Managing invasive species in the presence of endogenous technological change with uncertainty

This research incorporates the development and adoption of an induced technology under uncertainty into a conceptual dynamic model to more broadly examine efficient policies for mitigating invasive species infestations. We find that under optimal policy, marginal costs of adopting conventional control measures are equal to the sum of the marginal benefits from development and adoption of new technology, as well as the use of conventional control measures. This result implies that a resource allocation designed for controlling invasive species is not adequate when an induced technology is not considered. Our results also reveal that the shadow values associated with the probabilities of developing and then adopting an induced technology increase as the shadow values associated with the stock of an invasive species population increase.

Optimization of trichloroethylene degradation using soluble methane monooxygenase of Methylosinus trichosporium OB3b expressed in recombinant bacteria

By complementing cell-free extracts of Pseudomonas putida F1/pSMMO20 with purified soluble methane monooxygenase (sMMO) components of Methylosinus trichosporium OB3b, the low cloned-gene sMMO activity in the recombinant strain was found to be due to incomplete activity of the hydroxylase component. To address this incomplete activity, additional sMMO-expressing strains were formed by transferring mmo-containing pSMMO20 and pSMMO50 into various bacterial species including pseudomonads and alpha-2 subdivision strains such as methanotrophs, methylotrophs, Agrobacterium tumefaciens A114, and Rhizobium meliloti 102F34 (11 new strains screened); sMMO activity was detected in the last two strains. To increase plasmid segregational stability, the hok/sok locus originally from Escherichia coli plasmid R1 was inserted downstream of the mmo locus of pSMMO20 (resulting in pSMMO40) and found to enhance plasmid stability in P. putida F1 and R. meliloti 102F34 (first report of hok/sok in Rhizobium). To further increase sMMO activity, a modified Whittenbury minimal medium was selected from various minimal and complex media based on trichloroethylene (TCE) degradation and growth rates and was improved by removing the sMMO-inhibiting metal ions [Cu(II), Ni(II), and Zn(II)] and chloramphenicol from the medium and by supplementing with an iron source (3.6 microM of ferrous ammonium sulfate). Using chemostat-grown P. putida F1/pSMMO40, it was found that sMMO activity was higher for cells grown at higher dilution rates. These optimization efforts resulted in a twofold increase in the extent of TCE degradation and more consistent sMMO activity.

Clinical features and survival outcomes in patients with multiple myeloma: analysis of web-based data from the Korean Myeloma Registry

AIM

The Korean Multiple Myeloma Working Party performed a nationwide registration of multiple myeloma patients via a web-based data bank system.

METHODS

We retrospectively analyzed registered data from 3,209 patients since 1999.

RESULTS

The median overall survival (OS) was 50.13 months (95% confidence interval: 46.20-54.06 months). Patients < or =40 years demonstrated a longer OS than patients >65 years of age (median OS 71.13 vs. 36.73 months, p < 0.001). Patients who received novel agents at any time during their treatments showed a longer OS than patients who did not (median OS 42.23 vs. 55.50 months, p < 0.001). Response to treatment was associated with OS, with tandem autologous stem cell transplantation (SCT) producing longer OS than single autologous SCT.

CONCLUSIONS

We demonstrated associations between survival outcomes and treatment modalities as well as baseline disease characteristics in a registry of multiple myeloma patients using a web-based data analysis.

Plasmablastic lymphoma in the anal canal

Plasmablastic lymphoma (PBL) of the oral cavity is an acquired immunodeficiency syndrome-related lymphoma. The immunophenotype of this disease is associated with poor expression of B-cell markers but a positive reactivity for plasma cell markers. PBL is highly aggressive and responds poorly to treatment. Although originally described in the oral cavity, this disease can occur in other body niches. Here, we describe a very rare case of PBL in the anal canal of a 40-year-old woman with human immunodeficiency virus infection. The malignant cells were positive for Epstein-Barr virus and human herpes virus 8.

