Multicenter phase II study of sunitinib in patients with non-clear cell renal cell carcinoma

BACKGROUND

Retrospective and molecular biologic data suggest that sunitinib may be effective in patients with non-clear cell renal cell carcinoma (nccRCC).

PATIENTS AND METHODS

Eligibility criteria included advanced nccRCC except for collecting duct carcinoma and sarcomatoid carcinoma without identifiable renal cell carcinoma subtypes. Patients were treated with 50 mg/day oral sunitinib for 4 weeks, followed by 2 weeks of rest. The primary end point was overall response rate (RR).

RESULTS

Thirty-one eligible patients were enrolled. Twenty-four patients (77%) had prior nephrectomy. By Memorial Sloan-Kettering Cancer Center criteria, 8 patients (26%) had poor risk and 14 (45%) had intermediate risk. Twenty-two patients had papillary renal cell carcinoma (RCC), and three had chromophobe RCC. Eleven patients had partial response with a RR of 36% (95% confidence interval (CI) 19% to 52%) and an additional 17 patients (55%) had stable disease. Median duration of response was 12.7 months (95% CI 6.3-19.1 months), and median progression-free survival was 6.4 months (95% CI 4.2-8.6 months). At a median follow-up duration of 18.7 months (95% CI 13.7-23.7 months), 13 patients (42%) had died, resulting in an estimated median survival of 25.6 months (95% CI 8.4-42.9 months). Toxicity profiles were commensurate with prior reports.

CONCLUSIONS

Sunitinib has promising activity in patients with nccRCC (NCT01219751).

The effects of humidity and serum on the surface microhardness and morphology of five retrograde filling materials

The purpose of this study was to compare the surface morphology and surface hardness of five materials 24 h after filling, in conditions of 100% humidity, and fetal bovine serum. The five materials were ProRoot Mineral Trioxide Aggregate (MTA), Super-EBA, Intermediate Restorative Materials (IRM), Zinc Oxide Eugenol (ZOE), and Amalgam. The microhardness of these materials was evaluated by Vickers microhardness test, and their morphologies were compared by using scanning electron microscopy (SEM). To evaluate the microhardness, the mixed five materials were measured with Vickers microhardness test. Differences between the experimental groups were analyzed by two-way ANOVA and Duncan's multiple comparison tests. All analyses were performed using the Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL). For the microstructural morphological evaluation, the cross cut and root-end cavity prepared surfaces followed by retrograde filling with five different materials were observed under a Scanning Electron Microscope (Steroscan 440; Leica, Cambridge, England) at ×500. To summarize, Super EBA was less influenced by storage medium than the other materials, especially MTA. However, further long-term studies considering other factors, such as biocompatibility (i.e. cellular toxicity) and retention, are needed to be collaborated with these findings in the clinical context.

The effect of fractional carbon dioxide lasers on idiopathic guttate hypomelanosis: a preliminary study

BACKGROUND

Idiopathic guttate hypomelanosis (IGH) is a commonly acquired leucoderma that is characterized by discrete, round or oval porcelain-white macules ∼2-5 mm in diameter that increases in number with age. A variety of therapies with variable success rates, including cryotherapy, superficial abrasion and topical retinoids are currently being used.

OBJECTIVES

The effects of fractional CO(2) laser therapy on IGH were investigated in this pilot study.

PATIENTS AND METHODS

A total of 40 patients with IGH were enrolled. The hypopigmented lesions were treated using a 10 600-nm carbon dioxide fractional laser (CO(2) FL). Two months after a single treatment, physicians' clinical assessments were performed and the patients' overall satisfaction was evaluated.

RESULTS

The mean age of enrolled patients was 57.5 ± 10.9 years and the gender ratio was 7 : 33. The face was the most commonly treated area, although the extremities are epidemiologically the most frequently affected areas. Two months after treatment, objective assessments performed by two independent dermatologists indicated more than 50% improvement in 36 patients (90%), compared with baseline. In addition, 33 patients (82.5%) were very satisfied or satisfied with just one session of CO(2) FL treatment. Although a few patients complained of long-standing erythema and postinflammatory hyperpigmentation, these problems spontaneously resolved within 2 months after the assessments. No other noticeable side effects were observed.

