Targeting FGF19 inhibits tumor growth in colon cancer xenograft and FGF19 transgenic hepatocellular carcinoma models

Although fibroblast growth factor 19 (FGF19) can promote liver carcinogenesis in mice its involvement in human cancer is not well characterized. Here we report that FGF19 and its cognate receptor FGF receptor 4 (FGFR4) are coexpressed in primary human liver, lung and colon tumors and in a subset of human colon cancer cell lines. To test the importance of FGF19 for tumor growth, we developed an anti-FGF19 monoclonal antibody that selectively blocks the interaction of FGF19 with FGFR4. This antibody abolished FGF19-mediated activity in vitro and inhibited growth of colon tumor xenografts in vivo and effectively prevented hepatocellular carcinomas in FGF19 transgenic mice. The efficacy of the antibody in these models was linked to inhibition of FGF19-dependent activation of FGFR4, FRS2, ERK and beta-catenin. These findings suggest that the inactivation of FGF19 could be beneficial for the treatment of colon cancer, liver cancer and other malignancies involving interaction of FGF19 and FGFR4.

The lack of significance of Ca125 response in epithelial ovarian cancer patients treated with neoadjuvant chemotherapy and delayed primary surgical debulking

OBJECTIVES

To examine the prognostic significance of Ca125 response to neoadjuvant chemotherapy and delayed primary surgical debulking in epithelial ovarian cancer patients.

METHODS

Retrospective chart reviews were carried out from 1997 to 2005 to identify ovarian cancer patients treated with neoadjuvant chemotherapy. Ca125 response was defined as being a decrease of at least 50% from baseline assessment. Ca125 response was assessed in two phases: prior to surgical debulking to reflect the response to neoadjuvant chemotherapy and at the end of primary chemotherapy to assess the response to debulking surgery and further chemotherapy. Cox proportional hazard models were built to model progression-free intervals using predictor variables of: age, cancer stage, tumour grade, residual disease, and Ca125 response.

RESULTS

Ninety-one patients were included. About 83% had a positive Ca125 response following three cycles of neoadjuvant chemotherapy preoperatively. Cox regressions revealed two significant predictive variables of prolonged time to first progression: younger age (p=0.002) and microscopic residual disease compared to suboptimal residual disease (p=0.003). Ca125 response to neoadjuvant chemotherapy was not significantly predictive of progression-free survivals. The estimated median survival was 71.42 months (95% CI: 44.34-78.50) in patients with >50% Ca125 decrease from surgery and further chemotherapy whereas in those with no response, the corresponding survival estimate was 44.02 months (95% CI: 33.26-54.79).

CONCLUSION

The lack of Ca125 response from neoadjuvant chemotherapy is not an independent prognostic factor. All patients treated with neoadjuvant chemotherapy should undergo radical debulking surgery.

Prognostic significance of tumor necrosis in ovarian cancer patients treated with neoadjuvant chemotherapy and interval surgical debulking

The objective of this study was to study the significance of tumor necrosis documented at the time of interval surgical debulking after neoadjuvant chemotherapy. Retrospective chart reviews were carried out from 1997 to 2005 to identify ovarian cancer patients treated with neoadjuvant chemotherapy. Patients' demographics together with disease characteristics, treatment-related variables, and outcomes were recorded. Cox proportional hazard models were built to model time to progression using predictor variables such as age, cancer stage, tumor grade, residual disease, percentage change in CA125 level from baseline, and degree of necrosis in resected tumor specimens. One hundred one patients were included in the study. Optimal debulking was achieved in 74% of the patients. Cox regressions revealed three significant predictive variables of time to first progression: younger age (hazard ratio [HR] = 0.95, 95% CI 0.92-0.98, P= 0.004), residual disease (P= 0.048), and the absence/minimal tumor necrosis after three cycles of neoadjuvant chemotherapy (HR = 1.97, 95% CI 1.01-3.87, P= 0.048). The estimated median survival was 50.66 months (95% CI 46.12-55.20). The lack of or minimal tumor necrosis after neoadjuvant chemotherapy is an independent risk factor for recurrent disease.