Practical anatomic landmarks for determining the insertion depth of central venous catheter in paediatric patients

BACKGROUND

Various methods have been recommended to decide a proper insertion depth of central venous catheter (CVC). The carina is recommended as a useful target level for the CVC tip position. We evaluated the sternal head of a right clavicle and the nipples as anatomic landmarks for determining the optimal depth of CVC in paediatric patients.

METHODS

Ninety children, <5 yr, undergoing catheterization through the right internal jugular vein were enrolled. The insertion depth was determined as follows. The insertion point was designated as 'Point I'. The sternal head of the right clavicle was called 'Point A' and the midpoint of the perpendicular line drawn from Point A to the line connecting both nipples was called 'Point B'. The insertion depth of CVC was determined by adding the two distances (from I to A and from A to B) and subtracting 0.5 cm from this. A chest radiography was taken and the distance of the CVC tip from the carina level was measured by the Picture Archiving and Communicating System.

RESULTS

The mean distance of the CVC tip from the carina level was 0.1 (1.0) (P=0.293) cm above the carina (95% CI 0.1 cm below the carina-0.3 cm above the carina). There was no specific relationship between the distance of the CVC tip from the carina level and the patients' age, height, and weight.

CONCLUSIONS

The CVC tip could be placed near the carina by using the external landmarks without any formulae, images, and devices in children in our study.

[Factors associated with lower urinary tract symptoms for patients with Parkinson's disease]

PURPOSE

The study was done to identify lower urinary tract symptoms (LUTS) and to evaluate the factors affecting LUTS for the people with Parkinson's disease.

METHODS

The research design was a cross-sectional study with interviews using a structured questionnaire. The participants were 72 patients with Parkinson's disease who were seen in the Neurology clinic of a university hospital from September to November 2005.

RESULTS

Mean score of LUTS for the participants was 10.11. In each symptom score of LUTS (range 0-5), weak stream was the highest 2.06, followed by nocturia 1.71, and urgency 1.61. The severity of LUTS was moderate to severe group for 51%. LUTS were significantly different by regular exercise. Positive correlations were observed between Hoehn and Yahr stage (stage of disease severity) and frequency and between Hoehn and Yahr stage and urgency (r=.280, p=.018; r=.328, p=.005). LUTS were significantly predicted by regular exercise (p=.001) which explained 15.0% of the variance in LUTS.

CONCLUSION

Regular exercise was found to be a very important factor associated with LUTS for patients with Parkinson's disease.

Detection of small hepatocellular carcinoma: comparison of conventional gadolinium-enhanced MRI with gadolinium-enhanced MRI after the administration of ferucarbotran

We compared the diagnostic efficacy of gadolinium (Gd)-enhanced MRI with that of Gd-enhanced MRI after administration of ferucarbotran for revealing small hypervascular hepatocellular carcinomas (HCCs). 24 patients with 34 HCCs (ranging in size from 0.6-2.0 cm) underwent Gd-enhanced three-dimensional dynamic MRI followed, after an interval of 5-11 days (mean, 7 days), by Gd-enhanced three-dimensional dynamic MRI after administration of ferucarbotran. The two Gd-enhanced arterial-phase MRI scans were compared quantitatively by measuring the tumour-liver contrast-to-noise ratio (CNR) and qualitatively by evaluating the tumour-liver contrast using matched-pairs analysis. The tumour-liver CNR with Gd-enhanced arterial-phase imaging after ferucarbotran (250.3 +/- 103.7) was higher than that with Gd-enhanced arterial-phase imaging (221.1 +/- 96.1) (p < 0.001). Matched-pairs analysis indicated that, for three lesions, the relative tumour-liver contrast was slightly better with Gd-enhanced arterial-phase imaging after ferucarbotran than with conventional Gd-enhanced arterial-phase imaging; however, in the case of the remaining 31 lesions, the two images were equivalent. We concluded that, although Gd-enhanced arterial-phase imaging after ferucarbotran results in better tumour-liver CNR than Gd-enhanced arterial-phase imaging, the ability of the two techniques to reveal small hypervascular HCCs is the same.