CONCLUSION

CO(2) FL might be a very convenient and effective modality for treating IGH without significant side effects.

H⁺-myo-inositol transporter SLC2A13 as a potential marker for cancer stem cells in an oral squamous cell carcinoma

Cancer Stem Cells (CSCs) from tumors of different phenotypes possess a marked capacity for proliferation, self-renewal, and differentiation. They also play a critical role in cancer recurrence. Although CSC has been regarded as a new target for cancer therapy, the fundamental questions in the CSC study have not been resolved mainly due to the lack of proper CSC markers. To find new CSC markers for oral squamous cell carcinoma (OSCC), we cultured the primary tumor cells from OSCC patients the regular culture condition and the sphere-forming culture condition to enrich primary tumor cells and potential CSCs. We compared gene expression profiles between sphere-forming and non-forming cells, thus identifying that 23 membrane protein-coding genes were over-expressed in the sphere-forming cells. Among them, 8 belonged to the solute carrier (SLC) protein family. H⁺-myo-inositol transporter SLC2A13 and monocarbohydrate transporter SLC16A6 genes that were consistently increased in the sphere-forming cells in the primary cultures of OSCC samples. Confocal microscopy revealed that SLC2A13-expressing cells were embedded in the limited areas of tumor tissue as a cluster, while SLC16A6 was uniformly detected in hyperplastic epithelium. Moreover, SLC2A13 an expression was induced in human breast adenocarcinoma MCF7 cells after serum starvation. Taken together, our results suggest that SLC2A13 can be a potential markers for CSC in various tumors.

Diagnostic sensitivity of culture and drug resistance patterns in Korean patients with intestinal tuberculosis

SETTING

It is challenging to differentiate between intestinal tuberculosis (ITB) and Crohn's disease in areas where TB is still prevalent. The use of diagnostic tools and verifying the drug resistance patterns of ITB can be helpful for its correct diagnosis.

OBJECTIVE

To determine the diagnostic sensitivity of a culture assay using colonoscopic biopsy specimens and the drug resistance patterns of Mycobacterium tuberculosis isolated from ITB.

DESIGN

Data from 400 patients diagnosed with ITB were retrospectively analysed.

RESULTS

Of the 400 patients, 170 (42.5%) were males; the median age at diagnosis was 40 years. The sensitivity of culture was 44.1% (145/329). Resistance to at least one anti-tuberculosis drug was identified in 13 (17.6%) and multidrug-resistant TB (MDR-TB) was diagnosed in two (2.7%) of the 74 patients for whom drug susceptibility testing was performed. Including M. tuberculosis isolated from respiratory specimens, the proportion of MDR-TB was 4.4% (5/113); previous anti-tuberculosis treatment was an independent risk factor for MDR-TB (26.7% vs. 1.0%, P < 0.01).

CONCLUSION

Culture of colonoscopic biopsy specimens shows substantial diagnostic sensitivity; the frequency of MDR-TB is higher in previously treated cases than in new cases.

Randomised phase II trial of docetaxel and sunitinib in patients with metastatic gastric cancer who were previously treated with fluoropyrimidine and platinum

BACKGROUND

Docetaxel is widely used as a chemotherapeutic agent for gastric cancer treatment. A combined regimen with sunitinib demonstrated a synergistic antitumour effect in a preclinical model. The aim of this study was to evaluate the efficacy and safety of this combination in patients with unresectable or metastatic advanced gastric cancer following failure of treatment with a fluoropyrimidine and platinum combination.

METHODS

This open-label, phase II, randomised trial enrolled patients with unresectable or metastatic gastric cancer. Patients were assigned to either a docetaxel monotherapy arm (D only arm: 60 mg m(-2), every 3 weeks) or a combination arm (DS arm: docetaxel+sunitinib 37.5 mg every day). The primary end point of the study was time to progression and the secondary end points were overall response rate, disease control rate, overall survival, and toxicity profile. A pharmacokinetic study was also performed.

