A phase II study of gemcitabine-based chemoradiotherapy (CCRT) after triplet induction chemotherapy (ICT) for locally advanced pancreatic cancer (LAPC): A Taiwan Cooperative Oncology Group (TCOG) study

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The optimal management of LAPC remains controversial. The efficacy of CCRT is hampered by early systemic dissemination. To treat undetectable metastases and to select patients who are likely to benefit from CCRT, ICT followed by CCRT has recently been extensively evaluated in LAPC. Recently, we showed that triplet chemotherapy consisting of gemcitabine 800 mg/m2 (10 mg/m2/min) followed by oxaliplatin 85 mg/m2 and 48-hour infusion of 5-FU/LV 3,000 and 150 mg/m2 Q 2 weeks, the GOFL regimen, is feasible and active for pts with APC. Chemo-naïve pts with histo- /cytologically proven unresectable LAPC, and bi-dimensionally measurable diseases were eligible. Patients who did not experience disease progression (PD) after 6 cycles of GOFL would had CCRT consisting of weekly gemcitabine 400mg/m2 plus 50.4Gy/28 fractions of radiation 4–6 weeks later. After CCRT, pts were re-evaluated for surgical intervention and those with unresectable disease would continue GOFL until PD, unacceptable toxicity, patient's refusal or death. Among the 50 enrolled pts (24F/26M, median age 58.5 years), 48 had definitively unresectable diseases. After induction GOFL, 16 (32%) pts were off-studied because of PD in 12 (24%) and ICT-related toxicity in 4 (8%, PD/UE group). Among the 34 (68%) with objective response or stable disease after 6 cycles of ICT, 27 (54%) who completed the assigned multimodality treatment are categorized as CCRT group; whiles 7 (14%) who either declined CCRT (in 5) or still on ICT (in 2) are categorized as non-CCRT group. The median PFS and OS for the ITT population were 9.1 and 14.5 months, respectively. The median PFS for PD/UE, non-CCRT and CCRT groups were 2.1, 8.2 and 12.8 months, respectively; whiles the OS were 8.5, 15.0 and 18.3 months, respectively. The most common grade 3–4 toxicities were neutropenia (40%), anemia (14%), infection (16%), nausea (26%), vomiting (20%). Grade 2–3 peripheral neuropathy was observed in 7 of 29 who received post-CCRT GOFL. Conclusion: Three months of triplet ICT followed by gemcitabine-based CCRT is feasible and likely to prolong the survival of selected LAPC pts. Prospective, randomization study is warranted to validate the findings.

No significant financial relationships to disclose.

Dislocation after total knee arthroplasty

Two cases of dislocation of total knee arthroplasty presented to us within the same week. The first patient is a 71-year-old woman who underwent bilateral primary total knee arthroplasty. The left knee dislocated three weeks after the surgery. Due to failure of conservative measures, she underwent revision total knee arthroplasty. The other patient is a 72-year-old woman presenting ten years after primary total knee arthroplasty, with a traumatic dislocation of the knee joint. She was treated as an outpatient with closed manipulative reduction.

Studies on the antibacterial activities and mechanisms of chitosan obtained from cuticles of housefly larvae

Chitosan was obtained from cuticles of the housefly (Musca domestica) larvae. Antibacterial activities of different Mw chitosans were examined against six bacteria. Antibacterial mechanisms of chitosan were investigated by measuring permeability of bacterial cell membranes and observing integrity of bacterial cells. Results show that the antibacterial activity of chitosan decreased with increase in Mw. Chitosan showed higher antibacterial activity at low pH. Ca2+ and Mg2+ could markedly reduce the antibacterial activity of chitosan. The minimum inhibitory concentrations of chitosans ranged from 0.03% - 0.25% and varied with the type of bacteria and Mw of chitosan. Chitosan could cause leakage of cell contents of the bacteria and disrupt the cell wall.

Preparation and characterization of grafted collagen-multiwalled carbon nanotubes composites

This paper describes a new class of composite materials designed by combining multiwalled carbon nanotubes (MWCNTs) and grafted collagen matrix. These materials show high mechanical capabilities by taking advantage of the favorable mechanical characteristics of MWCNTs. Furthermore, doping carbon nanotubes into grafted collagen matrix results in a substantial improvement of thermal stability and infrared emissivity. Thus these materials possess potential applications in some fields such as biomedicine and infrared camouflage.

The clinical value of serum CEA, CA19-9, and CA242 in the diagnosis and prognosis of pancreatic cancer

AIM

Serum tumour markers carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) and CA242 were investigated to evaluate the values of single and combined test in the diagnosis and prognosis of pancreatic cancer.

