Quality of life research in oncology. Past achievements and future priorities

The status of quality of life research in oncology is assessed, and priorities for future research with regard to conceptual and theoretical developments, focus and content of research, research designs and practical strategies for research implementation, and transferring information to clinical practice and medical policy decision-making are identified. There is general agreement that quality of life is a subjective and multidimensional construct, yet comprehensive theoretical models have not been developed and applied fully. We recommend that future research be based on conceptual models that explicate the interrelationships among quality of life domains throughout the stages of cancer care. These models, and the longitudinal research that follows from them, should attend specifically to cross-class and cross-cultural issues to avoid overgeneralization from theory and research that are based largely on the views of the majority culture. We encourage the inclusion of this theory-based quality of life assessment as a standard component of clinical trials. Success in this endeavor will require additional standardization of quality of life measures for use across a range of cancer patient populations, including the development of age-specific norms and instruments designed to assess the entire family system.

Nerve growth factor stimulates phosphorylation of phospholipase C-gamma in PC12 cells

PC12 cells contain at least three immunologically distinct phospholipase C (PLC) isozymes, PLC-beta, PLC-gamma, and PLC-delta. Treatment of PC12 cells with nerve growth factor (NGF) leads to an increase in the phosphorylation of PLC-gamma, but not of PLC-beta or PLC-delta. This increase can be seen in as little as 1 minute. The increased phosphorylation occurs on both serine and tyrosine residues, with the major increase being in the former. This result suggests the possibility that the NGF-dependent increase in phosphoinositide hydrolysis in PC12 cells is due to selective phosphorylation of PLC-gamma by serine and tyrosine protein kinases associated with the NGF receptor.

Staphylococcus aureus alpha-toxin activates phospholipases and induces a Ca2+ influx in PC12 cells

Staphylococcal alpha-toxin at subcytotoxic concentrations stimulated phosphatidylinositol turnover and arachidonic acid release in undifferentiated cultures of pheochromocytoma PC12 cells. Stimulation of phospholipase A2 but not C was dependent on extracellular calcium. Addition of staphylococcal alpha-toxin to PC12 cells caused a dose-dependent, biphasic increase in intracellular calcium measured by fura-2 fluorescence technique. Elevation of intracellular Ca2+ content occurred with a time course similar to those observed for stimulation of phospholipase A2. Alteration of membrane structure and formation of staphylococcal alpha-toxin pores facilitating an influx of Ca2+, represent the probable mechanisms by which phospholipases C and A2 are activated, respectively. These results suggest a possible involvement of Ca2+, phosphoinositides and arachidonic acid metabolites in the pathogenic action of staphylococcus alpha-toxin and caution against the general usage of this toxin as a permeabilizing agent to study stimulus-secretion coupling in secretory cells.

[Thumb joint replantations without venous anastomosis. Report of 3 cases]

In this paper we report on three successfully replanted distal phalanx of thumbs without venous anastomosis. In our opinion the backflow can only be through the cancellous bone of the arthrodesis of the DIP joint or the osteosynthesis of the distal phalanx.

Sex- and age-related differences in bilirubin concentrations in serum

The relation between age and sex and the concentration of bilirubin in serum was evaluated in 6740 men and 11 215 women, ages 13 to 96 years. Mean serum bilirubin concentrations in the men significantly exceeded values in the women over all age groups examined. Further, mean serum bilirubin concentrations were greatest both in males and females in the 19-24 years age group and then declined to former values, which persisted throughout life. Pearson correlation coefficients for bilirubin with liver function indices (albumin and total protein) and with hemoglobin were low in all ages and in both sexes, suggesting that bilirubin concentrations do not correlate with those liver functions not directly concerned with bile pigment processing.

Sex- and age-related differences in bilirubin concentrations in serum

The relation between age and sex and the concentration of bilirubin in serum was evaluated in 6740 men and 11 215 women, ages 13 to 96 years. Mean serum bilirubin concentrations in the men significantly exceeded values in the women over all age groups examined. Further, mean serum bilirubin concentrations were greatest both in males and females in the 19-24 years age group and then declined to former values, which persisted throughout life. Pearson correlation coefficients for bilirubin with liver function indices (albumin and total protein) and with hemoglobin were low in all ages and in both sexes, suggesting that bilirubin concentrations do not correlate with those liver functions not directly concerned with bile pigment processing.

