Prognosis of primary peritoneal carcinoma: effect of cytoreductive surgery combined with neoadjuvant chemotherapy after laparoscopic diagnosis and evaluation: a multi-center trial

OBJECTIVE

To evaluate the clinical outcome and prognosis of patients with primary peritoneal carcinoma (PPC) treated with cytoreductive surgery and neoadjuvant chemotherapy after laparoscopic diagnosis.

MATERIAL AND METHODS

We retrospectively reviewed 29 patients with PPC, treated between March 2001 and June 2009 at three hospitals. All patients underwent laparoscopy to diagnose and evaluate whether they were good candidates for optimal cytoreductive surgery. After confirmed to be PPC histologically, the patients who were not suitable to undergo optimal cytoreductive surgery received chemotherapy for three to six cycles before operation, and then underwent cytoreductive surgery, followed with chemotherapy again for six cycles. The study included patient demographics, surgery procedures, surgery stage, pathologic findings, chemotherapy programs, and outcomes.

RESULTS

The mean age of the 29 patients was 58.5 years. One patient was at Stage IIIB, 23 at Stage IIIC, and five at Stage IV. The rate of optimal cytoreductive surgery was 79.3%. At the time of this review, three patients had stable disease--two with progressive disease, eight were partial responders, and 16 were complete responders; 16 patients were alive without evidence of disease, seven were alive with disease, and six had died from disease. The mean and median overall survival time was 46 and 48 months.

CONCLUSION

Combination of neoadjuvant chemotherapy and cytoreductive surgery after laparoscopic diagnosis and evaluation is effective in the treatment of patients with PPC.

Ubiquitin C-terminal hydrolase L1 is required for pancreatic beta cell survival and function in lipotoxic conditions

AIMS/HYPOTHESIS

Ubiquitin C-terminal hydrolase L1 (UCHL1) is associated with neurodegenerative diseases and has been suggested to have roles in pancreatic beta cells. Our proteomic analysis revealed that UCHL1 was the most increased protein in MIN6 cells exposed to palmitate. The present study used a genetic loss-of-function model to test the hypothesis that UCHL1 is required for normal beta cell function and fate under lipotoxic conditions.

METHODS

Human islets, mouse islets and MIN6 cells were used to analyse UCHL1 protein levels and regulation of UCHL1 by palmitate. The levels of free mono-ubiquitin and poly-ubiquitinated proteins were assessed. Gracile axonal dystrophy (GAD) mutant mice lacking UCHL1 were fed a normal or lipotoxic high-fat diet. Glucose tolerance, insulin tolerance and insulin secretion were assessed in vivo. Beta cell death and proliferation were assessed by TUNEL and proliferating cell nuclear antigen (PCNA) staining. Insulin secretion, calcium signalling, endoplasmic reticulum (ER) stress, apoptosis and SNARE protein levels were assessed in vitro.

RESULTS

UCHL1 protein, which was highly specific to beta cells, was increased by palmitate at basal glucose, but not in the context of hyperglycaemia associated with frank diabetes. Although islet development and function were initially normal in Uchl1 (-/-) mice, a 4-week high-fat diet caused glucose intolerance and impaired insulin secretion. Uchl1 (-/-) mice had increased ER stress and beta cell apoptosis. The levels of SNARE proteins were dysregulated in Uchl1 (-/-) islets. Palmitate-stimulated vesicle-associated membrane protein 2 (VAMP2) ubiquitination was modulated by a chemical UCHL1 inhibitor.

CONCLUSIONS/INTERPRETATION

Together, these data suggest that UCHL1 has essential functional and anti-apoptotic roles in beta cells under stress conditions associated with lipotoxicity.

The influence of interval between conization and laparoscopic radical hysterectomy on the morbidity of patients with cervical cancer

OBJECTIVE

To evaluate the correlations between postoperative sequelae and the intervals between conization and subsequent laparoscopic radical hysterectomy (LRH) and pelvic lymphadenectomy in patients with cervical cancer.

MATERIALS AND METHODS

A retrospective study was conducted in a tertiary care university hospital. The medical records of cervical cancer patients undergoing LRH and pelvic lymphadenectomy between April 2005 and August 2011 were reviewed. The subjects were divided into three groups according to time from conization to LRH: group 1 (within six weeks, n = 17), group 2 (> six weeks, n = 38), and group 3 (no previous conization, n = 40).

RESULTS

The three groups showed no significant differences with respect to patient and tumor characteristics, intraoperative variables such as surgical time, blood loss, conversion to laparotomy, and perioperative morbidity, while the complications in group 1 showed a significant difference compared to groups 2 and 3.

CONCLUSIONS

LRH is feasible for the treatment of cervical cancer patients with previous conization and the appropriate time interval is after six weeks. A careful separation of the bladder and ureters from the cervix is recommended to minimize morbidity associated with this surgery.

