Comparison of two different sites of measurement for transabdominal uterine artery Doppler velocimetry at 11-13 weeks

OBJECTIVES

To compare the feasibility of two transabdominal approaches for performing first-trimester uterine artery (UtA) Doppler and to evaluate the correlation with pulsatility index (PI) in the second trimester.

METHODS

This was a prospective longitudinal Doppler study of the uterine arteries at 11-13 and 21-22 weeks' gestation. Transabdominal ultrasound and color Doppler were used to measure the UtA-PI of the ascending branch of the uterine artery at the level of the internal cervical os (Site A) and at the level of the apparent crossover with the external iliac artery (Site B) at 11-13 weeks, and at Site B only at 21-22 weeks. In all cases the measured left and right PI were converted to a multiple of the median (MoM) for gestational age, and the intercorrelation between the measurements at different sites and gestational ages was calculated using non-parametric analysis (Spearman's rank correlation).

RESULTS

Satisfactory measurements were obtained at 11-13 weeks from both uterine arteries in all 81 women at Site A and in 50 (62%; 95% CI, 50-72%) at Site B (P < 0.01). Measurements were obtained at Site B at 21-22 weeks in all cases. In the 50 cases with measurements from both sites at 11-13 weeks, the correlation of PI-MoMs between Sites A and B at 11-13 weeks was only moderate (ρ = 0.61). The correlation between first-trimester UtA-PI MoMs at Site A and second-trimester UtA-PI MoMs was stronger than that between first-trimester UtA-PI MoMs at Site B and second-trimester UtA-PI MoMs (ρ = 0.73 vs ρ = 0.47, P < 0.01).

CONCLUSION

Evaluation of UtA-PI at 11-13 weeks can be achieved at the level of the internal cervical os in a greater proportion of women than at the level of the apparent crossover with the external iliac vessels, and the measurements obtained correlate better with second-trimester UtA-PI.

Measurement of cerebral microvascular compliance in a model of atherosclerosis with optical coherence tomography

Optical coherence tomography (OCT) has recently been used to produce 3D angiography of microvasculature and blood flow maps of large vessels in the rodent brain in-vivo. However, use of this optical method for the study of cerebrovascular disease has not been fully explored. Recent developments in neurodegenerative diseases has linked common cardiovascular risk factors to neurodegenerative risk factors hinting at a vascular hypothesis for the development of the latter. Tools for studying cerebral blood flow and the myogenic tone of cerebral vasculature have thus far been either highly invasive or required ex-vivo preparations therefore not preserving the delicate in-vivo conditions. We propose a novel technique for reconstructing the flow profile over a single cardiac cycle in order to evaluate flow pulsatility and vessel compliance. A vascular model is used to simulate changes in vascular compliance and interpret OCT results. Comparison between atherosclerotic and wild type mice show a trend towards increased compliance in the smaller arterioles of the brain (diameter < 80μm) in the disease model. These results are consistent with previously published ex-vivo work confirming the ability of OCT to investigate vascular dysfunction.

Selective epitaxy of semiconductor nanopyramids for nanophotonics

We present a detailed study of the parameters which affect the geometrical perfection of nanopyramids used for the site-selected nucleation of quantum dots. Through an understanding of crystal facet formation, we demonstrate that undesirable high index planes can be suppressed using carefully optimized lithography together with properly orientated source fluxes in the growth reactor. High quality InP nanopyramids are reported with individual InAs/InP quantum dots positioned with high precision. This represents an important milestone for the fabrication of complex quantum dot based nanophotonic devices.

Oscillatory response in a sensory network of ON and OFF cells with instantaneous and delayed recurrent connections

A neural field model with multiple cell-to-cell feedback connections is investigated. Our model incorporates populations of ON and OFF cells, receiving sensory inputs with direct and inverted polarity, respectively. Oscillatory responses to spatially localized stimuli are found to occur via Andronov-Hopf bifurcations of stationary activity. We explore the impact of multiple delayed feedback components as well as additional excitatory and/or inhibitory non-delayed recurrent signals on the instability threshold. Paradoxically, instantaneous excitatory recurrent terms are found to enhance network responsiveness by reducing the oscillatory response threshold, allowing smaller inputs to trigger oscillatory activity. Instantaneous inhibitory components do the opposite. The frequency of these response oscillations is further shaped by the polarity of the non-delayed terms.