[Concurrent chemoradiotherapy compared with concurrent chemoradiotherapy with surgery in locally advanced resectable esophageal cancer]

BACKGROUND/AIMS

This study was designed to compare the survival rates between patients with localized esophageal cancer who were treated with concurrent chemoradiation therapy without surgery and patients who were treated with concurrent chemoradiation therapy including surgery.

METHODS

Eighty-eight patients from January 1997 to December 2005 with locally advanced resectable esophageal cancer were selected and retrospectively analyzed. Survival period was defined as the time to death from the date of diagnosis or mid-monitor period of December 2005. Sixty-one patients were treated with chemoradiation therapy alone while twenty-seven patients were treated with chemoradiation therapy in addition to surgery as for curative intention. As for radiation therapy, 5,000-5,500 cGY was used. 5-Fluouracil and cisplatin were used for chemotherapy. The primary end point was overall survival time. The secondary end point was overall progression free survival time.

RESULTS

There was no significant difference in tissue type, location and clinical staging, but the median age was significantly younger in the group treated with surgery (63.4 years) than the group treated without surgery (68.8 years). Median period analyzed was 17.3 months. Five year survival rate for the group with chemoradiation alone was 7.4% and 4% for the group with surgery. The median survival rate was 11+/-3 months for the group with chemoradiation alone and 10+/-6 months for the group with surgery, in which there was no statistical difference (p=0.697).

CONCLUSIONS

There was no significant increase in survival rate in patients who were treated by chemoradiation with surgery compared with chemoradiation alone. Further analysis in terms of prospective study is needed.

GlideScope video laryngoscope: a randomized clinical trial in 203 paediatric patients

BACKGROUND

The GlideScope intubating device has been reported to provide a comparable or superior laryngoscopic view compared with direct laryngoscopy in adults. This study compared the use of the GlideScope with direct laryngoscopy for the laryngoscopic view and intubation time in children.

METHODS

The laryngoscopic view in 203 children was scored using both the Macintosh laryngoscope and the GlideScope using Cormack and Lehane (C&L) grades. After scoring each laryngoscopic view with and without BURP, the patients were randomly allocated to two groups. The trachea was intubated using direct laryngoscopy (Group DL, n=100) or the GlideScope (Group GS, n=103). We compared C&L grades for the two views in the same patient, and also the time to intubate for each group.

RESULTS

The GlideScope improved the view without BURP in the patients with C&L grade 2 (16/26, P<0.01) and with C&L grades 3 and 4 (7/11, P<0.05). The view with BURP was also improved by the GlideScope in C&L grade 2 (4/9, P<0.05) and with C&L grades 3 and 4 (4/5, P=0.059). The mean time for tracheal intubation was 36.0 (17.9) s in the GS group and 23.8 (13.9) s in the DL group (P<0.001).

CONCLUSIONS

In children, the GlideScope provided a laryngoscopic view equal to or better than that of direct laryngoscopy but required a longer time for intubation.

Visceral fat accumulation induced by a high-fat diet causes the atrophy of mesenteric lymph nodes in obese mice

OBJECTIVE

A high intake of fat in the diet plays a crucial role in promoting obesity and obesity-related pathologies, and especially visceral obesity is closely associated with obesity-related complications. Because adipose tissue is anatomically associated with lymph nodes, the secondary lymphoid organ, we hypothesized that fat tissue-derived factors may influence the cellularity of lymphoid tissue embedded in fat.

METHODS AND PROCEDURES

Mesenteric and inguinal lymph nodes were isolated from obese mice fed a high-fat diet and control mice fed a regular diet. T-cell population, activation state, and the extent of apoptosis were determined by flow cytometric analysis or terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling (TUNEL) assay.

