Results of semimonthly 5-florouracil/leucovorin combined with paclitaxel and oxaliplatin in treatment of advanced gastric cancer (AGC)

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Background: At present there is still no standard chemotherapy regimen for AGC, the progress of AGC exhibits a pessimistic result with a median survival of less than 9 months. The purpose of this trial was designed to enhance the treatment efficacy for AGC by using semimonthly FU/LV combined with paclitaxel and oxaliplatin. Methods: Patients chosen with histologically proven diagnosis of adenocarcinoma of the stomach or gastroesophageal junction, locally advanced (i.e., unresectable) or metastatic and measurable disease. The chemotherapy regimen was comprised of a 3-hour infusion of 135 mg/m2 of paclitaxel followed by oxaliplatin 85 mg/m2 and LV 400 mg/m2, administered simultaneously as a 2-hour infusion, then continued a 46-hour infusion of FU 2.4 g/m2 using an ambulatory pump. Treatment was continued until disease progressed, unacceptable toxicity, or patient choice. The primary endpoint was response rate. Results: Twenty-seven patients were enrolled onto this study in our center between September 19, 2005 and December 25, 2006. The median patient age was 51 years (range, 28 to 66 years), 21 were males and 6 were females. All patients received the chemotherapy between at least two cycles and maximum eight cycles with a median of three. Four CRs of 27 enrolled patients, fifteen PRs and eight SDs were observed. Nineteen patients were chemonaive within enrolled patients: Four CRs, eleven PRs. At a median follow-up of 8.7 months, the median survival was 6.8 months. Frequent grade 3 to 4 toxicities were: neutropenia (37.0%), stomatitis (7.4%), nausea (7.4%), vomiting (7.4%), hepatic dysfunction (3.7%), paresthesia (18.5%). No treatment-related death occurred. Conclusion: Semimonthly FU/LV combined with paclitaxel and oxaliplatin appears to be of well efficacy and is well tolerated in patients with AGC. Currently, this regimen is being tested in the phase III trial involving patients with AGC on the basis of well result.

No significant financial relationships to disclose.

Selective method for the analysis of perchlorate in drinking waters at nanogram per liter levels, using two-dimensional ion chromatography with suppressed conductivity detection

The United States Environmental Protection Agency (EPA) collected drinking water occurrence data for perchlorate in the Unregulated Contaminant Monitoring Regulation (UCMR 1; 2001-2005) using EPA Method 314.0. To address the interest in increasing sensitivity and selectivity for the analysis of perchlorate, three new methods, EPA Methods 314.1, 331.0 and 332.0, were subsequently published by EPA for the analysis of perchlorate in drinking water. In 2006, an automated two-dimensional ion chromatography (2D-IC) method for measuring perchlorate with suppressed conductivity detection was developed. Two-dimensional IC is essentially an automated "heart-cutting", column concentration and matrix elimination technique. In the first dimension, a large sample volume is injected onto a first separation column and the separated matrix ions are diverted to waste while the analyte(s) of interest are selectively cut, trapped and concentrated in a concentrator column. In the second dimension, the contents from the concentrator column are eluted onto a second analytical column for separation and quantitation of the analyte(s) of interest. Incorporation of two columns with different affinities for the analyte(s) in a single analysis can provide comparable selectivity and superior sensitivity to a method using second column confirmation in a second separate analysis step. Use of this approach led to the development of a new, highly sensitive and selective 2D-IC, suppressed conductivity method with a Lowest Concentration Minimum Reporting Level (LCMRL) of 55 ng/L for perchlorate in drinking water samples. This new method has comparable sensitivity and selectivity and is simpler and more economical than IC-mass spectrometric (MS) or IC-MS-MS techniques. The method is now being prepared for publication as EPA Method 314.2.

