Computational modeling of drug dissolution in the human stomach: Effects of posture and gastroparesis on drug bioavailability

The oral route is the most common choice for drug administration because of several advantages, such as convenience, low cost, and high patient compliance, and the demand and investment in research and development for oral drugs continue to grow. The rate of dissolution and gastric emptying of the dissolved active pharmaceutical ingredient (API) into the duodenum is modulated by gastric motility, physical properties of the pill, and the contents of the stomach, but current in vitro procedures for assessing dissolution of oral drugs are limited in their ability to recapitulate this process. This is particularly relevant for disease conditions, such as gastroparesis, that alter the anatomy and/or physiology of the stomach. In silico models of gastric biomechanics offer the potential for overcoming these limitations of existing methods. In the current study, we employ a biomimetic in silico simulator based on the realistic anatomy and morphology of the stomach (referred to as "StomachSim") to investigate and quantify the effect of body posture and stomach motility on drug bioavailability. The simulations show that changes in posture can potentially have a significant (up to 83%) effect on the emptying rate of the API into the duodenum. Similarly, a reduction in antral contractility associated with gastroparesis can also be found to significantly reduce the dissolution of the pill as well as emptying of the API into the duodenum. The simulations show that for an equivalent motility index, the reduction in gastric emptying due to neuropathic gastroparesis is larger by a factor of about five compared to myopathic gastroparesis.

Clinical usefulness of two-phase 18F-sodium-fluoride (18F-NaF) bone PET/CT for evaluating treatment response of bone metastases from breast cancer: Case report

We report the case of a breast cancer patient in whom a two-phase ¹⁸F-sodium-fluoride (¹⁸F-NaF) bone PET/CT was useful for detecting hidden bone metastases and assessing treatment response. The patient underwent a two-phase bone PET/CT to evaluate a newly developed lesion found on bone scintigraphy following surgery. In the perfusion and bone phase PET/CT images, focally increased perfusion and bony uptake were found in the sacrum and L5 vertebra, suggesting bone metastases of breast cancer. Therefore, the patient subsequently underwent palliative treatment. In another twoPET/CT studies (each including two-phase bone images) performed after 3and 6months of follow-up, the perfusion phase images showed an improvement of the lesion uptake more clearly than in the bone phase images in the visual and semi-quantitative analyses, and thus the perfusion phase images were more useful for clarifying the treatment response earlier than the bone phase images. This is the first case showing the clinical usefulness of ¹⁸F-NaF bone PET/CT with the perfusion imaging technique for evaluating bone metastases and the therapeutic response of metastatic bone lesions.

Strongly Coupled Magnetic and Electronic Transitions in Multivalent Strontium Cobaltites

The topotactic phase transition in SrCoO_x (x = 2.5–3.0) makes it possible to reversibly transit between the two distinct phases, i.e. the brownmillerite SrCoO_2.5 that is a room-temperature antiferromagnetic insulator (AFM-I) and the perovskite SrCoO₃ that is a ferromagnetic metal (FM-M), owing to their multiple valence states. For the intermediate x values, the two distinct phases are expected to strongly compete with each other. With oxidation of SrCoO_2.5, however, it has been conjectured that the magnetic transition is decoupled to the electronic phase transition, i.e., the AFM-to-FM transition occurs before the insulator-to-metal transition (IMT), which is still controversial. Here, we bridge the gap between the two-phase transitions by density-functional theory calculations combined with optical spectroscopy. We confirm that the IMT actually occurs concomitantly with the FM transition near the oxygen content x = 2.75. Strong charge-spin coupling drives the concurrent IMT and AFM-to-FM transition, which fosters the near room-T magnetic transition characteristic. Ultimately, our study demonstrates that SrCoO_x is an intriguingly rare candidate for inducing coupled magnetic and electronic transition via fast and reversible redox reactions.

Use of supplemental anti-HBc testing of donors showing non-discriminating reactive results in multiplex nucleic acid testing

BACKGROUND AND OBJECTIVES

The Korean Red Cross began nucleic acid amplification testing (NAT) for HIV and HCV in February 2005, and added HBV NAT beginning in June 2012. The current NAT system utilizes a multiplex assay for simultaneous detection of HBV DNA, HCV RNA and HIV-1 RNA. For samples that are reactive in the multiplex assay, we do specific tests for each virus. However, there have been cases of non-discriminated reactive (NDR) results which appear to be the result of non-specific reactions or cross-contamination, although some cases are considered to arise from the presence of low levels of HBV DNA due to occult hepatitis B infection.

