Corroboration of polymorphisms in the aromatase (CYP19A1) gene with response to neoadjuvant therapy with letrozole in postmenopausal women with stages II-II ER/PgR-positive breast cancer

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Background: Aromatase (CYP19A1) is the main enzyme implicated in estrogen biosynthesis. Polymorphisms in CYP19A1 can affect both aromatase expression and activity leading to changes in the estrogen levels. These changes have been previously associated with pathogenesis of estrogen-dependent diseases, including breast cancer. The purpose of this study is to evaluate whether the genotype of CYP19A1 can have an effect on the response to endocrine therapy with the aromatase inhibitor letrozole (L). Methods: We retrospectively analyzed a series of 58 postmenopausal women with stage II-III ER/PgR[+] breast cancer treated with L as neoadjuvant therapy. Response was evaluated by radiology (mammogram or ultrasound) at four months L (OMS) and data was available in 56 cases. A total of ten single nucleotide polymorphisms (SNPs) spanning the gene, a TCT insertion/deletion and a (TTTA)n repeat were evaluated. The (TTTA)n repeat was analyzed by using GeneScan to detect polymorphism length, TCT Ins/Del by direct sequencing and SNPs by allelic discrimination using TaqMan SNP Genotyping Assays (Applied Biosystems). Logistic regression analysis was used to estimate the most accurate predictive model for response to therapy. Results: Median age of our series was 77 years (range: 68 to 90). Twenty women (36%) responded to 4 months L, while 38 (67%) did not (2 PD and 36 EE). Allelic frequencies were determined for each polymorphism and the global genotype data was evaluated in a logistic regression analysis. In a first step, the analysis with the genetic information for the 12 polymorphisms resulted in a model that predicted radiological response to L with an accuracy of 80% (85% specifity, 69% sensibility). However, a reduction to 4 informative polymorphisms generated a simpler predictive model with an accuracy of 76% (76.5% specifity, 75% sensibility). Conclusions: Polymorphism analysis of CYP19A1 could predict for response to neoadjuvant therapy with L. A validation of this predictive model in an independent series is ongoing.

No significant financial relationships to disclose.

Predictive factors in advanced head and neck cancer treated by radio-chemotherapy and hypoxia modification

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Background: Anemia and tumor hypoxia are known factors for resistance to radio-chemotherapy (RT-CT). In a previous report we have suggested that spinal cord stimulation (SCS) can modify tumor oxygenation and regional blood flow in head and neck cancer (HNC). The aim of the present prospective study was to test the predictive value of pO2 measurement in HNC treated by RT-CT and hypoxia modification using SCS. Methods: Twelve male patients with advanced HNC were analyzed. Stage IVb-IVa: 8–4; mean age 58 + 7.6 years (46–70). Scheduled therapy was hyperfractionated RT (120 cGy/fraction, two fractions/day, total dose 81.6 Gy) from a Co- 60 source, and tegafur 800 mg/day. SCS devices were placed before RT-CT under local anesthesia. During treatment, SCS was connected from 20–30 min before to 20–30 min after each radiotherapy session. Before treatment, they were assessed: Hemoglobin levels and tumor oxygenation pre-SCS and pos-SCS (measured by a polarographic probe system ‘pO2 Histograph‘), expressed as median-pO2, and the fraction of pO2 values less than 5 mmHg (HF5) and less than 2.5 mmHg (HF2.5). Correlations were assessed using Pearson and Spearman tests, and actuarial survival using Kaplan-Meier estimates and Log-rank test. Results: Hemoglobin levels were correlated with oxygenation pre-SCS and pos-SCS: median-pO2 (p=0.005 and p=0.011), HF5 (p=0.048 and p=0.005) respectively. Anemia was associated with more advanced stage (IVb vs IVa, p=0.022), higher HF5 pos-SCS (p=0.028) and lower disease-free survival (p=0.019). The HF2.5 pos-SCS was adversely correlated with the 2 years actuarial: disease-free survival (p=0.027), cause-specific survival (p=0.008) and overall survival (p=0.008). HF2.5 was also correlated with hematocrit (p=0.044). Conclusions: Low hemoglobin levels and anemia are associated with more hypoxic and more advanced tumors. Pre-treatment tumor hypoxia (assessed by the fraction of pO2 values less than 2.5 mmHg during-SCS) is a strong predictive factor for survival in advanced HNC. Patients with highly hypoxic tumors should be selected for more aggressive treatments. Partially supported by: Grant ‘FUNCIS: PI 31–98‘. Scientific supervision was carried out by GICOR.