RESULTS

A total of 107 patients were entered into the study. The TTP was not significantly prolonged in the DS arm when compared with the D only arm (DS vs D only arm: 3.9 months (95% confidence interval (CI) 2.9-4.9) vs 2.6 months (95% CI 1.8-3.5) (P=0.206). The hazard ratio for TTP was 0.77 (95% CI 0.52-1.16). However, the objective response rate was significantly higher in the DS arm (41.1% vs 14.3%, P=0.002). Patients in the DS arm experienced stomatitis, diarrhoea, and hand-foot syndrome more frequently.

CONCLUSION

The addition of sunitinib to docetaxel did not significantly prolong TTP, although it significantly increased response.

A 6-month, open-label, multicenter clinical study in Korean de novo renal transplant patients evaluating the efficacy, safety, and tolerance of myfortic concomitantly used with tacrolimus

Enteric-coated mycophenolate sodium (myfortic, Novartis Pharma AG, Basel, Switzerland) is designed to improve the gastrointestinal tolerability of micophenolic acid. This study was designed to evaluate the efficacy and safety of myfortic in Korean de novo renal transplantation. A total of 65 patients from four transplantation centers received the study drug at least once and were included in the intention-to-treat analysis. This study was an open-label, single-arm, multicenter trial with 6-month patient follow-up. Patients received 360 mg (body weight < 50 kg) or 720 mg (body weight > 50 kg) of myfortic per day with tacrolimus and steroids. Induction therapy included basiliximab. The incidence of biopsy-confirmed acute rejection (primary endpoint) within 6 months after transplantation was 7/65 (10.8%). There were 2 (3.1%) graft losses due to severe acute rejection and 1 (1.5%) patient-death due to cardiac arrest. Twenty-two (38.8%) patients experienced gastrointestinal discomfort; however, only 3 (4.5%) cases were associated with an apparent drug reaction. Seventeen (25.4%) patients underwent dose adjustment or myfortic discontinuation during the study period. Patient and graft survival rates at 6 months posttransplantation were 98.1% and 97.0%. Myfortic with tacrolimus-based immunosuppression was efficient and safe after de novo renal transplantation in Korean patients.

Sorafenib in patients with metastatic gastrointestinal stromal tumors who failed two or more prior tyrosine kinase inhibitors: a phase II study of Korean gastrointestinal stromal tumors study group

PURPOSE

To evaluated the efficacy and safety of sorafenib in patients with advanced gastrointestinal stromal tumors (GIST) who failed to previous standard treatments.

EXPERIMENTAL DESIGN

Thirty-one patients with measurable metastatic GIST who failed both imatinib and sunitinib were accrued. Sorafenib was administered orally at 400 mg twice daily until disease progression or development of intolerance. The primary endpoint was disease control rate (response + stable disease, DCR) at 24 weeks.

RESULTS

Sorafenib was well tolerated, with hand-foot skin reaction, fatigue, hypertension, and abdominal pain being the most frequent adverse events. The relative dose intensity of sorafenib during the first 6 months was >80%. Four patients achieved partial response (response rate 13%, 95% CI 1-25%), and 16 (52%) had stable disease. DCR at 24 weeks was measured as 36% (95% CI 19-52%). Median progression-free and overall survivals were 4.9 and 9.7 months, respectively. Progression-free survival of patients with prior use of nilotinib (P = .0085) and with primary genotypes other than KIT exon 11 mutation (P = .0341) was significantly shorter than that of patients without.

CONCLUSIONS

Sorafenib showed antitumor activity in this population of imatinib and sunitinib pretreated GIST. With sorafenib, about one third of patients can maintain disease control for more than 24 weeks.

Is asymptomatic hemorrhagic transformation really innocuous?

OBJECTIVES

Asymptomatic hemorrhagic transformation (HT) is not associated with immediate deterioration of patients with acute ischemic stroke. However, it is unclear whether it is clinically innocuous with respect to long-term outcome. The aim of this study was to determine the impact of asymptomatic HT on 3-month outcome.

