Use of percent positive biopsy cores to predict prostate cancer–specific death in patients treated with dose-escalated radiotherapy

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Background: The percent of positive biopsy cores (PPC)-considered a surrogate of local disease burden-has been shown to predict biochemical failure (BF) after external beam radiation therapy (EBRT), but most series have used conventional dose RT. Dose-escalated RT has been demonstrated to improve prostate cancer outcomes, but the value of PPC is unclear in the setting of RT doses high enough to decrease local failure.

Methods: A retrospective evaluation was performed of 651 patients treated to ≥75 Gy with biopsy core information available. Patients were stratified for PPC by quartile, and differences by quartile in BF, freedom from metastasis (FFM), cause specific survival (CSS), and overall survival (OS) were assessed using the log-rank test. Receiver operated characteristic (ROC) curve analysis was utilized to determine an optimal cut-point for PPC. Cox proportional hazards multivariate regression was utilized to assess the impact of PPC on clinical outcome when adjusting for risk group.

Results: With median follow-up of 62 months the median number of cores sampled was 7 (IQR: 6–12) with median PPC in 38% (IQR: 17%-67%). On log-rank test, BF, FFM, and CSS were all associated with PPC (p < 0.005 for all), with worse outcomes only for the highest PPC quartile (>67%). There was no observed difference in OS based upon PPC. ROC curve analysis confirmed a cut-point of 67% as most closely associated with CSS (p<0.001, AUC=0.71). On multivariate analysis after adjusting for NCCN risk group and ADT use, PPC>67% increased the risk for BF (p<0.0001, HR:2.1 [1.4–3.0]), FFM (p<0.05, HR:1.7 [1.1 to 2.9]), and CSS (p<0.06 (HR:2.1 [1.0–4.6]). When analyzed as a continuous variable controlling for risk group and ADT use, increasing PPC increased the risk for BF (p < 0.002), metastasis (p < 0.05), and CSS (p < 0.02), with a 1–2% increase in relative risk of recurrence for each 1% increase in the PPC.

Conclusions: For patients treated with dose-escalated RT, the PPC adds prognostic value but at a higher cut-point then previously utilized. Patients with PPC >67% remain at increased risk for failure even with dose-escalated EBRT and may receive benefit from further intensification of therapy.

No significant financial relationships to disclose.

UTE-T2∗ mapping of human articular cartilage in vivo: a repeatability assessment

INTRODUCTION

Ultrashort echo-time enhanced T2∗ (UTE-T2∗) mapping of articular cartilage is a novel quantitative MRI technique with the potential to visualize deep cartilage characteristics better than standard T2 mapping. The feasibility and intersession repeatability of UTE-T2∗ mapping of cartilage in vivo has not previously been evaluated.

METHODS

Eleven asymptomatic subjects underwent repeat UTE-T2∗ imaging on a whole-body 3T MRI scanner on three consecutive days. Full-thickness, superficial and deep regions of interest (ROIs) were evaluated in the central weight-bearing zones of the medial femoral condyle (cMFC) and tibial plateau (cMTP). Intersession precision error across subjects was evaluated by the root-mean-square average coefficients of variation (RMSA-CV) and by the median of intra-subject standard deviations (SDs) of UTE-T2∗ values in each ROI.

RESULTS

UTE-T2∗ values in vivo were found to be repeatable with relative (RMSA-CV) intersession precision errors of 8%, 6%, 16% for full-thickness, superficial and deep cMFC ROIs, corresponding to absolute errors (SD) of 1.2, 1.5, 1.5 ms, respectively. In cMTP tissue, UTE-T2∗ relative repeatability was 8%, 8%, 13%, corresponding to absolute repeatability of 1.0, 1.5, 2.1 ms (full-thickness, superficial, deep). UTE-T2∗ values were higher in superficial cartilage compared to deep in both cMFC (P≪0.001) and cMTP (P=0.0004) regions.

CONCLUSION

In vivo 3D UTE-T2∗ mapping at 3T is feasible and can be implemented using a standard clinical MRI scanner and knee coil. Intersession precision error of UTE-T2∗ values in full-thickness ROIs in the weight-bearing regions of asymptomatic subjects is under 1.2 ms or 8% (RMSA-CV). Significant zonal and regional variations of UTE-T2∗ were seen.

Abstract P1-13-05: The Effect of Treatment with Denosumab or Zoledronic Acid on Health-Related Quality of Life in Patients with Metastatic Breast Cancer

Background: Patients with breast cancer and bone metastases often experience skeletal-related events (SREs) and pain, which may impact health-related quality of life (HRQoL). Denosumab is a fully human monoclonal antibody against RANKL shown to be superior in delaying/preventing SREs and more effective in delaying moderate or severe pain in patients with advanced breast cancer compared with zoledronic acid (ZA). Previously reported results from this study population showed that both denosumab and ZA patients showed improvement or maintenance in HRQoL relative to baseline (BL), and a greater proportion of denosumab-treated patients had a clinically meaningful improvement in HRQoL. We now describe the effect of denosumab and ZA treatment on HRQoL among patients with varying degrees of pain at BL.