No significant financial relationships to disclose.

Measurement of sigma chi c2 B(chi c2-->J/psi gamma)/sigma chi c1 B(chi c1 -->J/psi gamma) in pp collisions at square root s=1.96 TeV

We measure the ratio of cross section times branching fraction, Rp=sigma chi c2 B(chi c2-->J/psi gamma)/sigma chi c1 B(chi c1-->J/psi gamma), in 1.1 fb(-1) of pp collisions at square root s=1.96 TeV. This measurement covers the kinematic range pT(J/psi)>4.0 GeV/c, |eta(J/psi)<1.0, and pT(gamma)>1.0 GeV/c. For events due to prompt processes, we find Rp=0.395+/-0.016(stat)+/-0.015(syst). This result represents a significant improvement in precision over previous measurements of prompt chi c1,2 hadro production.

Inclusive search for new physics with like-sign dilepton events in pp collisions at square root of s =1.96 TeV

We describe a search for anomalous production of events with two leptons (e or mu) of the same electric charge in pp[over ] collisions at a center-of-mass energy of 1.96 TeV. Many extensions to the standard model predict the production of two leptons of the same electric charge. This search has a significant increase in sensitivity compared to earlier searches. Using a data sample corresponding to 1 fb(-1) of integrated luminosity recorded by the CDF II detector, we observe no significant excess in an inclusive selection (expect 33.2+/-4.7 events, observe 44) or in a supersymmetry-optimized selection (expect 7.8+/-1.1 events, observe 13.).

Protein polymorphism is negatively correlated with conservation of intronic sequences and complexity of expression patterns in Drosophila melanogaster

We report a significant negative correlation between nonsynonymous polymorphism and intron length in Drosophila melanogaster. This correlation is similar to that between protein divergence and intron length previously reported in Drosophila. We show that the relationship can be explained by the content of conserved noncoding sequences (CNS) within introns. In addition, genes with a high regulatory complexity and many genetic interactions also exhibit larger amounts of CNS within their introns and lower values of nonsynonymous polymorphism. The present study provides relevant evidence on the importance of intron content and expression patterns on the levels of coding polymorphism.

Observation of WZ production

We report the first observation of the associated production of a W boson and a Z boson. This result is based on 1.1 fb;-1 of integrated luminosity from pp collisions at sqrt[s]=1.96 TeV collected with the CDF II detector at the Fermilab Tevatron. We observe 16 WZ candidates passing our event selection with an expected background of 2.7+/-0.4 events. A fit to the missing transverse energy distribution indicates an excess of events compared to the background expectation corresponding to a significance equivalent to 6 standard deviations. The measured cross section is sigma(pp-->WZ)=5.0(-1.6)(+1.8) pb, consistent with the standard model expectation.

Measurement of the top-quark mass in all-hadronic decays in pp collisions at CDF II

We present a measurement of the top-quark mass Mtop in the all-hadronic decay channel tt-->W+bW-b-->q1q2bq3q4b. The analysis is performed using 310 pb-1 of sqrt[s]=1.96 TeV pp[over ] collisions collected with the CDF II detector using a multijet trigger. The mass measurement is based on an event-by-event likelihood which depends on both the sample purity and the value of the top-quark mass, using 90 possible jet-to-parton assignments in the six-jet final state. The joint likelihood of 290 selected events yields a value of Mtop=177.1+/-4.9(stat)+/-4.7(syst) GeV/c2.

Search for anomalous production of multilepton events in pp collisions at sqrt s=1.96 TeV

We report a search for the anomalous production of events with multiple charged leptons in pp[over] collisions at sqrt[s]=1.96 TeV using a data sample corresponding to an integrated luminosity of 346 pb(-1) collected by the CDF II detector at the Fermilab Tevatron. The search is divided into three-lepton and four-or-more-lepton data samples. We observe six events in the three-lepton sample and zero events in the > or =4-lepton sample. Both numbers of events are consistent with standard model background expectations. Within the framework of an R-parity-violating supergravity model, the results are interpreted as mass limits on the lightest neutralino (chi[over](1)(0)) and chargino (chi[over](1+/-) particles. For one particular choice of model parameters, the limits are M(chi[over](1)(0)>110 GeV/c2 and M(chi[over](1+/-)>203 GeV/c2 at 95% confidence level; the variation of these mass limits with model parameters is presented.

