First Report of Stem-End Rot of Mango Caused by Phomopsis mangiferae in Taiwan

Mango (Mangifera indica L.) is grown on approximately 20,000 ha in Taiwan. It is an economically important crop and the income of many fruit farmers comes primarily from mango production. During 2006 and 2007, a stem-end rot disease was observed 1 week after harvest on 28 to 36% of stored mangoes picked from six orchards in the Pingtung, Tainan, and Kaoshiung regions. Two popular mango cultivars, Keitt and Irwin, showed greater susceptibility to this disease, while 'Haden' was found to be moderately susceptible. In storage, symptoms initially appeared as light-to-dark brown lesions surrounding peduncles. Rot symptoms advanced slowly but eventually penetrated the mesocarp, which consequently reduced the commercial value of fruits. The fungus formed abundant pycnidia (0.1 to 0.6 mm in diameter) on infected fruits in advanced stages of symptom development. Pieces of symptomatic fruits plated on acidified potato dextrose agar (PDA) and incubated at 25 ± 1°C consistently yielded the same fungus. A single conidial isolate was cultured. Pycnidia developed on PDA after continuous exposure to light for 9 to 14 days. On the basis of morphological characteristics, the fungus was identified as Phomopsis mangiferae L. (2,3). Pycnidia released two types of conidia: α-conidia (5 to 10 × 2.3 to 4.0 μm) were hyaline and oval to fusoid; and β-conidia (15.0 to 37.5 × 1.3 to 2.5 μm) were hyaline and filiform with characteristic curves. Conidiophores were hyaline, filiform, simple or branched, septate, and 15 to 75 μm long. Cultures incubated under continuous fluorescent light (185 ± 35 μE·m^-2·s^-1) at 25°C for 3 days were used as inoculum for pathogenicity tests. Five fruits from 'Keitt' were wounded with a sterilized scalpel and each wound (2 × 2 × 2 mm) was inoculated with either a 5-mm mycelium agar plug or a 0.5-ml spore suspension (10⁵ conidia per ml) of the fungus. Five wounded fruits inoculated with 5-mm PDA plugs or sterile water alone served as controls. Inoculated areas were covered with moist, sterile cotton. Fruits were enclosed in plastic bags and incubated at 24°C for 3 days. The test was performed three times. The same symptoms were observed on all inoculated fruits, whereas no decay was observed on control fruits. Reisolations from the inoculated fruits consistently yielded P. mangiferae, thus fulfilling Koch's postulates. This disease has previously been reported in Australia, Brazil, China, Cuba, India, Malaysia, and the United States (1). To our knowledge, this is the first report of P. mangiferae causing stem-end rot disease on mangoes in Taiwan. Our report necessitates taking preventive strategies in the field, prior to or after harvest, to contain postharvest losses in mangoes. References: (1) G. I. Johnson. Page 39 in: Compendium of Tropical Fruit Diseases. R. C. Ploetz et al., eds. The American Phytopathological Society. St. Paul, MN, 1994. (2) R. C. Ploetz, ed. Page 354 in: Diseases of Tropical Fruit Crops. CABI Publishing. Wallingford, UK, 2003. (3) E. Punithalingam. No. 1168 in: Descriptions of Pathogenic Fungi and Bacteria. CMI, Kew, Surrey, UK, 1993.

Clinical significance of type 1 insulin-like growth factor receptor and insulin-like growth factor binding protein-3 expression in squamous cell carcinoma of head and neck

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Background: Type 1 insulin-like growth factor receptor (IGF-1R) plays an important role in the growth and apoptosis of cancer cell. The activities of IGF-1R are modulated by a family of high-affinity insulin-like growth factor binding proteins (IGFBPs), of which IGFBP-3 is the major serum carrier protein. The expression and significance of IGF-1R and IGFBP-3 in squamous cell carcinoma of the head and neck (SCCHN) is unknown. Methods: This study explored immunohistochemical expression of IGF-1R and IGFBP-3 in tumor samples from 131 patients with surgically resected SCCHN. Results: The positive expression of IGF-1R and IGFBP-3 was observed in 96 (73.3%) and 117 (89.3%) patients. There were no significant differences in baseline characteristics between the positive and negative expressed groups of IGF-1R and IGFBP-3. With the median follow up of 53.5 months, 3 year progression free (PFS) and overall (OS) survival rate was 64.0% and 72.9%, neither IGF-1R nor IGFBP-3 expression had prognostic values in the whole cohort. Thirty-seven (67.3%) of 55 stage IV patients demonstrated IGF-1R positivity. The subgroup analysis of in stage IV patients showed the poor PFS ( = 0.029) and OS (pp = 0.025) in IGF-1R positive groups. In a multivariate analysis using IGF-1R expression and other clinicopathological parameters, the IGF-1R expression was remained as an independent factor for PFS (p = 0.037, HR = 2.816, 95% C.I. 1.065 - 7.446) and OS (p = 0.034, HR = 3.169, 95% C.I. 1.089 - 9.225). Conclusions: Our work exhibited that IGF-1R expression is frequent in SCCHN patients and related with poor survival in advanced stage, this could support the attempts using the IGF-1R inhibitor for treatment of SCCHN.