METHODS

A consecutive series of 1,618 patients, hospitalized between January 2004 and August 2007 for ischemic stroke within 7 days from symptom onset were identified in a prospective stroke registry database. Those who had no evidence of acute cerebral ischemia on diffusion-weighted MRI, who did not undergo T2-weighted gradient echo MRI, whose modified Rankin Scale (mRS) score at 3 months after stroke onset was not available, or who had symptomatic HT were excluded. The odds ratio (OR) of asymptomatic HT was calculated for the full distribution of mRS score and adjusted for variables with p < 0.25 with respect to their associations with asymptomatic HT or functional outcome.

RESULTS

Of 1,412 patients eligible for the study, 100 (7.1%) had asymptomatic HT. Patients who experienced asymptomatic HT were more likely to have cardioembolic stroke, to receive thrombolytic therapy, to receive anticoagulation with heparin, and to have a higher initial NIH Stroke Scale score. The crude and adjusted ORs of asymptomatic HT for an increment of mRS score at 3 months were 2.94 (95% confidence interval 2.05-4.24) and 1.90 (1.27-2.82), respectively.

CONCLUSIONS

Our study shows that the odds of a worse outcome are increased by a factor of 2 in patients with asymptomatic HT compared with those without HT after acute ischemic stroke.

Long term follow-up of appendiceal and distal right-sided colonic inflammation

The aim of this study was to investigate the possibility of appendiceal orifice inflammation (AOI) as a preceding lesion in the development of ulcerative colitis. A total of 20 patients were identified (mean age 41.2 years; 11 males) who had ulcerative colitis-like inflammatory lesions at the appendiceal orifice without concomitant typical features of ulcerative colitis, such as rectal involvement. A total of 19 patients were followed up endoscopically for a mean duration of 18.4 months (range 2 - 84 months). Typical ulcerative colitis developed in five patients (25 %; four proctitis, one pancolitis) in a mean time of 18.4 months (range 2 - 36 months). Negative conversion of all inflammatory lesions occurred in seven patients (35 %) after a mean follow-up of 20 months (range 3 - 84 months). In the remaining seven patients (35 %), initial lesions did not progress to ulcerative colitis and did not go into remission during a mean follow-up of 16.9 months (range 2 - 42 months). These results suggest that, at least in some cases, AOI precedes development of ulcerative colitis.

Randomised clinical trial: the efficacy of a 10-day sequential therapy vs. a 14-day standard proton pump inhibitor-based triple therapy for Helicobacter pylori in Korea

BACKGROUND

The eradication rates of Helicobacter pylori (H. pylori) using a proton pump inhibitor (PPI)-based triple therapy have declined due to antibiotic resistance worldwide.

AIM

To compare the eradication rate of the 10-day sequential therapy for H. pylori infection with that of the 14-day standard PPI-based triple therapy.

METHODS

This was a prospective, randomised, controlled study. A total of 409 patients with H. pylori infection were randomly assigned to receive either the 10-day sequential therapy regimen, which consisted of pantoprazole (40 mg) plus amoxicillin (1000 mg) twice a day for 5 days, then pantoprazole (40 mg) with clarithromycin (500 mg) and metronidazole (500 mg) twice a day for another five consecutive days or the 14-day PPI-based triple therapy regimen, which consisted of pantoprazole (40 mg) with amoxicillin (1000 mg) and clarithromycin (500 mg) twice a day for 14 days. The pre- and post-treatment H. pylori status were assessed by rapid urease test, urea breath test, or histology. Successful eradication was confirmed at least 4 weeks after finishing the treatment.

RESULTS

In the intention-to-treat analysis, the eradication rates of the 10-day sequential therapy and of the 14-day PPI-based triple therapy were 85.9% (176/205) and 75.0% (153/205), respectively (P = 0.006). In the per-protocol analysis, the eradication rates were 92.6% (175/205) and 85% (153/204), respectively (P = 0.019). There was no statistically significant difference between the two investigated groups regarding the occurrence of adverse event rates (18.9% vs. 13.3%, P = 0.143).