Analysis of the quantum numbers J(PC) of the X(3872) particle

We present an analysis of angular distributions and correlations of the X(3872) particle in the exclusive decay mode X(3872)-->J/psipi+ pi- with J/psi-->mu+ mu-. We use 780 pb-1 of data from pp[over ] collisions at sqrt[s]=1.96 TeV collected with the CDF II detector at the Fermilab Tevatron. We derive constraints on spin, parity, and charge conjugation parity of the X(3872) particle by comparing measured angular distributions of the decay products with predictions for different J(PC) hypotheses. The assignments J(PC)=1++ and 2-+ are the only ones consistent with the data.

Monocyte cytokine and costimulatory molecule expression in patients infected with Leishmania mexicana

Leishmania mexicana causes localized and diffuse cutaneous leishmaniasis. Patients with localized cutaneous leishmaniasis (LCL) develop a benign disease, whereas patients with diffuse cutaneous leishmaniasis (DCL) suffer from a progressive disease associated with anergy of the cellular response towards Leishmania antigens. We evaluated the production of the interleukins (IL) IL-12, IL-15, IL-18 and tumour necrosis factor-alpha (TNF-alpha) and the expression of the costimulatory molecules CD40, B7-1 and B7-2 in monocytes from LCL and DCL patients, stimulated in vitro with Leishmania mexicana lipophosphoglycan (LPG) for 18 h. LCL monocytes significantly increased TNF-alpha, IL-15 and IL-18 production, and this increase was associated with reduced amounts of IL-12. DCL monocytes produced no IL-15 or IL-18 and showed a decreasing tendency of TNF-alpha and IL-12 production as the severity of the disease increased. No difference was observed in the expression of CD40 and B7-1 between both groups of patients, yet B7-2 expression was significantly augmented in DCL patients. It remains to be established if this elevated B7-2 expression in DCL patients is cause or consequence of the Th2-type immune response that characterizes these patients. These data suggest that the diminished ability of the monocytes from DCL patients to produce cell-activating innate proinflammatory cytokines when stimulated with LPG is a possible cause for disease progression.

Measurement of the Lambda b0 lifetime in Lambda b0-->J/psi Lambda 0 in pp collisions at square root s=1.96 TeV

We report a measurement of the Lambda b0 lifetime in the exclusive decay Lambda b0-->J/psi Lambda 0 in pp collisions at square root s=1.96 TeV using an integrated luminosity of 1.0 fb-1 of data collected by the CDF II detector at the Fermilab Tevatron. Using fully reconstructed decays, we measure tau(Lambda b0)=1.593(-0.078)(+0.083)(stat)+/-0.033(syst) ps. This is the single most precise measurement of tau(Lambda b0) and is 3.2sigma higher than the current world average.

Measurement of sigma Lambda b0/sigma B0 x B(Lambda b0-->Lambda c+pi-)/B(B0-->D+pi-) in pp collisions at square root s=1.96 TeV

We present the first observation of the baryon decay Lambda b0-->Lambda c+pi- followed by Lambda c+-->pK-pi+ in 106 pb-1 pp collisions at square root s=1.96 TeV in the CDF experiment. In order to reduce systematic error, the measured rate for Lambda b0 decay is normalized to the kinematically similar meson decay B0-->D+pi- followed by D+-->pi+K-pi+. We report the ratio of production cross sections (sigma) times the ratio of branching fractions (B) for the momentum region integrated above pT>6 GeV/c and pseudorapidity range |eta|<1.3: sigma(pp-->Lambda b0X)/sigma(pp-->B0X)xB(Lambda b0-->Lambda c+pi-)/B(B0-->D+pi-)=0.82+/-0.08(stat)+/-0.11(syst)+/-0.22[B(Lambda c+-->pK-pi+)].