RESULTS

The weight of mesenteric lymph nodes and the total number of lymphoid cells in the obese mice significantly decreased compared with those in the control mice; however, no change was observed in the weight of inguinal lymph nodes. The numbers of CD4(+) and CD8(+) T cells in the mesenteric lymph nodes of obese mice significantly decreased compared with those of the control. Enhanced T-cell activation and apoptosis were observed in the mesenteric lymph node cells of the obese mice. The treatment of lymph node cells with free fatty acids, oxidative stress, and chylomicrons, which are obesity-related factors, resulted in lymph node T-cell activation and apoptosis.

DISCUSSION

These results suggest that visceral fat accumulation with a high-fat diet can cause the atrophy of mesenteric lymph nodes by enhancing activation-induced lymphoid cell apoptosis. Dietary fat-induced visceral obesity may be crucial for obesity-related immune dysfunction.

Delayed pharmacological pre-conditioning effect of mitochondrial ATP-sensitive potassium channel opener on neurologic injury in a rabbit model of spinal cord ischemia

BACKGROUND

Diazoxide, pharmacological openers of mitochondrial ATP-sensitive potassium channels have been shown to induce early pre-conditioning in the spinal cord. Here, the authors investigated whether diazoxide also induce delayed pre-conditioning and thereby reduce neurologic complications using a rabbit model of spinal cord ischemia.

METHODS

Infrarenal blood flow was interrupted for 20 min in 21 rabbits. Non-treated control animals received no pre-treatment. Diazoxide (5 mg/kg) were given 48 h before 20 min ischemia in the 48-h DZ group, whereas 15-min DZ group received diazoxide (5 mg/kg) 15 min before 20-min ischemia. Neurological functions were evaluated using Johnson scores for 3 days after reperfusion, after which, spinal cords were procured for hematoxylin and eosin staining for cell counting.

RESULTS

Johnson scores revealed a marked improvement in both the diazoxide-treated groups vs. the non-treated control group at 3, 24, 48, and 72 h after reperfusion (P<0.01). The histologic changes were proportional to the Johnson scores, with better preservation of motor neuron numbers in the animals of the 48-h DZ and 15-min DZ group relative to the non-treated controls (81+/-12, 90+/-10, 50+/-23 motor neurons, respectively, P<0.01). No difference was found between the 48-h DZ group and 15-min DZ group with respect to the Johnson scores or neuron numbers.

CONCLUSIONS

The study demonstrates that pre-treatment with diazoxide 48 h before ischemia, induce delayed pharmacological pre-conditioning, thereby significantly improving clinical neurologic scores and histologic findings in this animal model.

Finite width and local field corrections to spin coulomb drag in a quasi-two-dimensional electron gas

We study the spin Coulomb drag in a quasi-two-dimensional electron gas of finite transverse width, including local field corrections beyond the random phase approximation (RPA). We find that the finite transverse width of the electron gas causes a significant reduction of the spin Coulomb drag. This reduction, however, is largely compensated by the enhancement coming from the inclusion of many-body local field effects beyond the RPA, thereby restoring good agreement with the experimental observations by C. P. Weber et al. [Nature (London) 437, 1330 (2005)].

Alternative method for predicting optimal insertion depth of the laryngeal tube in children

BACKGROUND

Little information is available about the accuracy of the teeth mark on the laryngeal tube (LT) as a guide to correct placement in children. The aim of this crossover study was to evaluate three methods for optimal insertion depth of the size (#) 2 tube in children weighing 12-25 kg.

METHOD

In 24 children, the LT #2 was consecutively inserted by three different methods: (A) until the thick teeth mark on the tube was aligned with the upper incisors, (B) until resistance was felt, and (C) by inserting to a depth, previously measured, of the curved distance between the cricoid cartilage and the upper incisor. In each case, the depth of insertion, the degree of effective ventilation, the presence of leakage, and the fibreoptic view were assessed.

RESULTS

Insertion based on the teeth mark led to a shorter insertion depth and a greater incidence of inadequate ventilation compared with the other two methods. There was no difference in the adequacy of ventilation between methods B and C. The vocal cords were more easily identified with methods B (62.5%) and C (75%) than with method A (12.5%).