Characterization of ANIT-induced toxicity using precision-cut rat and dog liver slices cultured in a dynamic organ roller system

This article describes the toxicity of alpha-naphthylisothiocyanate (ANIT), a compound known to induce dose-dependent hepatobiliary toxicity in vivo, using the slice model. Liver slices (200 microm thick) from male Sprague-Dawley rats and male beagle dogs were cultured for 7 days while exposed to a range of ANIT concentrations (1- 100 microM for rat and 4-320 microM for dog). Tissues (and medium for dog) were evaluated using a panel of clinically relevant biomarkers for liver and histological endpoints to assess viability and proliferation. ANIT increased slice levels of enzyme biomarkers corresponding to biliary markers. At high concentrations (80-100 microM for rat, 320 microM for dog) a diminution of tissue enzyme levels was observed, corresponding to severe hepatobiliary injury. By days 5 and 7, biochemical markers in the medium of dog slices indicated an elevation of hepatocellular and biliary markers. Histologically for both species, minimal hepatocellular injury was noted, but proliferation of biliary epithelial cells (BEC) was observed using 5-bromo-2-deoxyuridine (BrdU) immunostaining. In rat slices, ANIT increased the expression of inducible nitrous oxide synthase (iNOS) within 12 hrs of exposure. In summary, additional experimentation using slice culture may further demonstrate its value in screening compounds that cause hepatobiliary toxicity.

Sensitivity study of human crystalline lens accommodation

A nonlinear axisymmetric finite element method (FEM) analysis was employed to determine the critical geometric and material properties that affect human accommodation. In this model, commencing at zero, zonular traction on all lens profiles resulted in central lenticular surface steepening and peripheral surface flattening, with a simultaneous increase in central lens thickness and central optical power. An age-related decline in maximum zonular tension appears to be the most likely etiology for the decrease in accommodative amplitude with age.

Insights into the age-related decline in the amplitude of accommodation of the human lens using a non-linear finite-element model

AIM

To understand the effect of the geometric and material properties of the lens on the age-related decline in accommodative amplitude.

METHODS

Using a non-linear finite-element model, a parametric assessment was carried out to determine the effect of stiffness of the cortex, nucleus, capsule and zonules, and that of thickness of the capsule and lens, on the change in central optical power (COP) associated with zonular traction. Convergence was required for all solutions.

RESULTS

Increasing either capsular stiffness or capsular thickness was associated with an increase in the change in COP for any specific amount of zonular traction. Weakening the attachment between the capsule and its underlying cortex increased the magnitude of the change in COP. When the hardness of the total lens stroma, cortex or nucleus was increased, there was a reduction in the amount of change in COP associated with a fixed amount of zonular traction.

CONCLUSIONS

Increasing lens hardness reduces accommodative amplitude; however, as hardness of the lens does not occur until after the fourth decade of life, the age-related decline in accommodative amplitude must be due to another mechanism. One explanation is a progressive decline in the magnitude of the maximum force exerted by the zonules with ageing.

Phase II study of exemestane (E) in refractory ovarian cancer (ROC)