No significant financial relationships to disclose.

Clinical usefulness of PET/CT in initial staging and response evaluation of primary gastric lymphoma

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Background: Positron emission tomography (PET)/computed tomography (CT) scan has a well-established role in the management of non-Hodgkin's lymphoma (NHL). However, in case of the primary gastric lymphoma, which is the most frequent extranodal NHL, the role of PET/CT scan is still controversial. Methods: We retrospectively analyzed 42 patients with primary gastric lymphoma who underwent PET/CT scans; 32 patients with diffuse large B-cell lymphoma (DLBCL) and 10 patients with extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) were analyzed. The PET/CT scans were compared with clinicopathologic features and the results of CT and endoscopy. After corresponding treatment, response was evaluated by conventional CT scans or PET/CT scans and endoscopy with biopsy Results: Nine patients were up-staged based on the results of their PET/CT scan compared to CT (7 DLBCL, 2 MALT lymphomas) while six patients were down-staged by the PET/CT scan. The high SUVmax group, defined as SUVmax ≥ median value, was significantly associated with an advanced Lugano stage (P < 0.001). Three patients with DLBCL, who showed an initially high SUVmax, died of disease progression. Although not statistically significant, there was a tendency of inferior outcome in the group with high SUVmax. Among 24 patients for whom follow-up PET/CT scan with endoscopy was performed, 11 patients with ulcerative or mucosal lesions showed residual FDG uptake. All of these gastric lesions were grossly and pathologically benign lesions without evidence of lymphoma cells. Conclusions: PET/CT scan can help staging patients with primary gastric lymphoma, and the maximum SUV has possibility to have prognostic value. However, the residual FDG uptake observed during follow-up should be interpreted cautiously in association with the results of endoscopy and multiple gastric biopsies.

No significant financial relationships to disclose.

Histological hepatic changes in patients undergoing liver resection for colorectal metastasis: A retrospective cohort study

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Background: Patients with colorectal cancer (CRC) with liver metastases (LM) have a poor prognosis and the only potential cure is surgical resection. Neoadjuvant chemotherapy (NC) in this setting can increase the success of resection and can potentially improve survival. However, chemotherapy can be associated with hepatic toxicity which may influence postoperative morbidity. Methods: Consecutive patients who underwent hepatectomy for CRC with LM from 1999–2005 at a single institution (OCC) were retrospectively reviewed. Data on baseline characteristics, chemotherapy regimens, operative outcomes and pathology were collected. Results: 107 patients underwent hepatectomy for CRC LM. Median age was 62 years (range 24–84). 53 (53%) patients had positive lymph nodes (primary tumor) and 51 (48%) had with synchronous LM. 46 (43%) patients had a solitary LM and 90 (84%) underwent major resection (>4 segments). 63 (59%) patients received NC. 96% received a 5FU-based regimen. The majority of patients (55%) received 6–12 cycles of NC. The median time between NC and surgery was 6.5 weeks. Patients receiving NC before surgery were younger (mean 59.5 versus 65.5 years, p=0.0056). NC was more often administered in patients with positive primary lymph node status (72%,versus 40%, p=0.0014) and with multiple (versus solitary) LM (75% versus 37%, p=0.0001). Patients more often received NC with synchronous (versus metachronous) LM (90% versus 30%, p<0.0001). Operative and postoperative courses were not significantly different in patients with NC, including hemodynamic instability, postoperative complications, transfusion requirements (red blood cell and platelets) and mortality. Pathological analysis of the resected liver segments reviewed mild (<30%) steatosis in 58% of patients. Most specimens did not reveal lobular inflammation (56%) or ballooning (87%). Sinusoidal injury was most often graded as 1 (33%). There were no significant increased rates of liver toxicity in patients with NC. Conclusions: This study demonstrates that neoadjuvant chemotherapy, although associated with increased steatosis is not associated with increased perioperative morbidity and mortality with liver resection.

No significant financial relationships to disclose.