Improving spatial signal homogeneity in MR 2D chemical shift imaging using outer volume saturation bands

Many endeavors of improving chemical shift imaging (CSI) techniques have been made during last two decades. Good examples of two-dimensional CSI and three-dimensional CSI can be found in the literature. However, clinical CSI using available sequences is still not satisfactory. The purpose of this study was to assess the effect of outer volume saturation bands on signal homogeneity in MR 2D chemical shift imaging. The 2D CSI scans were acquired using a point resolved spectroscopy (PRESS) CSI sequence on a phantom filled with brain metabolites. A single PRESS volume of interest was prescribed graphically. The acquisition matrix was 18x18 phase encodings over a 24-cm FOV. Identical acquisitions were obtained with and without outer-volume saturation bands. After initial acquisition was obtained, four more acquisitions were repeated for both studies with and without saturation bands. Identical five groups of voxels were compared for both studies. Standard deviations of metabolite ratios were calculated in each group for both studies. Spectra obtained without outer-volume saturation bands showed signal to noise gradient with higher concentration of signal within voxels at the center of the volume of interest. Outer volume saturation bands reduced this gradient. In general, standard deviations of metabolite ratios with saturation bands were smaller than those without saturation bands. Improved spatial homogeneity of spectra in voxels of CSI with saturation bands was obtained. Outer-volume saturation bands improve spatial signal homogeneity of chemical shift imaging.

The value of detecting anti-VZV IgG antibody in CSF to diagnose VZV vasculopathy

BACKGROUND

Factors that may obscure the diagnosis of varicella zoster virus (VZV) vasculopathy include the absence of rash before TIAs or stroke as well as similar clinical features and imaging, angiographic, and CSF abnormalities to those of other vasculopathies. Diagnosis relies on virologic confirmation that detects VZV DNA, anti-VZV IgG antibody, or both in the CSF.

METHODS

We reviewed our current 14 cases of patients diagnosed with VZV vasculopathy based on combined clinical, imaging, angiographic, or CSF abnormalities. All CSFs must have been tested for VZV DNA by PCR and for anti-VZV IgG antibody by enzyme immunoassay and found to be positive for either or both. Of the 14 subjects, 8 had a history of recent zoster, whereas 6 had no history of zoster rash before developing vasculopathy.

RESULTS

All 14 subjects (100%) had anti-VZV IgG antibody in their CSF, whereas only 4 (28%) had VZV DNA. The detection of anti-VZV IgG antibody in CSF was a more sensitive indicator of VZV vasculopathy than detection of VZV DNA (p < 0.001).

CONCLUSIONS

In varicella zoster virus (VZV) vasculopathy, the diagnostic value of detecting anti-VZV IgG antibody in CSF is greater than that of detecting VZV DNA. Although a positive PCR for VZV DNA in CSF is helpful, a negative PCR does not exclude the diagnosis of VZV vasculopathy. Only when the CSF is negative for both VZV DNA and anti-VZV IgG antibody can the diagnosis of VZV vasculopathy be excluded.

Elevated HIV seroprevalence and risk behavior among Ugandan TB suspects: implications for HIV testing and prevention

OBJECTIVES

Voluntary counseling and testing (VCT) for the human immunodeficiency virus (HIV) is recommended for persons treated for tuberculosis (TB). Opportunities to diagnose HIV may be missed by limiting HIV testing to only persons diagnosed with TB. Among TB suspects in Uganda, we determined HIV prevalence, risk behaviors, and willingness to refer family for VCT.

METHODS

Consenting adult patients presenting for evaluation at a referral TB clinic received same-day VCT. TB diagnosis data were abstracted from clinical records.

RESULTS

Among 665 eligible patients, 565 (85%) consented to VCT. Among these, 238 (42%) were HIV-positive. Of the HIV-infected patients, 37% had received a non-TB diagnosis. HIV seroprevalence was higher in patients with a non-TB diagnosis (49%) than those diagnosed with TB (39%) (P = 0.02). Fewer than 6% of HIV-infected patients reported always using condoms with sexual partners. The majority of patients (86%) reported being 'very willing' to refer family members for VCT.

CONCLUSIONS

Over 35% of HIV-infected cases in our population would have been undetected if HIV testing was limited to cases with diagnosed TB. The high HIV seroprevalence in both TB and non-TB cases merits HIV testing for all patients evaluated at TB clinics. HIV-infected TB suspects reporting high-risk behavior are at risk for HIV transmission, and should receive risk-reduction counseling.