MATERIALS AND METHODS

We examined the incidence of NDR results in previous donations of some NAT-reactive donors. Additionally, for those donors with NDR results, we performed an HBV core antibody (anti-HBc) assay.

RESULTS

From November 2015 to March 2016, there were 408 NAT-reactive donors. Of these, nineteen HBV NAT-reactive donors showed a history of NDR results in the past donations. Seven donors showed NDR results more than once. Of 771 NDR donors, 362 (47·0%) were anti-HBc reactive.

CONCLUSION

The NDR donors had a substantially higher rate of anti-HBc reactivity than other blood donors indicating that some with anti-HBc reactivity represent donors with occult HBV. Therefore, the incorporation of an anti-HBc testing for NDR donors could improve blood safety testing for the Korean Red Cross.

Relationship between tinnitus and suicidal behaviour in Korean men and women: a cross-sectional study

OBJECTIVES

This study investigated the prevalence of suicidal ideation and behaviour in a representative sample of South Koreans with or without tinnitus.

DESIGN

A cross-sectional study.

SETTING

Based on data from the 2010 to 2012 Korean National Health and Nutrition Examination Survey (KNHANES).

PARTICIPANTS

The study included 17 446 Korean individuals.

MAIN OUTCOME MEASURES

Participants provided demographic, socio-economic and behavioural information, as well as responses to questionnaires assessing the presence and severity of tinnitus, mental health status regarding stress, depression, and suicidal ideation and attempts. In the univariate analysis, the Rao-Scott chi-square test and logistic regression analysis were used to test the association between tinnitus and risk factors. Simple and multiple linear regression analyses were used to examine the association between tinnitus and mental status.

RESULTS

A total of 20.9% and 1.2% of participants with tinnitus, and 12.2% and 0.6% of those without, reported suicidal ideation and attempts, respectively (P < 0.0001 and P = 0.001). Participants reporting suicide attempts showed a higher proportion of severe annoying (6.0%) and irritating (11.8%) tinnitus than those with suicidal ideation (1.4% and 10.2%, respectively). Risks for experiencing tinnitus were significantly associated with suicidal ideation and attempts after adjusting for confounding variables.

CONCLUSION

This study has important implications for enhanced screening and evaluation of mental health status and suicidal ideation/behaviour among tinnitus patients.

Retinoic Acid as a Radiosensitizer on the Head and Neck Squamous Cell Carcinoma Cell Lines

PURPOSE

Retinoic acid is a substance that has previously been reported to increase radiosensitivity, but at concentrations likely to inhibit cell growth or to induce celluar differentiation. We choose head and neck cancer cell lines to investigate the role of retinoic acid as a radiosensitizer and to elucidate the mechanism through the changes in the expression of retinoid receptors and squamous cell differentiation marker.

MATERIALS AND METHODS

Three cell lines (PCI-50, SqCC/ Y1 and UMSCC-11B) were used. 7-AAD staining for apoptosis and Western blot analysis for RAR-alpha, beta, gamma, RXR-alpha, beta, gamma and involucrin were performed after various treatments (control, beta-all-trans-retinoic acid (t-RA) only (10 6 M), radiation only (3 Gy), radiation with t-RA).

RESULTS

The synergistic radiosensitivity effect of t-RA was seen only radioresistant UMSCC-11B cell line. Expression of RAR-beta was induced by t-RA in maily UMSCC- 11B cell line. RAR-alpha,gamma, and RXR-alpha, beta, gamma expression were not changed in all cell lines tested. Expression of involucrin was inhibited by t-RA in PCI-50 cell line but other two cell lines were not changed by t-RA treatment.

CONCLUSION

We found that only radioresistant cell line (UMSCC-11B) showed synergistic radiosensitivity effect by t-RA and this mechanism may be through RAR-beta expression induction.