Distinct termination morphologies for vertically aligned carbon nanotube forests

Vertically aligned carbon nanotube forests, including single-walled nanotubes, are imaged optically as they grow in situ from cobalt/alumina catalyst using water-assisted acetylene chemical vapor deposition. Three distinct termination morphologies are identified and investigated optically and via scanning electron microscopy. Quantitative growth dynamics are extracted and show gradual deceleration and sudden termination of growth. The termination morphology is discussed in terms of the balance of forces within the forest. We speculate that sudden termination is a collective effect arising from an imbalance in these forces.

External or internal lateral osteotomy: why I choose the external percutaneous approach

The authors present their surgical experience with the management of patients with dorsum deformities using a precise technique: the external percutaneous approach. The indications for this technique have still not been set out very clearly in the rhinological textbooks or manuals, and so novices (and not only novices) have difficulty in understanding and applying it. We therefore try to systematise and clarify these indications in brief, together with the technical details, providing a comparison with another technique that is in very widespread use at present: the internal lateral osteotomy. Although the external percutaneous approach is not used very often--in our experience in 30% of cases only--we find the results very satisfactory and we recommend it when it is required by the anatomic conditions.

Strengthening of reentrant pinning by collective interactions in the peak effect

Since it was first observed about 40 years ago [A. B. Pippard, Proc. R. Soc. A 216, 547 (1953)10.1098/rspa.1953.0040], the peak effect has been the subject of extensive research mainly impelled by the desire to determine its exact mechanisms. Despite these efforts, a consensus on this question has yet to be reached. Experimentally, the peak effect indicates a transition from a depinned vortex phase to a reentrant pinning phase at a high magnetic field. To study the effects of intrinsic pinning on the peak effect, we consider FexNi1-xZr2 superconducting metallic glasses in which the vortex pinning force varies depending on the Fe content and in which a huge peak effect is seen. The results show that the peak effect broadens with decreasing pinning force. Typically, pinning is increased by pinning centers, but here we show that reentrant pinning is due to the strengthening of interactions and collective effects (while decreasing pinning strength).

A pan-European survey to gauge public awareness and understanding of head and neck cancer and associated risk factors

6073

Background: Head and neck cancer is the sixth most frequently occurring cancer worldwide yet there appears to be little awareness of this disease amongst the general public in Europe. As part of an ongoing program to fully understand the patient perspective, the ‘About Face’ survey was planned and conducted in collaboration with the European Head and Neck Society to gauge current awareness and understanding of head and neck cancer and its associated risk factors. Methods: A total of 7,520 Omnibus internet interviews were conducted in 7 European countries (FR, DE, IT, NL, SP, SW, UK) in September 2008. Results: Only 23% of respondents overall were aware of the term ‘head and neck cancer.’ While most symptoms of head and neck cancer were recognized; the majority were cited correctly by fewer than half of respondents; 60% believed that ‘head and neck cancer’ includes tumors of the brain. Sixty-one percent of those surveyed underestimated the incidence of head and neck cancer in Europe by at least a factor of 10. While the majority recognized the link between head and neck cancer and smoking or high alcohol intake, far fewer were aware of the role of excessive sun exposure or HPV infection in disease etiology. One in four respondents felt that the consequences of surgery would cause the most distress to a person diagnosed with the disease. Conclusions: There is a general lack of knowledge amongst the general public in Europe of the risk factors and symptoms of head and neck cancer. This is a significant issue that should be addressed as these data suggest that patients may be more likely to delay consulting a physician and therefore be diagnosed with this difficult-to-treat disease at a late stage. Further education of the public on head and neck cancer is warranted.

[Table: see text]

Sequential chemoradiotherapy (SCRT) for larynx preservation (LP): Preliminary results of the randomized phase II TREMPLIN study