A large noncoding RNA is a marker for murine hepatocellular carcinomas and a spectrum of human carcinomas

Tumor markers can facilitate understanding molecular cell biology of neoplasia and provide potential targets for the diagnosis and insight for intervention. We here identify a novel murine gene, hepcarcin (hcn), encoding a 7-kb mRNA-like transcript. The gene appears to be the murine ortholog of the human alpha gene, that is, MALAT-1. The gene and homologs lack credible open reading frames, consistent with a highly conserved large noncoding RNA (ncRNA). In all nodules of procarcinogen-induced murine hepatocellular carcinomas (HCCs) and human HCCs, expression was markedly elevated compared to the uninvolved liver. Quantitative analyses indicated a 6-7-fold increased RNA level in HCCs versus uninvolved liver, advancing this as a molecule of interest. This ncRNA was overexpressed in all five non-hepatic human carcinomas analysed, consistent with a potential marker for neoplastic cells and potential participant in the molecular cell biology of neoplasia.

Induction of IRF-3 and IRF-7 phosphorylation following activation of the RIG-I pathway

The induction of type I interferon (IFN) and the development of the innate antiviral response are mediated by the activation of interferon regulatory factor (IRF)-3 and IRF-7 under the control of the non-canonical kinases TBK-1 and IKKepsilon. The initial sensing of infection by RNA viruses is mediated by the cytoplasmic, retinoic acid inducible gene I (RIG-I), via a Toll-like receptor (TLR) independent signaling pathway. In the present study, we identify key residues involved in IRF-3 and IRF-7 phosphorylation using TAP-tag purification of TBK-1 and IKKepsilon proteins. Based on the identification of an extended sequence motif--SxSxxxS--common to both IRF-3 and IRF-7, an IRF-7 pSer477/479 phosphospecific antibody was generated. Virus infection, TBK-1/IKKepsilon expression or co-expression of different signaling adaptors such as RIG-I, MAVS and TRIF, all stimulated pSer477/479 phosphorylation. Furthermore, the newly identified adaptor of the RIG-I pathway (MAVS/IPS-1/VISA/Cardif) was able to induce IRF and NF-kappaB dependent promoter activity as efficiently as the constitutively active form of RIG-I (DeltaRIG-I). Co-expression of the NS3/4A protease activity of hepatitis C virus however blocked MAVS-mediated gene activation in a dose dependent manner. These studies link RIG-I sensing of viral RNA to downstream kinase signaling and phosphorylation of IRF-3 and IRF-7 via the MAVS/IPS/VISA/Cardif adaptor.

An integrated microfluidic device for influenza and other genetic analyses

An integrated microfluidic device capable of performing a variety of genetic assays has been developed as a step towards building systems for widespread dissemination. The device integrates fluidic and thermal components such as heaters, temperature sensors, and addressable valves to control two nanoliter reactors in series followed by an electrophoretic separation. This combination of components is suitable for a variety of genetic analyses. As an example, we have successfully identified sequence-specific hemagglutinin A subtype for the A/LA/1/87 strain of influenza virus. The device uses a compact design and mass production technologies, making it an attractive platform for a variety of widely disseminated applications.

Zero-Filling Interpolation Processing Technique Can Efficiently Suppress Segmental Stenosis Artifact on Small Arteries of Anatomical Phantoms

