Short communication: Streptococcus species isolated from mastitis milk samples in Germany and their resistance to antimicrobial agents

Mastitis is one of the most frequent infectious diseases in dairy cattle and is a reason for antimicrobial drug usage in dairy cows. The bacteria involved in bovine mastitis are mainly Streptococcus spp., Staphylococcus spp., and coliforms. The aim of this study was to determine antimicrobial resistance among Streptococcus spp. isolated from bovine mastitis milk. Antimicrobial resistance in Strep. uberis (n=227), Strep. dysgalactiae (n=49), and Strep. agalactiae (n=3) was determined for 9 antimicrobial agents using the broth microdilution method in accordance with Clinical and Laboratory Standards Institute recommendations. Of all Streptococcus spp., 13% were multidrug resistant. The rate of multidrug resistance was higher among Strep. uberis (15%) than among Strep. dysgalactiae (6%) and Strep. agalactiae (0%). Resistance to tetracycline was the most common, followed by resistance to erythromycin, pirlimycin, and gentamicin. Resistance rates were higher on farms with more than 80 cows compared with those with fewer than 20 cows. β-Lactams should remain the drugs of choice in the treatment of streptococcal mastitis. The slightly elevated minimum inhibitory concentrations determined for these antibiotics may indicate, however, the emergence of resistant streptococci. To identify such changes in susceptibility as early as possible, antimicrobial resistance in streptococci should be surveyed regularly.

SDF-1 in myocardial repair

Stem cell therapy for the prevention and treatment of cardiac dysfunction holds significant promise for patients with ischemic heart disease. Excitingly early clinical studies have demonstrated safety and some clinical feasibility, while at the same time studies in the laboratory have investigated mechanisms of action and strategies to optimize the effects of regenerative cardiac therapies. One of the key pathways that has been demonstrated critical in stem cell-based cardiac repair is (stromal cell-derived factor-1) SDF-1:CXCR4. SDF-1:CXCR4 has been shown to affect stem cell homing, cardiac myocyte survival and ventricular remodeling in animal studies of acute myocardial infarction and chronic heart failure. Recently released clinical data suggest that SDF-1 alone is sufficient to induce cardiac repair. Most importantly, studies like those on the SDF-1:CXCR4 axis have suggested mechanisms critical for cardiac regenerative therapies that if clinical investigators continue to ignore will result in poorly designed studies that will continue to yield negative results.

Illuminating the surface spin texture of the giant-Rashba quantum-well system Bi/Ag(111) by circularly polarized photoemission

We have mapped out the spin texture of a Bi/Ag surface alloy prepared on a thin Ag film by circularly polarized angle-resolved photoemission spectroscopy. A term proportional to ∇·A in the interaction Hamiltonian gives rise to strong surface photoexcitation, which interferes with a Rashba contribution to yield a pronounced circular dichroic effect in Bi/Ag. The dipole transition, often taken to be the only important photoexcitation mechanism, is actually negligible. A parameter-free calculation yields a dichroic pattern in excellent agreement with experiment.

Interfacial protection of topological surface states in ultrathin Sb films

Spin-polarized gapless surface states in topological insulators form chiral Dirac cones. When such materials are reduced to thin films, the Dirac states on the two faces of the film can overlap and couple by quantum tunneling, resulting in a thickness-dependent insulating gap at the Dirac point. Calculations for a freestanding Sb film with a thickness of four atomic bilayers yield a gap of 36 meV, yet angle-resolved photoemission measurements of a film grown on Si(111) reveal no gap formation. The surprisingly robust Dirac cone is explained by calculations in terms of interfacial interaction.

IVI epoprostenol as salvage therapy in pulmonary arterial hypertension: an Australian perspective

BACKGROUND

IVI epoprostenol is the only therapy for pulmonary arterial hypertension (PAH) with a randomized controlled trial demonstrating improved survival, when used as first-line monotherapy. In Australia it is used as salvage therapy for those failing treatment with other targeted therapies or presenting in World Health Organization functional class (FC) IV.