6010

Background: Induction chemotherapy (ICT) followed by irradiation (RT) and concurrent chemoradiotherapy (CRT) are validated options for LP. Docetaxel-based ICT, concurrent cetuximab and RT are new options and SCRT (ICT followed by CRT) has been reported as a potential new approach. However, to date there are no data assessing SCRT specifically for LP. Methods: Previously untreated patients (pts) with larynx or hypopharynx squamous cell carcinoma and candidates for a total laryngectomy were eligible for this randomized phase II study. Eligible pts received 3 cycles of ICT (docetaxel and cisplatin both 75 mg/m2 on day 1 and 5-FU 750 mg/m2/day on days 1–5). In case of response ≥ 50 % pts were randomized to receive either in arm A: RT (70 Gy) with cisplatin (100 mg/m2 on days 1, 22 and 43 of RT) or in arm B: Cetuximab (400 mg/m2 loading dose before RT and 250 mg/m2 on the first day of the 7 weeks of RT. Pts with response < 50% had salvage surgery. Primary endpoint was LP 3 months after treatment, secondary endpoints were larynx function preservation at 18 months, quality of function and tolerance to treatment. Results: From March 2006 to April 2008 (end of accrual), 153 pts with stage III-IV larynx/hypopharynx cancer were enrolled in the study and could start ICT. Of them 74 % could receive the planned ICT while the others had either reduced dosages or less than 3 cycles. Toxic deaths occurred in 3 pts (2%). Of the 147 evaluable pts after ICT, 22 were non-responders (15%), 4 pts were withdrawn from the study, 6 responding pts with ICT-related toxicity precluding any further cisplatin could not be randomized and finally 115 pts could be randomized (59 in arm A and 56 in arm B). 3 months after treatment there was no significant difference in LP (93% in arm A and 96% in arm B). In arm A, 45 % of pts could receive the full CRT protocol vs 71 % in arm B. In arm A 50% of pts had cisplatin-related toxicity (definitive in 52% the cases) while in arm B 26 % of patients had cetuximab-related toxicity (definitive in only 1 case). There was no CRT treatment-related death. Conclusions: SCRT is considered for LP. ICT followed by RT with concurrent cetuximab appeared better tolerated than with concurrent cisplatin with the same LP rate 3 months after treatment.

[Table: see text]

Phase III study on larynx preservation comparing induction chemotherapy and radiotherapy versus alternating chemoradiotherapy in resectable hypopharynx and larynx cancers. EORTC protocol 24954–22950

LBA6016

Background: Final analysis of a larynx preservation study comparing sequential induction chemotherapy and radiotherapy (XRT) versus alternating chemoradiotherapy in treating resectable hypopharynx and larynx cancers. Methods: Patients (pts) with untreated, resectable T3-T4 larynx or T2-T3-T4 hypopharynx, N0-N2, M0 squamous cell carcinoma (SCC) were randomized in this prospective Phase III trial. Pts received in the control arm (SEQ) 2 cycles of cisplatin/5-FU (CF), followed in case of response by 2 additional cycles of CF, followed on day 80 by XRT (70 Gy / 35 fractions / 7 weeks), or in the experimental arm a CF cycle in weeks 1, 4, 7 and 10, alternated with XRT (20 Gy / 10 fractions) during the three 2-week intervals (ALT). Pts had surgery and postoperative XRT in case of non- response. The primary endpoint was survival with a functional larynx (FLS), with events including local relapse, laryngectomy, tracheotomy, gastrostomy, feeding tube, and death. With 450 patients and 3 yrs minimum followup per pt, this trial was planned to provide 80% power to detect a difference of 11% (from 28% to 39%) in this endpoint at 3 years by 2-sided Logrank test (Type I error 5%). Results: The trial enrolled 450 pts (224 to SEQ, 226 to ALT) from July 1996 to May 2004. Median followup is 6.5 years (yrs). 76 pts discontinued treatment for toxicity (34 on SEQ, 42 on ALT). Hazard ratio (HR) for FLS was 0.84 (95% CI 0.67–1.05, p=0.12) with medians 1.6 yrs on SEQ and 2.3 yrs on ALT. OS (medians of 4.4 and 5.2 yrs) and PFS (medians of 3.0 and 3.1 yrs) were similar for SEQ and ALT, respectively. At 3 yrs, cumulative incidence of larynx events was 46% on SEQ and 38% on ALT (HR 0.79, p=0.09). Grade 3/4 mucositis was seen in 32% of pts who received RTX on SEQ, and 21% on ALT. Late severe edema and/or fibrosis was observed in 16% of pts in SEQ and 11% in ALT. Conclusion: A 8% difference in larynx function preservation rate at 3 yrs favoring ALT did not translate into statistically significant differences. ALT, as a form of chemoradiation, did not lead to increased incidence and severity of mucositis. There were no relevant long-term sequelae in either arm.

No significant financial relationships to disclose.

Polarized photoluminescence excitation spectroscopy of single-walled carbon nanotubes

The polarized photoluminescence excitation spectra of twenty-five single-walled carbon nanotube species are reported. For light polarized along the nanotube axis, the main absorption resonance at E22 shows sidebands attributed to phonon assisted absorption. Sidebands to E11 have a diameter dependent energy and are assigned to excited excitonic states. Along with longitudinal excitations, several transverse excitations are identified. The transverse E12 resonance has a specific family pattern with energy close to E22. Comparison with theory provides an estimate of the strength of the Coulomb interaction.