Methods: Enrolled patients received subcutaneous (SC) denosumab 120 mg or intravenous (IV) ZA 4 mg every 4 weeks in a double-blind, double-dummy fashion. Pain was evaluated using the Brief Pain Inventory — Short Form (BPI). Patients were divided into 2 subgroups based on the level of pain reported at BL: no/mild pain or moderate/severe pain. Patients completed the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire at BL, day 8, and before each monthly visit to assess overall HRQoL. Higher scores (range 0 to 108) represent better HRQoL. Improvement, maintenance, and worsening of HRQoL were assessed through month 18, when 30% of patients had dropped out due to death, disease progression, or withdrawal of consent. A change of ≥5 points (increase or decrease) in the FACT-G total score was considered a meaningful improvement.

Results: Among patients who reported no/mild pain at baseline, more denosumab-treated patients had a ≥5-point increase in their FACT-G score from month 4 onwards. Over the 18 month period, an average of 4.1% more (range: −0.6% to 9.3%) denosumab-treated patients experienced meaningful improvement in HRQoL than ZA-treated patients. There were also fewer denosumab-treated patients experiencing ≥5-point decrease in HRQoL over 18 months (average of 2.4% fewer [range:-4.4% to 6.3% fewer]). Similar patterns were also noted for patients with moderate/severe pain at baseline. An average of 3.0% more (range:-1.7% to 7.9%) denosumab-treated patients had ≥5-point increase in FACT-G scores compared with ZA-treated patients over 18 months. A lower proportion of denosumab-treated patients (3.5% fewer [range: −1.1% to 11.5% fewer]) than ZA-treated patients had a decrease ≥5-points in their FACT-G score over 18 months.

Conclusion: In patients with breast cancer and bone metastases, a greater proportion treated with denosumab than ZA had a meaningful improvement in HRQoL regardless of their pain level at BL.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-13-05.

Abstract P1-13-01: Comparing the Effects of Denosumab and Zoledronic Acid on Pain Interference with Daily Functioning in a Randomized Phase 3 Trial of Patients with Breast Cancer and Bone Metastases

In a recently completed trial of breast cancer patients with bone metastases, denosumab, a fully human monoclonal anti-RANKL antibody, was superior to zoledronic acid (ZA) in delaying/preventing skeletal-related events. Between-treatment differences in patient-reported pain interference with daily functioning were assessed.

Eligible breast cancer patients received monthly subcutaneous denosumab 120 mg or intravenous ZA 4 mg (double-bind, double-dummy design). Patients completed the Brief Pain Inventory (BPI) to assess pain severity and interference with daily functioning (range 0 [does not interfere]-10 [interferes completely]) at baseline (BL), day 8, and before each monthly visit through end of study. The BPI interference scale generated a total interference score as well as an activity subscale (interference with walking, general activity, and work) and an affective subscale (interference with relations with others, enjoyment of life, and mood). Analyses were conducted on all randomized patients with ≥1 PRO assessment and were performed through week 73, when 30% of patients had dropped out due to death, disease progression, or consent withdrawal. Subgroups included patients with no/mild and moderate/severe worst pain at BL. Analyses included time to improvement (≥2-point decrease) or worsening (≥2-point increase) in pain interference, mean change from baseline, and proportion of patients with improving or worsening pain interference scores. Time to improvement in pain interference with activity (PIWA) tended to occur more quickly with denosumab compared with ZA (N=1124; median: 70 days denosumab v 86 days ZA; P=0.09), and time to worsening PIWA tended to be longer with denosumab compared with ZA (N=1676; median: 394 days denosumab v 310 days ZA; P=0.13). In patients with no/mild pain at BL, denosumab also demonstrated a trend for shorter time to improvement in PIWA (N=388; 93 days denosumab v 120 days ZA; P=0.06) and longer time to worsening PIWA (N=755; 369 days denosumab v 232 days ZA; P=0.12). Overall, a greater proportion of patients on denosumab had improvement in PIWA on study than ZA (Figure). Findings were similar with the total interference score and affective subscale.

Figure Proportion of Patients With Improvement in Pain Interference With Activity (≥2-point decrease from BL)*

Daily functioning (total interference and interference with activity and affect) tended to be less disrupted by pain in patients on denosumab compared with ZA. Decreased pain interference showed a trend to occur more quickly with denosumab. Overall, a greater proportion of denosumab patients reported decreased pain interference than ZA patients.