CONCLUSIONS

Insertion of the LT #2 aligned with the teeth mark can result in a shallow insertion depth and inadequate ventilation. The measured distance from the cricoid cartilage to the upper incisor offers alternative guidance for correct LT insertion.

Pemetrexed and cisplatin in patients with advanced gastric cancer: a Korean cancer study group multicenter phase II study

BACKGROUND

Pemetrexed is a multitargeted antifolate enzyme inhibitor, which has activity against a variety of tumors, including advanced gastric cancer (AGC). The aim of this study was to assess efficacy and safety of pemetrexed plus cisplatin (PemCis) combination in the treatment of AGC in Korean patients.

PATIENTS AND METHODS

This was a multicenter, single arm, open label study. Patients with no prior palliative chemotherapy received pemetrexed 500 mg/m(2) and cisplatin 75 mg/m(2) day 1, every 3 weeks plus folic acid and vitamin B(12) supplementation. Response rate was assessed according to response evaluation criteria in solid tumors (RECIST) criteria.

RESULTS

Of the 50 patients evaluable for efficacy, 13 had partial response for an overall response rate of 26% (95% CI, 14.6-40.3%) and 15 (30%) had stable disease. Median time to progression was 2.8 months (95%CI, 2.2-4.4 months), and median overall survival was 6.6 months (95% CI, 4.8-10.4 months). Of the 51 patients evaluable for safety, the most frequent NCI-CTC grade 3/4 toxicities were neutropenia in 49% of patients (25% of cycles) and anorexia in 10% of patients (4% of cycles).

CONCLUSION

PemCis has a modest activity and acceptable toxicity profile in patients with AGC. Clinical trials with different combinations and dose regimens are, therefore, warranted.

Comparison of femoral arterial blood pressure with radial arterial blood pressure and noninvasive upper arm blood pressure in the reperfusion period during liver transplantation

PURPOSE

The reperfusion period during liver transplantation is hemodynamically unstable. Accurate blood pressure measurements are the mainstay for the efficient management of abrupt cardiovascular changes. We sought to compare femoral arterial blood pressure (FABP) with radial arterial blood pressure (RABP) and noninvasive upper arm blood pressure (NIBP) in the reperfusion period.

METHODS

Thirty-six adult living donor liver recipients were enrolled in this prospective study. Blood pressures in 3 locations were simultaneously recorded from 1 minute before reperfusion to 15 minutes after reperfusion. We evaluated agreements between FABP and RABP and between FABP and NIBP using intraclass correlation coefficients. Also, we investigated the rates of postreperfusion syndrome (PRS) based on the measurements from 3 locations.

RESULTS

After reperfusion, the mean and diastolic RABP agreed more with the corresponding FABP than NIBP. However, systolic NIBP showed high agreement with FABP from 3 to 10 minutes after reperfusion in contrast with the moderate agreement between systolic RABP with FABP, and systolic values of NIBP than RABP were closer to FABP. The rates of PRS based on FABP, RABP, and NIBP measurements were 50.0% (18/36), 80.6% (29/36), and 50.0% (18/36), respectively.

CONCLUSIONS

We believe that NIBP in addition to RABP may be considered to be a reliable alternative when FABP is not available to evaluate hemodynamic instability in the reperfusion period during liver transplantation.

Association of the 5,10-methylenetetrahydrofolate reductase (MTHFR C677T and A1298C) polymorphisms in Korean patients with adult acute lymphoblastic leukemia

BACKGROUND

Methylenetetrahydrofolate reductase (MTHFR) plays a central role in converting folate to methyl donor for DNA methylation. Because MTHFR is a key enzyme in folate metabolism, changes in its activity resulting from polymorphisms in the MTHFR gene could modify the susceptibility to cancer. Recently, the C677T and A1298C mutations of MTHFR were discovered to be associated with susceptibility in acute lymphoblastic leukemia (ALL).

PATIENTS AND METHODS

The association between MTHFR polymorphisms and susceptibility and clinical outcome in ALL was studied in 118 adult ALL patients and matched healthy controls (n =427). DNA samples taken from patients with ALL and controls were analyzed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assays to detect the MTHFR C677T and A1298C mutations.