Observation of exclusive electron-positron production in hadron-hadron collisions

We present the first observation of exclusive e(+)e(-) production in hadron-hadron collisions, using pp[over] collision data at (square root) s = 1.96 TeV taken by the run II Collider Detector at Fermilab, and corresponding to an integrated luminosity of 532 pb(-1). We require the absence of any particle signatures in the detector except for an electron and a positron candidate, each with transverse energy E(T) > 5 GeV and pseudorapidity |eta| < 2. With these criteria, 16 events are observed compared to a background expectation of 1.9+/-0.3 events. These events are consistent in cross section and properties with the QED process pp[over] --> p + e(+)e(-) + p[over] through two-photon exchange. The measured cross section is 1.6(-0.3)(+0.5)(stat) +/- 0.3(syst) pb. This agrees with the theoretical prediction of 1.71+/-0.01 pb.

Search for V+A current in top-quark decays in pp collisions at sqrts=1.96 TeV

We report an upper limit on the fraction of V+A current, fV+A, in top-quark decays, using approximately 700 pb-1 of pp[over ] collisions at sqrts=1.96 TeV acquired by the upgraded Collider Detector at Fermilab. For the decay t-->Wb-->lnub (where l=e or micro), the invariant mass of the charged lepton and the bottom quark jet is sensitive to the polarization of the W boson. We determine fV+A=-0.06+/-0.25 given a top-quark mass of 175 GeV/c2. We set an upper limit on fV+A of 0.29 at the 95% confidence level, an improvement by a factor of 2 on the previous best direct limit.

Measurement of the ratios of branching fractions B(B0s --> Ds- pi+ pi+ pi-)/B(B0-->D- pi+ pi+ pi-) and B(B0s --> Ds- pi+)/B(B0-->D- pi+)

Using 355 pb;{-1} of data collected by the CDF II detector in pp[over ] collisions at sqrt[s]=1.96 TeV at the Fermilab Tevatron, we study the fully reconstructed hadronic decays B_{(s)};{0}-->D_{(s)};{-}pi;{+} and B_{(s)};{0}-->D_{(s)};{-}pi;{+}pi;{+}pi;{-}. We present the first measurement of the ratio of branching fractions B(B_{s};{0}-->D_{s};{-}pi;{+}pi;{+}pi;{-})/B(B;{0}-->D;{-}pi;{+}pi;{+}pi;{-})=1.05+/-0.10(stat)+/-0.22(syst). We also update our measurement of B(B_{s};{0}-->D_{s};{-}pi;{+})/B(B;{0}-->D;{-}pi;{+}) to 1.13+/-0.08(stat)+/-0.23(syst), improving the statistical uncertainty by more than a factor of 2. We find B(B_{s};{0}-->D_{s};{-}pi;{+})=[3.8+/-0.3(stat)+/-1.3(syst)]x10;{-3} and B(B_{s};{0}-->D_{s};{-}pi;{+}pi;{+}pi;{-})=[8.4+/-0.8(stat)+/-3.2(syst)]x10;{-3}.

How accurate are predictive formulas calculating energy expenditure in adolescent patients with anorexia nervosa?

BACKGROUND & AIMS

To compare resting energy expenditure, measured by indirect calorimetry, to values estimated by different predictive formulas in adolescent patients with anorexia nervosa.

METHODS

We studied 22 female in-patients with a mean age of 14.7 years (SD 1.2). Resting energy expenditure was measured by indirect calorimetry (Deltatrac II MBM-200). We compared measured resting energy expenditure to values estimated by several predictive formulas [Fleisch, Harris-Benedict, FAO, Schofield-HW, Schebendach] using the intraclass correlation coefficient and the Bland-Altman method.

RESULTS

Body mass index increased significantly (P<0.001). Measured resting energy expenditure increased during hospitalization (P<0.05). All formulas overestimated resting energy expenditure with respect to indirect calorimetry except the Schebendach formula. The intraclass correlation between indirect calorimetry and the formulas were poor (0.09-0.20). We observed a poor clinical agreement (Bland-Altman).

CONCLUSIONS

Body mass index and resting energy expenditure increased during hospitalization. The majority of the predictive formulas overestimate resting energy expenditure in adolescent patients with anorexia nervosa. Therefore, indirect calorimetry may be a very useful tool for calculating caloric requirements in these patients.

Cerebral blood flow increase in cancer patients by applying cervical spinal cord stimulation

INTRODUCTION

Generally, high-grade gliomas and head and neck tumors have decreased loco-regional blood flow resulting in reduced delivery of chemotherapy and oxygen, as well as an increases in radiation resistance to radiotherapy. The aim of this study was to analyze the effect of cervical spinal cord electrical stimulation (cSCS) on cerebral blood flow in patients with those tumors.