Phosphorus release from ash and remaining tissues of two wetland species after a prescribed fire

Dead plant tissues and ash from a prescribed fire play an important role in nutrient balance and cycling in the Florida Everglades ecosystem. The objective of this study was to assess the dynamic changes in total phosphorus release (TPr) from ash or tissues of either cattail (Typha domingensis Pers.) or sawgrass (Cladium jamaicense Crantz) to water. Natural-dead (senesced-dead) and burning-dead (standing-dead due to a prescribed fire) cattail and sawgrass were collected from highly (H) and moderately (M) impacted zones in the Florida Everglades. This experiment was conducted by incubation and water-extraction of the materials in plastic bottles for 65 d at room temperature (24 +/- 1 degrees C). Results showed that 63 to 88%, 17 to 48%, 9 to 20%, and 13 to 28% of total P (TPp) were released as TPr from cattail and sawgrass ash, cattail tissues from the H zone, cattail tissues, and sawgrass tissues from the M zone, respectively. TPp means total P of plant tissues, whereas TPr is total P release from the tissues or ash. Most of the TPr was released within 24 h after burning. The quick release of TPr observed in this experiment may help explain the P surge in the surface water immediately following a fire in the marsh. These findings suggest that prescribed burning accelerates P release from cattail and sawgrass. They also imply that it is very important to keep the water stagnant in the first 24 h to maximize the benefits of a prescribed fire in the Everglades.

Enhanced effect of soluble transforming growth factor-beta receptor II and IFN-gamma fusion protein in reversing hepatic fibrosis

Objective

To examine the in vivo anti-fibrotic effect of rat soluble transforming growth factor β receptor II (RsTβRII) and IFN-γ fusion protein (RsTβRII-IFN-γ) in rat hepatic fibrosis model.

Methods

Model rats were divided into five groups and treated i.m. for 8 weeks: 1) fibrotic model group (each rat, 100 μl of 0.9% NaCl day^-1); 2) RsTβRII-IFN-γ treatment group (each rat, 0.136 mg· day^-1); 3) IFN-γ treatment group (each rat, 7.5 MU· day^-1); 4) RsTβRII treatment group (each rat, 0.048 mg· day^-1); and 5) mixture of IFN-γ and RsTβRII treatment group (each rat, IFN-γ 7.5 MU· day^-1+ RsTβRII 0.048 mg· day^-1). After treatment, hepatic fibrogenesis was evaluated by histopathological analysis and measurement of collagen III, α-smooth muscle actin (α-SMA), TGF-β1, TGF-βRII and their mRNA.

Results

Immunohistochemistry, Western blot and real-time RT-PCR showed that RsTβRII-IFN-γ treatment significantly inhibited liver expression of collagen III, α-SMA, TGF-β1 and TGF-βRII at both protein and mRNA levels. Histopathological analysis also showed that the enhanced anti-fibrotic effects were achieved in model rats treated with RsTβRII-IFN-γ.

Conclusion

Our results confirmed that RsTβRII-IFN-γ has the enhanced effects in reversing hepatic fibrosis.

The enigmatic autoimmune response in endemic pemphigus foliaceus

Endemic pemphigus foliaceus, known as Fogo Selvagem (FS) in Brazil, is a disease characterized by subcorneal blisters and IgG4 anti-dermoglein 1 (Dsg1) autoantibodies. Epidemiological studies of FS strongly an environmental etiology. A 15-year surveillance of the Limao Verde Amerindian reservation in Brazil has uncovered information on the transition of the autoimmune response from the pre-clinical stage to disease state. This incubation time may evolve over several years. The serological markers of the pre-clinical state of FS are IgM anti-Dsg1, IgE and non-IgG4 autoantibodies against Dsg1. The disease stage of FS is characterized by the rise of pathogenic IgG4 anti-Dsg1 autoantibodies. In this review, the authors reviewed the literature on the relevance of the humoral autoimmune response of FS as well as the possible environmental triggers of anti-Dsg1 autoantibody formation. Based on epidemiological observations, the authors hypothesize that the pathogenic IgG4 response in FS may be triggered by hematophagous insect bites.

Lung transplantation in the United States, 1999-2008

This article highlights trends and changes in lung and heart-lung transplantation in the United States from 1999 to 2008. While adult lung transplantation grew significantly over the past decade, rates of heart-lung and pediatric lung transplantation have remained low. Since implementation of the lung allocation score (LAS) donor allocation system in 2005, decreases in the number of active waiting list patients, waiting times for lung transplantation and death rates on the waiting list have occurred. However, characteristics of recipients transplanted in the LAS era differed from those transplanted earlier. The proportion of candidates undergoing lung transplantation for chronic obstructive pulmonary disease decreased, while increasing for those with pulmonary fibrosis. In the LAS era, older, sicker and previously transplanted candidates underwent transplantation more frequently compared with the previous era. Despite these changes, when compared with the pre-LAS era, 1-year survival after lung transplantation did not significantly change after LAS inception. The long-term effects of the change in the characteristics of lung transplant recipients on overall outcomes for lung transplantation remain unknown. Continued surveillance and refinements to the LAS system will affect the distribution and types of candidates transplanted and hopefully lead to improved system efficiency and outcomes.