A phase III trial of topotecan and whole brain radiation therapy for patients with CNS-metastases due to lung cancer

Brain metastases represent an important cause of morbidity in patients with lung cancer and are associated with a mean survival of less than 6 months. Thus, new regimens improving the outcome of these patients are urgently needed. On the basis of promising data raised in a phase I/II trial, we initiated an open, randomised, prospective, multicentric phase III trial, comparing whole brain radiation therapy (WBRT; 20 × 2 Gy) alone with WBRT+topotecan (RCT; 0.4 mg m⁻² day⁻¹ × 20). A total of 320 patients with CNS-metastases due to SCLC or NSCLC were projected. The primary end point was overall survival, whereas second end points were local response and progression-free survival. However, until the cutoff date of study completion (i.e., a study duration of 34 months), only a total of 96 (RCT:47, WBRT:49) patients had been recruited, and so an analysis was performed at that time point. Although the numbers of grade 3/4 non-haematological toxicities (besides alopecia 115 (RCT/WBRT: 55 out of 60) were evenly distributed, the 25 haematological events occurred mainly in the combined treatment arm (24 out of 1). Local response, evaluated 2 weeks after treatment, was assessable in 44 (RCT/WBRT: 23 out of 21) patients, showing CR in eight (3 out of 5), PR in 17 (11 out of 6), SD in 14 (8 out of 6) and PD in five (1 out of 4) patients (all differences n.s.). Neither OAS (RCT/WBRT: median (days)): 87 out of 95, range 3–752/4–433; HR 1.32; 95% CI (0.83; 2.10)) nor PFS (median (days)): 71 out of 66, range, 3–399/4–228; HR 1.28, 95% CI (0.73; 2.43) differed significantly. On the basis of these results and the slow recruitment, a continuation of the study did not seem reasonable. The available data show no significant advantage for concurrent radiochemotherapy for patients with lung cancer; however, the recruited number of patients is too low to exhibit a small advantage of combined treatment.

First Report of Downy Mildew Caused by Pseudoperonospora cubensis on Chayote (Sechium edule) in Taiwan

Chayote (Sechium edule) is cultivated on more than 500 ha in Taiwan for its edible shoots and fruit. In August 2005 and later, 40 to 75% of the chayote plants cultivated in the Taichung District Agricultural Improvement Station in Puli developed pale yellow, irregular spots on the upper leaf surfaces with corresponding sporulation on the lower leaf surfaces. The lesions eventually became necrotic and spread over the entire leaf surface, leading to defoliation. Pseudoperonospora cubensis, which was previously reported as the cause of downy mildew on squash (Cucurbita moschata), muskmelon (Cucumis melo), cucumber (Cucumis sativus), and sponge gourd (Luffa cylindrica) in Taiwan, was identified (1). Sporangiophores were 182 to 410 μm long, 4.8 to 7.2 μm wide, and dichotomously branched. Sporangia were grayish, ovoid to ellipsoidal, 18.2 to 38.6 μm long, and 13.5 to 25.2 μm wide. Biflagellate zoospores were 9.5 to 12.6 μm in diameter. Pathogenicity tests were conducted four times with six 2-week-old plants in each trial. A sporangial suspension (1 × 105 spores per ml) prepared from infected leaves (5 to 6 weeks after infection) was sprayed on all leaves until runoff. The plants were then covered with polythene bags and incubated for 48 h at 18 ± 1°C in a growth chamber. Control plants were sprayed with sterile water. Characteristic symptoms developed on all inoculated plants after 20 days, while control plants remained symptomless. Microscopic observation of leaf tissues of symptomatic plants confirmed the presence of P. cubensis. To our knowledge, this is the first report of P. cubensis causing downy mildew on chayote in Taiwan.

References: (1) S. T. Hsu et al. List of Plant Diseases in Taiwan. The Phytopathological Society of the Republic of China, 2002.

Advancing the understanding of the embryo transcriptome co-regulation using meta-, functional, and gene network analysis tools

Embryo development is a complex process orchestrated by hundreds of genes and influenced by multiple environmental factors. We demonstrate the application of simple and effective meta-study and gene network analyses strategies to characterize the co-regulation of the embryo transcriptome in a systems biology framework. A meta-analysis of nine microarray experiments aimed at characterizing the effect of agents potentially harmful to mouse embryos improved the ability to accurately characterize gene co-expression patterns compared with traditional within-study approaches. Simple overlap of significant gene lists may result in under-identification of genes differentially expressed. Sample-level meta-analysis techniques are recommended when common treatment levels or samples are present in more than one study. Otherwise, study-level meta-analysis of standardized estimates provided information on the significance and direction of the differential expression. Cell communication pathways were highly represented among the genes differentially expressed across studies. Mixture and dependence Bayesian network approaches were able to reconstruct embryo-specific interactions among genes in the adherens junction, axon guidance, and actin cytoskeleton pathways. Gene networks inferred by both approaches were mostly consistent with minor differences due to the complementary nature of the methodologies. The top-down approach used to characterize gene networks can offer insights into the mechanisms by which the conditions studied influence gene expression. Our work illustrates that further examination of gene expression information from microarray studies including meta- and gene network analyses can help characterize transcript co-regulation and identify biomarkers for the reproductive and embryonic processes under a wide range of conditions.

