A phase II study of R-CHOP in treatment of diffuse large B-cell lymphoma (DLBCL) subgroups

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Background: Recent studies with genes expression profiling and tissue microarray have divided the diffuse large B cell lymphoma (DLBCL) into prognostically important subgroups with germinal center B cell like (GCB) and non-GCB. However, these results are based on the samples of patients who were received standard CHOP regimen. Combination with CHOP and Rituximab (R-CHOP) has been proved to improve the survival of patients with DLBCL. To evaluate the efficacy of R-CHOP in different subgroups of DLBCL, this phase II study has been conducted. Methods: Previously untreated patients with DLBCL were enrolled in this study. No upper age limit was specified. Patients received six cycles of R-CHOP (rituximab 375 mg/m2, cyclophosphamide 750 mg/m2, doxorubicin 50 mg/m2, vincristine 1.4 mg/m2, and prednisone 40 mg/m2 for 5 days) every 3 weeks. Immunohistochemical stains on paraffin-embedded tissues from diagnostic biopsies from these patients with antibodies against GCB cell (CD10 and Bcl-6) and activation (MUM1). These patients are divided into GCB and non-GCB groups according to the expression of antibodies against CD10, BCL-6 and MUM1. Results: A total of 64 patients were evaluated, 19 in GCB group and 45 in non-GCB group. Complete Remission (CR) rate was achieved 57.9% and 53.3%, in GCB group and in non-GCB group, respectively. (p = 0.737). A median follow-up of 2.2 years, the two-year failure free survival was no different between two groups (p = 0.566). Conclusions: In patients with GCB group or non-GCB group of DLBCL, addition of Rituximab in CHOP regimen, preliminary result was showed in similar response and survival.

No significant financial relationships to disclose.

Relationship between biological and self-reported measures of stress among informal caregivers of patients with prostate cancer

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Background: Informal caregivers of prostate cancer patients often experience chronic psychological stress that may adversely impact their physical and mental health, and their ability to care for their families and the patient. This study aims to determine the association between perceived and biological stress among informal caregivers of prostate cancer patients. Methods: A total of 24 informal caregivers of prostate cancer patients were recruited from both the Jesse Brown VA Center (Lakeside and Westside, Chicago) and the Robert H. Lurie Comprehensive Cancer Center at Northwestern University. Caregivers completed self-reported measures of stress, somatization, life events, burden, health status (SF-36) and mental health. Capillary blood spot samples from caregivers were used to examine two measures of biological stress, Epstein-Barr virus antibody titer and C-reactive protein. Results: Informal caregivers had a mean age of 63 years and were mostly female and spouses of patients with prostate cancer. Many had preexisting co-morbidities, including 45.8% with hypertension, 45.8% with arthritis, and 33.3% with diabetes. Nearly 30% had been hospitalized in the last 12 months. 33.3% of caregivers experienced at least one major life event in the last year and 62.5% had symptoms of somatization illness. Caregivers with symptoms of somatization illness had higher mean Epstein-Barr antibody titers as compared with those without symptoms (Mean EBV antibody titer: 198.3 versus 141.8, respectively (p < 0.05)). Caregiver-reported measures were not correlated with C-reactive protein levels. Caregivers with higher levels of strain perceived more stress in their lives (p < 0.05), but showed relatively high self-esteem (mean = 30.6, SD = 2.8, on a 7–35 scale). Conclusions: These preliminary findings suggest that informal caregivers who report symptoms of somatization illness exhibit signs of relative suppression of the cell-mediated immune processes as a result of the reactivation of the Epstein-Barr virus. Final analyses will be conducted that control for potential confounders and will further elucidate if caregiver stress is associated with suppression of the immune system.

No significant financial relationships to disclose.

Role of lateral alkyl chains in modulation of molecular structures on metal surfaces

We use low energy electron diffraction, scanning tunneling microscopy, first-principles density-functional theory, and molecular mechanics calculations to analyze the adsorption and growth of quinacridone derivatives (QA) with alkyl chains of 4 and 16 carbon atoms on a Ag(110) substrate. Surprisingly, we find that the alkyl chains determine the orientation of the molecular overlayers. While the interaction of QA and the Ag substrate is primarily due to chemical bonding of oxygen to the silver substrate, determining the molecular orientation and preferred adsorption site, the intermolecular arrangement can be adjusted via the length of alkyl chains. We are thus able to fabricate uniform QA films with very well controlled physical properties.