METHODS

Pre-operative serum CEA, CA19-9 and CA242 were measured in 105 pancreatic cancers, 70 non-pancreatic malignancies and 30 benign pancreatic diseases.

RESULTS

The sensitivity of CA19-9 alone was the highest in pancreatic cancer patients (80%), but the specificity was significantly lower than that of CEA and CA242 (P<0.01). The combination of CEA and CA242 could increase the specificity to 92%. In serum CA242 positive patients, the survival time was remarkably shorter than that of patients with negative result (P<0.01). The survival time in patients with more than two markers positive expression of CEA, CA19-9 and CA242 was obviously shorter than that of only one or no marker positive expression (P<0.05).

CONCLUSION

The diagnostic rate of CA19-9 in pancreatic cancer is better than that of CEA and CA242. Combined detection of CEA and CA242 can improve the diagnostic specificity obviously. High levels of serum markers are associated with advanced stage of the disease. Patients with two or three markers positive expression of CEA, CA19-9, and CA242 simultaneously had a shorter survival time.

Cloning and characterization of the mouse Arht2 gene which encodes a putative atypical GTPase

ARHT is a new subgroup of the Rho family identified recently, which consists of two Rho-like genes, Arht1 and Arht2. ARHT may be involved in mitochondrial homeostasis and apoptosis. Constitutively active mutants of ARHT1 induced an aggregation of the mitochondrial network and resulted in an increased apoptotic rate of the cells. Here we report the molecular cloning and characterization of a novel mouse cDNA encoding a putative atypical GTPase protein, Arht2. Mouse Arht2 consists of 19 exons and has been mapped to mouse chromosome 17A3.3. Both human and mouse Arht2 genes are ubiquitously expressed in adult tissues. The results of RT-PCR experiments indicated that the Arht2 gene is expressed in all stages of mouse testis and reached the adult level of transcription at postnatal day 30. In situ hybridization revealed strong hybridization signals of Arht2 in residual bodies. In the mouse testis, Arht2 may be involved in the differentiation of testis and spermiogenesis. The molecular characterization of the mouse Arht2 gene may provide a clue for functional studies of the human ARHT genes.

Identification of an 85-kb DNA fragment containing pms1, a locus for photoperiod-sensitive genic male sterility in rice

Photoperiod-sensitive genic male-sterile rice has a number of desirable characteristics for hybrid rice production. Previous studies identified pms1, located on chromosome 7, as a major locus for photoperiod-sensitive genic male sterility. The objective of this study was to localize the pms1 locus to a specific DNA fragment by genetic and physical mapping. Using 240 highly sterile individuals and a random sample of 599 individuals from an F2 population of over 5000 individuals from a cross between Minghui 63 and 32001S, we localized the pms1 locus by molecular marker analysis to a genetic interval of about 4 cM, 0.25 cM from RG477 on one side and 3.8 cM from R1807 on the other side. A contig map composed of seven BAC clones spanning approximate 500 kb in length was constructed for the pms1 region by screening a BAC library of Minghui 63 DNA using RFLP markers and chromosomal walking. Analysis of recombination events in the pms1 region among the highly sterile individuals reduced the length of the contig map to three BAC clones. Sequencing of one BAC clone, 2109, identified two SSR markers located 85 kb apart in the clone that flanked the pms1 locus on both sides, as indicated by the distribution of recombination events. We thus concluded that the pms1 locus was located on the fragment bounded by the two SSR markers.

Prediction of protein interaction sites from sequence profile and residue neighbor list

Protein-protein interaction sites are predicted from a neural network with sequence profiles of neighboring residues and solvent exposure as input. The network was trained on 615 pairs of nonhomologous complex-forming proteins. Tested on a different set of 129 pairs of nonhomologous complex-forming proteins, 70% of the 11,004 predicted interface residues are actually located in the interfaces. These 7732 correctly predicted residues account for 65% of the 11,805 residues making up the 129 interfaces. The main strength of the network predictor lies in the fact that neighbor lists and solvent exposure are relatively insensitive to structural changes accompanying complex formation. As such, it performs equally well with bound or unbound structures of the proteins. For a set of 35 test proteins, when the input was calculated from the bound and unbound structures, the correct fractions of the predicted interface residues were 69 and 70%, respectively.

The regulatory effect of ERK1/2 signal pathway on production of TNFalpha induced by LPS in mice Kupffer cells

OBJECTIVE

To study the rule of ERK1/2 activity and regulative effect of ERK1/2 pathway on the production of pro-inflammatory cytokine TNFalpha in mice Kupffer cells (mKC) induced by LPS, and to exploring novel methods to prevent and treat clinical patients of endotoxemia.