5026

Background: Despite biologic rationale, endocrine therapeutic strategies have been under investigated in ovarian cancer. This is the first study to report the efficacy of an aromatase inhibitor, E, in patients (pts) with ROC. Methods: This was a pilot, phase II, single-centre, non-comparative, open-label study. Pts with ROC stage II - IV who had received no more than 2 lines of prior chemotherapy, had ECOG PS ≤ 2, and measurable disease or non-measurable disease with a CA 125 ≥ 30 U/mL and/or ascites were eligible. All pts must have received prior platinum and taxane chemotherapy. Treatment consisted of E 25mg p.o. daily until disease progression. The primary endpoint was objective response rate (ORR) and secondary endpoints were time to progression (TTP), duration of response (DR) and toxicity. Results: 24 pts have been enrolled to date. Only 2 pts who withdrew consent or never started E were excluded from this analysis. Subjects had stage III (77%) or IV (18%) ovarian cancer, the majority were grade 3,serous histology. 15 pts (68%) had 2 prior lines of therapy and 7 pts (32%) had only 1 prior line of therapy. Treatment was commenced in the majority immediately after progression on chemotherapy. There were no objective clinical responses; however 8/22 (36%) pts had stable disease (SD) >14 weeks (med. duration 23 wks). One pt remains with SD > 95 wks duration. The median TTP was 8.8 wks. Receptor status was available in 16/22 pts: ER+ (41%), PgR+ (32%), BCL-2+ (23%) and HER2+ (0%). Correlation of ORR/SD with receptors and CA 125 will be presented. Toxicity was evaluated in all pts who received at least one dose of E. Hyponatremia (gr 4), attributed to disease, was observed in 1 pt. All other toxicities were NCI CTC grade ≤ 2: fatigue (14%), hot flashes (9%), skin reaction (5%), and fluid retention (5%). Conclusions: In this highly refractory ROC pt population, E was associated with an impressive, clinically meaningful SD rate of 36%. As this potentially represents a less toxic, well-tolerated therapeutic option for women with ROC, further investigation is warranted. Supported by a grant from Pfizer Canada

No significant financial relationships to disclose.

Psychologic morbidities prior to loop electrosurgical excision procedure in the treatment of cervical intraepithelial neoplasia

The objective of this study was to assess and compare anxiety and distress in patients undergoing colposcopic examinations and loop electrosurgical excision procedure (LEEP). Patients seen for evaluation of cervical intraepithelial neoplasia (CIN) and LEEP were recruited. All patients received further teaching with respect to their abnormality right after the colposcopic evaluation by nursing staff. The Hospital anxiety and Depression Scale (HADS) and the Psychosocial Effects of Abnormal Pap Smears (PEAPS) questionnaires were used to measure and compare distress between the two groups. Linear regression models were built to identify significant predictive variables for psychologic morbidities. Twenty-one colposcopy and 20 LEEP patients participated in this study. No significant demographic differences were noted. Eighty-one percent of patients having colposcopy and 65% of those undergoing LEEP can be classified as having significant anxiety and depression based on the HADS questionnaire. Patients undergoing LEEP scored significantly better than colposcopy patients on the mean total PEAPS score and on the self-belief/cancer concern and effects on sexual relationship dimension scores. Significant psychologic morbidities exist in patients diagnosed with CIN. Face-to-face individualized education and support after colposcopy can decrease patients' distress at subsequent treatment visits.

Prognostic significance of tumor necrosis in ovarian cancer patients treated with neoadjuvant chemotherapy and interval surgical debulking

The objective of this study was to study the significance of tumor necrosis documented at the time of interval surgical debulking after neoadjuvant chemotherapy. Retrospective chart reviews were carried out from 1997 to 2005 to identify ovarian cancer patients treated with neoadjuvant chemotherapy. Patients' demographics together with disease characteristics, treatment-related variables, and outcomes were recorded. Cox proportional hazard models were built to model time to progression using predictor variables such as age, cancer stage, tumor grade, residual disease, percentage change in CA125 level from baseline, and degree of necrosis in resected tumor specimens. One hundred one patients were included in the study. Optimal debulking was achieved in 74% of the patients. Cox regressions revealed three significant predictive variables of time to first progression: younger age (hazard ratio [HR] = 0.95, 95% CI 0.92–0.98, P = 0.004), residual disease (P = 0.048), and the absence/minimal tumor necrosis after three cycles of neoadjuvant chemotherapy (HR = 1.97, 95% CI 1.01–3.87, P = 0.048). The estimated median survival was 50.66 months (95% CI 46.12–55.20). The lack of or minimal tumor necrosis after neoadjuvant chemotherapy is an independent risk factor for recurrent disease.