Crystal structure of bis(bis(3-methoxysalicylaldehydato)copper(II)) hexakis(adamantylammonium) hexaperchlorate dihydrate, [{Cu(C8H7O3)2}2] · (C10H15NH3)6(ClO4)6 · 2H2O

C92H140Cl6Cu2N6O38, triclinic, P1̅ (no. 2), a = 12.819(3) Å, b = 13.240(3) Å, c = 16.721(3) Å, α = 95.25(3)°, β = 103.27(3)°, ϒ = 106.01(3)°, V = 2618.5 Å3, Z = 1, Rgt(F) = 0.071, wRref(F2) = 0.220, T = 293 K.

Selective analysis of molecular states by functionalized scanning tunneling microscopy tips

Selective analysis of molecular states in scanning tunneling microscopy (STM) has so far been achieved in a few cases by tuning the bias range of the STM in high-resolution measurements. Correspondingly, perylene adsorbed in a close-packed monolayer on Ag(110) is imaged mainly through the pi states of the molecule. By contrast, functionalizing the STM tip with a perylene molecule leads to a mismatch between the energy levels of the STM tip and the molecule adsorbates and, instead, images only the metal states of the underlying silver surface. The observation opens a route for better energy selectivity in electron transport measurements through organic interfaces.

Impaired development of broiler chickens by stress mimicked by corticosterone exposure

The effects of corticosterone (CORT) administration on the development of muscular tissues of broiler chickens (Gallus gallus domesticus) fed with diets differing in lipid content were investigated. The experimental chickens were given one of two experimental diets: high lipid diet (9.9% crude fat) or control diet, from 21 d of age. At 28 d of age, half of the chickens in each dietary treatment were exposed to CORT treatment, supplemented with 30 mg CORT/kg diet for 12 days, while the other half continued to consume the former diet. The zootechnical parameters were recorded at 21, 28, 35 and 39 d, and a blood sample was obtained from 8 birds of each group, respectively. The growth performance of broiler chickens was significantly depressed by CORT administration, but not by dietary treatment. Corticosterone treatment resulted in enhanced energy expenditure. The results indicate that the development of breast muscle was more susceptible to stress mimicked by CORT administration. The results suggest that corticosterone administration enhanced hepatic fatty acid synthesis and resulted in the redistribution of energy to abdominal store from peripheral tissues. Diet rich in lipid content was favorable to the central fat deposit in stressed broiler chickens.

Successful term pregnancy after selective embolization of a large postmolar uterine arteriovenous malformation

Uterine arteriovenous malformations (AVM) are very uncommon disorders. Successful conservative treatment with subsequently conceived is rarely reported. We describe a 31-year-old woman with a complex and large postmolar AVM; she was successfully treated with transarterial selective embolization for a long history of repeated excessive vaginal bleeding and anemia. She resumed normal menstrual periods soon after treatment, and she subsequently conceived about 2 years later. A healthy male baby was delivered at 39 weeks of gestation via vaginal route. Selective embolization of a complex and large uterine AVM seems to be feasible for the treatment of uterine bleeding and preservation of reproductive capability.

Successful term pregnancy after selective embolization of a large postmolar uterine arteriovenous malformation

Uterine arteriovenous malformations (AVM) are very uncommon disorders. Successful conservative treatment with subsequently conceived is rarely reported. We describe a 31-year-old woman with a complex and large postmolar AVM; she was successfully treated with transarterial selective embolization for a long history of repeated excessive vaginal bleeding and anemia. She resumed normal menstrual periods soon after treatment, and she subsequently conceived about 2 years later. A healthy male baby was delivered at 39 weeks of gestation via vaginal route. Selective embolization of a complex and large uterine AVM seems to be feasible for the treatment of uterine bleeding and preservation of reproductive capability.

Effects of internal and external scatter on the build-up characteristics of Monte Carlo calculated absorbed dose for electron irradiation

The effects of internal and external scatter on surface, build-up and depth dose characteristics simulated by Monte Carlo code EGSnrc for varying field size and SSD for a 10 MeV monoenergetic electron beam with and without an accelerator model are extensively studied in this paper. In particular, sub-millimetre surface PDD was investigated. The percentage depth doses affected significantly by the external scatter show a larger build-up dose. A forward shifted Dmax depth and a sharper fall-off region compared to PDDs with only internal scatter considered. The surface dose with both internal and external scatter shows a marked decrease at 110 cm SSD, and then slight further changes with the increasing SSD since few external scattered particles from accelerator model can reach the phantom for large SSDs. The sharp PDD increase for the 5 cm x 5 cm field compared to other fields seen when only internal scatter is considered is significantly less when external scatter is also present. The effect of external scatter on surface PDD is more pronounced for large fields than small fields (5 cm x 5 cm field).