AIMS

Report experience with IVI epoprostenol, administered as salvage therapy for the treatment of adults with PAH in a single Australian PAH centre.

METHODS

Retrospective case series of all patients commenced on IVI epoprostenol for PAH, between 2002 and 2010. Review of case notes with collection of data at baseline and after treatment, including FC, 6-min walk test (6MWT), right ventricular systolic pressure (RVSP) on echocardiogram, patient survival and treatment complications. Change in indices was assessed using the Wilcoxon Sign Rank Test and is expressed as median (inter-quartile range).

RESULTS

A total of 23 patients was included. Treatment was generally well tolerated with few major complications. At the end of the study period, nine patients were successfully bridged to transplant, five had a sustained response to IVI epoprostenol, six had an incomplete response but were clinically stabilized, two died awaiting transplant and one died who was not a candidate for transplantation. Overall, when measured at best level post initiation of IVI epoprostenol, there were significant improvements in FC -1 [0 to -1] (P < 0.0001), 6MWT (m) +117 [70-264] (P= 0.002) and RVSP (mmHg) -7.0 [4.0 to -45] (P= 0.03).

CONCLUSION

Findings support efficacy of epoprostenol as salvage therapy for patients with PAH.

Fragility of surface states and robustness of topological order in Bi2Se3 against oxidation

Topological surface states are protected against local perturbations, but this protection does not extend to chemical reaction over the whole surface, as demonstrated by theoretical studies of the oxidation of Bi(2)Se(3) and its effects on the surface spin polarization and current. While chemisorption of O(2) largely preserves the topological surface states, reaction with atomic O removes the original surface states and yields two new sets of surface states. One set forms a regular Dirac cone but is topologically trivial. The other set, while topologically relevant, forms an unusual rounded Dirac cone. The details are governed by the hybridization interaction at the interface.

Human adenovirus-vectored foot-and-mouth disease vaccines: establishment of a vaccine product profile through in vitro testing

Next generation, foot-and-mouth disease (FMD) molecular vaccines based on replication deficient human adenovirus serotype 5 viral vectored delivery of FMD capsid genes (AdFMD) are being developed by the United States Dept. of Homeland Security and industry partners. The strategic goal of this program is to develop AdFMD licensed vaccines for the USA National Veterinary Stockpile for use, if needed, as emergency response tools during an FMD outbreak. This vaccine platform provides a unique opportunity to develop a set of in vitro analytical parameters to generate an AdFMD vaccine product profile to replace the current lot release test for traditional, inactivated FMD vaccines that requires FMDV challenge in livestock. The possibility of an indirect FMD vaccine potency test based on a serological alternative was initially investigated for a lead vaccine candidate, Adt.A24. Results show that serum virus neutralization (SVN) based serology testing for Adt.A24 vaccine lot release is not feasible, at least not in the context of vaccine potency assessment at one week post-vaccination. Thus, an in vitro infectious titer assay (tissue culture infectious dose 50, TCID50) which measures FMD infectious (protein expression) titer was established. Pre-validation results show acceptable assay variability and linearity and these data support further studies to validate the TCID50 assay as a potential potency release test. In addition, a quantitative physiochemical assay (HPLC) and three immunochemical assays (Fluorescent Focus-Forming Unit (FFU); tissue culture expression dose 50 (TCED50); Western blot) were developed for potential use as in vitro assays to monitor AdFMD vaccine lot-to-lot consistency and other potential applications. These results demonstrate the feasibility of using a traditional modified-live vaccine virus infectivity assay in combination with a set of physiochemical and immunochemical tests to build a vaccine product profile that will ensure the each AdFMD vaccine lot released is similar to a reference vaccine of proven clinical safety and efficacy.

Visualizing electronic chirality and Berry phases in graphene systems using photoemission with circularly polarized light

Electronic chirality near the Dirac point is a key property of graphene systems, which is revealed by the spectral intensity patterns as measured by angle-resolved photoemission spectroscopy under various polarization conditions. Specifically, the strongly modulated circular patterns for monolayer (bilayer) graphene rotate by ±90° (±45°) in changing from linearly to circularly polarized light; these angles are directly related to the phases of the wave functions and thus visually confirm the Berry's phase of π (2π) around the Dirac point. The details are verified by calculations.