Chemical vapour deposition of single walled carbon nanotubes freely suspended over nanotube supports

Single walled carbon nanotubes (SWNTs) suspended above the substrate can be fabricated simply and rapidly by chemical vapour deposition growth over pre-grown multi-walled carbon nanotubes (MWNTs). SWNTs are suspended either on a randomly organized carbon nanotube network on an unpatterned substrate, or between organized pillars made from vertically aligned nanotube forests on a patterned substrate. All nanotubes are produced during a single growth run using a two step growth technique. This approach enables the fabrication of laterally suspended SWNT networks which are well suited for optical applications.

Genomic structure and tissue-specific expression of human and mouse genes encoding homologues of the major bovine seminal plasma proteins

Sperm capacitation is a maturation event that takes place in the female reproductive tract and is essential for fertilization. A family of phospholipid-binding proteins present in bovine seminal plasma (BSP proteins) binds the sperm membrane at ejaculation and promotes bovine sperm capacitation. Homologues of these proteins have also been isolated from boar, ram, goat, bison and stallion seminal fluid, suggesting that BSP proteins and their homologues are conserved among mammals. However, there have been no reports on BSP-homologous proteins in mice and humans to date. A search of the mouse and human genomes, using the nucleic acid sequences of BSP proteins, revealed the presence of three BSP-like sequences in the mouse genome, named mouse BSP Homologue 1 (mBSPH1), mBSPH2 and mBSPH3, and one sequence in the human genome (hBSPH1). Mouse epididymal expressed sequence tags corresponding to partial sequences of mBSPH1 and mBSPH2 were identified. The entire complementary DNA (cDNA) sequences of mBSPH1 and mBSPH2 from mouse epididymis and hBSPH1 from human epididymis were obtained by 5'-/3'-rapid amplification of cDNA ends (RACE) and encode predicted proteins containing two tandemly repeated fibronectin type II domains, which is the signature of the BSP family of proteins. Using RT-PCR, it was revealed that mBSPH1, mBSPH2 and hBSPH1 mRNA are expressed only in the epididymis. Expression of mBSPH3 was not detected in any tissue and probably represents a pseudogene. This work shows, for the first time, that BSP homologues are expressed in mouse and human and may be involved in sperm capacitation in these species.

Neo-adjuvant treatment with erlotinb in squamous cell carcinoma head and neck (SCCHN) patients before surgery provides an opportunity to find predictive factors of response

5513

Background: To date, neither immunohistochemistry (IHC) nor molecular analyses have identified prognostic markers of response to epidermal growth factor receptor (EGFR) tyrosine kinase (TK) inhibitors in SCCHN. Thus, the selection of patients who could benefit from such agents remains a challenge. We designed a ‘pilot’ clinical trial of patients (pts) with SCCHN pending first-line surgery of their disease. Methods: Pts with resectable SCCHN received erlotinib at 150mg/day during the period between pan-endoscopy and surgery. Pharmacokinetic (PK) samples were collected during treatment, which ceased the day before surgery. Results: Thirty five pts were recruited. All of them had resectable SCCHN: oral cavity (17 pts), oropharyngeal (7 pts), hypopharyngeal (5 pts), larygeal (6 pts). Thirty pts received full treatment with erlotinib and the main reason for discontinuation was rash. The median duration of treatment was 21 days (14–27). All pts were evaluated clinically and their tumors assessed radiologically before and after treatment. Out of 30 evaluable pts, 8 were considered as good responders (30–80% decrease in tumor size), 18 had stable disease and 2 had minor progression. Expected toxicities were observed: rash (grade 2/3 in 11 pts), diarrhea (grade 2 in 1 pt). All pts underwent surgery. The incidence of post-operative complications was similar to our historical series. No mutations in the catalytic domain of EGFR TK were found. All tumors were positive for EGFR by IHC. Correlative statistical analyses between PK, toxicity and response data are ongoing and will be presented. Neither over expression of EGFR nor other IHC markers alone were found to be good predictive markers of efficacy. Retrospective analysis of morphological and IHC evaluation in some cell cycle regulators (mainly p21) appeared to be predictive of erlotinib efficacy (sensitivity 87.5%, specificity 88%). Conclusions: Neo-adjuvant treatment with erlotinib in SCCHN pts is well-tolerated. This trial demonstrated a useful prospective method to potentially aid patient selection to improve the design of post-operative adjuvant treatment combinations.

No significant financial relationships to disclose.