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This study aims to acquire an understanding of the fundamental feature of IJV and DV under heating operation. Full‐scale experiments were conducted under these two different systems and supply air conditions along with temperature distribution and ventilation effectiveness. A wall surface of the test room was cooled as a heating load, and heating elements simulating occupants were located as internal heat load and contaminant emission source. Three cases of supply temperature were tested and the flow rate was also varied correspondingly. The position of the supply terminal was also changed to see its effect on heating performance, that is, mounted on the interior/exterior wall. For DV, the temperature/contaminant distribution differed significantly depending on the supply conditions, while that of IJV remained almost the same as a perfect mixing condition. Generally, IJV can achieve better temperature distribution compared to DV; however, the ventilation effectiveness of DV was superior to that of IJV with large supply flow rate. The correlation between the Archimedes number based on supply conditions and indices expressing local temperature and ventilation effectiveness is obtained. For IJV, the position of the terminal was found to have a larger impact on air distribution than the supply flow rate, while the opposite feature was obtained for DV.

The impinging jet ventilation (IJV) system has been proposed as a new air distribution strategy and is expected to overcome the disadvantages of mixing ventilation (MV) system, which is the most wi...

Overexpression of HER2 in breast cancer is correlated with poor prognosis. HER2-targeted drugs, such as trastuzumab and lapatinib, have been successful to treat HER2-positive breast cancers, however, the acquisition of the drug resistance of the cells is recognized. Here we suggest the novel molecular targets to cure HER2-positive breast cancers. The oncogenic roles of Rac1, a Rho family small GTPase, in a variety of cancers have been demonstrated. For example, the elevated expression or hyperactivation of Rac1 is frequently observed in human cancers, correlating with their aggressiveness and poor prognosis. In breast cancers, upregulation of Rac1 GEF (GTP exchange factor) and downregulation of Rac1 GAP (GTPase activating protein) have been reported. Moreover, activation of Rac1 contributed to trastuzumab resistance, which poses a serious problem during chemotherapy. In the present study, we first investigated in detail in which subtypes of breast cancers mRNA expression of Rac1 is correlated with their poor prognosis. Using the METABRIC database, we found that high mRNA expression of Rac1 significantly correlated with the poor prognosis of HER2-positive breast cancer (p=0.0012, High: n=49, Low: n=171). On the other hands, other three types (basal, claudin-low, or luminal-B type) did not show significant correlation between the expression levels of Rac1 mRNA and their prognosis (p=0.15, High: n=97, Low: n=102; p=0.052, High: n=110, Low: n=89; p=0.17, High: n=70, Low: n=391; respectively). In luminal-A type breast cancer, low mRNA expression of Rac1 significantly correlated with poor prognosis (p=0.0046, High: n=492, Low: n=187). We next investigated the molecular mechanism underlying Rac1 activation in HER2-positive breast cancer cells, SKBR-3 cells. We found that Cullin-3 (CUL3, a subunit of a RING ubiquitin E3 ligase complex) and its adaptor protein KCTD10 are essential for Rac1 activation. Mechanistically, CUL3/KCTD10 ubiquitinate RhoB, a Rho family small GTPase that suppresses the activation of Rac1, leading to the degradation RhoB. We also found that HER2 signaling is essential for the activation of Rac1. Conclusions: This study reveals that the novel molecular axis CUL3/KCTD10/RhoB regulates the Rac1 activation in HER2-positive breast cancer cells. The interference of CUL3/KCTD10 complex formation may be a new strategy to the treatment of HER2- and Rac1-positive breast cancers. Citation Format: Murakami A, Maekawa M, Kusakabe E, Yamasawa H, Aoki R, Komatsu S, Taguchi K, Nishiyama K, Yamashita M, Sugimori W, Kawai K, Nakayama J, Araki N, Semba K, Taguchi T, Kamei Y, Takada Y, Higashiyama S. Novel mechanisms of Rac1 activation by the Cullin-3/KCTD10 ubiquitin E3 complex in HER2-positive breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-05-02.