The siRNA cocktail targeting interleukin 10 receptor and transforming growth factor-β receptor on dendritic cells potentiates tumour antigen-specific CD8(+) T cell immunity

Dendritic cells (DCs) are promising therapeutic agents in the field of cancer immunotherapy due to their intrinsic immune-priming capacity. The potency of DCs, however, is readily attenuated immediately after their administration in patients as tumours and various immune cells, including DCs, produce various immunosuppressive factors such as interleukin (IL)-10 and transforming growth factor (TGF)-β that hamper the function of DCs. In this study, we used small interfering RNA (siRNA) to silence the expression of endogenous molecules in DCs, which can sense immunosuppressive factors. Among the siRNAs targeting various immunosuppressive molecules, we observed that DCs transfected with siRNA targeting IL-10 receptor alpha (siIL-10RA) initiated the strongest antigen-specific CD8(+) T cell immune responses. The potency of siIL-10RA was enhanced further by combining it with siRNA targeting TGF-β receptor (siTGF-βR), which was the next best option during the screening of this study, or the previously selected immunoadjuvant siRNA targeting phosphatase and tensin homologue deleted on chromosome 10 (PTEN) or Bcl-2-like protein 11 (BIM). In the midst of sorting out the siRNA cocktails, the cocktail of siIL-10RA and siTGF-βR generated the strongest antigen-specific CD8(+) T cell immunity. Concordantly, the knock-down of both IL-10RA and TGF-βR in DCs induced the strongest anti-tumour effects in the TC-1 P0 tumour model, a cervical cancer model expressing the human papillomavirus (HPV)-16 E7 antigen, and even in the immune-resistant TC-1 (P3) tumour model that secretes more IL-10 and TGF-β than the parental tumour cells (TC-1 P0). These results provide the groundwork for future clinical development of the siRNA cocktail-mediated strategy by co-targeting immunosuppressive molecules to enhance the potency of DC-based vaccines.

Association of aldehyde dehydrogenase 1 expression and biologically aggressive features in breast cancer

Aldehyde dehydrogenase 1 (ALDH1) has been regarded as a breast cancer stem cell marker. Several studies have reported that ALDH1 expression is associated with poor prognosis in breast cancer. We aimed, therefore, to determine the prognostic value of ALDH1 expression and its association with several biomarkers in breast cancer tissue using immunohistochemistry. Furthermore, we investigated the characteristics of and differences between cellular and stromal expression of ALDH1. We performed tissue microarray (TMA) analysis of 425 breast cancer tissue samples collected during surgery. Immunohistochemical staining was then performed to measure the expression of ALDH1 and other breast cancer biomarkers. Statistical analysis of the relationship between ALDH1 expression and clinicopathologic characteristics was performed for 390 TMA samples. We found that ALDH1 was expressed in 71 cases (18.2%) in the tumor cells and/or stroma. Of these cases, 38 (9.7%) showed ALDH1 expression in tumor cells and 38 (9.7%) showed ALDH1 expression in the stroma. ALDH1 expression was significantly associated with markers of a poor prognosis, such as young age, estrogen receptor negativity, progesterone receptor negativity, a high histological grade, and a high Ki-67 index. However, ALDH1 expression was not associated with p53, transforming growth factor-beta, Gli-1, YKL-40, or sonic hedgehog expression status. With regard to the expression site, the clinical characteristics did not differ between cases of cellular expression and those of stromal expression. However, ALDH1 expression in tumor cells was correlated with hormone receptor status, histological grade, molecular subtype, epidermal growth factor receptor expression status, and cytokeratin 5/6 expression status while stromal expression of ALDH1 was only correlated with hormone receptor status. Overall, these findings suggest that ALDH1 expression in tumor tissue is associated with a biologically aggressive phenotype.

KEYWORDS

ALDH1, biologically aggressive, breast cancer.

Relationship between early postoperative C-reactive protein elevation and long-term postoperative major adverse cardiovascular and cerebral events in patients undergoing off-pump coronary artery bypass graft surgery: a retrospective study

BACKGROUND

Inflammation plays a key role in the pathogenesis of vascular occlusive diseases, such as myocardial infarction and stroke. Additionally, these conditions are predicted by C-reactive protein (CRP), a general inflammation marker. We hypothesized that the inflammation induced by surgery itself augments vascular occlusive disease. We retrospectively evaluated the relationship between postoperative CRP elevation and postoperative major adverse cardiovascular and cerebral events (MACCE) in patients undergoing off-pump coronary artery bypass surgery (OPCAB).