Electronic structure and trilayer growth of indium films on Si(111): a photoemission study

We report on the preferred trilayer growth of indium films on Si(111) studied by angle-resolved photoemission spectroscopy. By employing an interfactant and optimized annealing conditions, the kinetic constraint on the In atoms due to the substrate is greatly reduced and 'electronic growth'-where film morphology is controlled by the quantized electronic structure of the film-can be achieved at low coverage. Our photoemission spectra reveal that films of 4 ML (monolayers) and 7 ML thicknesses are energetically favored due to a lower surface energy, as confirmed by theoretical calculations. A detailed comparison of the photoemission spectra between In films grown on the In-√3 × √3/Si(111) surface and those on the Si(111) 7 × 7 surface shows that the √3 × √3 interfactant is a better template for growing In films at low coverage and effectively reduces the electronic coupling between the film and the substrate. In addition, the observed band structures of In films are in reasonable agreement with first-principles calculations and suggest that In films grown on the √3 × √3 interfactant might already be close to the bulk-like body-centered tetragonal structure at around 10 ML.

Passage from spin-polarized surface states to unpolarized quantum well states in topologically nontrivial Sb films

Topological materials have unusual surface spin properties including a net surface spin current protected by the bulk symmetry properties. When such materials are reduced to thin films, their gapless spin-polarized surface states must connect, by analytic continuation, to bulk-derived quantum-well states, which are spin-unpolarized in centrosymmetric systems. The nature of this passage in a model system, Sb films, is investigated. Angle-resolved photoemission shows a smooth transition, while calculations elucidate the correlated evolution of the spin and charge distributions in real space.

Photoemission Studies of the Initial Adsorption and Growth of Ag on Ge(111)

We present electron diffraction, and high-resolution angle-resolved and angle-integrated photoemission studies of the initial phases of adsorption and growth of Ag on Ge(111). The results provide information on the structural properties of the Ge(111)-c(2×8) substrate surface, show Ag grows upon it almost laminarly at room temperature, and unambiguously demonstrate the presence of a small amount of Ge segregating on top of the growing Ag overlayer. The origins and behavior of these segregated atoms are discussed. Ag films more than a few monolayers thick exhibit quantum well states which are observed to evolve as a function of film thickness.

Structural Analysis and Electronic Properties of in on Si(100) from Synchrotron Photoemission Studies

High-resolution photoemission spectroscopy was used to study the initial growth and interaction of In on Si(100). A quantification of the number of Si surface atoms selectively modified in the presence of an In adatom is enabled by decomposing the Si 2p core level into bulk and surface-shifted components; this analysis leads to an In-Si bonding coordination number determination. The In-to-Si bonding coordination number is 3 for very low In coverages and decreases to 2 for one half monolayer coverage. An analysis of the In 4d core levels indicates that the In adatoms occupy equivalent sites for the first 0.5 monolayers. Surface state emission near the top of the valence band persists for coverages exhibiting no Si 2p surface core level shift; implications regarding the different mechanisms I ehind the surface state and surface core level shift are addressed. The results are consistent with a structural model deduced from electron diffraction, Auger, and scanning electron microscopy studies.

Safety of 1000 CT-guided steroid injections with air used to localize the epidural space

Historically, ESIs were performed without any imaging guidance, resulting in erroneous placement in up to 30% of injections. Fluoroscopic imaging is now used to guide most procedures. Recently, several reports have described the use of CT to guide ESIs instead of fluoroscopy. CT provides the ability to use air as contrast to localize the epidural space. This retrospective review will discuss findings in 1000 CT-guided ESIs with air localization.