Breast cancer subtypes have been classified based on the gene expression profiles, and the specifically effective treatments for each subtype have been developed and applied in clinical situations. However, there is no effective treatment for metaplastic breast carcinomas, which are pathological tissue types with poor prognosis. Metaplastic breast carcinomas are almost resistant to existing chemotherapy because it has not been identified the specific therapeutic target molecules. Recently, Lehmann et al. reported that breast cancers with chondroid metaplasia are categorized in Mesenchymal (M) type, which is one subtype out of six triple negative breast cancer (TNBC) subtypes based on drug susceptibility. From the knowledge on this report, we hypothesized that integrative analyses using the gene expression profile data sets obtained from various types of breast cancers with or without cartilage formation may enable us to identify the therapeutic target genes for metaplastic breast carcinomas, especially for breast cancers with chondroid metaplasia. Bioinformatics analyses were performed using the gene expression profile data sets of TNBC, which are registered in Gene Expression Omnibus (GEO). When compared with metaplastic breast carcinomas (28 data sets), 200 genes were specifically fluctuated over 2-fold in breast cancer with chondroid metaplasia (8 data sets). On the other hand, M type (11 data sets) specific 578 genes were identified over 56 TNBC data sets. In addition, 57 genes were overlapped between chondoroid metaplastic 200 genes and M type 578 genes. Therefore, these 57 overlapped genes might be considered as possible poor prognostic factors in breast cancer with chondroid metaplasia. As a result of Gene Ontology analysis on these 57 genes, skeletal system development and extracellular matrix structural constituent were significantly enriched in Biological process and Molecular function, respectively. Also, SCRG1, SOX8 and SOX10, which are genes related to cartilage differentiation, were included. Next, we focused 14 genes because these genes could serve as therapeutic targets. Then, we validated the expression levels of these 14 genes using tissues obtained from surgically resected human breast cancer with chondroid metaplasia dividing into three parts, the invasive ductal carcinoma, the chondroid metaplasia and normal mammary gland. As a result, SCRG1, CD86, HCLS1, EPSTI1, LYZ, and SLA were significantly increased in chondroid metaplasia part, suggesting that these validated genes were identified as possible therapeutic targets for breast cancer with chondroid metaplasia. Further study will help us to investigate a novel and effective therapeutic strategy for metaplastic breast carcinomas. Citation Format: Yamashita M, Kamei Y, Kusakabe E, Yamasawa H, Aoki R, Taguchi K, Nishiyama K, Murakami A, Sawada Y, Takada Y, Imai Y. Exploring novel therapeutic target molecules for metaplastic breast carcinoma using comprehensive genome-wide gene expression analyses [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-07-07.

Background: The 2019 version 1 of the National Comprehensive Cancer Network guidelines states that magnetic resonance imaging (MRI)-based diagnosis of breast cancer “May be used for staging evaluation to define extent of cancer or presence of multifocal or multicentric cancer in the ipsilateral breast, or as screening of the contralateral breast cancer at time of initial diagnosis.” Therefore, we performed breast MRI to evaluate the extent of spread of breast cancer as part of the preoperative diagnosis. Dual-energy computed tomography (DECT) is a new imaging technology that uses X-ray tube and detectors with two different tube voltages. High-contrast and low-noise images, termed “virtual monochromatic image,” can be obtained using DECT. Recently, clinical cases using DECT have been reported in urology; however, only few cases have been reported on the diagnostic use of DECT for breast cancer. Purpose: Evaluation of the usefulness of DECT in the preoperative diagnosis of extent of breast cancer spread. Patients: Thirty-three patients with breast cancer, who underwent preoperative DECT and MRI, and were operated at our hospital from November 2016 to July 2018. The surgical specimens from the patients were excised horizontally. Patients who underwent preoperative chemotherapy were excluded from the study. Methods: The maximum diameter, including that of the mass and non-mass enhancements in the horizontal sections of each lesion, was retrospectively measured by DECT and MRI. Moreover, the maximum diameter of the invading and intraductal lesions in the horizontal sections of the postoperative pathological sample were retrospectively measured. In addition, the information on the patients’ background, clinical characteristics of the tumor, etc. were retrospectively collected and reviewed from the patients’ electronic medical records. Results: The median age of the patients was 62 years. The median lesion size was 14.3 mm (0-75.8 mm) when measured with DECT, 13.1 mm (0-99.1 mm) with MRI, and 13 mm (3-95 mm) with postoperative pathology. Spearman's rank correlation coefficient was 0.752 (p Subgroup analysis of factors, such as age and menopausal status, showed significant positive correlation in all subgroups. Conclusion: As compared to MRI, DECT is advantageous in that it can simultaneously perform a whole-body metastasis search and scan in the supine position, more closer to the surgical position. Furthermore, in this study, DECT was able to evaluate the extent of spread of lesions, including the intraductal extension, almost similar to that of MRI, suggesting that the diagnostic performance may not differ across subgroups. Additional analysis, such as evaluation of the size of infiltrated area alone, will be conducted and reported in future. Citation Format: Haruna Yamasawa, Akari Murakami, Megumi Takaoka, Erina Kusakabe, Reina Aoki, Kana Taguchi, Kanako Nishiyama, Michiko Yamashita, Wakana Sugimori, Mie Kurata, Mana Fukushima, Riko Kitazawa, Kanako Okada, Megumi Matsuda, Yoshiaki Kamei, Yasutsugu Takada. Evaluating the usefulness of dual-energy computed tomography for the preoperative diagnosis of the extent of spread of breast cancer [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-02-12.