METHODS

The electronic medical records of 1046 patients who underwent OPCAB were reviewed retrospectively. The relationship between postoperative serum CRP and long-term postoperative MACCE (median follow-up 28 months) was investigated.

RESULTS

Patients were divided into quartiles according to maximum postoperative CRP levels (<18, 18-22, 22-27, ≥27 mg dl(-1)). The adjusted hazard ratios (HRs) were 2.15, 2.45, and 2.81, respectively (P=0.004), compared with the lowest quartile (<18 mg dl(-1)). In the multivariate analysis, the postoperative CRP quartile (HR 2.81; P=0.004), postoperative non-use of statins (HR 1.86; P=0.003), and postoperative maximum troponin I (HR 1.02; P<0.001) independently predicted postoperative MACCE, while preoperative CRP did not (P=0.203). Several parameters were correlated with postoperative maximum CRP level: body temperature (P=0.001) and heart rate (P<0.001) at the end of surgery; intraoperative last lactate (P<0.001) and base excess (P<0.001); and red blood cell transfusion (P=0.019).

CONCLUSIONS

Postoperative CRP elevation was associated with long-term postoperative MACCE in OPCAB patients. This was mitigated by postoperative statin medication. Furthermore, postoperative CRP elevation was associated with intraoperative parameters reflecting hypoperfusion and inflammation.

Pulse pressure variation to predict fluid responsiveness in spontaneously breathing patients: tidal vs. forced inspiratory breathing

We evaluated whether pulse pressure variation can predict fluid responsiveness in spontaneously breathing patients. Fifty-nine elective thoracic surgical patients were studied before induction of general anaesthesia. After volume expansion with hydroxyethyl starch 6 ml.kg(-1) , patients were defined as responders by a ≥ 15% increase in the cardiac index. Haemodynamic variables were measured before and after volume expansion and pulse pressure variations were calculated during tidal breathing and during forced inspiratory breathing. Median (IQR [range]) pulse pressure variation during forced inspiratory breathing was significantly higher in responders (n = 29) than in non-responders (n = 30) before volume expansion (18.2 (IQR 14.7-18.2 [9.3-31.3])% vs. 10.1 (IQR 8.3-12.6 [4.8-21.1])%, respectively, p < 0.001). The receiver-operating characteristic curve revealed that pulse pressure variation during forced inspiratory breathing could predict fluid responsiveness (area under the curve 0.910, p < 0.0001). Pulse pressure variation measured during forced inspiratory breathing can be used to guide fluid management in spontaneously breathing patients.

Abstract P2-02-08: MRI in predicting pathological response of breast cancer after neoadjuvant chemotherapy: Correlation with tumor size and morphology changes

PURPOSE

Contrast enhanced MR imaging is widely used to monitor the response of neoadjuvant chemotherapy (NAC) in breast cancer patients. The objectives of the study are 1) to assess the response of neoadjuvant chemotherapy (NAC) according to molecular biomarker status using MRI, 2) to evaluation of changes in morphological variation, and 3) to compare MR imaging-pathological size discrepancy depending on molecular biomarker status.

MATERIALS AND METHODS

Between May 2007 and March 2012, a total of 47 patients (age range, 34-65 years; mean age, 48 years) underwent NAC prior to surgery. Among them, 34 patients who performed MRI before and after NAC were enrolled. The extent of the lesion is measured by longest diameter. The response to NAC was calculated as reduction rate between pre NAC MRI and post NAC MRI. Histological grading system - Miller and Payne grade - was also recorded. Patients were divided into subgroups based on human epidermal growth factor receptor 2 (HER2), hormone receptors (HRs), and the proliferation marker Ki-67 status. The morphologic changes were classified into 1) concentric reduction, 2) fragmentation, 3) non-mass like, and 4) architectural distortion.

RESULTS

Total of 34 lesions from 34 patients were included. Among them, 12 lesions (35.3%) were pathologically proven to have no residual tumor (Miller and Payne grade 5). The mean MR reduction rate tended to be higher in HER2-positive (62.7%) and triple negative subgroups (61.9%) than HR-positive subgroup (47.7%). The mean MR imaging-pathologic size discrepancy tended to be smaller in triple negative subgroup (0.5cm) than HER2-positive (1.2cm) and HR-positive subgroups (1.4cm). All results showed no statistical significance (P&gt;0.05). Ki-67 expression showed no significant correlations in tumor response (r = 0.17, P = 0.4) and MR imaging-pathologic size discrepancy (r = 0.1, P = 0.6). The majority of morphologic change is concentric reduction (57.6%). MRI is tended to overestimate residual size of the lesion (62.5%)

CONCLUSION

HER2-positive and triple negative subgroups showed relatively better response. Tumors were most likely to response in the manner of concentric reduction. The mean MR imaging-pathologic size discrepancy tended to be smaller in triple negative subgroup. MRI is reliable method in predicting histopathological response to NAC, but is more likely to overestimate the residual size of the lesion.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-02-08.