Phonon-induced gaps in graphene and graphite observed by angle-resolved photoemission

Mapping by angle-resolved photoemission spectroscopy of the spectral functions of graphite and graphene layers at low temperatures reveals a heretofore unreported gap of ~ 67 meV at normal emission. This gap persists to room temperature and beyond, and diminishes for increasing emission angles. We show that this gap arises from electronic coupling to out-of-plane vibrational modes at the K(¯) point in the surface Brillouin zone in accordance with conservation laws and selection rules governed by quantum mechanics. Our study suggests a new approach for characterizing phonons and electron-phonon coupling in solids.

Using electronic coherence to probe a deeply embedded quantum well in bimetallic Pb/Ag films on Si(111)

We report an experiment in which we utilize electronic coherence to probe a deeply embedded thin film as a quantum well. An atomically uniform Ag film prepared on Si(111) was covered by Pb films up to 70 A thick, and the resulting electronic structure was examined by angle-resolved photoemission spectroscopy. Despite a photoemission escape depth of just a few Angströms and an incommensurate Pb/Ag interface, the data reveal a striking Fabry-Pérot-like structure characteristic of an Ag etalon buried deeply under the Pb overlayers. Our simulations clearly illustrate the manifest coherence of the electronic structures, permitting the characterization of the embedded Ag quantum well.

Phase relations associated with one-dimensional shell effects in thin metal films

The physical and chemical properties of thin metal films show damped oscillations as a function of film thickness (one-dimensional shell effects). While the oscillation period, determined by subband crossings of the Fermi level, is the same for all properties, the phases can be different. Specifically, oscillations in the work function and surface energy are offset by 1/4 of a period. For Pb(111) films, this offset is approximately 0.18 monolayers, a seemingly very small effect. However, aliasing caused by the discrete atomic layer structure leads to striking out-of-phase beating patterns displayed by these two quantities.

Cyclic supraventricular tachycardia in the parturient: to treat or not to treat?

Cardiac arrhythmias are more common in pregnant women than in non-pregnant women. In the asymptomatic pregnant patient with a stable fetus, watchful waiting might be the best strategy. Herein, we describe the first reported case of a pregnant patient who developed cyclic supraventricular tachycardia during labor. No treatment was prescribed, with a good maternal and fetal outcome.

Cost of injuries from a prospective cohort study of North Carolina high school athletes

OBJECTIVE

To estimate the economic cost of injuries in a population of US high school varsity athletes.

DESIGN AND SETTING

The North Carolina High School Athletic Injury Study, conducted from 1996 to 1999, was a prospective cohort study of injury incidence and severity. A two-stage cluster sampling technique was used to select athletic teams from 100 high schools in North Carolina. An injury cost model was used to estimate the economic cost of injury.

PARTICIPANTS

Varsity athletes from 12 sports: football, girls' and boy's soccer, girls' and boys' track, girls' and boy's basketball, baseball, softball, wrestling, volleyball, and cheerleading.

MAIN OUTCOME MEASURES

Descriptive data were collected at the time of injury. Three types of costs were estimated: medical, human capital (medical costs plus loss of future earnings), and comprehensive (human capital costs plus lost quality of life).

RESULTS

The annual statewide estimates were $9.9 million in medical costs, $44.7 million in human capital costs, and $144.6 million in comprehensive costs. The mean medical cost was $709 per injury (95% CI $542 to $927), $2223 per injury (95% CI $1709 to $2893) in human capital costs, and $10,432 per injury (95% CI $8062 to $13,449) in comprehensive costs. Sport and competition division were significant predictors of injury costs.

CONCLUSIONS

Injuries among high school athletes represent a significant economic cost to society. Further research should estimate costs in additional populations to begin to develop cost-effective sports injury prevention programs.

A phase I/II study of galiximab (an anti-CD80 monoclonal antibody) in combination with rituximab for relapsed or refractory, follicular lymphoma

BACKGROUND

Galiximab is a monoclonal antibody that targets CD80, a costimulatory molecule constitutively expressed on follicular and other lymphomas. Modest single-agent clinical activity and tolerability were demonstrated in a phase I study in relapsed or refractory, follicular non-Hodgkin's lymphoma (NHL). A phase I/II study was conducted to evaluate galiximab in combination with a standard course of rituximab. Safety, pharmacokinetics, and efficacy were evaluated.