CONCLUSION

The 10-day sequential therapy achieved significantly higher eradication rates than the 14-day standard PPI-based triple therapy in Korea.

Comparison of premolar cuspal deflection in bulk or in incremental composite restoration methods

OBJECTIVES

This study examined the cuspal deflection of maxillary premolars when either a bulk filling or incremental filling technique was employed using a range of composites with different elastic moduli.

METHODS

Four brands of composite materials, Heliomolar (HM, Ivoclar Vivadent, Schaan, Liechtenstein), Heliomolar HB (HH, Ivoclar Vivadent, Schaan, Liechtenstein), Filtec Supreme XT (FS, 3M Dental Product, St Paul, MN, USA), and Renew (RN, Bisco Inc, Schaumburg, IL, USA), as well as three filling techniques, bulk filling, two-layer incremental filling, and three-layer incremental filling methods, were used. One hundred twenty caries-free human premolars were collected and divided into four groups according to the filling material used. Each of these four groups was then subdivided into three groups according to filling method. In group 1, a bulk filling of 0.15 g of each resin was inserted and light-cured with LED light from the occlusal, mesial, and distal surfaces for 60 seconds each. Group 2 was given two horizontal increments, 0.08 g and 0.07 g, with each increment light-cured from the occlusal, mesial, and distal surfaces for 30 seconds each. In group 3, three horizontal increments of 0.05 g were used, each of which was light-cured from the occlusal, mesial, and distal surfaces for 20 seconds each. The cuspal deflection was measured using a customized cuspal deflection measuring machine for 10 minutes after initiating light polymerization. The elastic modulus of each composite resin material was measured using a three-point bending test. Two-way analysis of variance (ANOVA) with a Dunnet test was used to examine the effect of the two variables (curing methods, materials) on the amount of cuspal deflection at the 95% confidence level. In each material, groups 1, 2 and 3 were compared using one-way ANOVA and a Dunnet test at the 95% confidence level. The elastic moduli of HM, HH, FS, and RN were compared using one-way ANOVA and a Tukey test at the 95% confidence level. The relationship between the amount of cuspal deflection in each group and the elastic modulus of the composite was analyzed using a Pearson correlation test.

RESULTS

The amount of cuspal deflection in HH was larger than in the other materials (HM, FS, and RN; p<0.05). There was no significant difference between HM, FS, and RN. The amount of cuspal deflection was greatest in group 1, followed in order by groups 2 and 3 (p<0.05). The amount of cuspal deflection was in the following order: group 1≥2≥3 in HM, and 1>2, 3 in HH, FS, and RN. The elastic modulus was HH>RN>FS>HM (p<0.05). There was a positive correlation between the cuspal deflection and the elastic modulus of the composite.

CONCLUSIONS

The incremental filling techniques reduced the amount of cuspal deflection in all composite groups with different elastic moduli. The amount of cuspal deflection showed a positive correlation with the elastic modulus of the composite.

Outcomes of endoscopic transpapillary gallbladder stenting for symptomatic gallbladder diseases: a multicenter prospective follow-up study

BACKGROUND AND STUDY AIMS

Endoscopic transpapillary gallbladder drainage for symptomatic gallbladder disease is a safe and effective bridge therapy in patients at high risk for surgery or who have terminal liver disease and are awaiting transplantation. However, there are few reports on long-term results in terms of stent patency and clinical course. Our study was designed to investigate the long-term patency and clinical course after endoscopic transpapillary gallbladder stenting (ETGS) in patients with symptomatic gallbladder disease.

PATIENTS AND METHODS

A total of 29 patients who were unsuitable for cholecystectomy underwent ETGS from June 2006 to March 2010 using a 7-Fr double-pigtail stent between the gallbladder and the duodenum. Their clinical progress, adverse events, and stent patency after ETGS were recorded prospectively in two tertiary referral centers.