A novel maneuver to blindly position bronchial blockers

BACKGROUND

The use of a fiberoptic bronchoscope is fundamental to the positioning of bronchial blockers. However, a fiberoptic bronchoscope could be unavailable. We tried to devise a blind method to locate the blocker without help of a fiberoptic bronchoscope.

METHODS

In 56 thoracic surgical patients requiring one-lung ventilation, a Uniblocker® was inserted into the endotracheal tube and advanced until the blocker balloon just protruded from the endotracheal tube tip. With inflation of the balloon, peak inspiratory pressure increased abruptly with disappearance of expiratory tidal volume. The blocker was advanced with its tip directed to one side until peak inspiratory pressure abruptly dropped and expiratory tidal volume re-appeared. Thereafter, the blocker was advanced 3 cm further with the cuff deflated. Using a fiberoptic bronchoscope, the position of the blocker was checked after re-inflation of the cuff. The entire procedure was repeated on the other side.

RESULTS

Acceptable blocker placements were achieved on 48 of 56 (85.7%) right attempts; the right upper bronchus was not blocked in 5 cases and blocker positions were too shallow in 3. Only 33 of 56 (58.9%) left attempts were acceptable in that blockers could not be advanced into the left bronchus in 19 and were positioned too shallow in 4.

CONCLUSION

This novel technique to blindly position bronchial blockers could be almost successful in isolating the right lung. However, isolation of the left lung was frequently unsuccessful in spite of several attempts.

Influence of a modified propofol equilibration rate constant (k(e0)) on the effect-site concentration at loss and recovery of consciousness with the Marsh model

This study compared the predicted effect-site concentration of propofol at loss and recovery of consciousness when using target-controlled infusion devices with the same pharmacokinetic model (Marsh) but a different plasma effect-site equilibration rate constant (ke0 ), the Diprifusor(TM) (ke0 0.26 min(-1) ) and Base Primea™ (ke0 1.21 min(-1) ). We studied 60 female patients undergoing minor gynaecological surgery under general anaesthesia. Although the total dose of propofol and time until loss of consciousness were comparable, the effect-site concentration at loss of consciousness was significantly lower with the Diprifusor than with the Base Primea (1.2 (0.3) μg.ml(-1) vs 4.5 (0.9) μg.ml(-1) , respectively, p < 0.001). The effect-site concentration at recovery of consciousness was significantly higher with the Diprifusor than with the Base Primea (1.8 (0.4) μg.ml(-1) vs 1.5 (0.2) μg.ml(-1) , respectively, p = 0.01). In conclusion, the effect-site concentration of propofol differs depending on the ke0 , despite the use of the same pharmacokinetic model. Therefore, the ke0 should be considered when predicting loss and recovery of consciousness based on the effect-site concentration of propofol.

A randomized, multi-center, open-label, phase II study of once-per-cycle DA-3031, a biosimilar pegylated G-CSF, compared with daily filgrastim in patients receiving TAC chemotherapy for early-stage breast cancer

BACKGROUNDS

A pegylated form of recombinant granulocyte-colony stimulating factor (G-CSF) was developed for prophylactic use in breast cancer. The aim of this study was to evaluate the efficacy and safety of once-per-cycle DA-3031 in patients receiving chemotherapy for breast cancer.

METHODS

A total of 61 patients receiving docetaxel, doxorubicin, and cyclophosphamide (TAC) chemotherapy were randomized in cycle 1 to receive daily injections of filgrastim (100 μg/m(2)) or a single subcutaneous injection of pegylated filgrastim DA-3031 at a dose of either 3.6 mg or 6 mg.