Overexpression of type-A rice response regulators, OsRR3 and OsRR5, results in lower sensitivity to cytokinins

Response regulators are part of a two-component regulatory system. The type-A Arabidopsis response regulators act as negative regulators. To understand the function of type-A response regulators in the model monocot plant, rice (Japonica cultivar-group: Zhonghua11), we overexpressed two type-A OsRR genes, OsRR3 and OsRR5 (pACT1:OsRR3 and pACT1:OsRR5). We hoped to gain insight into their molecular function in cytokinin-signaling pathways. Both OsRR3 and OsRR5 overexpressors had longer roots and more lateral roots compared with Zhonghua11, when treated with exogenous cytokinin. Using callus formation and chlorophyll content assays, we found that Zhonghua11 was more sensitive to cytokinin compared with other cultivars of rice, expressing high transcript levels of OsRR3 and OsRR5. The expression of most type-A OsRR genes was repressed by OsRR3 and OsRR5 overexpression. However, semi-quantitative RT-PCR showed that three type-A OsRR genes showed increased expression. Our results suggest that both OsRR3 and OsRR5 mainly act as negative regulators of cytokinin signaling, as indicated by the reduced sensitivity of OsRR3 and OsRR5 overexpressors to exogenous cytokinins.

Intensive insulin therapy reduces the urinary intercellular adhesion molecule-1 excretion in patients with Type 2 diabetes mellitus

OBJECTIVE

To observe the change of urinary intercellular adhesion molecule-1 (ICAM-1) excretion in the patients with Type 2 diabetes mellitus (T2DM) compared to normal control group, and to investigate the effect and significance of insulin intensive therapy on the urinary ICAM-1 excretion.

METHOD

We examined the urinary ICAM-1 and creatinine (Cr) of random urine in 20 patients with T2DM and 20 normal subjects using enzyme-linked immunosorbent assay. All diabetics were given intensive insulin therapy for 2 weeks, urinary ICAM- 1 and Cr was examined once again at the end of observation.

RESULTS

Compared with the normal control group, not only the fasting blood glucose (FBG), post-prandial 2-h blood glucose (P2hBG), and glycosylated hemoglobin (HbA1c), but also the urinary ICAM-1 to urinary Cr ratio in patients with T2DM increased significantly (p<0.01). The urinary ICAM-1/urinary Cr ratio of diabetics had a positive correlation with FBG (r=0.51, p<0.01), P2hBG (r=0.496, p<0.01), and HbA1c (r=0.478, p<0.05), respectively. After 2 weeks of intensive insulin therapy in Type 2 diabetics, both the level of blood glucose and the level of urinary ICAM-1/urinary Cr ratio had a remarkable decrease compared with the basal values (p<0.01).

CONCLUSION

Intensive insulin therapy is capable of alleviating the enhanced local inflammation reaction of renal tissue under hyperglycemia state with the reduction of urinary ICAM-1 excretion.

Intensive insulin therapy decreases urinary MCP-1 and ICAM-1 excretions in incipient diabetic nephropathy

BACKGROUND

Nowadays, intensive insulin treatment has been widely used in type 2 diabetics who have poor control of blood glucose, to reduce the risk of chronic complications of diabetes. Recently, some scholars have paid more attention to the pivotal role of inflammation involved in type 2 diabetes and its complications. Monocyte chemoattractant protein-1 (MCP-1) and intercellular adhesion molecule-1 (ICAM-1), which are two important inflammatory chemokines, have been documented to participate in the onset and development of type 2 diabetes and its complications, such as diabetic nephropathy (DN).

DESIGN

In the current study, we recruited 30 type 2 diabetics with microalbuminuria to be treated with multiple insulin injections daily for 2 weeks. Random spot urine samples (corrected for creatinine-Cr) were collected for the examination of urinary MCP-1, ICAM-1 and albumin (Alb) levels before and after the intensive insulin therapy. Changes in their levels were observed to test the hypothesis that type 2 diabetes with microalbuminuria is associated with elevated urinary concentrations of MCP-1 and ICAM-1, and intensive insulin therapy can result in a decline of Alb by reducing the inflammatory reaction.

RESULTS

The urinary MCP-1/Cr and urinary ICAM-1/Cr ratios in type 2 diabetic patients with microalbuminuria were much higher than those in normal controls, and intensive insulin treatment could decrease significantly the urinary MCP-1/Cr, ICAM-1/Cr and Alb/Cr ratios in type 2 diabetics with microalbuminuria.

CONCLUSION

Intensive insulin treatment may protect against renal injury in early DN by reducing the urinary MCP-1 and ICAM-1 excretions.