RESULTS

Technically, ETGS was successful in 23 (79.3%) of the 29 patients. The mean procedure time was 22.4 ± 11.5 min. Postprocedure adverse events were mild pancreatitis (8.7%) and cholestasis (8.7%), all of which resolved with conservative management. During the follow-up period (median 586 days, range 11-1403 days), 20 patients were analyzed as per protocol, and scheduled follow-up was performed. Late adverse events developed in four patients (20%), including distal migration (n = 2), cholangitis (n = 1), and recurrent biliary pain (n = 1). The remaining 16 patients were followed for more than 12 months (nine patients were followed for more than 24 months). Median stent patency was 760 days, as determined by the Kaplan-Meier method.

CONCLUSIONS

As a primary therapy, ETGS is technically feasible and effective in patients who are unsuitable for cholecystectomy. ETGS may also provide long-term stent patency without the need for scheduled stent exchanges.

Detection of Salmonella spp. survival and virulence in poultry feed by targeting the hilA gene

AIMS

The objectives of this work were to evaluate immunomagnetic beads and a reverse transcriptase (RT)-PCR method for the detection of Salmonella inoculated into feed. In addition, a reverse transcriptase (RT)-PCR method was evaluated for quantifying virulence gene hilA expression of Salmonella ssp. in poultry feed matrices and utilized to determine the influence of poultry feed environmental factors on Salmonella hilA expression.

METHODS AND RESULTS

An immunomagnetic separation technique was evaluated for increased recovery of Salmonella from feed. Salmonella cultures were inoculated into feed samples and exposed to heat treatments of 70°C and sampled periodically. From these samples, RNA was collected and hilA gene expression was measured relative to the housekeeping 16S rRNA gene. The immunomagnetic bead protocol increased recovery by 1 log. The up-regulation of hilA was demonstrated after 5 and 10 min of inoculated feed samples being exposed to heat treatment.

CONCLUSIONS

From this work, the data indicate that the ability to detect live Salmonella cells in feed samples may be increased by targeting the hilA gene.

SIGNIFICANCE AND IMPACT OF THE STUDY

Foodborne salmonellosis originating from poultry is a major problem, and feed is a leading source of contamination in poultry, but detection in feed is complicated by low concentrations. The assays and experiments in this study examine possible improvements to recovery and detection of Salmonella in feed.

Design of species-specific oligonucleotide probes for the detection of Bacteroides and Parabacteroides by fluorescence in situ hybridization and their application to the analysis of mouse caecal Bacteroides-Parabacteroides microbiota

AIMS

To develop species-specific monitoring techniques for rapid detection of Bacteroides and Parabacteroides inhabiting the mouse intestine by fluorescence in situ hybridization.

METHODS AND RESULTS

The specificity of oligonucleotide probes was evaluated by fluorescence whole-cell hybridization. Oligonucleotide probes specific for each species hybridized only with the target bacteria. Using these probes, caecal Bacteroides-Parabacteroides microbiota of conventional mice and specific pathogen-free (SPF) mice from three different breeders were analysed. It was shown that Bacteroides acidifaciens Group-1, Group-2 and Group-3 were dominant in conventional mice and SPF mice from two out of three breeders. Bacteroides vulgatus and Parabacteroides distasonis were detected in one of these two SPF breeding colonies in addition to Bact. acidifaciens. SPF mice of the remaining breeder harboured characteristic Bacteroides-Parabacteroides microbiota, consisting of Bacteroides sp. ASF519 and Bacteroides caccae.

CONCLUSIONS

Bacteroides acidifaciens is the dominant and most typical species in the mouse Bacteroides-Parabacteroides microbiota. The Group-3 was identified as a novel group and revealed to occupy a major niche together with Bact. acidifaciens Group-1 and Group-2.

SIGNIFICANCE AND IMPACT OF THE STUDY

The species-specific probe set developed in this study was the efficient tool for rapid detection of target bacterial groups inhabiting the mouse intestine. The results of this study provide important new information on the mouse Bacteroides-Parabacteroides community.

