyrate, not propionate, since the proportion of propionate was lower in lactose-fed calves. In addition, we observed a higher abundance of Coriobacteriaceae and Pseudoramibacter-Eubacterium in the LAC10 group. Both these bacterial taxa include acetate-producing bacteria, and a positive correlation between the acetate-to-propionate ratio and the abundance of Pseudoramibacter-Eubacterium was observed. Therefore, the higher abundance of Coriobacteriaceae, Mitsuokella spp., and Pseudoramibacter-Eubacterium in the rumen of lactose-fed calves partially explains the increase in the proportion of rumen acetate that was observed in our previous study.

Neurologist Attitudes on Practicing in Hawai'i

There is a shortage of neurologists nationwide, and the demand for neurologists is expected to increase in the upcoming years while the pool of practicing neurologists dwindles. Per Hawai'i Neurological Society, there were 44 practicing neurologists in the state of Hawai'i in 2019, representing a shortage of approximately 28 neurologists. Considering that Hawai'i is geographically, demographically, and culturally distinct compared to other states, a concern is that practicing neurology in Hawai'i poses unique challenges that may contribute to the low numbers of neurologists. An anonymous online survey was sent via email to all members of the Hawai'i Neurological Society from February 2019 to June 2019, inquiring about aspects of their practice they considered unique to Hawai'i. Twenty-three neurologists completed the survey, representing 52% of Hawai'i's neurology workforce. One neurologist completed a portion of the survey. Twenty-five percent of participants were born and raised or completed their medical education in Hawai'i. Self-reported reasons for practicing in Hawai'i included family, lifestyle, and patient population despite financial challenges and limited resources and opportunities. Participants suggested introducing a mandatory neurology rotation for Hawai'i medical students and creating an instate neurology residency program to combat the growing neurologist shortfall in Hawai'i. This survey identified local strengths and challenges in the field of neurology, potential ways to improve the practice environment in Hawai'i, and neurologists' perspectives on ways to address the neurology shortage.

Effect of eicosapentaenoic acid/docosahexaenoic acid on coronary high-intensity plaques detected with non-contrast T1-weighted imaging: subgroup analysis of the AQUAMARINE EPA/DHA study

Background

In the recent the Reduction of Cardiovascular Events with EPA-Intervention Trial (REDUCE-IT), statin therapy plus high-dose eicosapentaenoic acid (EPA) significantly reduced the risk of cardiovascular death in patients with coronary artery disease (CAD) with elevated triglyceride (TG) levels. An epidemiologic study has shown that increasing the intake of long-chain n-3 polyunsaturated fatty acids, especially EPA and docosahexaenoic acid (DHA), are associated with a lower risk of fatal CAD. However, the anti-atherosclerotic effect of high-dose EPA/DHA has not be clarified.

We reported that coronary high-intensity plaques (HIPs) detected with non-contrast T1-weighted imaging (T1WI) on cardiac magnetic resonance (CMR), which can be uniquely quantitative assessed using the plaque-to-myocardium signal intensity ratio (PMR) of ≥1.4, are significantly associated with future coronary events. Moreover, we demonstrated that intensive statin therapy reduces the PMR of coronary HIPs by 19% but is unlikely to completely resolve HIP (PMR&lt;1.0).

In the AQUAMARINE EPA/DHA study, our goal was to assess the anti-atherogenic effect of EPA/DHA in an exploratory manner by examining the change in PMR of coronary HIPs after 12 months of EPA/DHA therapy in patients with CAD on statin therapy.

Methods

This study was designed as a single-center, triple-arm, parallel-group, randomized controlled, open-label, superiority trial examining the effect of 12 months of additional EPA/DHA therapy on coronary HIPs in patients with CAD who receiving statin therapy. Eligible subjects are randomly assigned to the 2 g/day EPA/DHA group (n=26), the 4 g/day group (n=23), or the no EPA/DHA (statin-only) group (n=24) between May 2014 and December 2017. The PMR was defined as the signal intensity of the coronary plaque divided by that of nearby left ventricular myocardium. The primary endpoint is the change in PMR after EPA/DHA treatment.