PATIENTS AND METHODS

We have evaluated 27 cancer patients with 12 with high grade gliomas and 15 with advanced head and neck tumors, who had cSCS devices placed after tumor diagnoses and before the commencement initiating of radio-chemotherapy. They were 12 high grade gliomas and 15 advanced head and neck tumors. Before and after cSCS, cerebral blood flow was assessed bilaterally by transcranial Doppler.

RESULTS

During cSCS there was a significant (p<0.001) increase in systolic (mean > 22%) and diastolic (> 29%) blood-flow velocities in both, healthy and tumor middle cerebral arteries. The analyses by subgroup of tumors showed similarly significant outcomes findings.

CONCLUSIONS

The results suggest that neuro-stimulation spinal cord electrical stimulation can increase cerebral blood flow in cancer patients. The implication is that this technique could be useful in modifying locoregional ischemia in brain tumors thus improving the outcomes of after radio-chemotherapy. Further research is in progress to confirm the advantages of the technique.

Selective immediate hypersensitivity to cefepime

Cefepime is a fourth-generation cephalosporin with a broad antimicrobial spectrum and good activity against both gram-positive and gram-negative organisms. We present the case of a 61-year-old man who developed an immediate urticarial reaction after receiving a single dose of cefepime. Skin tests were positive to cefepime and negative to the other beta-lactam antibiotics. Controlled administration of amoxicillin-clavulanic acid and ceftazidime was well tolerated by the patient. To the best of our knowledge, this is the first report of selective hypersensitivity to cefepime demonstrated by skin and challenge tests. Complete allergological studies, including challenge tests with other beta-lactam antibiotics that produce a negative result in skin tests, should be considered in these patients.

Vascular endothelial cadherin regulates vascular permeability: Implications for ovarian hyperstimulation syndrome

CONTEXT

Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of treatment with fertility drugs. It is characterized by increased vascular permeability and simultaneous overexpression of vascular endothelial growth factor (VEGF) in ovarian cells.

OBJECTIVE

We tested the hypothesis that the endothelium and endothelial cell-to-cell junctions are downstream targets of VEGF during OHSS pathogenesis. We investigated the potential involvement of vascular endothelial (VE)-cadherin, an interendothelial adhesion molecule, in the capillary hyperpermeability in OHSS.

DESIGN

Human endothelial cells from umbilical veins (HUVEC) were used as an in vitro model of OHSS.

INTERVENTION

Cell cultures were treated with varying doses of estradiol (E2), human chorionic gonadotropin (hCG), VEGF, and antihuman VEGF antibodies, either alone or in combination, and the effect on VE-cadherin release was evaluated at different time points. Permeability assays were performed using fluoresceinisothiocyanate-labeled albumin, and actin filaments rearrangement was evaluated by fluorescent microscopy.

RESULTS

Culturing of HUVEC with high doses of E2 produced no significant changes in VE-cadherin concentration, but hCG and VEGF produced a significant increase in VE-cadherin release. Time-course experiments showed that VE-cadherin was secreted 12 h after VEGF addition. Antihuman VEGF antibodies prevented these changes. Permeability assays demonstrated that, although E2 did not alter the arrangement of HUVEC in vitro, hCG and VEGF caused changes in the actin fibers indicative of increased capillary permeability. VEGF also induced an increase in paracellular permeability of HUVEC at the same doses used in the previous experiments.

CONCLUSIONS

Adhesion molecules like VE-cadherin may play a role in the development and progression of increased capillary permeability in severe OHSS.

HOM-C evolution in Drosophila: is there a need for Hox gene clustering?

The conservation of Homeotic (Hox) gene clustering and colinearity in many metazoans indicates that functional constraints operate on this genome organization. However, several studies have questioned its relevance in Drosophila. Here, we analyse the genomic organization of Hox and Hox-derived genes in 13 fruitfly species and the mosquito Anopheles gambiae. We found that at least seven different Homeotic complex (HOM-C) arrangements exist among Drosophila species, produced by three major splits, five microinversions and six gene transpositions. This dynamism contrasts with the stable organization of the complex in many other taxa. Although there is no evidence of an absolute requirement for Hox gene clustering in Drosophila, we found that strong functional constraints act on the individual genes.