Estimation of postfire nutrient loss in the Florida everglades

Postfire nutrient release into ecosystem via plant ash is critical to the understanding of fire impacts on the environment. Factors determining a postfire nutrient budget are prefire nutrient content in the combustible biomass, burn temperature, and the amount of combustible biomass. Our objective was to quantitatively describe the relationships between nutrient losses (or concentrations in ash) and burning temperature in laboratory controlled combustion and to further predict nutrient losses in field fire by applying predictive models established based on laboratory data. The percentage losses of total nitrogen (TN), total carbon (TC), and material mass showed a significant linear correlation with a slope close to 1, indicating that TN or TC loss occurred predominantly through volatilization during combustion. Data obtained in laboratory experiments suggest that the losses of TN, TC, as well as the ratio of ash total phosphorus (TP) concentration to leaf TP concentration have strong relationships with burning temperature and these relationships can be quantitatively described by nonlinear equations. The potential use of these nonlinear models relating nutrient loss (or concentration) to temperature in predicting nutrient concentrations in field ash appear to be promising. During a prescribed fire in the northern Everglades, 73.1% of TP was estimated to be retained in ash while 26.9% was lost to the atmosphere, agreeing well with the distribution of TP during previously reported wild fires. The use of predictive models would greatly reduce the cost associated with measuring field ash nutrient concentrations.

Effects of burn temperature on ash nutrient forms and availability from cattail (Typha domingensis) and sawgrass (Cladium jamaicense) in the Florida Everglades

Plant ash derived from fire plays an important role in nutrient balance and cycling in ecosystems. Factors that determine the composition and availability of ash nutrients include fire intensity (burn temperature and duration), plant species, habitat nutrient enrichment, and leaf type (live or dead leaf). We used laboratory simulation methods to evaluate temperature effects on nutrient composition and metals in the residual ash of sawgrass (Cladium jamaicense) and cattail (Typha domingensis), particularly on post-fire phosphorus (P) availability in plant ash. Live and dead leaf samples were collected from Water Conservation Area 2A in the northern Everglades along a soil P gradient, where prescribed fire may be used to accelerate recovery of this unique ecosystem. Significant decreases in total carbon and total nitrogen were detected with increasing fire temperature. Organic matter combustion was nearly complete at temperatures > or = 450 degrees C. HCl-extractable P (average, 50% of total P in the ash) and NH(4)Cl-extractable P (average, 33% of total P in the ash) were the predominant P fractions for laboratory-burned ash. Although a low-intensity fire could induce an elevation of P availability, an intense fire generally resulted in decreased water-soluble P. Significant differences in nutrient compositions were observed between species, habitat nutrient status, and leaf types. More labile inorganic P remained in sawgrass ash than in cattail ash; hence, sawgrass ash has a greater potential to release available P than cattail. Fire intensity affected plant ash nutrient composition, particularly P availability, and the effects varied with plant species and leaf type. Therefore, it is important to consider fire intensity and vegetation community when using a prescribed fire for ecosystem management.

Renoprotective effect of rosiglitazone through the suppression of renal intercellular adhesion molecule-1 expression in streptozotocin-induced diabetic rats

OBJECTIVE

To observe the effect of rosiglitazone on serum intercellular adhesion molecule-1 (SICAM-1) level, urinary excretion of ICAM-1, and renal expression of ICAM-1, and investigate its possible renoprotective mechanisms in diabetic rats.

METHOD

Twenty-four Wistar Rats were divided into 3 groups: non-diabetic control rats (group A, no.=8), streptozotocin-induced diabetic rats (group B, no.=8), and diabetic rats treated with rosiglitazone (group C, no.=8). Rats in group C were treated with rosiglitazone (5 mg x kg(-1) x d(-1)) 1 week after the establishment of diabetic model, group A and B were treated with corresponding sodium chloride. Peripheral blood glucose was tested weekly. Glycosylated hemoglobin (HbA1c) and SICAM-1 as well as urinary albumin excretion rate (UAER), urinary retinol binding-protein (URBP) excretion rate, and urinary ICAM-1 (UICAM- 1) excretion rate were tested at the 8th week, and the renal tissues of all rats were obtained for evaluating kidney/body weight ratio, observing pathologic change via electron microscope, and for examining the expression of ICAM-1 mRNA by reverse transcriptase-PCR.

RESULTS

At the 8th week, the blood glucose, HbA1c levels, UAER, URBP excretion rate, kidney/body weight ratio and serum, urinary ICAM-1 levels all increased significantly in group B and group C in comparison with group A; however, the above-mentioned parameters in group C (except the blood glucose and HbA1c levels) were much lower than those in group B. In addition, both SICAM-1 and UICAM-1 were highly correlated with the UAER, URBP level, and kidney/body weight ratio in all rats; renal pathological lesions observed by electron microscope in group C were much lighter than those of group B; compared with group A, the expression of ICAM-1 mRNA was markedly up-regulated in group B and group C, and rosiglitazone was able to decrease the expression of ICAM-1 mRNA in the renal tissue.

CONCLUSION

Rosiglitazone could definitely protect against the renal injury of diabetic rats, which may be partly associated with decreasing the expression of ICAM-1 in the renal tissue, reducing ICAM-1 productions in both serum and urine.