The purpose of this study was to evaluate the zero-filling interpolation processing (ZIP) technique for contrast-enhanced MR angiography (CE-MRA). Phantoms of arteries were made with different lumen diameters. Gadolinium-enhanced three-dimensional MR angiography was performed on a GE 1.5T scanner. The parameters of FSPGR pulse sequence were: flip angle 30°, TR 6ms, TE 1.4ms, bandwidth 31.25 kHz, slice thickness 1.2 mm, matrix 256×256. The sequence parameters were kept constant for the studies, whereas four selections were chosen: 1) with ZIP1024 and ZIP×4 techniques; 2) only with ZIP1024 technique; 3) only with ZIP×4 technique; 4) without ZIP technique. For image quality evaluation, MR maximum intensity projection (MIP) images were created. Signal-to-noise ratio (SNR) was measured on MIP images. Vessel edge was determined using full width at half maximum (FWHM) for lumen diameter calculation and results were compared with the actual lumen diameter. The distinctness of the vessel edge and the artifacts on the phantoms were compared for all sequences. Three experienced radiologists made consensus evaluation. The FWHM results of lumen measurements for all the sequences with ZIP techniques were more accurate than that of the sequence without ZIP technique in all phantoms, no matter what the size of the artery. The vessel edge with ZIP1024 technique was more distinct. However, the highest average SNR was obtained with the sequence without ZIP technique. The segmental stenosis artifacts on small artery of phantoms were only efficiently suppressed with the ZIP×4 technique. ZIP technique is excellent for CE-MRA to obtain high quality MR angiography. It not only can improve the spatial resolution and the distinctness of the vessel edge on CE-MRA, but can also efficiently suppress segmental stenosis artifact on small arteries of phantoms.

An exceptionally bright flare from SGR 1806–20 and the origins of short-duration γ-ray bursts

Soft-gamma-ray repeaters (SGRs) are galactic X-ray stars that emit numerous short-duration (about 0.1 s) bursts of hard X-rays during sporadic active periods. They are thought to be magnetars: strongly magnetized neutron stars with emissions powered by the dissipation of magnetic energy. Here we report the detection of a long (380 s) giant flare from SGR 1806-20, which was much more luminous than any previous transient event observed in our Galaxy. (In the first 0.2 s, the flare released as much energy as the Sun radiates in a quarter of a million years.) Its power can be explained by a catastrophic instability involving global crust failure and magnetic reconnection on a magnetar, with possible large-scale untwisting of magnetic field lines outside the star. From a great distance this event would appear to be a short-duration, hard-spectrum cosmic gamma-ray burst. At least a significant fraction of the mysterious short-duration gamma-ray bursts may therefore come from extragalactic magnetars.

Experiment studies of iodinated oil nanometer ferrofluid retention in rabbit liver

To study possibility for iodinated oil nanometer ferrofluid retention in rabbit liver. 131I- iodinated oil nanometer ferrofluid were injected into liver right lobe through portal vein in 5 rabbits... - calibrate meter showed continuous.. counts in the region injected. Then the relative metabolic parameters were calculated. Left lobe livers, right lobe livers and lungs of the rabbits were examined in pathology, and the right lobe livers were examined by electron microscope. Five rabbits injected purely 131Iiodinated oil were designated as control group. Single metabolic mode was found in the rabbits in nanometer ferrofluid group. The biological half-life of 131I- iodinated oil nanometer ferrofluid was not different from control group's slow metabolic portion. But control group's rapid metabolic portion were eliminated in a higher speed, range from 8% to 44%. More damage was found in nanometer ferrofluid group's right lobe livers. 131I- iodinated oil nanometer ferrofluid possess the opportunity of local retention in human body and further study is worthwhile.

GNB3 gene C825T and ACE gene I/D polymorphisms in essential hypertension in a Kazakh genetic isolate

The Kazakh inhabitants living in Barkol pasture of northeast China belong to a genetic isolate characterized by ethnically homogeneous and a communal pastoral lifestyle. To investigate whether the polymorphisms in the G-protein beta-3 subunit (GNB3) gene and angiotensin-converting enzyme (ACE) gene are associated with essential hypertension (EH), we carried out a case-control study of 290 hypertensive subjects and 244 normotensive (NT) controls randomly selected from Kazakh populations of Barkol. A previous medical history of diabetes and hypertension, and body mass index (BMI) was recorded. Plasma glucose, triglyceride, and cholesterol were measured. The insertion/deletion (I/D) polymorphism of the ACE gene and the C825T polymorphism of the GNB3 gene were determined by the polymerase chain reaction (PCR) technique. The distributions of genotypes and alleles for the two polymorphisms did not differ significantly between the case and control populations, and odds ratio of EH related to the ACE gene D allele and GNB3 gene T allele was not significantly different from 1.0. Logistic regression analysis shows the variation at the GNB3 and ACE did not have any statistically significant synergistic effect on blood pressure (BP). Stratification of NT and untreated hypertensives according to I/D polymorphism of ACE gene and C825T polymorphism of GNB3 gene disclosed no significant difference across genotypes with respect to BMI, glucose, triglyceride, cholesterol, systolic and diastolic BP. In conclusion, the polymorphisms in the GNB3 gene and ACE gene, solely or combined, did not confer a significantly increased risk for the development of EH in the Kazakh isolate of northeast China.

