Palliative response and functional interference outcomes using the Brief Pain Inventory for spinal bony metastases treated with conventional radiotherapy

AIMS

To report pain and functional interference responses in patients radiated for painful spinal metastases, and to determine if location within the vertebral column or dose fractionation are associated with response.

MATERIALS AND METHODS

Patients treated with palliative radiotherapy for symptomatic spinal metastases from May 2003 to June 2005 were analysed. All patients completed the Brief Pain Inventory (BPI) assessment tool at 1, 2 and 3 months after radiotherapy. The pain response was determined using the International Bone Metastases Consensus response definitions. Given seven BPI functional interference items, a Bonferroni adjusted P value of less than 0.007 was considered significant.

RESULTS

One hundred and nine treated patients were assessed. About 50% of patients were treated with a single fraction of 8Gy. All pain scores and functional interference scores significantly decreased over time after radiotherapy. At 3 months, 64% of patients achieved a response. Mood was significantly improved for responders (P=0.003) and a trend in improvement was observed for general activity (P=0.01) and normal work (P=0.04). Breast and prostate primaries were more likely to achieve an early response as compared with a lung primary. Neither location within the vertebral column or radiotherapy dose fractionation independently predicted for pain or functional interference responses.

CONCLUSION

Conventional radiotherapy with 8Gy in a single fraction for spine metastases resulted in effective palliation of pain at 3 months and had a positive effect on a patient's mood. Location within the spine was not a predictive factor.

A novel, multichannel, comb-frequency Doppler backscatter system

Doppler backscattering has emerged in recent years as a powerful diagnostic tool in high temperature fusion plasmas. The technique is sensitive to plasma turbulence flow and has been utilized to determine radial electric field and to study geodesic acoustic modes, zonal flows, and intermediate scale density turbulence. The current manuscript describes a novel technique for creating a stable, multichannel system covering the V-band frequency range (50-75 GHz) which enables simultaneous monitoring of turbulent flows and fluctuation levels at eight distinct spatial locations. The system is based on a high-frequency, low phase noise comb-frequency generator combined with a filter bank and quadrature detection system. The system is now in operation on DIII-D and has allowed monitoring of the flow and turbulence levels across the plasma radius during events such as the L-H transition.

Hyperglycaemia confers resistance to chemotherapy on breast cancer cells: the role of fatty acid synthase

The prognosis for women with breast cancer is adversely affected by the comorbidities of obesity and diabetes mellitus (DM), which are conditions associated with elevated levels of circulating fatty acids, hyperglycaemia and hyperinsulinaemia. We investigated the effects of exposure of non-malignant and malignant human breast epithelial cells to elevated levels of fatty acids and glucose on their growth, survival and response to chemotherapeutic agents. We found that palmitate induced cell death in the non-malignant cells but not in the malignant cells, which was abrogated through the inhibition of ceramide production and by oleate but not by IGF1. Fatty acid synthase (FAS) is responsible for the de novo synthesis of fatty acids from sugars, and is over-expressed in many epithelial cancers. Abundance of FAS was higher in malignant cells than in non-malignant cells, and was up-regulated by IGF1 in both cell types. IGF-induced growth of non-malignant cells was unaffected by suppression of FAS expression, whereas that of malignant cells was blocked as was their resistance to palmitate-induced cell death. Palmitate did not affect cell proliferation, whereas oleate promoted the growth of non-malignant cells but had the opposite effect, that is, inhibition of IGF1-induced growth of malignant cells. However, when the phosphatidylinositol 3-kinase pathway was inhibited, oleate enhanced IGF1-induced growth in both cell types. Hyperglycaemia conferred resistance on malignant cells, but not on non-malignant cells, to chemotherapy-induced cell death. This resistance was overcome by inhibiting FAS or ceramide production. Understanding the mechanisms involved in the associations between obesity, DM and breast cancer may lead to more effective treatment regimens and new therapeutic targets.

Small heat shock proteins: recent advances in neuropathy

Small heat shock proteins(sHSPs), with a small molecular mass of 12-43 kDa, are molecular chaperones that protect cells against stress by assisting them in the correct folding of denatured proteins and thus prevent aggregation of misfolded proteins. During the past several years, there has been an increasing interest in the relationship between sHSPs and neuropathy. sHSPs have emerged as a particularly potent neuroprotectant in diverse neurological disorders. Therefor, in this review, we will focus on the expression of sHSPs in different neurological disorders, and discuss the recent findings of the biological implications of sHSPs in physiological and pathological processes in these diseases. Novel therapeutic strategies aiming at restoring sHSPs in neuropathy will also be presented.

Small Heat Shock Proteins: Recent Advances in Neuropathy

Small heat shock proteins(sHSPs), with a small molecular mass of 12-43 kDa, are molecular chaperones that protect cells against stress by assisting them in the correct folding of denatured proteins and thus prevent aggregation of misfolded proteins. During the past several years, there has been an increasing interest in the relationship between sHSPs and neuropathy. sHSPs have emerged as a particularly potent neuroprotectant in diverse neurological disorders. Therefor, in this review, we will focus on the expression of sHSPs in different neurological disorders, and discuss the recent findings of the biological implications of sHSPs in physiological and pathological processes in these diseases. Novel therapeutic strategies aiming at restoring sHSPs in neuropathy will also be presented.

The study of the Golgi apparatus in blood--basic science and clinical applications

The Golgi apparatus (GA) is a cytoplasmic organelle that is of great interest to all scientists for its key role in the biosynthesis, transporting and sorting of both lipids and proteins located at the intersection of the secretory and endocytic pathways. Recently, more and more evidence shows that changes in the Golgi apparatus play an important role in the clinical progression and pathological development of many diseases. In this review, we will summarize the alteration of the Golgi apparatus in blood cells and anti-Golgi complex antibodies in blood serum under different conditions and further clarify the contribution of the Golgi apparatus dysfunction to the course of these diseases and its pathophysiological basis, which will significantly improve our understanding and impact our ability to develop more effective therapies for these diseases.