Thermoregulation responses of broiler chickens to humidity at different ambient temperatures. I. One week of age

Three trials were conducted to investigate the effect of RH (35, 60, and 85%) on thermoregulation of 1-wk-old broiler chickens at different temperatures (35, 30, and 25 degrees C). The response to humidity in rectal temperature and plumage temperature at the back and breast within 24 h after exposure were recorded at 5 time points (1,4,8,16, and 24 h). Humidity affected the thermoregulation of 1-wk-old broiler chickens by redistributing heat within the body at high, low, and thermoneutral temperatures. The redistribution of heat resulted in decreased rectal temperature and increased peripheral temperature, which were, respectively, beneficial and unfavorable at high and low temperatures. These results suggested that feedback effects of surface temperature on core temperature also exist in poultry, as already observed in mammals, and could be induced not only by changed ambient temperature but also by the changes in humidity at high temperature. The disturbance of thermal equilibrium could not be established solely by changes in RT, but rather core and surface temperatures had to be considered. The daily rhythms in rectal and surface temperatures were affected by humidity.

Thermoregulation responses of broiler chickens to humidity at different ambient temperatures. II. Four weeks of age

Two experiments were conducted to investigate the effect of RH (35, 60, and 85%) on thermoregulation of broiler chickens at high (35 degrees C) and mild (30 degrees C) temperatures at the age of 4 wk. The effects of humidity on rectal temperature (RT) and plumage temperature at back (PBAT) and skin temperature at breast (SBRT) were determined at 1, 4, 8, 16, and 24 h after exposure. The RT, PBAT, and SBRT were all significantly increased by high temperature (35 degrees C). Humidity had a significant influence on RT at 35 degrees C but not at 30 degrees C. The peripheral temperatures (PBAT and SBRT) were significantly affected by humidity but responded differently at high (35 degrees C) compared with mild temperature (30 degrees C). In conclusion, high humidity above 60% impaired the heat transmission from body core to the periphery at 35 degrees C but facilitated it at 30 degrees C in 4-wk-old broiler chickens. The effect of humidity on nonevaporative heat loss was depended on air temperature, as nonevaporative heat loss was suppressed by high humidity (>60% RH) at high temperature but enhanced at the mild temperature. The effect of humidity on the relationship between peripheral and core temperature depends on ambient temperature as well as on the age of the broiler chicken. The disturbance of thermal balance could not be determined only by changes in RT or peripheral temperature at a single time point but could be determined by mean body temperature within a certain time frame.

‘Survival gene’ Bcl-xl potentiates DNA-raised antitumor immunity

T-cell priming is strongly affected by the longevity of antigen-bearing dendritic cells (DCs), which are typically short-lived in lymphoid tissues. 'Survival gene' Bcl-xl is critical for the lifespan of DCs in vivo. Here, we showed that in vivo coadministration of Bcl-xl under control of the DC-specific promoter (CD11c-Bcl-xl) and TRP2hsp70 DNA prolonged T-cell stimulation by DCs and augmented TRP2-specific-IFN-gamma-producing CD8+ T-cell responses. Consistent with these findings, enhanced protection and significant therapeutic immunity to B16 melanoma was generated by this coimmunization strategy, which also augmented therapeutic immunity to GL-26 tumor. In this B16 melanoma model, results from animal experiments with depletion of immune cells indicate that CD8+ T cells and NK cells are important in the antitumor immunity induced by this coimmunization strategy. These observations suggest that 'survival gene' Bcl-xl potentiates the magnitude of antigen-specific-CD8+ T-cell responses and the efficacy of antitumor immunity induced by DNA vaccine, and is relevant for the design of in vivo targeted DC-based vaccine strategies to improve immunity against cancer.

Extrauterine müllerian adenosarcoma associated with endometriosis and rectal villotubular adenoma: report of a case and review of the literature

Extrauterine mullerian adenosarcoma is rare and is thought to arise from endometriotic deposits or pluripotent mesothelial and mesenchymal cells of the pelvic cavity. Concomitant colon-rectal neoplasm was reported but the relationship between extrauterine adenosarcoma and colon tumor was not studied. We describe an extrauterine adenosarcoma with a concomitant rectal tubulovillous adenoma. The patient had a long-term history of endometriosis and unopposed estrogen therapy. Immunohistochemical study was performed to investigate the origin and nature of the adenosarcoma. Immunostaining provided the evidence to distinguish between rectal tumor and adenosarcoma. Extrauterine adenosarcoma may arise from endometriosis, and hormone replacement therapy may have some role in the malignant transformation process. Adenosarcoma should be considered in the differential diagnosis of a new pelvic tumor in a patient with a history of endometriosis.