The correlation between plasma fibrinogen levels and the clinical features of patients with ovarian carcinoma

Pre-operative plasma levels of fibrinogen, plasma prothrombin time, activated partial thromboplastin time and thrombin time (TT) were retrospectively examined in 105 patients with ovarian carcinoma and 21 control patients with benign ovarian tumour. Plasma cancer antigen 125 (CA-125) levels, pathological type, age, body mass index and blood group were evaluated. The TTs of patients with stage III and stage IV ovarian carcinoma were significantly shorter than in controls. Levels of plasma fibrinogen in patients with stage III and IV ovarian carcinoma were higher than those in patients with stage I and II ovarian carcinoma and the controls. There was a positive relationship between levels of plasma CA-125 and plasma fibrinogen in patients with stage II malignancy. There were no significant differences between plasma fibrinogen levels in patients of different age, BMI, blood group and pathological type. Shorter TT was an indication of advanced stage ovarian carcinoma, and fibrinogen was associated with the peritoneal carcinomatosis of ovarian carcinoma.

Head and neck squamous cell cancer as part of the germline p16/INK4a mutation-induced FAMMM syndrome

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Background: p16/INK4a constitutes an important cancer susceptibility locus. Germline mutations at this locus have been implicated in several human cancer syndromes, including familial atypical multiple mole melanoma (FAMMM) syndrome, FAMMM-pancreatic cancer (FAMMM-PC) syndrome, and more recently, in familial head and neck cancer syndrome. Methods: We present an individual with a family history of both pancreatic cancer and melanoma, who developed squamous cell carcinoma of the tongue at 21 years old, multiple melanomas, a second squamous cell cancer of the tongue at 40 years old, and ultimately a pancreatic cancer. Results: We identify a germline mutation in INK4a that leads to a substitution of tryptophan for glycine in the Ankyrin III domain of the p16 protein (G101W). We demonstrate loss of heterozygosity at the INK4a locus and lack of p16 expression in the second head and neck squamous cell cancer (HNSCC) tissue. Based on these and on previously published data, we propose that HNSCC resulting from an INK4a germline mutation is a variant of the FAMMM/FAMMM-PC syndrome. Further studies will determine whether there is genotype-phenotype correlation between these syndrome variants. Conclusions: We conclude that young individuals who develop HNSCC should be considered at high-risk for other cancers, including pancreatic cancer and melanoma. They should be advised to avoid cigarette smoking and should be considered for pancreas cancer screening.

No significant financial relationships to disclose.

Rituximab in combination with CHOP chemotherapy for the treatment of diffuse large B cell lymphoma in Chinese patients

The objective of this study is to evaluate the long-term efficacy and safety of rituximab combined with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) in Chinese patients with newly diagnosed diffuse large B cell lymphoma (DLBCL). The study comprised a retrospective analysis of patients treated at a single center. Patients received four to six infusions of rituximab (375 mg/m(2) per dose) on day 1 of each cycle of CHOP chemotherapy. CHOP was initiated on day 3 of each cycle; cycles were repeated at 21-day intervals. A total of 82 patients with a median age of 45 years (range 18-76 years) was included. The overall response (OR) and complete response (CR) rates were 90.2 and 70.7%, respectively. The estimated 5-year progression-free survival (PFS) and overall survival (OS) rates were 56.4 +/- 8.3% and 74.1 +/- 7.4%, respectively. Patients with International Prognostic Index (IPI) scores < or = 2 had significantly higher OR, CR, PFS, and OS rates (p = 0.01, p = 0.02, p = 0.01, p < 0.001, respectively) compared with patients with IPI scores >2. The hematologic toxicity was mild. Five patients with a history of chronic hepatitis B experienced a reactivation of viral hepatitis. The rituximab-CHOP combination was effective and well tolerated in Chinese patients with newly diagnosed DLBCL.

Seasonality of selected surface water constituents in the Indian River Lagoon, Florida

Seasonality is often the major exogenous effect that must be compensated for or removed to discern trends in water quality. Our objective was to provide a methodological example of trend analysis using water quality data with seasonality. Selected water quality constituents from 1979 to 2004 at three monitoring stations in southern Florida were evaluated for seasonality. The seasonal patterns of flow-weighted and log-transformed concentrations were identified by applying side-by-side boxplots and the Wilcoxon signed-rank test (p < 0.05). Seasonal and annual trends were determined by trend analysis (Seasonal Kendall or Tobit procedure) using the U.S. Geological Survey (USGS) Estimate TREND (ESTREND) program. Major water quality indicators (specific conductivity, turbidity, color, and chloride), except for turbidity at Station C24S49, exhibited significant seasonal patterns. Almost all nutrient species (NO(2)-N, NH(4)-N, total Kjeldahl N, PO(4)-P, and total P) had an identical seasonal pattern of concentrations significantly greater in the wet than in the dry season. Some water quality constituents were observed to exhibit significant annual or seasonal trends. In some cases, the overall annual trend was insignificant while opposing trends were present in different seasons. By evaluating seasonal trends separately from all data, constituents can be assessed providing a more accurate interpretation of water quality trends.