Ibex-Associated Malignant Catarrhal Fever–Like Disease in a Group of Bongo Antelope (Tragelaphus eurycerus)

A private zoological facility experienced an outbreak of malignant catarrhal fever (MCF) in 3 bongo antelope ( Tragelaphus eurycerus). All cases were periparturient bongos that presented acutely anorectic beginning ~6 weeks after being housed with a Nubian ibex. Disease quickly progressed to respiratory distress and death within 24–72 hours of onset of clinical signs. Consistent gross findings in affected bongos were pulmonary edema and small pale tan foci in the livers. Histological lesions included a nonsuppurative vasculitis in multiple tissues, which is well recognized in MCF, but additionally included necrotizing cholangiohepatitis and neutrophilic, necrotizing myocarditis. Ibex-associated viral DNA was detected by polymerase chain reaction and was identical in sequence whether derived from bongos or ibex. The sequence closely matched an MCF viral DNA fragment that had been amplified from an ibex and bongo in a previous case report.

Viscosity-density sensor with resonant torsional paddle for direct detection in liquid

A novel micro-machined biosensor based on the resonant torsional paddle with electromagnetic excitation which can work in liquid directly is presented. The sensor designed consists of two paddles with resonant torsional mode, in which the energy loss of the resonator during the vibration is so lower that it can be suitable for detection in liquid. Finite element method analysis was carried out to guarantee the sensitivity of the sensor. Micro electro-mechanical system (MEMS) bulk silicon processes were adopted to accomplish the fabrication. A positive-feedback circuit with energy compensation is designed to improve the characteristics of the sensor in liquid. Experiments show that the resonant torsional paddle can work directly in liquid and the Q-factor of the sensor in liquid can be improved from 2.65 to 40 with energy compensation. Viscosity tests and density tests for the sensor show that the decrease in frequency and the decrease in Q-factor are related to density and viscosity of the solutions, respectively.

Methylenetetrahydrofolate reductase genotypes and haplotypes associated with susceptibility to colorectal cancer in an eastern Chinese Han population

Methylenetetrahydrofolate reductase (MTHFR) plays an important role in folate metabolism and is involved in DNA synthesis, DNA repair and DNA methylation. The two common functional polymorphisms of MTHFR, C677T and A1298C have been associated with several diseases, including cancer. We made a case-control study to analyze a possible association of MTHFR gene polymorphisms C677T and A1298C with risk for colorectal cancer in an eastern Chinese Han population of 137 patients with a confirmed histopathological diagnosis of CRC and 145 age- and gender-matched controls with no history of cancer. DNA was isolated from peripheral blood samples and the genotypes were determined by PCR-RFLP. The concentrations of folate in plasma were measured by chemiluminescence immunoassay. The MTHFR 677TT genotype had a protective effect against colorectal cancer, with an odds ratio (OR) = 0.467 (95% confidence interval (CI) = 0.225-0.966). The 1298CC genotype was significantly correlated with a reduced risk of colorectal cancer (OR = 0.192; 95%CI = 0.040-0.916). Compared with the MTHFR 677CC and MTHFR 1298 AA genotypes, for individuals who carried both MTHFR 677CC and 1298CC genotypes, the OR of colorectal cancer was 0.103 (95%CI = 0.012-0.900); among individuals who carried both MTHFR 677TT and 1298AC genotypes, the OR for risk of colorectal cancer was 0.169 (95%CI = 0.044-0.654). MTHFR 677TT+CT genotypes had a significantly lower plasma folate concentration than those with the MTHFR 677CC genotype. MTHFR 1298AC+CC genotypes had a lower plasma folate concentration than those with the MTHFR 1298AA genotype (P < 0.05). In conclusion, subjects with the MTHFR 677TT and MTHFR 1298CC genotypes appeared to have a significantly lower risk for colorectal cancer. MTHFR haplotypes 677CC/1298CC and 677TT/1298AC were less common in cases than in controls. These haplotypes, when compared to the most common haplotype 677CC/1298AA, were associated with a decreased risk for colorectal cancer. We conclude that plasma folate level is influenced by MTHFR genotypes.

Nocardia infection in kidney transplant recipients: case report and analysis of 66 published cases

Nocardiosis is a rare but life-threatening opportunistic infection, especially in immune compromised patients, including kidney transplant recipients. Primary pulmonary infection is the most common clinical pattern, and can easily result in disseminated Nocardia infection if treatment therapy is not adequate at the beginning. In this article, we report a new case of disseminated nocardiosis (lungs, skin, and pericardium) after renal allograft transplantation. We also review the English literature published from 1980 to 2010 and analyze the clinical characteristics of nocardiosis in kidney transplant recipients.