RESULTS

The mean duration of grade 4 neutropenia in cycle 1 was comparable among the treatment groups (2.48, 2.20, and 2.05 days for filgrastim, DA-3031 3.6 mg and 6 mg, respectively; P=0.275). No statistically significant differences were observed in the incidence of febrile neutropenia between the treatment groups (9.5 %, 15.0 %, and 5.0 % for filgrastim, DA-3031 3.6 mg and 6 mg, respectively; P=0.681) in cycle 1. The incidences of adverse events attributable to G-CSF were similar among the treatment groups.

CONCLUSIONS

Fixed doses of 3.6 mg or 6 mg DA-3031 have an efficacy comparable to that of daily injections of filgrastim in ameliorating grade 4 neutropenia in patients receiving TAC chemotherapy.

Effects of surface chemical structure on the mechanical properties of Si(1-x)Ge(x) nanowires

The Young's modulus and fracture strength of Si(1-x)Ge(x) nanowires (NWs) as a function of Ge concentration were measured from tensile stress measurements. The Young's modulus of the NWs decreased linearly with increasing Ge content. No evidence was found for a linear relationship between the fracture strength of the NWs and Ge content, which is closely related to the quantity of interstitial Ge atoms contained in the wire. However, by removing some of the interstitial Ge atoms through rapid thermal annealing, a linear relationship could be produced. The discrepancy in the reported strength of Si and Ge NWs between calculated and experimented results could be related to SiO(2-x)/Si interfacial defects that are found in Si(1-x)Ge(x) NWs. It was also possible to significantly decrease the number of interfacial defects in the NWs by incorporating a surface passivated Al2O3 layer, which resulted in a substantial increase in fracture strength.

Coil protection using small helical coils for wide-neck intracranial aneurysms: a novel approach

BACKGROUND AND PURPOSE

A number of remodeling or protective techniques available to treat wide-neck intracranial aneurysms are increasingly being used, provided that the shape/type of aneurysm, vessel diameter, and inherent course of the vessel are conducive to their use. The purpose of this study was to describe a novel method using coil protection for treatment of wide-neck aneurysms.

MATERIALS AND METHODS

This technique involves sequential maneuvers to the aneurysm and affected branch artery. A microcatheter is first introduced into the aneurysmal sac, and another microcatheter is introduced into the entrance of the branch artery, followed by partial deployment of a small helical coil into the branch artery. A framing coil is then placed within the aneurysmal sac, under the protection of the helical coil. After completion of the first coil insertion, the helical coil should be retrieved to confirm the stability of the framing coil. The helical coil can also serve as a filler.

RESULTS

This technique was successfully applied to 12 intracranial saccular aneurysms of the MCA bifurcation (5 patients); anterior communicating artery (3 patients); and A1 and M1 segments, distal ACA, and basilar tip (1 patient each). Selective endovascular treatment was successfully performed and resulted in excellent outcomes in all patients. There were no complications directly related to coil protection.

CONCLUSIONS

Our small study suggests that coil protection can be a safe alternative to traditional remodeling or protective techniques when those techniques have failed or are not possible due to vascular geometry. It is particularly suited for the treatment of wide-neck aneurysms arising from small and acutely angulated branching vessels.

Prevalence of atopy and allergic diseases in Korean children: associations with a farming environment and rural lifestyle

BACKGROUND

The results of recent studies suggest that factors in rural environments may protect against the development of allergic diseases, but the underlying mechanisms are not well understood. The aim of this study was to investigate the prevalence of allergic diseases, to establish if this prevalence is influenced by migration from rural to urban areas and to identify environmental risk factors associated with these diseases.

METHODS

A cross-sectional study of children aged 9-12 years from a rural village, a rural town and an urban city in Korea was conducted. Demographic and disease-related information was obtained via a detailed questionnaire, and skin prick tests were performed.

RESULTS

There were significant differences in lifestyle and environmental factors between children from the rural village, the rural town and the urban children. The prevalence of allergic diseases and atopy was higher in urban children. A lower prevalence of allergic diseases and atopy was associated with farming parents, contact with farm animals during pregnancy, owning pets or a stable, breast-feeding and having older siblings. A comparison of rural village and rural town children revealed no evidence of an association of allergic diseases and atopy with farming parents, contact with farm animals during pregnancy or owning a stable. On the other hand, having older siblings and antibiotic use during infancy were significantly associated with allergic diseases and atopy in these children.