Repeated cannabinoid administration increases indices of noradrenergic activity in rats

The present study examined the impact of repeated administration of a synthetic cannabinoid agonist, WIN 55,212-2 on the coeruleo-cortical pathway, a circuit implicated in anxiety. Male Sprague-Dawley rats received repeated systemic injections of WIN 55,212-2 (3.0 mg/kg). A separate group of rats received repeated WIN 55,212-2 injections followed by a period of abstinence. Control animals received vehicle injections. Ninety minutes following the last injection on day 8, anxiety-related behavior was assessed using the elevated plus maze. The abstinent group was tested after another 8 days. Following behavioral testing, brain tissue was extracted from the locus coeruleus (LC) and probed for tyrosine hydroxylase (TH) expression. In a separate group of animals, in vivo microdialysis was used to monitor extracellular norepinephrine efflux in the frontal cortex following repeated WIN 55,212-2 administration and following a period of abstinence. Repeated administration of WIN 55,212-2 evoked an anxiogenic-like response that was accompanied by an increase in TH protein expression in the LC. A similar neurochemical profile was observed using in vivo microdialysis where an augmented increase in cortical norepinephrine efflux was identified in response to a systemic injection of WIN 55,212-2 on day 8. Anxiety-like behavior, catecholamine synthesizing enzyme levels and NE efflux returned to control values after 8 days of abstinence. The present findings indicate that repeated administration of a synthetic cannabinoid receptor agonist induces transient anxiety-like behaviors that correlate with increases in catecholamine synthesizing enzyme expression in the LC and augmented norepinephrine efflux in response to a challenge injection of WIN 55,212-2.

Analysis of amino acids and biogenic amines in biological tissues as their o-phthalaldehyde/ethanethiol/fluorenylmethyl chloroformate derivatives by high-performance liquid chromatography. A deproteinization study

The extraction of ornithine, lysine, putrescine, cadaverine, 1,7-diaminoheptane, spermidine and spermine from biological tissues was optimized for HPLC quantitation as their o-phthalaldehyde/ethanethiol/fluorenylmethyl chloroformate (OPA/ET/FMOC) derivatives. In applying perchloric acid deproteinization two approaches have been followed: (i) deproteinization with subsequent neutralization by potassium hydroxide and lyophilization, and (ii) deproteinization without neutralization and lyophilization. Neutralization and lyophilization resulted in the loss of free biogenic amines. HPLC analysis of ornithine (Orn), lysine (Lys), putrescine (Put), cadaverine (Cad), 1,7-diaminoheptane (Dah), spermidine (Spd) and spermine (Spm) content of biological tissues as their OPA/ET/FMOC derivatives was performed in the supernatant of perchloric acid-deproteinized samples (model solutions and tissues) with an average reproducibility of < or =2.6% relative standard deviation (RSD), including recovery of sample treatment and chromatography.

Decreased peritoneal concentrations of interleukin-15 in women with advanced stage endometriosis

OBJECTIVE

To assess the concentrations of interleukin-15 (IL-15) in peritoneal fluid from women with endometriosis and fertile disease-free controls.

STUDY DESIGN

Peritoneal fluid samples were obtained from 50 women with endometriosis and 29 fertile women having tubal ligation. Concentrations of IL-15 were measured.

RESULTS

The mean (S.D.s) concentration of IL-15 in peritoneal fluid was 11.17 pg/mL (3.89) for women with endometriosis, and 12.59 pg/mL (4.11) for fertile disease-free controls. The difference of peritoneal IL-15 concentrations between endometriosis and control women was not statistically significant. However, peritoneal IL-15 concentrations were significantly lower in women with moderate/severe endometriosis when compared with those in women with minimal/mild endometriosis, and in controls (P<0.05). In addition, peritoneal IL-15 concentrations did not correlate with the phase of menstrual cycle in endometriosis or control women.

CONCLUSIONS

Our results suggest that the decreased peritoneal IL-15 concentrations in women with moderate/severe endometriosis imply a role of IL-15 in the pathogenesis of advanced endometriosis as compared to those with minimal/mild endometriosis and fertile disease-free controls.

Effects of electrokinetics and cationic surfactant cetyltrimethylammonium bromide [CTAB] on the hydrocarbon removal and retention from contaminated soils