v-Src-mediated phosphorylation of connexin43 on tyrosine disrupts gap junctional communication in mammalian cells

It is not clear how the v-Src oncoprotein disrupts gap junctional communication (GJC) established by connexin43 (Cx43) in mammalian cells. In this study, an experimental system was established to stably express v-Src and wild type (wt) Cx43, or Y247F, Y265F, or Y247F/Y265F Cx43 mutants in a Cx43 knockout (KO) mouse cell line. When co-expressed with v-Src, the levels of phosphotyrosine (pTyr) from Y247F, Y265F, and Y247F/Y265F Cx43 mutants were reduced to approximately 57%, 10%, and 2% of the level of pTyr from wt Cx43, indicating that Y247 and Y265 were phosphorylation targets of v-Src in vivo. These data also implied that phosphorylation of Cx43 at Y265 was required for efficient phosphorylation of Cx43 at Y247. Most importantly, our measurements of GJC demonstrated that, in contrast to the wt Cx43 gap junction channels, the Y247F, Y265F, and Y247F/Y265F Cx43 channels were resistant to the disruption by v-Src. In conclusion, our studies support a model for processive phosphorylation of Cx43 on tyrosine, at the Y265 site followed by the Y247 site, in mediating the disruption of GJC induced by v-Src in mammalian cells.

Myocardial protection of immature rabbits with an ATP-sensitive K+ channel opener pinacidil

OBJECTIVE

To investigate the effectiveness of pinacidil, an opener of ATP-sensitive K+ channels, in protecting the myocardium of immature rabbit hearts from ischemic reperfusion injury.

METHODS

Rabbit hearts underwent 30 min of global normothermic ischemia followed by 30 min of reperfusion on the modified Langendorff apparatus. Fifty-two isolated hearts of 3-4 week-old immature rabbits were divided into 4 groups randomly. During ischemia, 3 different cardioplegic solutions were administered intermittently by infusion every 15 min (20-25 ml each time in all groups). Group 1: control group (n = 13); group 2: Krebs-Henseleit (K-H) solution with potassium (16 mmol/L) (n = 13); group 3: K-H solution with potassium (16 mmol/L) and pinacidil (50 mumol/L) (n = 13); group 4: K-H solution with potassium (16 mmol/L), pinacidil (50 mumol/L) and glibenclamide (10 mumol/L) (n = 13). The pre-ischemic and post-ischemic myocardial functions were assessed by the percentage recovery of the left ventricular developed pressure (LVDP); the left ventricular end-diastolic pressure (LVEDP); both the positive peak and negative peaks of the first derivative of the left ventricular pressures (+/- dp/dtmax); coronary flow; the level of creatine kinase (CK), lactic dehydrogenase (LDH) and aspartate transcarbamoylase (AST) in coronary sinus venous effluent; and by myocardial ultrastructural changes.

RESULTS

Before myocardial ischemia, there were no significant differences among the four groups in any of the parameters mentioned above. Post-ischemic recovery of LVDP, LVEDP, +/- dp/dtmax, coronary flow, the level of CK, LDH and AST, and myocardial ultrastructural changes were better in group 3 than those in the three other groups.

CONCLUSIONS

As a new and effective composition, pinacidil can significantly improve myocardial protection from cardioplegia for immature rabbit hearts.