First Report of Fruit Rot of Strawberry Caused by an Alternaria sp. in Taiwan

In March 2005, a fruit rot disease was found in several commercial strawberry (Fragaria × ananassa Duchesne) fields at Fongyuan, 24.25°N, 120.72°E, in Taichung County in central Taiwan. The disease was rare and was negligible in most cultivated areas. However, disease incidence has increased by 4 to 5% over the last 2 years and causes significant postharvest losses. In storage, symptoms on berries include light brown-to-black, sunken, irregularly shaped lesions. The lesions gradually enlarge and become firm with a dark green-to-black, velvety surface composed of mycelia, conidiophores, and conidia. Twelve single conidial isolates (AF-1 to AF-12) of a fungus were isolated by placing portions of symptomatic fruit from four locations onto acidified potato dextrose agar (PDA) and incubating at 24 ± 1°C. One isolate from each of the four locations, AF-2, 6, 9, and 12, was selected for identification and pathogenicity studies. The fungus was identified as an Alternaria sp. according to the morphological descriptions of A. tenuissima (2,3). Conidiophores were simple or branched, straight or flexuous, septate, pale to light brown, 3.0 to 5.0 μm in diameter, and bore two to six conidia in a chain. Conidia were dark brown, obclavate or oval, and multicellular with seven transverse (in most cases) and numerous longitudinal septa. Conidia were 15.5 to 56.5 μm (average 35.0 μm) long × 6.0 to 15.0 μm (average 11.0 μm) wide at the broadest point. The pathogen was consistently isolated from berries in the field or in storage. Pathogenicity tests were conducted by inoculating 12 surface-sterilized berries with each of the four isolates. Approximately 300 μl of a spore suspension (2 × 10⁵ conidia per ml) was placed at two points on the uninjured surface of each fruit and allowed to dry for 5 min. Control fruits were treated with sterile water. The berries were then enclosed in a plastic bag and incubated at 24 ± 1°C for 2 days. Disease symptoms similar to those described above were observed on 95% of inoculated berries 3 days after inoculation, while no symptoms developed in control berries. Reisolation from the inoculated berries consistently yielded the Alternaria sp. described above. Pathogenicity tests were performed three times. Previously, strawberry fruit rot caused by A. tenuissima was reported from Florida (2) and Malaysia (1), however, to our knowledge, this is the first report of fruit rot of strawberry caused by a species of Alternaria in Taiwan. References: (1) W. D. Cho et al. List of Plant Diseases in Korea. Korean Society of Plant Pathology, 2004. (2) C. M. Howard and E. E. Albregts. Phytopathology 63:938, 1973. (3) R. D. Milholland. Phytopathology 63:1395, 1973.

First Report of Gummosis Disease of Plum (Prunus salicina) Caused by a Botryosphaeria sp. in Taiwan