RESULTS

No significant difference was found in the development of adult ALL among those with different MTHFR genotypes of the C677T or A1298C polymorphisms. However, the MTHFR 677CT+TT genotype showed a tendency to be associated with adult ALL [crude odds ratio (OR), 0.67; 95% confidence interval (CI), 0.44-1.02; adjusted OR, 0.74 95% CI, 0.47-1.14].

CONCLUSION

The MTHFR C677T and A1298C polymorphisms are not significant risk factors in adult acute leukemia in the Korean population.

Plutonium and 137Cs in surface water of the South Pacific Ocean

The present plutonium and 137Cs concentrations in South Pacific Ocean surface waters were determined. The water samples were collected in the South Pacific mid-latitude region (32.5 degrees S) during the BEAGLE expedition conducted in 2003-04 by JAMSTEC. 239,240Pu concentrations in surface seawater of the South Pacific were in the range of 0.5 to 4.1 mBq m(-3), whereas 137Cs concentrations ranged from 0.07 to 1.7 Bq m(-3). The observed 239,240Pu and 137Cs concentrations in the South Pacific were almost of the same level as those in the North Pacific subtropical gyre. The surface 239,240Pu in the South Pacific subtropical gyre showed larger spatial variations than 137Cs, as it may be affected by physical and biogeochemical processes. The 239,240Pu/137Cs activity ratios, which reflect biogeochemical processes in seawater, were generally smaller than that observed in global fallout, except for the most eastern station. The 239,240Pu/137Cs ratios in the South Pacific tend to be higher than that in the North Pacific. The relationships between anthropogenic radionuclides and oceanographic parameters such as salinity and nutrients were examined. The 137Cs concentrations in the western South Pacific (the Tasman Sea) and the eastern South Pacific were negatively correlated with the phosphate concentration, whereas there is no correlation between the 137Cs and nutrients concentrations in the South Pacific subtropical gyre. The mutual relationships between anthropogenic radionuclides and oceanographic parameters are important for better understanding of transport processes of anthropogenic radionuclides and their fate in the South Pacific.

Evaluation of corrected flow time in oesophageal Doppler as a predictor of fluid responsiveness

BACKGROUND

Corrected flow time (FTc) by oesophageal Doppler is considered to be a 'static' preload index. We evaluated the ability of FTc to predict fluid responsiveness and compared this with the abilities of other preload indices, such as pulse pressure variation (PPV), central venous pressure (CVP), and left ventricular end-diastolic area index (LVEDAI).

METHODS

Twenty neurosurgical patients were studied. After induction of anaesthesia, FTc, PPV, LVEDAI, CVP, and stroke volume index (SVI) were measured before and 12 min after fluid loading with 6% hydroxyethyl starch solution (7 ml kg(-1)). Responders and non-responders were defined as those patients with an SVI increase >or= 10% or < 10% after fluid loading, respectively. Pearson's correlation was used to assess correlations between changes in SVI and initial haemodynamic variables. Receiver operating characteristic (ROC) curves were constructed and compared to evaluate the overall performance of preload indices (FTc, PPV, LVEDAI, and CVP) in terms of predicting fluid responsiveness.

RESULTS

FTc and PPV before fluid loading differed between responders (n = 11) and non-responders (n = 9), and correlated with changes in SVI (r = -0.515 and r = 0.696, respectively), which was opposite to that observed for CVP or LVEDAI. Areas under ROC curves for FTc [0.944 (SD 0.058)] and PPV [0.909 (0.069)] were significantly greater than those for CVP [0.540 (0.133), P < 0.001] and LVEDAI [0.495 (0.133), P < 0.001]. The optimal threshold value given by ROC analysis was 357 ms for FTc.

CONCLUSIONS

In this study, FTc predicted fluid responsiveness. However, FTc should be used in conjunction with other clinical information.