Analysis of clinical data of patients with different outcomes after short-time insemination

The study is to analyse the clinical data of the two groups of patients with different fertilisation outcomes after short-time insemination and probe into short-time insemination indications. A retrospective study including 558 cycles of short-time insemination in our centre during January 2009 to June 2010 which were divided into two groups by the method of fertilisation, 472 cycles by IVF and 86 cycles by Re-ICSI group according to fertilisation conditions to and compare the differences between the two groups in the indexes of average female age, average male age, duration of infertility, forward-moving sperm counts, abnormal sperm rate, proportion of primary infertility, etc. The differences between the two groups have statistical significance in duration of infertility, forward-moving sperm counts, abnormal sperm rate and proportion of primary infertility (5.02 ± 3.12 versus 5.86 ± 3.35; 83.06 ± 78.55 versus 54.02 ± 61.78; 83.56 ± 5.24% versus 86.31 ± 5.26%; 56.87% versus 74.42%; P < 0.05). The discrepancy between the two groups has no statistical significance in average female age and average male age (P > 0.05). Duration of infertility, forward-moving sperm counts, abnormal sperm rate and previous pregnancy history have great significance to predict fertilisation failure, so decisions should be made on the basis of the above indexes when evaluating whether a patient should conduct short-time insemination.

Permanent genetic resources added to Molecular Ecology Resources Database 1 August 2011-30 September 2011

This article documents the addition of 299 microsatellite marker loci and nine pairs of single-nucleotide polymorphism (SNP) EPIC primers to the Molecular Ecology Resources (MER) Database. Loci were developed for the following species: Alosa pseudoharengus, Alosa aestivalis, Aphis spiraecola, Argopecten purpuratus, Coreoleuciscus splendidus, Garra gotyla, Hippodamia convergens, Linnaea borealis, Menippe mercenaria, Menippe adina, Parus major, Pinus densiflora, Portunus trituberculatus, Procontarinia mangiferae, Rhynchophorus ferrugineus, Schizothorax richardsonii, Scophthalmus rhombus, Tetraponera aethiops, Thaumetopoea pityocampa, Tuta absoluta and Ugni molinae. These loci were cross-tested on the following species: Barilius bendelisis, Chiromantes haematocheir, Eriocheir sinensis, Eucalyptus camaldulensis, Eucalyptus cladocalix, Eucalyptus globulus, Garra litaninsis vishwanath, Garra para lissorhynchus, Guindilla trinervis, Hemigrapsus sanguineus, Luma chequen. Guayaba, Myrceugenia colchagüensis, Myrceugenia correifolia, Myrceugenia exsucca, Parasesarma plicatum, Parus major, Portunus pelagicus, Psidium guayaba, Schizothorax richardsonii, Scophthalmus maximus, Tetraponera latifrons, Thaumetopoea bonjeani, Thaumetopoea ispartensis, Thaumetopoea libanotica, Thaumetopoea pinivora, Thaumetopoea pityocampa ena clade, Thaumetopoea solitaria, Thaumetopoea wilkinsoni and Tor putitora. This article also documents the addition of nine EPIC primer pairs for Euphaea decorata, Euphaea formosa, Euphaea ornata and Euphaea yayeyamana.

Vitamin B12, cognition, and brain MRI measures: a cross-sectional examination

OBJECTIVE

To investigate the interrelations of serum vitamin B12 markers with brain volumes, cerebral infarcts, and performance in different cognitive domains in a biracial population sample cross-sectionally.

METHODS

In 121 community-dwelling participants of the Chicago Health and Aging Project, serum markers of vitamin B12 status were related to summary measures of neuropsychological tests of 5 cognitive domains and brain MRI measures obtained on average 4.6 years later among 121 older adults.

RESULTS

Concentrations of all vitamin B12-related markers, but not serum vitamin B12 itself, were associated with global cognitive function and with total brain volume. Methylmalonate levels were associated with poorer episodic memory and perceptual speed, and cystathionine and 2-methylcitrate with poorer episodic and semantic memory. Homocysteine concentrations were associated with decreased total brain volume. The homocysteine-global cognition effect was modified and no longer statistically significant with adjustment for white matter volume or cerebral infarcts. The methylmalonate-global cognition effect was modified and no longer significant with adjustment for total brain volume.

CONCLUSIONS

Methylmalonate, a specific marker of B12 deficiency, may affect cognition by reducing total brain volume whereas the effect of homocysteine (nonspecific to vitamin B12 deficiency) on cognitive performance may be mediated through increased white matter hyperintensity and cerebral infarcts. Vitamin B12 status may affect the brain through multiple mechanisms.

Uptake kinetics of different arsenic species in lowland and upland rice colonized with Glomus intraradices

The effect of Glomus intraradices on four As species (arsenate; arsenite; dimethylarsinic acid, DMA; and monomethylarsonic acid, MMA) uptake by lowland rice and upland rice were investigated based on two experiments: (1) high (0-0.05 mM) and low (0-2.5mM) - affinity uptake kinetics of four As species in the short-term, and (2) As speciation in rice treated with 1mM arsenate, arsenite, DMA or MMA solutions. The results showed that mycorrhizal roots of two rice cultivars reduced the arsenate uptake significantly (P<0.001) in low-affinity uptake system, and decreased the uptake of arsenite and MMA noticeably (P<0.05) in high or low-affinity uptake systems. The four As species influx have significant differences (P<0.05) between two rice varieties in low-affinity uptake systems. In the arsenate treatment, the ratio of arsenate/arsenite reduced in shoots while increased in roots because of G. intraradices presence.