PATIENTS AND METHODS

Patients with follicular NHL who had relapsed or failed primary therapy were enrolled. Rituximab-refractory patients (no response or a response with time to progression <6 months) were excluded. Patients received 4 weekly i.v. infusions of galiximab (125, 250, 375, or 500 mg/m(2)) and rituximab (375 mg/m(2)). International Workshop Response Criteria (IWRC) were used to evaluate response.

RESULTS

Seventy-three patients received treatment. All had received at least one prior lymphoma therapy; 40% were rituximab naive. Infusions were delivered in an outpatient setting and were well tolerated. The most common study-related adverse events (AE) were lymphopenia, leukopenia, neutropenia, fatigue, and chills. The overall response rate at the recommended phase II dose of galiximab (500 mg/m(2)) was 66%: 19% complete response, 14% unconfirmed complete response, and 33% partial response. The median progression free survival was 12.1 months. Combination therapy did not appear to alter pharmacokinetics.

CONCLUSION

These results indicate that galiximab can be safely combined with a standard course of rituximab. This doublet biologic approach offers the potential to avoid or delay chemotherapy or to integrate with other lymphoma therapies. A phase III, randomized study evaluating clinical benefit of rituximab versus the combination has been initiated.

Incidence and lifetime costs of injuries in the United States

BACKGROUND

Standardized methodologies for assessing economic burden of injury at the national or international level do not exist.

OBJECTIVE

To measure national incidence, medical costs, and productivity losses of medically treated injuries using the most recent data available in the United States, as a case study for similarly developed countries undertaking economic burden analyses.

METHOD

The authors combined several data sets to estimate the incidence of fatal and non-fatal injuries in 2000. They computed unit medical and productivity costs and multiplied these costs by corresponding incidence estimates to yield total lifetime costs of injuries occurring in 2000.

MAIN OUTCOME MEASURES

Incidence, medical costs, productivity losses, and total costs for injuries stratified by age group, sex, and mechanism.

RESULTS

More than 50 million Americans experienced a medically treated injury in 2000, resulting in lifetime costs of 406 billion dollars; 80 billion dollars for medical treatment and 326 billion dollars for lost productivity. Males had a 20% higher rate of injury than females. Injuries resulting from falls or being struck by/against an object accounted for more than 44% of injuries. The rate of medically treated injuries declined by 15% from 1985 to 2000 in the US. For those aged 0-44, the incidence rate of injuries declined by more than 20%; while persons aged 75 and older experienced a 20% increase.

CONCLUSIONS

These national burden estimates provide unequivocal evidence of the large health and financial burden of injuries. This study can serve as a template for other countries or be used in intercountry comparisons.

Coherent Electronic Fringe Structure in Incommensurate Silver-Silicon Quantum Wells

Atomically uniform silver films grown on highly doped n-type Si(111) substrates show fine-structured electronic fringes near the silicon valence band edge as observed by angle-resolved photoemission. No such fringes are observed for silver films grown on lightly doped n-type substrates or p-type substrates, although all cases exhibited the usual quantum-well states corresponding to electron confinement in the film. The fringes correspond to electronic states extending over the silver film as a quantum well and reaching into the silicon substrate as a quantum slope, with the two parts coherently coupled through an incommensurate interface structure.

[Predictive validity of the Scale of Prodromal Symptoms (SOPS)]

INTRODUCTION

We conduct an exploratory factor analysis with the Scale of Prodromal Symptoms (SOPS) items, to determine its psychometric characteristics and construct validity, as well as we analyze criterion or predictive validity of its clinical subscales in the conversion of high mental risk subjects from prodrome to psychosis in a 1 year follow-up period.

METHOD

The subjects were 30 patients referred for evaluation with the Structured Interview of Prodromal Syndromes (SIPS), which includes the SOPS, because of a suspected psychosis prodromal syndrome, a factor analysis with varimax rotation was carried out: Cronbach internal coherence indices were obtained, and predictive validity of the subscales comprising this instrument were analyzed using logistic regression.