Psychologic morbidities prior to loop electrosurgical excision procedure in the treatment of cervical intraepithelial neoplasia

The objective of this study was to assess and compare anxiety and distress in patients undergoing colposcopic examinations and loop electrosurgical excision procedure (LEEP). Patients seen for evaluation of cervical intraepithelial neoplasia (CIN) and LEEP were recruited. All patients received further teaching with respect to their abnormality right after the colposcopic evaluation by nursing staff. The Hospital anxiety and Depression Scale (HADS) and the Psychosocial Effects of Abnormal Pap Smears (PEAPS) questionnaires were used to measure and compare distress between the two groups. Linear regression models were built to identify significant predictive variables for psychologic morbidities. Twenty-one colposcopy and 20 LEEP patients participated in this study. No significant demographic differences were noted. Eighty-one percent of patients having colposcopy and 65% of those undergoing LEEP can be classified as having significant anxiety and depression based on the HADS questionnaire. Patients undergoing LEEP scored significantly better than colposcopy patients on the mean total PEAPS score and on the self-belief/cancer concern and effects on sexual relationship dimension scores. Significant psychologic morbidities exist in patients diagnosed with CIN. Face-to-face individualized education and support after colposcopy can decrease patients' distress at subsequent treatment visits.

Aortic dissection associated with Campylobacter aortitis

Infective aortitis and associated mycotic aneurysms are uncommon clinical entities and most reported cases are associated with Salmonella species. We report successful surgical and medical treatment of a mycotic aneurysm of the aorta which presented as acute pericarditis and may have been caused by Camplyobacter jejuni.

Prospective evaluations of continuous weekly paclitaxel regimen in recurrent platinum-resistant epithelial ovarian cancer

BACKGROUND

Paclitaxel administered on a weekly basis has been reported to possess both anti-angiogenic and apoptotic-inducing effects. We investigated the activity of a weekly continuous paclitaxel regimen in patients with recurrent platinum-resistant ovarian cancer.

METHODS

Patients with recurrent ovarian cancer and documented platinum-resistant disease were treated with weekly intravenous paclitaxel (60-80 mg/m(2)) continuously for up to 24 weeks over an 18-month period. Prospective data collection included: information on patients' demographics together with disease- and treatment-related toxicities. Response was evaluated using radiographic and Ca125 criteria. Chi-square tests were used to test for significant associations between categorical variables. Progression-free survival and overall survival time from commencement of weekly treatment were estimated using the Kaplan-Meier method. All P values less than 0.05 were considered to be statistically significant.

RESULTS

Thirty-four patients were treated on protocol. Five patients (15%) reported grade 3/4 neurotoxicity at the end of 12 weeks. No dose reduction or treatment delay was required. No significant hematologic toxicity was observed. Responses were evaluable in thirty-two patients. Complete response was observed in three patients (9%), and another 14 patients showed a partial response (44%). Seven patients (22%) had disease stabilization. The estimated median progression-free survival and overall survival were 6.10 months (95% CI:3.81-8.39) and 10.43 months (95% CI: 8.49-12.38) respectively from the start of the regimen.

CONCLUSION

Continuous weekly paclitaxel is a well-tolerated and active regimen in patients with recurrent platinum-resistant ovarian cancer.

Primary chemotherapy and adjuvant tumor debulking in the management of advanced-stage epithelial ovarian cancer