Results

These 3 groups were well matched at baseline, with no statistically significant differences in age, male sex, conventional coronary risk factors, TG level, medications, and PMR. Figure 1 shows subgroup analysis of patients with high triglyceride levels (&gt;150mg/dl). In the patient-based analysis (A), 12 months of EPA/DHA therapy significantly reduced the PMR of primary lesions. In the segment-based analysis (B), additional reduction of PMR was observed in the high-dose EPA/DHA group compared with the no EPA/DHA treatment group.

Discussion

The present study of patients with high triglyceride levels demonstrated that EPA/DHA had a dose-dependent anti-atherosclerotic effect. This finding may provide additional information of EPA/DHA for lowering the residual risk in patients with CAD on statin therapy.

Funding Acknowledgement

Type of funding source: Private company. Main funding source(s): Takeda Pharmaceutical Co., Ltd.

P177 Left atrial strain in patients with cardiac amyloidosis. Relationship to left atrial amyloid deposition focusing on prognosis

Background

 In cardiac amyloidosis (CA), the left atrium (LA) is frequently infiltrated by the amyloid fibrils. It is currently known that LA strain is a marker of LA function and prognosis in many cardiac diseases, however its significance in CA remains unknown. 

Purpose

 Our aim was to investigate correlation between LA strain measured by Cardiovascular Magnetic Resonance (CMR) and amyloid deposit in LA, and also evaluate the LA strain on the prognostic significance. 

Methods and results

 Of 74 consecutive patients with biopsy-proven CA, we analyzed 42 patients (age 72 ± 10 years; 76 % males) with contrast-enhanced CMR, and examined LA late gadolinium enhancement (LGE) and CMR derived LA strain using feature tracking method. Of the 42 patients, 29 patients (69 %) was transthyretin cardiac amyloidosis (ATTR-CA) in the majority. We divided these 42 patients into two groups according to the CMR measured peak atrial longitudinal strain (PALS) (&gt; = or &lt; median); high-strain (&gt; = 6.67 %, n = 21) and low-strain (＜ 6.67 %, n = 21) and compared the patient’s characteristics, blood test data, echocardiography and CMR parameters. There were no significant differences between two groups in these parameters but in the extent of LA-LGE (54 % vs 80 %, p = 0.008). The PALS correlated with the extent of LA-LGE (ρ= 0.50, p = 0.001). In multivariate analysis including LVEF, E/e’ and BNP, LA-LGE was an independent determinant of PALS. During three-year follow up, the LA strain significantly related to heart failure hospitalization in the ATTR-CA patients (p = 0.036)(Figure). 

Conclusions

 In CA patients, CMR measured LA longitudinal strain correlates with the LA-LGE. It also provides useful information for poor prognosis of patients with ATTR-CA.

Abstract P177 Figure. Heart failure hospitalization in ATTR-CA

A self-reported measurement scale on a potential component of competency in the healthcare staff engaged in the prevention and control of non-communicable disease in Fiji

Background

According to the World Health Organization, an estimated 80% or more deaths in Pacific island countries, including Fiji, were related to non-communicable diseases (NCDs). Although competency-based approaches have been effective for developing healthcare workers’ capabilities, there are only a few reports on competency scales of healthcare workers for NCD prevention. We aimed to develop a self-reported measurement scale on a potential component of competency in the healthcare staff engaged in the prevention and control of NCDs in Fiji.

Methods

There were 378 Ministry of Health and Medical Services staff members working on NCD prevention and control in Fiji included in this study, which was a cross-sectional survey of social factors, working situation factors, and competency. Exploratory factor analysis was conducted to assess potential competency components, whereas Cronbach’s α coefficient and analysis of variance were used to assess the validity and reliability of the scale items, respectively. Multivariate regression analyses were conducted to analyze the respondents’ factor scores relative to social status and work situations.