Direct evidence that the protein kinase catalytic subunit mediates the effects of cAMP on tyrosine aminotransferase synthesis

The effect of purified beef heart cAMP-dependent protein kinase catalytic subunit on tyrosine aminotransferase activity in intact cultured rat H35 hepatoma cells was directly tested by micro-injection using human red blood cell ghosts as vehicles. Although the micro-injection procedure itself produced temporary fluctuations in protein synthesis and in tyrosine aminotransferase activity in H35 cells, after a recovery period of 8-12 h, these parameters returned to normal in parallel with restoration of full inducibility of the aminotransferase by both 8-Br-cAMP and dexamethasone. Eight to sixteen hours after fusion of H35 cells with unloaded ghosts, ghosts loaded with bovine serum albumin or mock-loaded with the partially purified protein kinase catalytic subunit, no significant change in the activity of the aminotransferase was detected. In contrast, fusion with ghosts loaded with the catalytic subunit at concentrations between 0.1-2 mg/ml caused reproducible 2-3-fold increases in enzyme activity. Homogeneous preparations of the catalytic subunit exhibited even greater potency as an inducer. The effect was both time- and concentration-dependent and was abolished by inactivation of the catalytic subunit with N-ethylmaleimide prior to loading. The partially purified inhibitor of protein kinase from beef heart, while not affecting basal tyrosine aminotransferase activity, selectively inhibited the ability of 8-Br-cAMP but not that of dexamethasone to stimulate the activity of this enzyme. In addition, micro-injection of the pure regulatory subunit of the kinase blocked the response of the aminotransferase to low concentrations of 8-Br-cAMP. These results provide strong support for the proposition that the catalytic subunit of protein kinase mediates the effects of cAMP on the synthesis of tyrosine aminotransferase.

[Remote flap transplantation using microvascular anastomosis for scar correction (author's transl)]

The method of tissue displacement from a donor region to a receiving area with the help of microvascular anastomosis represents a synthesis of the traditional classical remote flap graft and free tissue transplantation. The method of defect replenishment with the help of a freely transplanted skin-fat-connective tissue flap from the groin region (groin flap) is demonstrated by the example of a correction of a shrinking scar on the neck of a 21-year-old patient, and the anatomical basis and operation technique are described. The advantages and disadvantages of the method are discussed.

Avoidance of certain systematic pitfalls in the detection of HLA-DR antibodies defining find specificities

A selective screening program has been established to identify rapidly and effectively the fine specificity of HLA-DR antibodies in pregnancy anti-HLA sera. Following initial HLA-A, B, C screening sera with extra- or multispecific reactions were selected and specifically tested after platelet absorption on isolated B- and T-lymphocyte populations of the serum donor's husband. Identification of the HLA-DR serum. Multispecific anti-DR sera were defined and rendered operationally monospecific by titration. Some critical steps in a reliable assessment of HLA-DR typing reagents could be worked out. Weak HLA-A, B antibodies, B-cell auto- and Lewis antibodies may cause positive reactivity preferentially or even selectively on B lymphocytes. Of particular importance was the hidden presence of HLA-C specific antibodies, since they cannot be absorbed out of stored platelets. In addition they are not readily detectable through screening on typed panel cells. Because of the frequently very high linkage disequilibrium between HLA-B and HLA-C alleles it is difficult to select appropriately dissecting panel cells. The two points demonstrated above gain even more weight when isolated T and B cell populations are used for HLA-DR typing, because HLA-C antibodies preferentially kill B cells. In this fashion contaminating HLA-C antibodies are not only difficult to detect but can mimic the presence of HLA-DR antibodies.

Oncornavirus-induced sarcoma formation obscured by rapid development of lethal leukemia

Injection i.v. of avian erythroblastosis virus (AEV) strain ES4 causes a high incidence of leukemia and the death of most of the inoculated chicks within 2 weeks. As found earlier, the virus is defective for replication and transforms bone marrow cultures in vitro, and surprisingly, also chick embryo fibroblasts. Inoculation of transformed AEV cells negative for virus production into newborn chicks induced the formation of sarcomas only, whereas cells superinfected with helper virus induced the formation of erythroblastosis in addition to sarcomas. The helper virus alone caused neither sarcomas nor erythroblastosis during the experimental period. These findings were explained by the hypothesis that AEV-induced erythroblastosis develops more rapidly than do AEV-induced sarcomas and that animals receiving i.v. injections die of the leukemia before sarcomas become detectable. The observation that animals receiving i.m. injections of AEV developed sarcomas at the site of injection strongly supports this concept. Most of the animals that received i.m. injections also developed an erythroblastosis that was delayed, however, in comparison to the animals receiving i.v. injections. Our data also suggest that the erythroblastosis induced by AEV does not suppress the formation of sarcomas in the same animal.

Coherent detection SNR of an array of detectors

General equations are derived for the SNR of a coherent (heterodyne) receiver constructed from an array of detectors and i.f. amplifiers. The equations are in terms of the distribution functions of the signal and local oscillator fields, the distributions of gain and phase shift among the i.f. amplifiers, and the sizes and shapes of the individual detectors. Such a receiver can efficiently detect any signal distribution function, no matter how badly aberrated, if the individual detectors are small enough, and the i.f. amplifier gains and phase shifts are set correctly.