METHODS

Immunoprecipitate kinase assay and Western blotting analysis were used to detect the phosphorylated ERK1/2 kinase activity in mKC stimulated by LPS, and ELISA was used to study the effect of ERK1/2 signaling cascade on LPS-induced TNFalpha production in mKC.

RESULTS

In mKC, LPS treatment resulted in transient and rapid increase of kinase activity of ERK1/2 that phosphorylated their specific substrate ELK-1, with maximal value at 30 minutes and a return near to baseline within 2 hours, and LPS-induced ERK1/2 activity from LPS concentration of 10 pg/ml to the top activity at 100 ng/ml. No activity was observed in unstimulated mKC. Inhibition of the ERK1/2 pathway using the specific ERK1/2 signal pathway inhibitor PD98059 caused a marked and concentration-dependent reduction of TNFalpha production.

CONCLUSIONS

The results show that LPS can markedly activate ERK1/2 pathway in mKC. PD98059 causes a significant and concentration-dependent reduction of TNFalpha production. ERK1/2 may be a novel target to treat clinical patient of endotoxemia.

[The impact of lateral rhinotomy on nasal airway]

OBJECTIVE

In order to ascertain the lateral operation and medial maxillectomy affect on nasal airway.

METHOD

Report 16 cases of nasal cavity or nasal sinus neoplasm who were therapied by lateral rhinotomy and medial maxillectomy. They were observed by acoustic rhinometer (AR) and CT examination in 1-2.5 years after the surgery.

RESULT

The feeling of nasal obstruct were disappeared in 3 months after the surgery. The nasal airway resistance(NAR) of the ill nasal cavity was markedly decreased after the surgery, and the total NAR were decreasing unmarkably. The mucous proliferation was notable only in the first year after surgery, and especially on remains of the inferior turbinate or extra wall of nasal cavity.

CONCLUSION

Lateral rhinotomy operation and medial maxillectomy have less impact on nasal airway and the functions.

Natural course of schizophrenia: 2-year follow-up study in a rural Chinese community

BACKGROUND

A number of studies have questioned whether the natural course of schizophrenia is more favourable in "developing" than "developed" societies and whether culture is a factor in producing a favourable course.

AIMS

This prospective study tests the hypothesis that the natural outcome of schizophrenia would be favourable in a Chinese rural area.

METHOD

We investigated all patients with schizophrenia, including patients who had not received any treatment, among 149 231 rural community population in Xinjin County, Sichuan in 1994. Those patients who had never received treatment were followed up for two years.

RESULTS

Three-quarters of patients with schizophrenia who had not been treated remained symptomatic. As the duration of illness increased, the illness became more serious. The clinical outcome of the drug-treatment group was significantly better than for patients who had not received any treatment.

CONCLUSIONS

The natural clinical outcome of schizophrenia in the Chinese rural community was poor, and occupational functioning of patients with schizophrenia was comparatively better. Schizophrenia itself has a specific natural course--antipsychotic drug treatment and psychosocial treatment will produce an improvement in prognosis.

CADASIL: the dermatologic diagnosis of a neurologic disease. Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy

Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an increasingly recognized neurologic disease characterized by pathognomonic changes to the small vessels, particularly in the brain and skin. Although much has recently been written about this disease in the neuropathology literature, to our knowledge nothing has appeared in the dermatology literature. We wish to call attention to the unique role dermatologists and dermatopathologists can play in the diagnosis of this disease. We review the condition's clinical, histologic, and ultrastructural features.

Fold recognition and accurate query-template alignment by a combination of PSI-BLAST and threading

A homology-based structure prediction method ideally gives both a correct fold assignment and an accurate query-template alignment. In this article we show that the combination of two existing methods, PSI-BLAST and threading, leads to significant enhancement in the success rate of fold recognition. The combined approach, termed COBLATH, also yields much higher alignment accuracy than found in previous studies. It consists of two-way searches both by PSI-BLAST and by threading. In the PSI-BLAST portion, a query is used to search for hits in a library of potential templates and, conversely, each potential template is used to search for hits in a library of queries. In the threading portion, the scoring function is the sum of a sequence profile and a 6x6 substitution matrix between predicted query and known template secondary structure and solvent exposure. "Two-way" in threading means that the query's sequence profile is used to match the sequences of all potential templates and the sequence profiles of all potential templates are used to match the query's sequence. When tested on a set of 533 nonhomologous proteins, COBLATH was able to assign folds for 390 (73%). Among these 390 queries, 265 (68%) had root-mean-square deviations (RMSDs) of less than 8 A between predicted and actual structures. Such high success rate and accuracy make COBLATH an ideal tool for structural genomics.