Hydrocarbon contaminated soil and groundwater is considered to be a leading cause for increased health risk and environmental contamination. Therefore, an efficient technique is needed to retard the movement or enhance the removal of the contaminant depending on the remediation objective. The goals of this study were to evaluate the impact of the addition of a cationic surfactant on the movement of hydrocarbons within a contaminated clay soil subjected to electrokinetic treatment. Water-flushing and surfactant-flushing experiments were conducted on one-dimensional soil columns. The model diesel fuel was composed of a mixture of benzene, toluene, ethylbenzene, xylenes [BTEX] and three selected polycyclic hydrocarbons [PAHs]. In the water-flushing experiments, the application of an electrokinetic treatment was found to enhance the removal of PAHs from the clay columns by about 20%. In contrast, the application of an electrokinetic treatment, when coupled with cationic surfactant-flushing, retarded the movement of BTEX and the three selected PAHs in the clay columns. Hydraulic columns with surfactant (CTAB) removed 17% more naphthalene and 11% more 2-methylnaphthalene compared to columns subjected to electrokinetic treatment with CTAB. The flux through the electrokinetic columns during water flushing as well as surfactant flushing was higher than the flux due to hydraulic gradient alone. As the solubility of hydrocarbons increased, they moved farther with electrokinetic treatment without CTAB. However, with CTAB the electrokinetic treatment tends to retard the movement. Use of a cationic surfactant coupled with electrokinetic treatment was found to retard the movement of contaminants.

A novel SNP at exon 17 of INSR is associated with decreased insulin sensitivity in Chinese women with PCOS

To investigate the association of single-nucleotide polymorphisms (SNPs) in exon 17 of the insulin receptor (INSR) gene with insulin resistance and INSR beta-subunit expression in polycystic ovary syndrome (PCOS) patients, a case-control study was carried out in an academic endocrinology clinic of China. One hundred and nine Chinese patients with PCOS and 107 healthy Chinese women as control were recruited. Their leukocytes and red blood cells were separated from blood samples, for SNP analysis with single-stranded conformation polymorphism and for the INSR beta-subunit expression detection by western blot analysis, respectively. A novel T/C SNP at codon Cys1008 (position 3128 of NM_000208) of INSR was found in two allele genotypes, i.e. the homozygous CC and the heterozygous TC. A higher frequency of the mutant homozygous CC was observed in the PCOS women with PCOS than that in the controls (21.1 versus 5.6%, P < 0.01). In contrast with the women with wild-type genotype, a significantly lower insulin sensitivity index in the women with each of the two mutant genotypes was revealed (CC: 0.335 +/- 0.026/TC: 0.346 +/- 0.027 versus TT: 0.367 +/- 0.029, P < 0.05). No relationship was found between the novel SNP and the INSR beta-subunit expression. We concluded that the novel T/C SNP at codon Cys1008 of INSR is associated with decreased insulin sensitivity in Chinese women with PCOS and that the association is not by the change of synthesis or secretion of INSR beta-subunit, but most possibly by the effects of this novel SNP on the function of INSR beta-subunit.

Elevated μ-opioid receptor expression in the nucleus of the solitary tract accompanies attenuated withdrawal signs after chronic low dose naltrexone in opiate-dependent rats

We previously described a decrease in withdrawal behaviors in opiate-dependent rats that were chronically treated with very low doses of naltrexone in their drinking water. Attenuated expression of withdrawal behaviors correlated with decreased c-Fos expression and intracellular signal transduction elements [protein kinase A regulatory subunit II (PKA) and phosphorylated cAMP response element binding protein (pCREB)] in brainstem noradrenergic nuclei. In this study, to determine whether similar cellular changes occurred in forebrain nuclei associated with drug reward, expressions of PKA and pCREB were analyzed in the ventral tegmental area, frontal cortex, striatum, and amygdala of opiate-treated rats that received low doses of naltrexone in their drinking water. No significant difference in PKA or pCREB was detected in these regions following drug treatment. To examine further the cellular mechanisms in noradrenergic nuclei that could underlie attenuated withdrawal behaviors following low dose naltrexone administration, the nucleus of the solitary tract (NTS) and locus coeruleus (LC) were examined for opioid receptor (OR) protein expression. Results showed a significant increase in muOR expression in the NTS of morphine-dependent rats that received low doses of naltrexone in their drinking water, and increases in muOR expression were also found to be dose dependent. Protein expression of muOR in the LC and deltaOR in either brain region remained unchanged. In conclusion, our previously reported decreases in c-Fos and PKA expression in the NTS following pretreatment with low doses of naltrexone may be partially explained by a greater inhibition of NTS neurons resulting from increased muOR expression in this region.

Microbial population structure changes in a suspended carrier biofilm reactor

The changes of microbial population structure in biofilm caused by variations of COD/NHNH4(+)-N ratio in influent were investigated in a suspended carrier biofilm reactor (SCBR). When COD/NHNH4(+)-N was 10, the highest COD removal reached was about 73.8 per cent, whereas the highest NH4(+)-N removal, about 55.9 per cent, was reached when COD/NH4(+)-N was 5. By using fluorescence in situ hybridization (FISH) and confocal laser scanning microscopy (CLSM) observation, it was found that the thickness of the biofilm formed on the carrier was about 80 to 120 microm, and ammonia-oxidizing bacteria (AOB) and nitrifying bacteria existed mainly in the upper layer about 20 to 30 microm. The results of the quinone profile analysis showed that when the COD/NH4(+)-N increased, the microbial diversity (DQ) increased, while the proportions of AOB and nitrifying bacteria in the biofilm communities decreased.