Results

The factor analysis revealed 16 items that identified competency in four work types: 1) work management, 2) monitoring and evaluation, 3) community partnership, and 4) community diagnosis. The monitoring and evaluation roles were related to ethnic background, community partnership was related to religion, and community diagnosis was related to academic qualifications.

Conclusions

Based on the results, we developed a competency scale for the four work types. This scale can help healthcare workers engage in better management of residents with NCDs in Fiji.

Comprehensive molecular exploration identified promoter DNA methylation of the CRBP1 gene as a determinant of radiation sensitivity in rectal cancer

BACKGROUND

Neoadjuvant chemoradiotherapy (NCRT) for advanced rectal cancer (RC) is a well-evidenced therapy; however, some RC patients have no therapeutic response. Patient selection for NCRT so that non-responsive patients are excluded has been subjective. To date, no molecular markers indicating radiation sensitivity have been reported.

METHODS

We irradiated six colorectal cancer (CRC) cell lines and identified HCT116 cells as radiation-sensitive and HCT15 and DLD-1 cells as radiation resistant. Using a microarray, we selected candidate radiation sensitivity marker genes by choosing genes whose expression was consistent with a radiation-resistant or sensitive cell phenotype.

RESULTS

Among candidate genes, cellular retinol binding protein 1 (CRBP1) was of particular interest because it was not only induced in HCT116 cells by tentative 10 Gy radiation treatments, but also its expression was increased in HCT116-derived radiation-resistant cells vs parental cells. Forced expression of CRBP1 decreased the viability of both HCT15 and DLD-1 cells in response to radiation therapy. We also confirmed that CRBP1 was epigenetically silenced by hypermethylation of its promoter DNA, and that the quantitative methylation value of CRBP1 significantly correlated with histological response in RC patients with NCRT (P=0.031).

CONCLUSIONS

Our study identified CRBP1 as a radiation-sensitive predictor in RC.

Lymphatic Architecture of Suncus Murinus (House Musk Shrew) Palatum

The architecture of craniocervical lymphatic vessels in rodents has been examined previously. In the present study, we evaluated the distribution of collecting lymphatic vessels in the palate of Suncus, which is known to retain the prototype of placental mammals and is more similar to humans in terms of jaw bone morphology when compared with rodents. Three-dimensional reconstructed images of the Suncus palatum revealed that the collecting lymphatic vessels were connected to each other via smaller branches, and ran in an antero-posterior direction in the periosteum. The vessels entered the pair of posterior palatine foramina located near the fourth premolar or the first molar bilaterally, coursed through the posterior palatine canals, and reached the pterygopalatine fossa positioned posteriorly in the palate. The collecting lymphatic vessels changed directions from medial to superior to lateral while wrapping around arteries during their course, perhaps to enable the smooth transition from the palate to the deep cervical node. Inefficient lymphatic flow in humans is attributed to the superior location of the pterygopalatine fossa in the palate when compared with its location in the Suncus.

Technical Note. Labral-ligamentous complex of the shoulder: Evaluation with double oblique axial MR arthrography

Purpose: To assess the ability of double oblique axial (DOA) MR arthrography in evaluating labral-ligamentous complex compared with conventional axial (CA) MR arthrography.

Material and Methods: MR arthrography of 51 shoulders, subsequently examined with arthroscopy, were retrospectively reviewed. DOA imaging was performed in all 51 shoulders and both DOA and CA imaging in 37 using a 1.5 T unit with gradient recalled-echo T2*-weighted sequences. DOA imaging was performed using perpendicular planes to the long axis of the glenoid fossa obtained by an oblique sagittal scout image. We compared the ability of DOA with that of CA MR arthrography to assess labral injuries and to demonstrate the whole length of the anterior band of the inferior glenohumeral ligament (AIGHL), which were shown to be intact by arthroscopy.