Improved light extraction efficiency of InGaN-based multi-quantum well light emitting diodes by using a single die growth

We have demonstrated that the light extraction efficiency of the InGaN based multi-quantum well light-emitting diodes (LEDs) can be improved by using a single die growth (SDG) method. The SDG was performed by patterning the n-GaN and sapphire substrate with a size of single chip (600 x 250 microm2) by using a laser scriber, followed by the regrowth of the n-GaN and LED structures on the laser patterned n-GaN. We fabricated lateral LED chips having the SDG structures (SDG-LEDs), in which the thickness of the regrown n-GaN was varied from 2 to 6 microm. For comparison, we also fabricated conventional LED chips without the SDG structures. The SDG-LEDs showed lower operating voltage when compared to the conventional LEDs. In addition, the output power of the SDG-LEDs was significantly higher than that of the conventional LEDs. From optical ray tracing simulations, the increase in the thickness and sidewall angle of the regrown n-GaN and LED structures may enhance photon escapes from the tilted facets of the regrown n-GaN, followed by the increase in light output power and extraction efficiency of the SDG-LEDs.

The effects of mesenchymal stem cells injected via different routes on modified IL-12-mediated antitumor activity

Owing to its tumor tropism and prolonged transgene expression, mesenchymal stem cell (MSC) has been considered as an ideal delivery vehicle for cancer gene therapies or therapeutic vaccines. In this study, we demonstrated that intratumoral (i.t.) injection of MSCs expressing modified interleukin-12 (MSCs/IL-12M) exhibited stronger tumor-specific T-cell responses and antitumor effects as well as more sustained expressions of IL-12 and interferon (IFN)-γ in both sera and tumor sites than did IL-12M-expressing adenovirus (rAd/IL-12M) in mice bearing both solid and metastatic tumors. Subcutaneous (s.c.) injection of MSCs/IL-12M at contralateral site of tumor exhibited similar levels of serum IL-12 and IFN-γ as i.t. injection, but much weaker antitumor effects in both B16F10 melanoma and TC-1 cervical cancer models than i.t. injection. Although intravenous (i.v.) injection elicited earlier peak serum levels of cytokines, it induced weaker tumor-specific T-cell responses and antitumor effects than i.t. injection, indicating that serum cytokine levels are not surrogate indicators of antitumor effects. Taken together, these results indicated that MSC is more efficient than adenovirus as a cytokine gene delivery vehicle and that i.t. injection of MSCs/IL-12M is the best approach to induce strong tumor-specific T-cell responses that correlate with anti-metastatic effects as well as inhibition of solid tumor growth, although MSCs themselves have an ability to migrate into the tumor site. In addition, MSCs/IL-12M embedded in Matrigel (MSCs/IL-12M/Matrigel) exhibited significant antitumor effects even in immunodeficient mice such as SCID and BNX mice lacking T, B and natural killer (NK) cells, but not in IFN-γ knockout mice. Our findings provide an optimal approach for designing an efficient clinical protocol of MSC-based cytokine gene therapy to induce strong tumor-specific T-cell responses and therapeutic anticancer efficacy.

Detection and characterization of enterovirus associated with herpangina and hand, foot, and mouth disease in Seoul, Korea

BACKGROUND

Human enteroviruses (HEVs) are a major cause of herpangina, HFMD (hand, foot, and mouth disease), and other neurological diseases in Seoul, Korea.

METHODS

A total of 56 specimens from hospitalized patients collected from February to December 2009 (37 females and 19 males) in Seoul were tested for HEV from stool, throat swab, and vesicle swab samples taken from patients with herpangina or HFMD using cell culture and RT-PCR in 2009. By the 1D gene, encoding the VP1 capsid protein, seven different HEV genotypes were detected with Coxsackievirus A2, A4, A5, A9, A16 (CA), Coxsackievirus B1 (CB), and Enterovirus 71 (EV71). The most prevalent genotype was CA16 (6, 10.7%), followed by CA2 (4, 7.1%), CA5 (4, 7.1%), EV71 (2, 3.6%), CA4 (1, 1.8%), CA9 (1, 1.8%), and CB1 (1, 1.8%). The 1D gene sequences of two EV71 strains were closely related with one another (98.5% nucleotide similarity) and belonged to the C4 genotype.