RESULTS

Three first-order factors were found, one of them was a homogeneous component made up of negative symptoms, consistent with previous studies, and higher scores were observed in negative, disorganized and general symptoms in males. Cronbach's alpha indices were 0.880, in the recruitment phase of risk patients, and 0.952 one year later. With an incidence rate of psychosis of 26.67 % in the sample studied, during the 1 year follow-up period, an excellent positive predictive value of the SOPS subscales was found, with negative symptoms having the best specificity (95.5 %) and sensitivity (100 %) indices.

CONCLUSIONS

Diagnostic criteria based on the SIPS/ SOPS make it possible to identify persons at high risk of psychosis, and to make an accurate prediction of medium term psychotic episodes. It is a valid, economical and easy to use instrument in primary health care systems.

Umklapp-mediated quantization of electronic states in Ag films on Ge(111)

We employ angle-resolved photoemission to study the electronic structure of atomically uniform films of Ag grown on Ge(111). A new kind of quantum well state is observed near a specific emission direction away from the surface normal. In contrast with the usual quantum well state arising from electron confinement by specular reflections at the surface and interface of the film, the new kind involves retroreflections, or umklapp reflections, at the interface. It requires four reflections, instead of the usual two reflections, to complete a coherent interference path.

Iris ring melanoma: fine needle biopsy

AIMS

To delineate the diagnostic accuracy of fine needle biopsy in iris ring melanoma and determine the tumour related mortality of this neoplasm.

METHODS

A retrospective analysis of 22 patients with iris melanomas that involve the entire 360 degrees of the anterior chamber angle.

RESULTS

Iris ring melanomas were correctly diagnosed in all cases. In 11 of 16 cases (69%) a fine needle biopsy performed 180 degrees away from the main mass was positive for an iris ring melanoma. The tumour related mortality in iris ring melanoma cases was four of 22 patients (18%). Actuarial survival analysis showed a 10 year mortality (Kaplan-Meier) of 15%.

CONCLUSION

A fine needle aspiration biopsy can be used to diagnose an iris ring melanoma. Iris ring melanomas have significant mortality compared with focal tumours.

Peripheral neuropathies in Waldenström's macroglobulinaemia

OBJECTIVE

We sought to determine the prevalence, clinical features, and laboratory characteristics of polyneuropathies in Waldenström's macroglobulinaemia (WM), a malignant bone marrow disorder with lymphocytes that produce monoclonal IgM.

METHODS

We prospectively studied 119 patients with WM and 58 controls. Medical history was taken, and neurological examinations, electrodiagnostic tests, and serum studies were performed by different examiners who were blinded to results except the diagnosis of WM.

RESULTS

Polyneuropathy symptoms, including discomfort and sensory loss in the legs, occurred more frequently (p<0.001) in patients with WM (47%) than in controls (9%). Patients with WM had 35% lower quantitative vibration scores, and more frequent pin loss (3.4 times) and gait disorders (5.5 times) than controls (all p<0.001). Patients with IgM binding to sulphatide (5% of WM) had sensory axon loss; those with IgM binding to myelin associated glycoprotein (MAG) (4% of WM) had sensorimotor axon loss and demyelination. Patients with WM with IgM binding to sulphatide (p<0.005) or MAG (p<0.001) had more severe sensory axon loss than other patients with WM. Demyelination occurred in 4% of patients with WM with no IgM binding to MAG. Age related reductions in vibration sense and sural SNAP amplitudes were similar ( approximately 30%) in WM and controls.

CONCLUSIONS

Peripheral nerve symptoms and signs occur more frequently in patients with WM than controls, involve sensory modalities, and are often associated with gait disorders. IgM binding to MAG or sulphatide is associated with a further increase in the frequency and severity of peripheral nerve involvement. Age related changes, similar to those in controls, add to the degree of reduced nerve function in patients with WM.