Plum (Prunus salicina Lindell) is grown on more than 3,870 ha in Taiwan. In 2004, a gummosis disease was observed on plum in the Ming Jian Region of Nantou County (120.675°E, 23.919°N), with 15% of the trees affected. Infections started on the current year's growth, primarily through lenticels, and formed small, sunken, discolored lesions. At later stages, white gum exuded from the lesions. Circular to oval, brown, necrotic areas were seen on the inner bark. Severely infected twigs showed defoliation and dieback. During the winter months, numerous black pycnidia or perithecia formed on infected twigs. Single conidial isolates of the pathogen were obtained from diseased twigs on acidified potato dextrose agar (PDA) and incubated at 25 ± 1°C for 3 days. On the basis of morphological traits, the fungus was identified as a Botryosphaeria sp. according to the CMI descriptions of Botryosphaeria ribis (3). Conidia (14.2 to 26.8 × 4.3 to 7.2 μm) were single celled, hyaline, and spindle shaped. Asci (105 to 135 × 12.5 to 15.5 μm) were hyaline, clavate, and bitunicate. Ascospores (18 to 22 × 7.0 to 8.2 μm) were hyaline and spindle shaped or fusoid. For pathogenicity tests, inoculum was prepared by culturing the fungus on PDA under continuous fluorescent light (128 ± 25 μE·m^-2·s^-1) at 25°C for 3 days. Two twigs on each of six trees were inoculated. Sharp incisions (3 × 3 × 3 mm) were made on healthy twigs (12 to 15 months old) with a sterilized scalpel and inoculated with either a 5-mm mycelial disc or 0.5 ml of a conidial suspension (10⁵ conidia/ml) of the fungus. Inoculated areas were covered with moist, sterile cotton and the entire twigs were enclosed in plastic bags. Twigs inoculated with 5-mm PDA discs or sterile water alone served as controls. The symptoms described above were observed on all inoculated twigs 14 days after inoculation, whereas control twigs did not develop any disease symptoms. Reisolation from the inoculated twigs consistently yielded the Botryosphaeria sp., thus fulfilling Koch's postulates. Botryosphaeria spp. have been reported to cause stem blight of many plants in temperate and tropical regions of the world (4). In Taiwan, B. dothidea has been reported as the causal agent of gummosis disease of peach (1) and fruit ring rot of pear (2); however, to our knowledge, this is the first report of a Botryosphaeria sp. causing gummosis of plum. References: (1). Y. Ko et al. Plant Pathol. Bull. 1:70, 1992. (2) Y. Ko et al. Plant Prot. Bull. (Taiwan) 35:211, 1993. (3) E. Punithalingam and P. Holliday. No. 395 in: Descriptions of Pathogenic Fungi and Bacteria. CMI, Kew, Surrey, UK, 1973. (4) W. A. Sinclair et al. Diseases of Trees and Shrubs. Cornell University Press, Ithaca, NY, 1987.

First Report of Gray Leaf Spot of Mango (Mangifera indica) Caused by Pestalotiopsis mangiferae in Taiwan

Mango (Mangifera indica L.; family Anacardiaceae) is one of the world's most important fruit crops and is widely grown in tropical and subtropical regions. Since 2001, a leaf spot disease was found in mango orchards of Taiwan. Now, the disease was observed throughout (approximately 21,000 ha) Taiwan in moderate to severe form, thus affecting the general health of mango trees and orchards. Initial symptoms were small, yellow-to-brown spots on leaves. Later, the irregularly shaped spots, ranging from a few millimeters to a few centimeters in diameter, turned white to gray and coalesced to form larger gray patches. Lesions had slightly raised dark margins. On mature lesions, numerous black acervuli, measuring 290 to 328 μm in diameter, developed on the gray necrotic areas. Single conidial isolates of the fungus were identified morphologically as Pestalotiopsis mangiferae (Henn.) Steyaert (2,3) and were consistently isolated from the diseased mango leaves on acidified (0.06% lactic acid) potato dextrose agar (PDA) medium incubated at 25 ± 1°C. Initially, the fungus grew (3 mm per day) on PDA as a white, chalky colony that subsequently turned gray after 2 weeks. Acervuli developed in culture after continuous exposure to light for 9 to 12 days at 20 to 30°C. Abundant conidia oozed from the acervulus as a creamy mass. The conidia (17.6 to 25.4 μm long and 4.8 to 7.1 μm wide) were fusiform and usually straight to slightly curved with four septa. Three median cells were olivaceous and larger than the hyaline apical and basal cells. The apical cells bore three (rarely four) cylindrical appendages. Pathogenicity tests were conducted with either 3-day-old mycelial discs or conidial suspension (10⁵ conidia per ml) obtained from 8- to 10-day-old cultures. Four leaves on each of 10 trees were inoculated. Before inoculation, the leaves were washed with a mild detergent, rinsed with tap water, and then surface sterilized with 70% ethanol. Leaves were wounded with a needle and exposed to either a 5-mm mycelial disc or 0.2 ml of the spore suspension. The inoculated areas were wrapped with cotton pads saturated with sterile water and the leaves were covered with polyethylene bags for 3 days to maintain high relative humidity. Wounded leaves inoculated with PDA discs alone served as controls. The symptoms described above were observed on all inoculated leaves, whereas uninoculated leaves remained completely free from symptoms. Reisolation from the inoculated leaves consistently yielded P. mangiferae, thus fulfilling Koch's postulates. Gray leaf spot is a common disease of mangos in the tropics and is widely distributed in Africa and Asia (1-3); however, to our knowledge, this is the first report of gray leaf spot disease affecting mango in Taiwan. References: (1) T. K. Lim and K. C. Khoo. Diseases and Disorders of Mango in Malaysia. Tropical Press. Malaysia, 1985. (2) J. E. M. Mordue. No. 676 in: CMI Descriptions of Pathogenic Fungi and Bacteria. Surrey, England, 1980. (3) R. C. Ploetz et al. Compendium of Tropical Fruit Diseases. The American Phytopathological Society. St. Paul, MN, 1994.