Inhibition of angiotensin II induced endothelin-1 gene expression by 17-beta-oestradiol in rat cardiac fibroblasts

OBJECTIVE

To examine whether 17-beta-oestradiol (E(2)) may alter angiotensin II (Ang II) induced cell proliferation and to identify the putative underlying signalling pathways in rat cardiac fibroblasts.

DESIGN

Cultured rat cardiac fibroblasts were preincubated with E(2) then stimulated with Ang II. [(3)H]Thymidine incorporation and endothelin-1 (ET-1) gene expression were examined. The effect of E(2) on Ang II induced NADPH oxidase activity, reactive oxygen species (ROS) formation, and extracellular signal regulated kinase (ERK) phosphorylation were tested to elucidate the intracellular mechanism of E(2) in proliferation and ET-1 gene expression.

RESULTS

Ang II increased DNA synthesis, which was inhibited with E(2) (1-100 nmol/l). E(2), but not 17-alpha-oestradiol, inhibited Ang II induced ET-1 gene expression as shown by northern blotting and promoter activity assay. This effect was prevented by co-incubation with the oestrogen receptor antagonist ICI 182,780 (1 micromol/l). E(2) also inhibited Ang II increased NADPH oxidase activity, ROS formation, ERK phosphorylation, and activator protein-1 mediated reporter activity.

CONCLUSIONS

The results suggest that E(2) inhibits Ang II induced cell proliferation and ET-1 gene expression, partially by interfering with the ERK pathway through attenuation of ROS generation. Thus, this study provides important new insight regarding the molecular pathways that may contribute to the proposed beneficial effects of oestrogen on the cardiovascular system.

PET Detection of Solitary Distant Skeletal Muscle Metastasis of Esophageal Adenocarcinoma

A 67-year-old man with progressive dysphagia was recently diagnosed with a gastroesophageal junction adenocarcinoma. Contrast-enhanced CT scans of the abdomen and pelvis reported a large GE junction tumor without evidence of metastatic disease. FDG positron emission tomography revealed intense tracer accumulation in the soft tissue mass at the GE junction consistent with the primary neoplasm. In addition, PET scan also identified a solitary focus of intense FDG accumulation at the musculotendinous junction of the right gluteus minimus muscle. Subsequent MRI demonstrated mild enhancement and could not differentiate between tumor versus inflammation. Needle biopsy was performed and confirmed metastatic esophageal adenocarcinoma. A case of skeletal muscle metastases from late-stage (IV) gastroesophageal adenocarcinoma was previously reported. However, a solitary metastasis to a distant skeletal muscle without evidence of other lymphatic and hematogenous metastasis is quite unusual. The case supports the previous report that PET is superior in detecting distant metastases for initial staging of esophageal carcinoma over CT.

Follicular phase hormone levels and menstrual bleeding status in the approach to menopause

OBJECTIVE

(1) Characterize the relationship between follicular phase hormone levels and menstrual bleeding patterns in the approach to menopause; (2) identify racial differences in hormone levels; (3) determine independent contributions of menstrual status, race, age, BMI, and smoking to hormone levels.

DESIGN

Randomly identified, population-based cohort, stratified to obtain equal numbers of African American and Caucasian women, prospectively followed for 5 years.

SETTING

Women in Philadelphia County, PA, identified by random-digit telephone dialing.

PARTICIPANT(S)

Women aged 35 to 47 years with regular menstrual cycles at enrollment (N = 436).

DATA COLLECTION

Blood sampling twice in each of 7 assessment periods during days 1-6 of the cycle, menstrual dates identified through structured interview and daily symptom reports, anthropometric measures and standardized questionnaires at each assessment period.

MAIN OUTCOME MEASURE(S)

Serum levels of follicular E(2), FSH, inhibin B, and LH.

RESULT(S)

The mean levels of E(2), FSH, inhibin B, and LH were differentially associated with the 5 menstrual status groups defined by changes in bleeding patterns. Significant changes in hormone levels occurred prior to missed menstrual cycles for inhibin B, FSH, and LH. All hormones had a highly significant interaction between menstrual status and BMI. African American women had significantly lower levels of E(2) and LH compared to Caucasian women in univariate analyses. The interaction of race, menstrual status, and BMI was highly significant (P<.001) for E(2), with African American women having lower E(2) levels until postmenopause, when E(2) levels were higher in AA women with BMI > or =25 and BMI > or =30.

CONCLUSION(S)

Levels of E(2), FSH, LH, and inhibin B are significantly associated with menstrual bleeding patterns in late reproductive age women and differentiate the earliest stages of the menopausal transition. Racial differences in mean levels of E(2) appear strongly mediated by BMI.