To evaluate the image quality and lesion visibility of virtual monoenergetic images (VMIs) reconstructed using a new monoenergetic reconstruction algorithm (nMERA) for evaluation of breast cancer. Forty-two patients with 46 breast cancers who underwent 4-phasic breast contrast-enhanced computed tomography (CT) using dual-energy CT (DECT) were enrolled. We selected the peak enhancement phase of the lesion in each patient. The selected phase images were generated by 120-kVp-equivalent linear blended (M120) and monoenergetic reconstructions from 40 to 80 keV using the standard reconstruction algorithm (sMERA: 40, 50, 60, 70, 80) and nMERA (40 +, 50 +, 60 +, 70 +, 80 +). The contrast-to-noise ratio (CNR) was calculated and objectively analyzed. Two independent readers subjectively scored tumor visibility and image quality each on a 5-point scale. The CNR at 40 + and tumor visibility scores at 40 + and 50 + were significantly higher than those on M120. The CNR at 50 + was not significantly different from that on M120. However, the overall image quality score at 40 + was significantly lower than that at 50 + and on M120 (40 + vs M120, P

This study aimed to compare the antiemetic efficacy and safety of a four-drug combination with those of a standard three-drug combination in Japanese patients with breast cancer treated with anthracycline. We retrospectively analyzed data from Japanese patients with breast cancer, who had received their first cycle of anthracycline and were treated with aprepitant, palonosetron, and dexamethasone with or without olanzapine. This retrospective observational study was performed at Ehime University Hospital using the electronic medical records. Multivariable and propensity score-adjusted analyses were performed to compare the onset of complete response (CR) failure between the groups. One-hundred and thirty patients were included in this study and the four- and three-drug group had 22 and 108 patients, respectively. Similar to multivariable logistic regression analysis, propensity-adjusted logistic regression analysis revealed that the four-drug group was markedly associated with a decreased odds of CR failure in the overall, acute, and delayed phases (odds ratio [OR]: 0.27, 95% confidence interval [CI]: 0.10–0.73; OR: 0.28, 95% CI: 0.10–0.76; and OR: 0.15, 95% CI: 0.04–0.57, respectively). Additionally, treatment-related adverse events were well tolerated in both the groups. These findings suggest that the antiemetic efficacy of the four-drug combination is superior to that of the standard three-drug combination.

Case 1 involved a 75-year-old woman with breast cancer and diffuse large B-cell lymphoma(DLBCL).Although we initially administered the R-CHOP regimen, the breast tumor increased in size and surgery had to be performed.After surgery, the R-CHOP regimen was re-initiated and DLBCL achieved clinical complete response.Case 2 involved a 74-year-old woman with breast cancer and gastric MALT lymphoma.After administration of rituximab and H. pylori eradication, a therapeutic effect was achieved in the lymphoma.A docetaxel and FEC regimen was continuously administered and surgery was performed. Case 3 involved a 62-year-old woman with breast cancer and follicular lymphoma.She presented with a history of DLBCL treatment.We performed mastectomy and sentinel lymph node biopsy, which revealed metastasis of breast cancer, and axillary lymph node dissection was subsequently performed.Considering the pathological stage, adjuvant chemotherapy was needed.We selected the TCH regimen based on her past treatment.In conclusion, it is necessary to treat patients with double presentation of breast cancer and malignant lymphoma through cooperation with different departments.

We report a case of microangiopathic hemolytic anemia(MHA)caused by metastatic breast cancer treated with weekly paclitaxel. A 58-year-old woman was diagnosed with metastatic breast cancer 2 years earlier. She was treated with various chemotherapy regimens and hormonal therapy, before being switched to fulvestrant 3 months earlier. She presented with severe anemia, and was diagnosed with MHA with bone marrow carcinomatosis following bone marrow biopsy. She was treated with weekly paclitaxel and recovered successfully. A subsequent biopsy showed that the bone marrow carcinomatosis had decreased. MHA due to breast cancer is rare and is associated with poor prognosis; however, rapid initiation of chemotherapy may be effective.