The aim of this article was to review the experience with neoadjuvant chemotherapy and interval surgical debulking in patients with metastatic epithelial ovarian cancer. A retrospective chart review was carried out to identify patients treated with neoadjuvant platinum/Taxol chemotherapy and interval debulking. Cox regression modeling was used to identify significant predictors of progression-free interval. The Kaplan-Meier method was used to estimate the survival statistic for the study group. Sixty-one patients were identified after being treated with neoadjuvant chemotherapy and interval debulking surgeries. All surgeries were performed after three cycles of platinum/Taxol combination chemotherapy. Eighty percent of patients had a residual disease status of 2 cm or less after surgery. Suboptimal debulking was statistically associated with tumor involvement of the upper abdominal organs (P < 0.001) and non-normalization of CA125 before surgery (P= 0.03). The perioperative complication rate was 7%. At a mean follow-up time of 19 months, 77% of patients were still alive. Cox regression modeling identified the microscopic tumor residual status as the only significant predictor of progression-free interval. The estimated median survival for the group was 41.70 months (95% confidence interval = 13.84-69.56 months). Neoadjuvant chemotherapy with interval debulking surgery appeared to be safe and feasible in patients with metastatic epithelial ovarian carcinoma.

Quality of life assessments in epithelial ovarian cancer patients during and after chemotherapy

To study the immediate and long-term effects of chemotherapy on quality of life (QoL) of advanced ovarian cancer patients. All consecutive patients undergoing chemotherapy for metastatic ovarian cancer and those presenting for follow-up post chemotherapy were recruited. Participants were asked to fill out a short QoL questionnaire (Functional Assessment Cancer Therapy-Ovarian) during each clinic visit. Two-factor analysis of variance analyses were used to examine the effects of chemotherapy treatment and current disease status on QoL scores. Ninety-four patients on chemotherapy and 159 follow-up patients participated. Patients on chemotherapy for recurrent disease had a significantly worsened overall, emotional, and ovarian cancer-specific concerns QoL scores compared to those receiving first-line chemotherapy. There were favorable significant differences between those on follow-up compared to those on chemotherapy in the mean overall QoL scores and in the means of physical, functional, and concern scores. There were significant differences favoring patients with complete response compared to those with partial response or progressive disease in the mean overall QoL scores as well as the physical, emotional, functional, and concern domains mean scores. There were improvements in most QoL measures after completion of chemotherapy. Complete disease remission remained important in maintaining improved QoL.

Quality of life assessment during adjuvant and salvage chemotherapy for advance stage epithelial ovarian cancer

OBJECTIVES

This report assessed the quality of life of ovarian cancer patients undergoing adjuvant and salvage chemotherapy treatment.

METHODS

All epithelial ovarian cancer patients requiring chemotherapy to manage their disease were recruited from university based gynecologic oncology clinics. Quality of life was measured using the FACT-O (Functional Assessment of Cancer Therapy-Ovarian module version 4) questionnaire. Descriptive statistics and two-way analysis of variance were used to compare the effect on the mean quality of life scores with respect to the indications of chemotherapy and best radiologic response. Any P value of less than 0.10 was considered worthy of interest.

RESULTS

Ninety-three patients participated. In the adjuvant setting, there was a trend towards better quality of life with better response to therapy. In patients with a first recurrence, complete response to therapy clearly had a beneficial effect on overall quality of life compared to stable or partial response. There was no significant quality of life difference between those with partial response versus stable disease in a first recurrent setting. In patients with more than one recurrence, no large change in overall quality of life was observed across the range of tumor responses.

CONCLUSION

Chemotherapy is beneficial to improve quality of life of ovarian cancer patients. Differential effect of tumor response status on quality of life at different treatment phases requires further investigations.

Human papilloma virus testing knowledge and attitudes among women attending colposcopy clinic with ASCUS/LGSIL pap smears

OBJECTIVE

To study women's knowledge regarding the role of human papilloma virus (HPV) in cervical intraepithelial neoplasia and their attitudes toward the integration of HPV testing as part of routine follow-up of atypical squamous cell of uncertain significance/low-grade squamous intraepithelial lesion (ASCUS/LGSIL) abnormalities.

