Study design: Prospective single centre study. Objectives: Pulmonary rehabilitation focuses on improving the expiratory muscle function in order to increase the reduced cough capacity in patients with cervical spinal cord injuries (SCI). However, an improvement in the inspiratory function is also important for coughing effectively. Therefore, this study was to examine the significance of the inspiratory muscle strength on the cough capacity in the patients with a cervical SCI. Setting: SCI unit, Yonsei Rehabilitation Hospital, Seoul, Korea. Methods: The vital capacity (VC), maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP) were measured. Moreover, the unassisted peak cough flow (PCF) and assisted PCF under three conditions were evaluated. Results: All three assisted cough methods showed a significantly higher value than the unassisted method (Po0.001). The VC correlated with the voluntary cough capacity and the MIP (R ¼ 0.749) correlated more significantly with the VC than the MEP (R ¼ 0.438) (Po0.01). The MIP showed a higher correlation with both the unassisted PCF and all three assisted PCFs than the MEP (Po0.001). Conclusions: The management of the inspiratory muscle strength should be considered in the pulmonary rehabilitation at cervical SCI patients.

Cell migration and angiogenesis are key steps in tumor metastasis. However, the mechanism of migration regulated by vascular endothelial growth factor (VEGF), a potent regulator of angiogenesis, is not completely understood. This study examined the relationship between VEGF and migration, along with the mechanism involved in the VEGF-regulated migration of human gastric cancer cells. The level of cell migration was increased by recombinant human (rh)VEGF-165 in the VEGF receptor-2-expressing SNU-601 cells. Interleukin (IL)-18 is associated with the malignant progression of tumors. Accordingly, this study examined the effect of IL-18 on the migration of cancer cells in order to identify the factors involved in VEGF-enhanced migration. Inhibiting IL-18 markedly reduced the level of VEGF-enhanced migration, and IL-18 increased cell migration directly through filamentous-actin polymerization and tensin downregulation. It was confirmed that rhVEGF-165 increased IL-18 production significantly. An antioxidant and an extracellular signal-regulated kinase (ERK)1/2-specific inhibitor blocked rhVEGF-165-enhanced IL-18 production. Accordingly, rhVEGF-165 increased the generation of region of interest (ROI) and activated the ERK1/2 pathway. These results suggest that rhVEGF-165 enhances IL-18 production via the generation of ROI and ERK1/2 phosphorylation, which results in the increased migration of gastric cancer cells.

Apaf-1-interacting protein (APIP) was previously isolated as an inhibitor of mitochondrial cell death interacting with Apaf-1. Here, we report a hypoxia-selective antiapoptotic activity of APIP that induces the activation of AKT and extracellular signal-regulated kinase (ERK)1/2. Stable expression of APIP in C2C12 (C2C12/APIP) cells suppressed cell death induced by hypoxia and etoposide. Unlike etoposide, however, APIP induces the sustained activation of AKT and ERK1/2 and the phosphorylation of caspase-9 during hypoxia. Inhibition of AKT and ERK1/2 activation by the treatments with phosphatidylinositol 3 0 -kinase and mitogen-activated protein kinase kinase (MEK)1/2 inhibitors sensitized C2C12/APIP cells to hypoxic cell death and abolished the hypoxia-induced phosphorylation of caspase-9. Further, overexpression of phosphorylation-mimic caspase-9 mutants (caspase-9-T125E and caspase-9-S196D), but not phosphorylation-defective caspase-9 mutants (caspase-9-T125A and caspase-9-S196A), effectively suppressed hypoxia-induced death of C2C12 cells. These results elucidate a novel Apaf-1-independent antiapoptotic activity of APIP during hypoxic cell death, inducing the sustained activation of AKT and ERK1/2 and leading to caspase-9 phosphorylation.

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Background: Breast cancer screening program makes it possible to detect early cancer, thus to reduce breast cancer mortality. The authors studied clinicopathologic characteristics and prognosis of screen detected invasive breast cancer compared with symptomatic breast cancer. Furthermore, we compared the result according to molecular subtypes (luminal A, luminal B, Her2, triple negative), so intended to identify the role of screening in each subtypes. Material and Methods: From January 2002 to June 2008, 3141 patients who underwent operation for the treatment of invasive ductal carcinoma(NOS) at Samsung medical center were included. Among them, 1025 patient were screen detected, 2116 patient were symptomatic, out of screening over 2 years. We reviewed the medical records retrospectively. Result: Screen detected breast cancer was associated with older patients, smaller tumor size, more hormone receptor- positive, less lymph node involvement, lower stage and reduced mortality compared with symptomatic breast cancer (P < .001). According to the molecular subtype, in luminal A subtype, the result shows better pathologic feature and also favorable overall and recur-free survial significantly. Conclusion: Compared to symptomatic breast cancer patients, screen detected breast cancer patients have favorable pathological and molecular characteristics, so better outcomes. According to the molecular subtype, only in luminal A subtype, screen detected breast cancer shows both overall and disease free survival benefit, and also acts as an independent prognostic factor itself. So, screening program seems to have a different efficacy depending on the molecular subtype of breast cancer Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-14-02.