CONCLUSIONS

Protective factors associated with a farming environment and/or rural lifestyle may influence the prevalence of allergic diseases and atopy in Korean children.

P1-01-07: ErbB-2 Peptide Vaccination Suppresses Spontaneous Tumorigenesis and Tumor Stem Cell Expansion in MMTV-PyVT Transgenic Mouse

Immunization targeting ErbB-2 could have considerable therapeutic potential by controlling growth and metastasis of highly aggressive tumor cells in the earlier preclinical and clinical studies. Just a few studies have examined preventive potential of ErbB-2 vaccines in preclinical studies. However, animal model systems used in the previous studies were tumor transplantation or neu-transgenic mouse, which were not relevant to human HER-2 positive breast tumorigenesis. In this study, active immunotherapy against tumor antigen ErbB-2/neu for primary prevention of breast cancer was tested using FVB/N-Tg (MMTV-PyVT) transgenic mice model. Mice were grouped to receive either ErbB-2 peptide vaccine, immune adjuvant only, tetanus toxoid, or PBS every 2 weeks for 3 times and monthly thereafter. The MMTV-PyVT transgenic mice in control groups (PBS, immune adjuvant only, or tetanus toxoid peptide) developed spontaneous mammary adenocarcinomas in 12 to 15 weeks, but vaccination against ErbB-2 strongly suppressed tumor formation by 30 weeks of observation. Further pathologic examination showed complete prevention of tumorigenesis was observed in ErbB-2 vaccinated mice, whereas the mice in control groups developed highly aggressive ErbB-2 overexpressing tumors similar to human breast cancer. The tumor protective effect of peptide vaccination was associated with induction of ErbB-2-specific humoral immune responses as well as T cell responses. Additionally, role of signal through ErbB-2 pathway and the relationship with stemness of cancer cells were determined by Aldefluor assay, mammosphere formation assay using Mouse mammary carcinoma (MMC) cells in vitro, and level of nestin expression determined by Western blot analysis. Further analysis of mammosphere formation capacity of MMC cells using immune sera showed that sera from ErbB2 vaccinated mice had a significant inhibitory effect on mammosphere formation in ErbB-2 overexpressing MMC cells. These results suggest that ErbB-2 targeting by cancer vaccination might be useful adjuvant to standard therapy, helping to prevent relapse in patients with ErbB-2-overexpressing tumors by suppressing stem/progenitor cell population.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-01-07.

A study on white organic light-emitting diodes co-doped with red fluorescent and blue phosphorescent dopants

White organic light-emitting diodes (WOLEDs) have drawn increasing attention due to their potential use in various applications such as solid-state lighting and backlight of liquid crystal displays and full-color OLEDs of red, green, and blue pixel. N,N'-dicabazolyl-3,5-benzene (mCP), the host material, was co-doped with Iridium (III) bis[(4,6-difluorophenyl)-pyridinato-N,C2']-picolinate (FIrpic), which functions not only as phosphorescent sensitizer but also blue emitter, and (2Z,2'Z)-3,3'-[4,4"-bis (dimethylamino)-1,1':4',1"-terphenyl-2',5'-diyl]bis (2-phenylacrylonitrile) (ABCV-P), which is a red fluorescent material. The fabricated device structures were as follows: (device A) Indium tin oxide (ITO)/N,N'-bis-(1-naphyl)-N,N'-diphenyl-1,1'-biphenyl-4,4'-diamine (NPB)/(mCP)/mCP:ABCV-P (1%)/4,7-diphenyl-1,10-phenanthroline (Bphen)/lithium quinolate (Liq)/aluminum (Al), (device B) ITO/NPB/mCP/mCP:FIrpic (8%)/Bphen/Liq/Al and (device C) ITO/NPB/mCP/mCP:FIrpic:ABCV-P (8%, 1%)/Bphen/Liq/Al, respectively. Phosphorescent FIrpic harvesting both singlet and triplet excitions not only emitted blue light but also transferred energy to fluorescent ABCV-P. The maximum luminance efficiency, external quantum efficiency, and luminance of white light device were measured to be 5.95 cd/A, 2.45% and 2500 cd/m2, respectively. The white device gave practically white light with the Commision Internationale de l'Eclairage (CIE(xy)) coordinate of (0.44, 0.49) which was close to warm white color (CIE(xy) = 0.45, 0.45).