Results: For anterior labral injuries, sensitivity and specificity were 87% and 93% with CA, and 94% and 100% with DOA imaging, respectively. For posterior labral injuries, sensitivity and specificity were 47% and 100% with CA, and 79% and 96% with DOA imaging, respectively. There were no statistically significant differences between CA and DOA images, except for the ability to diagnose posterior labral injuries, where DOA imaging had a significant superior sensitivity ( p = 0.0327). DOA images also demonstrated the whole length of the intact AIGHL in 10 of 11 shoulders, while CA imaging showed this in only 3 of 11.

Conclusion: DOA imaging was equal or better than CA imaging for evaluating the labral-ligamentous complex.

Development of compartment for studies on the growth of protein crystals in space

To clarify the growth mechanism of a protein crystal, it is essential to measure its growth rate with respect to the supersaturation. We developed a compartment (growth cell) for measuring the growth rate (<0.1 nm s(-1)) of the face of a protein crystal at a controlled supersaturation by interferometry over a period of half a year in space. The growth cell mainly consists of quartz glass, in which the growth solution and a seed crystal are enclosed by capillaries, the screw sample holder, and a helical insert. To avoid the destruction of the cell and the evaporation of the water from the solution inside the cell, we selected the materials for these components with care. The equipment was successfully used to examine the growth of a lysozyme crystal at a controlled supersaturation in space, where convection is negligible because of the microgravity environment, thereby advancing our understanding of the mechanism of protein crystal growth from solution. The technique used to develop the growth cell is useful not only for space experiments but also for kinetic studies of materials with very slow growth and dissolution rates (<10(-3) nm s(-1)).

Abstract P1-06-02: A force-sensitive organoid assay to quantify regenerative potential of single primary human mammary cells

We have developed an organoid regeneration assay to quantify the ability of freshly isolated, single human mammary epithelial cells to generate complex branched ductal structures with basal and luminal features.

For this purpose, cells are cultured in adherent or floating collagen gels, corresponding to a rigid or compliant matrix. In both conditions, single luminal progenitors form spheres, whereas basal cells generate branched ductal structures. In compliant but not rigid collagen gels, branching ducts in multicellular structures generated by basal cells develop a lumen and alveoli at their tips. Importantly, branched structures generated by single basal cells express basal and luminal markers at correct positions, thereby demonstrating bi-potential. Functionally, basal cells in branched structures display cellular contractility, which we reveal to be required for alveologenesis. In conclusion, branched structures generated by single basal cells in compliant collagen gels resemble terminal ductal-lobular units (TDLU), the functional units of the mammary gland.

To prospectively isolate basal cells with regenerative potential, we added the membrane metallo-endopeptidase CD10 as a cell surface marker to existing sorting protocols, thereby enriching for TDLU-formation and enabling rigorous quantification of regenerative potential by extreme limiting dilution assay (ELDA). Moreover, the use of CD10 as a cell surface marker reveals the presence of stromal cells with endothelial qualities within the CD49fhi/EpCAM– population, previously labeled basal. In summary, we describe a defined in vitro assay system to quantify primary human mammary epithelial cells with regenerative potential and systematically investigate their interaction with the physical environment at distinct steps of morphogenesis.

Citation Format: Scheel CH, Linnemann JR, Miura H, Meixner LK, Irmler M, Kloos UJ, Hirschi B, Bartsch HS, Sass S, Beckers J, Theis FJ, Gabka C, Sotlar K. A force-sensitive organoid assay to quantify regenerative potential of single primary human mammary cells. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-06-02.

Long-term stability of novel double rhodanine indoline dyes having one and two anchor carboxyl group(s) in dye-sensitized solar cells

An indoline dye having both α-cyanoacrylic and rhodanine acetic acid anchor groups at the acceptor moiety exhibited improved stability upon fluorescence lamp irradiation.