METHODS

Over a 12-month period, all women attending the University of Ottawa colposcopy clinic for evaluation and follow-up of ASCUS/LGSIL Pap smears were recruited. Demographic data included age, nature of the Pap smear abnormality, gravidity, parity, occupation and education level, smoking history, previous history of abnormal smears, colposcopic examination and treatment, and current method of contraception. The women were asked to rate their level of concern over their Pap smear abnormality, from 0 (not concerned) to 10 (very concerned). Women's knowledge regarding the role of HPV in cervical intraepithelial neoplasia and the rationale behind the use of HPV testing was assessed by the clinic nurse as being minimal, moderate, or good, as defined by pre-specified criteria. Upon explanation by the nurses of the results of the recent ALTS (ASCUS/LGSIL Triage Study) trial, the women were asked to state whether they preferred to continue with regular colposcopic surveillance every 6 months, or to use the results of the HPV test, if negative, to reduce the number of colposcopy examinations to one annually. Descriptive statistics and logistic regression analysis were used to identify significant demographic factors associated with the women's preference for incorporation of HPV testing in their follow-up. All P values less than.10 were considered to be statistically significant, due to the exploratory nature of the study.

RESULTS

Of the 100 women who participated in the study, 42% presented with ASCUS. The mean age (+/- SD) of the women was 33.63 +/- 11.25 years (range, 18-75 years); 66% were office workers with at least a community college degree, 86% reported previous abnormal Pap smears, and 67% had previously been seen for colposcopy. Fifty-eight percent of the women rated their concern level as being 6 or more, while 15% ranked their concerns as maximal at 10. In terms of knowledge about HPV, 75% of the women had no or very minimal knowledge of the role of HPV in cervical intraepithelial neoplasia. With regard to HPV testing, 84% of the study group had either never heard of the test or had only a minimal knowledge of HPV testing. After being informed of the ALTS results, 64% of the women chose to use HPV testing to help in triaging the needs for frequent colposcopy. Logistic regression modelling showed that a college level education (odds ratio [OR], 2.27; 95% confidence interval [CI], 0.95-;5.45; P =.06) and history of previous treatment for abnormal Pap smears (OR, 3.31; CI, 0.88- 12.46; P =.07) were closely associated with the adoption of HPV testing in clinical management.

CONCLUSION

There exists a significant lack of knowledge about HPV and its role in the pathogenesis of cervical intraepithelial neoplasia. Women who have received previous treatments for cervical intraepithelial neoplasia and those with college-level educations were more likely to adopt this new technology as part of their care.

High expression of lipoprotein lipase in poor risk B-cell chronic lymphocytic leukemia

We investigated the pattern of lipoprotein lipase (LPL) expression in B-cell chronic lymphocytic leukemia (B-CLL) and assessed its prognostic relevance. Expression of LPL mRNA as well as protein was highly restricted to leukemic B cells. The intensity of intracellular immunoreactivity of LPL was higher in samples of patients with unmutated immunoglobulin heavy-chain variable region genes (IGV(H)) compared to those with mutated IGV(H) genes. LPL mRNA levels in peripheral blood mononuclear cells (PBMNC) from 104 CLL patients differed by 1.5 orders of magnitude between cases with mutated (N=51) or unmutated (N=53) IGV(H) (median: 1.33 vs 45.22 compared to normal PBMNC). LPL expression correlated strongly with IGV(H) mutational status (R=0.614; P<0.0001). High LPL expression predicted unmutated IGV(H) status with an odds ratio of 25.90 (P<0.0001) and discriminated between mutated and unmutated cases in 87 of 104 patients (84%). LPL expression was higher in patients with poor risk cytogenetics. High LPL expression was associated with a shorter treatment-free survival (median 40 vs 96 months, P=0.001) and a trend for a shorter median overall survival (105 months vs not reached). Our data establish LPL as a prognostic marker and suggest functional consequences of LPL overexpression in patients with B-CLL.