Endovascular treatment of wide-neck intracranial aneurysms using a microcatheter protective technique: results and outcomes in 75 aneurysms

BACKGROUND AND PURPOSE

The microcatheter protective technique positions an additional microcatheter in the parent or side-branching artery to protect it during coil embolization. The purpose of this study was to describe this method and to evaluate its efficacy and safety as an alternative to a multiple-microcatheter or balloon- or stent-assisted technique for wide-neck aneurysms.

MATERIALS AND METHODS

A retrospective review of 74 patients (43 women; mean age, 59.6 years) with 75 wide-neck aneurysms treated with the microcatheter protective technique between January 2003 and April 2010 was performed. Immediate postembolization angiograms were evaluated by using a conventional angiographic scale, and clinical evaluation was performed by using the GOS. Clinical and imaging follow-up were available in 57 (76%) patients, with a mean of 14.7 months.

RESULTS

Postembolization angiograms demonstrated total occlusion in 45 of 75 (60%) aneurysms, a neck remnant in 17 (22.7%), and body filling in 13 (17.3%). The technique-related complication rate was 17.4% (13/75), and the procedural-related morbidity rate was 1.3% (1/74). All patients, except 3 complicated cases with a GOS of <4, had a GOS of 5 at the end of the study period. Of the 57 aneurysms with follow-up, recanalization developed in 5 (8.8%) aneurysms, and 3 (5.3%) cases of major recanalization were re-treated endovascularly.

CONCLUSIONS

The microcatheter protective technique is feasible and safe for coil embolization of wide-neck aneurysms, especially in cases that are not suitable for multiple catheter or balloon- or stent-assisted techniques.

Multimodality imaging in the surgical treatment of children with nonlesional epilepsy

OBJECTIVES

To evaluate the diagnostic value of individual noninvasive presurgical modalities and to study their role in surgical management of nonlesional pediatric epilepsy patients.

METHODS

We retrospectively studied 14 children (3-18 years) with nonlesional intractable focal epilepsy. Clinical characteristics, surgical outcome, localizing features on 3 presurgical diagnostic tests (subtraction peri-ictal SPECT coregistered to MRI [SISCOM], statistical parametric mapping [SPM] analysis of [18F] FDG-PET, magnetoencephalography [MEG]), and intracranial EEG (iEEG) were reviewed. The localization of each individual test was determined for lobar location by visual inspection. Concordance of localization between each test and iEEG was scored as follows: 2=lobar concordance; 1=hemispheric concordance; 0=discordance or nonlocalization. Total concordance score in each patient was measured by the summation of concordance scores for all 3 tests.

RESULTS

Seven (50%) of 14 patients were seizure-free for at least 12 months after surgery. One (7%) had only rare seizures and 6 (43%) had persistent seizures. MEG (79%, 11/14) and SISCOM (79%, 11/14) showed greater lobar concordance with iEEG than SPM-PET (13%, 3/14) (p<0.05). SPM-PET provided hemispheric lateralization (71%, 10/14) more often than lobar localization. Total concordance score tended to be greater for seizure-free patients (4.7) than for non-seizure-free patients (3.9).

CONCLUSIONS

Our data suggest that MEG and SISCOM are better tools for lobar localization than SPM analysis of FDG-PET in children with nonlesional epilepsy. A multimodality approach may improve surgical outcome as well as selection of surgical candidates in patients without MRI abnormalities.

Optimization of fermentation processes using recombinant Escherichia coli with the cloned trp operon

Optimal operating conditions have been determined for recombinant Escherichia coli cells in a fed-batch and two-stage continuous fermentors. The model expression system used in this article was the E. coli trp promoter cloned on plasmids. Model equations for cell growth and cloned-gene expression have been formulated and used to evaluate process performances under different operating modes. The operating variables manipulated for maximum performance include the timing of IAA addition to derepress transcription from the trp promoter. The total operating period and the nutrient concentration profile during fermentations. For a fed-batch mode, the performance was significantly improved by adjusting the IAA addition (environmental switch) time relative to the total operation period. It was found that the optimal switching time exists for a given total operation period. For a two-stage continuous fermentation system, the productivity is more sensitive to the combination of the dilution rates than to the volume ratio of two reactors. In general, as long as the down time is less than the total operation time in the fed-batch mode, the fed-batch mode gives higher productivity than the two-stage continuous system.