Capecitabine plus oxaliplatin (CapOx) versus capecitabine plus gemcitabine (CapGem) versus gemcitabine plus oxaliplatin (mGemOx): final results of a multicenter randomized phase II trial in advanced pancreatic cancer

BACKGROUND

To compare the efficacy and safety of three different chemotherapy doublets in the treatment of advanced pancreatic cancer (PC).

PATIENTS AND METHODS

At total of 190 patients were randomly assigned to receive capecitabine 1000 mg/m(2) twice daily on days 1-14 plus oxaliplatin 130 mg/m(2) on day 1 (CapOx), capecitabine 825 mg/m(2) twice daily on days 1-14 plus gemcitabine 1000 mg/m(2) on days 1 and 8 (CapGem) or gemcitabine 1000 mg/m(2) on days 1 and 8 plus oxaliplatin 130 mg/m(2) on day 8 (mGemOx). Treatment cycles were repeated every three weeks. The primary end point was progression-free survival (PFS) rate at 3 months; secondary end points included objective response rate, carbohydrate antigen 19-9 response, clinical benefit response, overall survival and toxicity.

RESULTS

The PFS rate after 3 months was 51% in the CapOx arm, 64% in the CapGem arm and 60% in the mGemOx arm. Median PFS was estimated with 4.2 months, 5.7 months and 3.9 months, respectively (P = 0.67). Corresponding median survival times were: 8.1 months (CapOx), 9.0 months (CapGem) and 6.9 months (mGemOx) (P = 0.56). Grade 3/4 hematological toxicities were more frequent in the two Gem-containing arms; grade 3/4 non-hematological toxicity rates did not exceed 15% in any arm.

CONCLUSION

CapOx, CapGem and mGemOx have similar clinical efficacy in advanced PC. Each regimen has a distinct but manageable tolerability profile.

First Report of Gray Mold Disease of Sponge Gourd (Luffa cylindrica) Caused by Botrytis cinerea in Taiwan

A disease of sponge gourd (Luffa cylindrica (L.) Roem., family Cucurbitaceae) has become a serious threat to sponge gourd production since 2003 in central Taiwan. Initially, symptoms appear as small, brown spots on the flower petals that spread to the entire flower and cause blossom blight within 2 to 3 days. Subsequently, the pathogen develops abundant mycelium and moves from the petals onto the fruits causing blossom end rot and fruit stem rot. Severely infected fruits become completely rotten and desiccate. Tissues were excised from diseased sponge gourd fruits (sampled from Fongyuan, located at 24.25°N, 120.72°E in Taichung County), immersed in a solution containing 3% sodium hypochlorite and 70% ethanol for 1 min, washed three times with sterile water, and then cultured on potato dextrose agar (PDA) medium. A fungus, identified as Botrytis cinerea, produced abundant mycelium on PDA medium when incubated under constant fluorescent light 185 ± 35 μE·m^-2·s^-1 at 24°C. The conidia were smooth, hyaline, and globoid or slightly ellipsoid. The conidia measured 9.5 to 19.3 μm (average 13.8 μm) long and 6.0 to 17.8 μm (average 10.1 μm) wide, dimensions that are similar to the descriptions of B. cinerea (11 × 11 to 15 μm) that causes gray mold of strawberry (2). The identity of B. cinerea was also confirmed by the production of numerous black sclerotia on PDA plates incubated either in the dark or under light at 20 to 24°C for 9 to 10 days. Koch's postulates were fulfilled by using 3-day-old mycelial agar discs of the fungus or a spore suspension containing 10⁵ conidia per milliliter of distilled water as inoculum. Shallow (2 × 2 × 2 mm) incisions were made on fresh sponge gourd fruits with a sterile scalpel and inoculated with either a 5-mm mycelial disc or 0.5 ml of the spore suspension. Inoculated areas were covered with moist sterile cotton, and the fruits were enclosed in a plastic bag and incubated at 20 to 24°C for 3 days. Wounded fruits inoculated with PDA discs or sterile distilled water alone served as controls. Pathogenicity tests were performed three times using five fruits in each trial. Symptoms and signs of the disease similar to those described above were observed in all (100%) the inoculated fruits, while no symptoms developed in the control fruits. Reisolation from the inoculated fruits consistently yielded B. cinerea. Reciprocal inoculations on sponge gourd, guava, and strawberry with mycelial discs or spore suspensions of a B. cinerea isolate obtained from sponge gourd, guava, and strawberry showed cross pathogenicity among isolates and hosts. Important groups of plants that are attacked by B. cinerea are vegetables, small berry fruits, ornamentals, and bulbs (1). Though 80 species of host plants, mostly shrubs and nursery plants, were reported to be the host of B. cinerea in Taiwan (3), to our knowledge, this is the first report of gray mold disease affecting sponge gourd in Taiwan. References: (1) G. N. Agrios. Plant Pathology. Academic Press. San Diego, 2005. (2) J. L. Mass, ed. Page 56 in: Compendium of Strawberry Diseases. The American Phytopathological Society. St. Paul, MN, 1984. (3). Y. Ko et al. Plant Prot. Bull. (Taiwan) 37:439, 1995.