Modification of surface states in ultrathin films via hybridization with the substrate: a study of Ag on Ge

The Shockley surface state of Ag(111) develops unusual band dispersion relations for Ag films of decreasing thicknesses on Ge(111), as observed by angle-resolved photoemission. Its parabolic dispersion in the thick-film limit shifts toward higher binding energies and splits into multiple bands with dispersions that reflect the valence band structure of Ge including the heavy-hole, light-hole, and split-off bands. The results are explained in terms of a hybridization interaction between the Ag surface state and the Ge substrate states.

Correlation between initial and early follow-up CT perfusion parameters with endoscopic tumor response in patients with advanced squamous cell carcinomas of the oropharynx treated with organ-preservation therapy

BACKGROUND AND PURPOSE

Current organ-preservation regimens for upper aerodigestive tract squamous cell carcinoma (SCCA) require endoscopic procedures under general anesthesia to evaluate the tumor response. The purpose of our study was to determine whether CT perfusion (CTP) parameters correlate with response to induction chemotherapy as assessed by endoscopy under general anesthesia.

METHODS

Nine patients with advanced (stage 3 or 4) SCCA of the oropharynx were enrolled in a nested phase 2 prospective trial in which induction chemotherapy was used to assess the tumor response. Patients underwent direct laryngoscopy and CTP before and 3 weeks after one cycle of induction chemotherapy. The outcome variables were the surgeon's estimate of tumor volume during endoscopy with biopsy under anesthesia and CTP parameters (capillary permeability (CP), blood volume (BV), blood flow (BF), and mean transit time (MTT)). Wilcoxon rank sum analysis was used to correlate the baseline values of BF and BV with response to induction chemotherapy. Comparison of agreement between the reduction in tumor volume and change in CTP parameters was performed by using kappa estimates.

RESULTS

Seven of 9 patients demonstrated > or =50% tumor volume reduction, representing positive response to induction chemotherapy. In the responder group, the following changes in mean pre- and postinduction chemotherapy values were noted: mean BF, 114.2 mL/100 g /min (preinduction) to 45.1 mL/100 g/min (postinduction); mean BV, 5.11 mL/100 g to 3.1 mL/100 g; mean CP, 25.6 mL/100 g /min (preinduction) to 18.3 mL/100 g / min (postinduction); mean MTT, 4.9 seconds (preinduction) to 8.0 seconds (postinduction). In the nonresponder group, the following changes were noted: mean BF, 56.9 mL/100 g/min to 75.9 mL/100 g/min; mean, BV 2.7 mL/100 g to 4.71 mL/100 g; mean CP, 24.1 mL/100 g/min to 23.7 mL/100 g/min; mean MTT, 4.3 seconds to 5.34 seconds. Higher baseline (pretherapy) values of BV showed significant correlation with endoscopic tumor response (P < .05). Reduction in the BV (by >/=20%) on follow-up studies also showed substantial agreement with clinical response as assessed with endoscopy (kappa = 0.73). The agreement between decreased BF, decreased CP, and increased MTT and clinical response was fair (kappa = 0.37).

CONCLUSION

These preliminary results show that deconvolution-based CTP technique offers potential for noninvasive monitoring of response to induction chemotherapy in patients with oropharyngeal cancers. Percentage reduction of BV is significantly correlated to endoscopic response to induction chemotherapy, though we acknowledge that the data correspond to short-term outcomes and long-term durability of response cannot be established. Nevertheless, validation of the use of deconvolution CTP parameters as predictors of tumor response may permit replacement of an invasive diagnostic procedure conducted under anesthesia currently used to assess response with noninvasive perfusion CT imaging.

Controlling the thermal stability of thin films by interfacial engineering

The quantized electronic structure in Pb films on Si(111) varies substantially as the film thickness increases. The changes in electronic energy cause the thermal stability of the films to oscillate with an approximate bilayer period. The phase of the oscillations can be controlled by interfacial engineering. Comparison of Pb films prepared on Si(111) terminated by In, Au, and Pb as interfactants reveals a phase reversal. For , films made of odd numbers of atomic layers (5, 7, and 9) are more stable than the even ones. This trend is reversed for the other two cases.