CONCLUSIONS

It is important to continuously survey the genetic characteristics of EV71 and CA16 from patients, which will provide useful data that aids in our understanding of HFMD infections in Seoul, Korea and may contribute to future control.

Degradation of organic dye using zero-valent iron prepared from by-product of pickling line

In this study, zero-valent iron (ZVI) was produced using iron oxide that is a by-product of a pickling line at a steel works. The reaction activity of the produced ZVI was evaluated through a series of decomposition experiments of Orange II aqueous solution. The size of ZVI particles increased with reduction temperature due to coalescence. Correspondingly, the specific surface area of ZVI decreased with increasing reduction temperature. The decomposition efficiency of synthesized ZVI particles was higher at a lower pH. In particular, no significant decomposition reaction was observed at pH of 4 and higher. The rate of the ZVI-assisted decomposition of Orange II was increased by addition of H2O2 at pH of 3, whereas it was reduced by addition of H2O2 at a higher pH of 6. Nevertheless, simultaneous use of ZVI, UV and H2O2 led to a considerable increase in the decomposition rate even at a high pH condition (pH = 6).

Viral agents associated with acute gastroenteritis in Seoul, Korea

BACKGROUND

The present study was carried out to describe the epidemiologic characteristics of viral gastroenteritis and determine the phylogenetic composition of norovirus strains detected in hospitalized children with acute gastroenteritis in Seoul, Korea.

METHODS AND RESULTS

In total, 10,603 stool samples were collected from 2004 to 2008 and tested by RT-PCR or ELISA. In 4,170 (39.3%) samples at least one viral pathogen was present. Rotavirus (RoV) (1,864, 17.5%) was found to be the causative agent followed by norovirus (NoV) (1,845, 17.4%), human adenovirus (HAdV) (266, 2.5%), human astrovirus (HAstV) (194, 1.8%), and sapovirus (SV) (1, 0.009%). Five GI genotypes (GI-1, GI-3, GI-4, GI-8, and GI-9) and eight GII genotypes (GII-2, GII-3, GII-4, GII-6, GII-7, GII-12, GII-16, and GII-17) of NoV were identified in acute gastroenteritis patients in 2008.

CONCLUSIONS

The genetic characteristics of norovirus and the epidemiologic patterns of a viral pathogen from acute gastroenteritis patients may give potentially effective data for epidemiological studies in Seoul, Korea.

A short period of inhalation induction with sevoflurane prevents rocuronium-induced withdrawal in children

BACKGROUND

the aim of this study was to determine whether or not inhalation induction with sevoflurane can prevent the withdrawal movement associated with the injection of rocuronium.

METHODS

a total of 75 pediatric patients were randomly allocated to five groups (S 1.5, 2.0, 2.5, 3.0, and the control group). In the control group (n=15), 2.5% thiopental 5 mg/kg was injected intravenously. Rocuronium 0.4 mg/kg was injected immediately after loss of consciousness. In the S 1.5, 2.0, 2.5, or 3.0 group, rocuronium 0.4 mg/kg was injected at 1.5, 2, 2.5, or 3 min after inhalation induction, respectively, and the withdrawal response was recorded. End-tidal sevoflurane concentrations were recorded at the time of the rocuronium injection. The inhalation time of sevoflurane before rocuronium injection required to provide no withdrawal response in 50% and 95% of patients (IT(50) and IT(95) ) was calculated.

RESULTS

the incidence of withdrawal was 80% (12/15), 71.4% (10/14), 21% (3/14), 0% (0/14), and 0% (0/15) in group C, group S 1.5, group S 2.0, group S 2.5, and group S 3.0, respectively. IT(50) of the rocuronium injection time was 1.7 min (95% CI: 1.5-1.9) and IT(95) was 2.3 min (95% CI: 2.0- 2.9).

CONCLUSIONS

this study demonstrated that inhalation induction with sevoflurane can prevent the withdrawal movement induced by rocuronium in children, and IT(50) and IT(95) for the prevention of movement was 1.7 and 2.3 min, respectively.