Overexpression of VEGF-C and -D may predict unfavorable outcome in resected non-small cell lung cancer

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Background: Correlation of Vascular endothelial growth factor (VEGF)-C, VEGF-D and/or VEGF receptor 3 (VEGFR-3) with lymphatic spread, tissue invasion and poor clinical outcomes has been observed in various cancers. Nodal metastasis is known to one of poor prognostic factors in non-small cell lung cancer (NSCLC). We investigated the correlation of VEGF-C,-VEGF-D and VEGFR-3 with clinicopathologic parameters and patient survival in NSCLC. Methods: Using immunohistochemial staining, we analyzed the protein expressions of VEGF-C, VEGFD and VEGFR-3 on the tissue array specimens from 180 patients with completely resected NSCLC. A 0 to +1 immunohistochemical staining (IHCS) of the cancer cell was defined as negative, +2 to +3 IHCS was as positive. Results: The expressions of VEGF-C, VEGF-D and VEGFR-3 were observed in 28.9%, 32.8% and 30.6% of cases, respectively. In the Cox regression-based multivariate analysis, it was proved that VEGF-C and D proved to be an independent prognostic factors as well as known prognostic factors, such as tumor size and lymph node metastases (VEGF-C, p=0.001; VEGF-D, p=0.014). VEGF-C expression showed statistically significant correlation with the expression of VEGFR-3 (p=0.02). Conclusion: To be taken, the present study revealed that VEGF-C and D expression may predict poor prognosis in resected NSCLC patients. Therefore, these results seems to be worth developing promising targeting inhibitors on lymphangiogenesis which plays major role in locoregional recurrence for surgically NSCLC patinets.

No significant financial relationships to disclose.

A phase III trial of topotecan and whole brain radiation (WBRT) therapy for patients with CNS metastases due to lung cancer

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Background: Brain metastases represent an important cause of morbidity in patients (pts) with lung cancer and are associated with a mean survival of less than 6 months. Thus studies to improve outcome are urgently needed. Methods: Based on promising data raised in a phase I/II trial, in which WBRT was combined with topotecan (ASCO #444, 2003), we initiated an open, randomized, prospective, multicentric phase III trial, comparing WBRT (20 x 2 Gy; arm A) alone with WBRT + topotecan (0.4 mg/m2/d x 20; arm B). 320 pts with CNS-metastases due to SCLC or NSCLC were projected. Primary endpoint was overall survival (OS), secondary endpoints were local response and progression-free survival (PFS). However, since until the cut off date of study completion (i.e. a study duration of 34 months) only a total of 96 (A: 49, B: 47) pts have been recruited, an interim analysis was performed at that time point. Results: The demographic data (ø age 59 (34–75), 64% male, 66% NSCLC, mainly (64%) ECOG 0–1, extracerebral metastases in 75% and more than 4 cerebral lesions in 26% of pts) were evenly distributed in the two groups. Also the rate of grade 3/4 toxicities (besides alopecia 115 non-hematological (A/B: 60/55) and 43 hematological events (18/25)) did not differ remarkably between the arms. Early deaths (within 6 weeks after recruitment) occurred in 24% of the patients (A/B: 30%/18%), mainly due to tumor progression. Local response, evaluated 2 weeks after treatment, was assessable in 44 (A/B: 21/23) pts, showing CR in 8 (5/3), PR in 17 (6/11), SD in 14 (6/8) and PD in 5 (4/1) pts (all differences n.s.). Neither PFS (median A/B; days: 76/97, range, 24–251/20–428) nor OS (median A/B; days: 95/87, range 4–433/3–752) differed significantly (Cox-Mantel test; p=0.82 and 0.43, respectively). Conclusions: The available data, gained from the only phase III trial regarding concurrent WBRT and topotecan, show no significant advantage for concurrent radiochemotherapy for patients with lung cancer, however due to the limited number of recruited patients a possible small advantage of a combined treatment could not be demonstrated. Based on these results and the slow recruitment a continuation of the study did not seem reasonable.