Pseudomyxoma peritonei: a case series and review of the literature

The purpose of this study was to use descriptive methodology to study the management of patients with pseudomyxoma peritonei (PMP) at the Princess Margaret Hospital. This is a case series of patients with a diagnosis of PMP treated between January 1, 1995 and December 31, 2001. A health record search using the morphology code for PMP was done and identified 70 patients. Additionally, an unrestricted Medline search was conducted between 1990 and 2002 for PMP. Eight cases of PMP were treated by the Gynecologic Oncology service at Princess Margaret Hospital during the study period. The patients ranged in age from 43 to 84 and presented with a pelvic mass and/or increasing abdominal girth. All but two patients underwent appendectomy as part of their surgery. Postoperative management was by gynecologic oncology for seven of eight patients. An appendiceal origin was confirmed for six patients and highly suspicious for one patient. The remaining patient underwent appendectomy, but it was not sufficiently sectioned for diagnosis. Chemotherapy was given to patients in a non-uniform fashion. Removal of mucinous tumors of the ovary should include appendectomy. Consultation from a general surgical oncologist should be sought where appendiceal origin is confirmed. Coding errors may occur in medical records at a frequency greater than is anticipated.

Pseudomyxoma peritonei: a case series and review of the literature

The purpose of this study was to use descriptive methodology to study the management of patients with pseudomyxoma peritonei (PMP) at the Princess Margaret Hospital. This is a case series of patients with a diagnosis of PMP treated between January 1, 1995 and December 31, 2001. A health record search using the morphology code for PMP was done and identified 70 patients. Additionally, an unrestricted Medline search was conducted between 1990 and 2002 for PMP. Eight cases of PMP were treated by the Gynecologic Oncology service at Princess Margaret Hospital during the study period. The patients ranged in age from 43 to 84 and presented with a pelvic mass and/or increasing abdominal girth. All but two patients underwent appendectomy as part of their surgery. Postoperative management was by gynecologic oncology for seven of eight patients. An appendiceal origin was confirmed for six patients and highly suspicious for one patient. The remaining patient underwent appendectomy, but it was not sufficiently sectioned for diagnosis. Chemotherapy was given to patients in a non-uniform fashion. Removal of mucinous tumors of the ovary should include appendectomy. Consultation from a general surgical oncologist should be sought where appendiceal origin is confirmed. Coding errors may occur in medical records at a frequency greater than is anticipated.

Advances in broad bandwidth light sources for ultrahigh resolution optical coherence tomography

Novel ultra-broad bandwidth light sources enabling unprecedented sub-2 microm axial resolution over the 400 nm-1700 nm wavelength range have been developed and evaluated with respect to their feasibility for clinical ultrahigh resolution optical coherence tomography (UHR OCT) applications. The state-of-the-art light sources described here include a compact Kerr lens mode locked Ti:sapphire laser (lambdaC = 785 nm, delta lambda = 260 nm, P(out) = 50 mW) and different nonlinear fibre-based light sources with spectral bandwidths (at full width at half maximum) up to 350 nm at lambdaC = 1130 nm and 470 nm at lambdaC = 1375 nm. In vitro UHR OCT imaging is demonstrated at multiple wavelengths in human cancer cells, animal ganglion cells as well as in neuropathologic and ophthalmic biopsies in order to compare and optimize UHR OCT image contrast, resolution and penetration depth.

Identification of three novel HLA class I alleles: HLA-B*3928, HLA-B*400104 and HLA-B*4437

Three new human leukocyte antigen (HLA) class I alleles have been identified in the Tissue Typing Laboratory in Sydney, Australia. Sequence analysis of exon 2 and exon 3 of the HLA-B gene revealed the novel polymorphism. A silent substitution of C to T at nucleotide position 369 has been identified for the HLA-B*400104 allele when compared to the closest matched allele, HLA-B*400101. The HLA-B*3928 allele was identified with a nucleotide substitution of G to C at position 362 when compared to the closest matched allele, HLA-B*390101, resulting in an amino acid substitution of Arginine to Threonine. A nucleotide substitution of C to G at position 572 resulting in the amino acid change Serine to Tryptophan was identified in the new allele HLA-B*4437, when compared to the closest matched allele HLA-B*440301. Both amino acid substitutions implicate a different specificity and affinity of antigen binding for the alleles HLA-B*3928 and HLA-B*4437.