Central penetration and stability of N-terminal tripeptide of insulin-like growth factor-I, glycine-proline-glutamate in adult rat

Insulin-like growth factor-I is a neurotrophic factor and can prevent neurons from ischemic brain injury. However, the large molecular weight and metabolic effects can be problematic in its central delivery. Glycine-proline-glutamate (GPE) is the N-terminal tripeptide of insulin-like growth factor-I, which is naturally cleaved in the plasma and brain tissues. GPE reduces neuronal loss from hypoxic-ischemic brain injury following central administration. Central penetration and the stability of GPE in the plasma and central nervous system were examined in rats using radioimmunoassay and HPLC. GPE was rapidly metabolised in the plasma (8 min) after intraperitoneal administration. Despite having a short half-life in plasma, GPE was detected in the cerebrospinal fluid up to 40 min after intraperitoneal administration. With present of peptidase inhibitors, GPE existed in the brain tissue up to 3 h after intracerebroventricular administration, suggesting a role for peptolysis in its stability. The endopeptidase inhibitors 4- (2-aminoethyl) benzenesulfonyl fluoride hydrochloride (AEBSF) reduced GPE metabolism in the brain tissue while acid peptidase inhibitor pepstatin-A decreased GPE metabolism in the plasma. GPE reduced neuronal loss in the CA1-2 sub-region of the hippocampus given (intraperitoneally) after 30 min of hypoxic-ischemic injury in adult rats, further suggested the effectiveness of GPE central uptake. These results indicated that GPE crosses the blood-CSF and the functional CSF-brain barriers. The longer half-life of GPE in the CNS may be due to its unique enzymatic stability.

Effects of treatment distance and field size on build-up characteristics of Monte Carlo calculated absorbed dose for electron irradiation

Surface, build-up and depth dose characteristics of a monoenergetic electron point source simulated by Monte Carlo code MCNP4c for varying field size and SSD are extensively studied in this paper. MCNP4c (Monte Carlo N-Particle Transport Code System) has been extensively used in clinical dose simulation for its versatility and powerful geometrical coding tool. A sharp increase in PDD is seen with the Monte Carlo Modelling immediately at the surface within the first 0.2 mm. This effect cannot be easily measured by experimental instruments for electron contamination, and may lead to a clinical underdosing of the basal cell layer, which is one of the most radiation sensitive layers and the main target for skin carcinogenesis. A high percentage build-up dose for electron irradiation was shown. No significant effects in surface PDDs were modelled with different SSD values from 95 cm to 125 cm. Three depths were studied in detail, these being 0.05 mm, the lower depth of the basal cell layer; 0.95 mm, the lower depth of the dermal layer; and 0.95 cm, a position within the subcutaneous tissue. Results showed only small surface PDD differences were modelled for SSD variations from 95 cm to 125 cm and field sizes variation from the values between 5 cm and 10 cm squares to 25 cm. When the field side length is smaller than this, the surface dose shows an increasing trend by about 7% at 5 x 5 cm2.

Neuroprotective effects of the N-terminal tripeptide of insulin-like growth factor-1, glycine-proline-glutamate (GPE) following intravenous infusion in hypoxic-ischemic adult rats

The N-terminal tripeptide of insulin-like growth factor-1, GPE is neuroprotective when given intracerebroventricularly 2 h after hypoxic-ischemic (HI) brain injury in rats. We have now examined whether GPE can cross the blood-brain barrier and exert neuroprotective actions following intravenous administration. Following a single bolus intravenous injection, GPE was rapidly metabolized and cleared from the circulation. The short half-life (<2 min) in blood was subsequently associated with modest and inconsistent neuroprotection. In contrast, potent neuroprotection of GPE was consistently observed in all brain regions examined following 4 h intravenous infusion (12 mg/kg). The neuroprotective effects of GPE after infusion showed a broad effective dose range (1.2-120 mg/kg) and an extended window of treatment to 7-11 h after injury. The central penetration of GPE after intravenous infusion was injury-dependent. GPE also improved long-term somatofunction with a comparable neuronal outcome. GPE reduced both caspase-3-dependent and -independent apoptosis in the hippocampus. Treatment with GPE also inhibited microglial proliferation and prevented the injury-induced loss of astrocytes. In conclusion, the neuroprotective actions of GPE infusion were global, robust and displayed a broad effective dose range and treatment window. GPE's activity included the prevention of neuronal apoptosis, promotion of astrocyte survival and inhibition of microglial proliferation. With injury specific central penetration, GPE has considerable promise as a systemic neuroprotective treatment after acute encephalopathies.