No significant financial relationships to disclose.

Preliminary results of a phase II study of continuous low dose metronomic (LDM) cyclophosphamide (CTX) and celecoxib (CEL) for asymptomatic hormone refractory prostate cancer (HRPC) with assessment of anti-angiogenic biomarkers

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Background: LDM CTX is a minimally toxic anti-angiogenic therapy that has demonstrated activity in multiple tumour types including HRPC. Increased Cyclooxygenase 2 (COX 2, a prostaglandin synthase enzyme) expression appears to be a consistent feature of a variety of human tumours, including prostate cancer. COX 2 inhibitors like CEL exhibit anti-tumour activity in pre-clinical studies, at least in part due to their anti-angiogenic activity. Pre-clinical work supports the concept that the combination of selective angiogenesis inhibitors like CEL with metronomic chemotherapy can enhance the effects of these agents on tumour angiogenesis. Methods: Men with asymptomatic HRPC at a single Canadian centre received celecoxib 400 mg po BID and cyclophosphamide 50 mg po daily. The primary efficacy endpoint of this 2 stage phase II study is disease control rate (DCR): 50% PSA response, tumour response or prolonged (=6 mos) PSA or stable measurable disease. This study is also assessing the safety of LDM CTX and CEL as well as potential anti-angiogenic biomarkers in these patients including circulating endothelial cells and their precursors (CEC/P), plasma levels of thrombospondin-1 (TSP-1) and vascular endothelial growth factor (VEGF). Results: Enrollment for the first stage of this study (10 men) has been completed. There were 2 patients with disease control by the a priori criteria: one patient with a partial tumour response (PR) (PR duration 13 mos with PSA stabilization for 12 mos) and one patient that had both prolonged stable PSA (7 mos) and prolonged stable measurable disease (8 mos). In addition, another patient had an unconfirmed PR. The therapy was well tolerated. One patient had angina that responded well to medical therapy but there were no serious arterial-thromboembolic events. One patient developed grade 3 hypertension. All other toxicities were grade 1/2. Data on CEC/P, TSP-1 and VEGF levels will be presented at the meeting. Conclusions: LDM CTX + CEL is a well tolerated therapy in men with asymptomatic HRPC. 2/10 patients achieved disease control in the first stage of the trial, meeting the criteria to proceed to the second stage.

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Clinical implication of distinction from clinical features and treatment outcome of malignant lymphoma in Korean childhood and young adult

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Background: The Clinicopathologic features of malignant lymphomas vary to geography and differ to age. The goal of this study was to find the implication of distinction from biology, clinical features and treatment outcome of malignant lymphoma in childhood and young adult. Methods: We analysed the clinical features including age, gender, histologic type, and treatment outcome of 294 children and young adults during 13-year period (from May 1993 to November 2005) in Samsung medical center and compared our study to all age group and western childhood and adolescence group on clinical features or treatment outcome in malignant lymphoma. Results: Median age at diagnosis was 20.7 years (range: 0.1–30.1 years). Male to female ratio was 1.37:1, Of 294 cases, there were 248 cases of non-hodgkin’s lymphoma (NHL) (84.3%) and 44 cases of hodgkin’s disease (HD) (15%). This rate was significantly different to rate of all age group (HD= 5.3%) (p=0.001). Of 248 cases of non-hodgkin’s lymphoma, 134 cases (54.0%) were B-lineage and 113 cases (45.6%) were T- or NK-cell lineage. Our study group had higher rates of T- or NK-cell NHL compared to all age group (p=0.001) and western group (p=0.001). Among 248 cases of NHL, the most common histologic type was diffuse large cell lymphoma (DLBL) in our study group. Burkitt’s lymphoma (BL) was the most common histologic types in Western study group. 5-year survival rate (5YSR) was 80.4% and was superior for BL and was inferior for NK/T cell lymphoma. However male T-LBL patients had better outcome in western study group. NHL and T-cell NHL had significantly worse outcomes than HD and B-cell NHL (p=0.049, 0.001, respectively). Comparing age-groups 0–10, 10–20 and 20–30, 5YSR was inferior for the oldest patients only in NHL-, T-cell NHL- and T-cell LBL-groups. Conclusions: Our study suggested environmental and genetic factor was associated with the development of malignant lymphoma.

No significant financial relationships to disclose.