Granulocytic sarcoma manifested as a parametrial mass mimicking a haemorrhagic abscess: a case report with CT and MR findings

Granulocytic sarcoma is a neoplasm arising from myeloid precursor cells and frequently accompanies leukaemia and myeloproliferative disorders. Granulocytic sarcoma can arise anywhere, and it frequently involves bones, perineural tissues and lymph nodes. However, granulocytic sarcoma in the female genital organs is uncommon, and it is extremely rare that it presents as an adnexal or parametrial mass. We report here the CT and MR findings in a case of granulocytic sarcoma that manifested as a uterine cervical and parametrial mass mimicking a haemorrhagic abscess in a 50-year-old woman with chronic myelogenous leukaemia.

Effects of sevoflurane on the cAMP-induced short-circuit current in mouse tracheal epithelium and recombinant Cl- (CFTR) and K+ (KCNQ1) channels

BACKGROUND

An optimal level of airway surface liquid is essential for mucociliary clearance in lungs. The cAMP-activated cystic fibrosis transmembrane conductance regulator (CFTR) and KCNQ1 channels in tracheal epithelium play key roles in luminal and basolateral membranes, respectively. The aim of this study was to examine the effects of sevoflurane on cAMP-induced chloride secretion by the mouse tracheal epithelium and the modulation of recombinant CFTR and KCNQ1 channels.

METHODS

The equivalent short-circuit current (Isc) of the mouse tracheal epithelium was measured using a flow-type Ussing chamber technique. Inhibition of Na+ absorption was achieved through the luminal application of amiloride. cAMP-dependent Cl- secretion was evoked by forskolin and isobutylmethylxanthine (Fsk/IBMX) applied to the basolateral side. The effect of sevoflurane on CFTR and KCNQ1 channels was assessed using a whole-cell patch clamp in human embryonic kidney 293T cells expressing CFTR and KCNQ1 channels.

RESULTS

Fsk/IBMX induced a sustained Isc that was suppressed by the application of sevoflurane [decreased by 49 (4.5)% at 190 microM]. The Fsk/IBMX-induced Isc was also blocked by basolateral application of chromanol 293B, a blocker of the KCNQ1 K+ channel. In KCNQ1-expressing cells, sevoflurane 190 microM reduced the outward currents to 59 (4.9)% at 80 mV. The CFTR current was not affected by sevoflurane (approximately 360 microM).

CONCLUSIONS

These results suggest that the inhibition of KCNQ1 underlies sevoflurane-induced decrease in airway secretion.

The clinical and immunogenetic characteristics of adult-onset type 1 diabetes mellitus in Korea

Although the HLA class II alleles and immunological abnormalities are associated with type 1 diabetes mellitus (T1DM) in all racial groups, there are considerable variations in the genotypes and the prevalence of autoantibodies. In order to investigate the characteristics of the immunogenetic patterns and to use these as an early diagnostic tool and guideline for a therapeutic plan, we examined the clinical characteristics and the patterns of anti-GAD antibody (GADA), IA-2 antibody (IA-2A), HLA-DR and HLA-DQ in Korean adult-onset T1DM patients. Adult-onset patients had higher serum C-peptide levels than child-onset patients. In adult-onset patients, the prevalence of GADA and IA-2A were 59.5% and 15.3% respectively, and increased frequencies of HLADR4 and-DR9 were found. The frequencies of HLADQA1,-DQB1 and-DQ heterodimers were similar to those of the control, but child-onset patients had high frequencies of the HLA-DR3,-DR4,-DR9, DQA1*0301, DQA1*0501 and DQB1*0201 genotypes. In conclusion, Korean adult-onset T1DM patients had a lower prevalence of GADA, which was comparable to that found in Caucasian patients. The detection of GADA might help to predict the insulin dependency of adult-onset diabetes. Difference in the frequencies of diabetes associated with HLA type suggests that there might be a heterogeneity in the pathogenesis of diabetes according to the age of onset.