Importance of fluorescence lifetimes for efficient indoline dyes in dye-sensitized solar cells

To make a molecular design of efficient indoline dyes, fluorescence lifetimes should be longer than ca. 0.8 ns in chloroform, in addition to suitable HOMO and LUMO levels and bathochromic UV-vis absorption bands.

Purification and Some Properties of Acidocin 8912, a Novel Bacteriocin Produced byLactobacillus acidophilusTK8912

Acidocin 8912, a bacteriocin produced by Lactobacillus acidophilus TK8912, was purified by ammonium sulfate fractionation and successive chromatographies on CM-cellulose, Sephadex G-50, Sephadex G-25, and reversed-phase HPLC on Aquapore RP-300. The purified acidocin 8912 migrated as a single band on SDS-PAGE. The molecular weight was estimated to be 5200 by SDS-PAGE, and 5400 by HPLC gel filtration on TSKgel G3000PWXL. Both the amino acid composition and the N-terminal amino acid sequence analysis indicated that acidocin 8912 was a peptide composed of presumably 50 amino acids containing a Lys residue at the N-terminus. The purified acidocin 8912 showed a bactericidal effect on sensitive cells but not a bacteriolytic effect.

Malignant female adnexal tumor of Wolffian origin (FATWO) positive for CD56: a possible diagnostic role for the biomarker

Female adnexal tumors of Wolffian origin (FATWOs) are rare tumors that arise in the broad ligament from the remnants of the mesonephric duct. Most FATWOs behave in a benign fashion, and there are only 14 case reports worldwide describing malignant FATWOs. The authors report herein the case of a 69-year-old woman with a malignant FATWO, positive for CD56. The mass was composed mainly of solid neoplastic epithelial cells, closely packed, branching, and anastomosing in slender tubules. There was an eosinophilic secretion within the lumens of some of the cysts and tubules. The number of mitoses was somewhat high in the active areas, numbering five to seven per ten high-power fields. The tumor cells were strongly positive for glutathione S-transferase π, and positive for cal- retinin, vimentin, c-Kit, CD99, and CD56; neuron-specific enolase was also partially expressed. The tumor cells were negative for inhibin α, estrogen receptors, progesterone receptors, B-cell lymphoma 2, and S100. Taken together, these immunohistochemical and pathological findings gave the diagnosis of malignant FATWO. The patient experienced a recurrence one year after her initial surgery. CD56 immunostaining was negative in two benign FATWO cases at the present institution. These findings suggest that CD56-positivity may be a diagnostic biomarker to differentiate malignant FATWOs from benign lesions.

Peristaltic hemodynamics of a new pediatric circulatory assist system for Fontan circulation using shape memory alloy fibers

Fontan procedure is one of the common surgical treatments of congenital heart diseases. Patients with Fontan circulation have single ventricle in the systemic circulation with the total cavopulmonary connection. We have been developing a pulmonary circulatory assist device using shape memory alloy fibers for Fontan circulation with total cavopulmonary connection. It consisted of the shape memory alloy fibers, the diameter of which are 100 µm. The fibers could wrap the ePTFE conduit for Fontan TCPC connection from the outside. We designed the sequential motion control system for sophisticated pulmonary hemodynamics by the pulsatile flow generation. In order to achieve pulsatile flow assistance in pulmonary arterial system, we fabricated a mechanical structure by sequential contraction of shape memory alloy fibers. Then, we developed a sequential contraction controller for the assist system, which could reproduce the wall contractile velocity at 6.0 to 20.0 cm/sec. We examined hemodynamic characteristic of its function using a mock circulatory system, which consisted of two overflow tanks representing venous and pulmonary arterial pressures in Fontan circulation. As a result, the pulmonary circulation assist device with sequential contraction could achieve effective promotion of the pulsatility in pulmonary arterial flow.