Multicenter phase II trial of Genexol-PM, a Cremophor-free, polymeric micelle formulation of paclitaxel, in patients with metastatic breast cancer

Genexol-PM is a novel Cremophor EL-free polymeric micelle formulation of paclitaxel. This single arm, multicenter phase II study was designed to evaluate the efficacy and safety of Genexol-PM in patients with histologically confirmed metastatic breast cancer (MBC). Forty-one women received Genexol-PM by intravenous infusion at 300 mg/m2 over 3 h every 3 weeks without premedication until disease progression or intolerability. A total of 331 chemotherapy cycles were administered, with a median of 8 cycles per patient (range, 1-16). Overall response rate was 58.5% (95% CI: 43.5-72.3) with 5 complete responses and 19 partial responses. Thirty-seven patients who received Genexol-PM as a first-line therapy for their metastatic disease showed a response rate of 59.5% (95% CI: 43.5-73.7), and two responses were reported in four patients treated in the second-line setting for their metastatic disease. The median time to progression (TTP) for all patients was 9.0 months (range, 1.0-17.0+ months). Grade 3 non-hematologic toxicities included sensory peripheral neuropathy (51.2%), and myalgia (2.4%). Eight patients (19.5%) experienced hypersensitivity reactions, with grade 3 in two patients. Hematologic toxicities were grade 3 and 4 neutropenia (51.2 and 17.1%, respectively), and grade 1 and 2 thrombocytopenia (22.0%). Notably, no febrile neutropenia was observed. Genexol-PM appears a promising new paclitaxel in view of significant efficacies. Further trials with different dosing schedules, durations of delivery, or in combination with other drugs are warranted.

Glutathione S-transferase A1 polymorphisms and acute graft-vs.-host disease in HLA-matched sibling allogeneic hematopoietic stem cell transplantation

Busulfan and the metabolites of cyclophosphamide are conjugated with glutathione and catabolized by enzymes of the cytosolic glutathione S-transferases family. There are clearly linked single nucleotide polymorphisms in the promoter region of the glutathione S-transferase A1 gene (i.e., GSTA1*A, -567T, -69C and -52G; GSTA1*B, -567G, -69T and -52A). We assessed whether the clinical outcomes, including acute graft-vs.-host disease, of 61 patients with hematological malignancies, following HLA-matched sibling allogeneic stem cell transplantation using busulfan/cyclophosphamide conditioning are altered by glutathione S-transferase A1 genotypes. Globally, grade II-IV acute graft-vs.-host disease developed in 13 patients (21%). Grade II-IV acute graft-vs.-host disease developed in 15.2% of 46 patients with GSTA1*A/*A diplotype and in 40.0% of 15 patients with GSTA1*A/*B or GSTA1*B/*B diplotype (p = 0.04). Moreover, this relationship between GSTA1*A/*A diplotypes and lower incidence of acute graft-vs.-host disease was independent of the age, gender, stem cell source, and disease status. The incidences of acute skin graft-vs.-host disease were 7% (3/46) in patients with GSTA1*A/*A and 27% (4/15) in patients without GSTA1*A/*A (p = 0.009, univariate; p = 0.01, multivariate). Acute hepatic graft-vs.-host disease developed in 6 (13%) of 46 patients with the GSTA1*A/*A diplotype and in 4 (27%) of 15 patients without this diplotype (p = 0.09, univariate; p = 0.12, multivariate). Ten patients (16%) developed hepatic veno-occlusive disease. No significant difference was found in the incidence of hepatic veno-occlusive disease between patients with and without the GSTA1*A/*A diplotype (19.6% vs. 6.7%; p = 0.24). We conclude that the GSTA1*A/*A diplotype is an independent protective factor against acute graft-vs.-host disease, especially for skin graft-vs.-host disease, and probably for hepatic graft-vs.-host disease, in patients using busulfan/cyclophosphamide conditioning. The identification of glutathione S-transferase A1 genotypes prior to allogeneic stem cell transplantation could allow conditioning regimens and graft-vs.-host disease prophylaxis to be modified to improve outcome.