Erratum: Epigenetic silencing of miR-34a in human prostate cancer cells and tumor tissue specimens can be reversed by BR-DIM treatment

Androgen Receptor (AR) signaling is critically important during the development and progression of prostate cancer (PCa). The AR signaling is also important in the development of castrate resistant prostate cancer (CRPC) where AR is functional even after androgen deprivation therapy (ADT); however, little is known regarding the transcriptional and functional regulation of AR in PCa. Moreover, treatment options for primary PCa for preventing the occurrence of CRPC is limited; therefore, novel strategy for direct inactivation of AR is urgently needed. In this study, we found loss of miR-34a, which targets AR, in PCa tissue specimens, especially in patients with higher Gleason grade tumors, consistent with increased expression of AR. Forced over-expression of miR-34a in PCa cell lines led to decreased expression of AR and prostate specific antigen (PSA) as well as the expression of Notch-1, another important target of miR-34a. Most importantly, BR-DIM intervention in PCa patients prior to radical prostatectomy showed reexpression of miR-34a, which was consistent with decreased expression of AR, PSA and Notch-1 in PCa tissue specimens. Moreover, BR-DIM intervention led to nuclear exclusion both in PCa cell lines and in tumor tissues. PCa cells treated with BR-DIM and 5-aza-dC resulted in the demethylation of miR-34a promoter concomitant with inhibition of AR and PSA expression in LNCaP and C4-2B cells. These results suggest, for the first time, epigenetic silencing of miR-34a in PCa, which could be reversed by BR-DIM treatment and, thus BR-DIM could be useful for the inactivation of AR in the treatment of PCa.[This corrects the article on p. 14 in vol. 4.].

Phase II trial of combination therapy with intravenous bevacizumab (B), oral satraplatin (S), and prednisone (P) in docetaxel-pretreated (DP) metastatic castrate-resistant prostate cancer (CRPC)

152

Background: Satraplatin is an oral platinum that has demonstrated efficacy and tolerability in metastatic CRPC. Bevacizumab has revealed safety and efficacy in advanced prostate cancer, and synergy was noted between platinum based chemotherapy and B.

Methods: Primary endpoint was time to progression (TTP). Latter wasdefined per RECIST 1.0 or onset of a skeletal event, or > 2 new areas of bone metastases. DP metastatic CRPC patients were eligible. S 80mg/m2 orally on days 1-5, P 5 mg twice daily, and B 10mg/kg on day 1, and 15mg/kg on day 15 were administered in 35 day cycles.

Results: 31 patients enrolled (13 African American and 18 Caucasian) to complete accrual. Median age was 67 years (range 50-85 years) and 21 patients (68%) were > 65 years of age. Median pretherapy PSA was 180.7 ng/ml (range 4.7-1,433 ng/ml). 21 (68%) had bone pain, Gleason score was > 8 in 20 (65%) patients. Pretherapy 12 patients had measurable disease progression, 17 (55%) had bone scan progression, and 8 had PSA only progression. 176 cycles have been administered; median 4 cycles (range 0-12 cycles). Grade 4 toxicities noted were, pulmonary embolism in 2 patients and thrombocytopenia in 1 patient. Grade 3 toxicities observed were neutropenia and hypertension in 3, anemia in 7 and , thrombocytopenia and diarrhea in 2 patients each. No treatment related deaths. 29 patients are response evaluable to date; 10 (34%) had a ≥30% PSA decline and 3 (10%) had a > 90% PSA decline. Of 12 patients with MD, 2 had a response and 7 had stable disease. Median TTP was 7.4 months (90% CI 4.8-12.8 months) and median survival was 11.2 months (90% CI 9.1-18.3 months). 47% of patients were alive at 12 months. Genotype characterization for excision repair cross-complementation group 1 (ERCC1) polymorphism was performed in 17 patients with 9 having homozygous (CC), 3 with heterozygous, (CT) and 2 patients with absence of ERCC expression respectively.

Conclusions: The combination was tolerable and revealed promising efficacy in metastatic CRPC. ERCC1 testing will be correlated with outcome endpoints. Supported in part by Genentech Inc and GPC Biotech.

[Table: see text]

Phase II trial of bevacizumab (B) and oral satraplatin (S) and prednisone in docetaxel pretreated metastatic castrate resistant prostate cancer (CRPC)

e16028

Background: In metastatic CRPC, second line therapy after docetaxel, remains a currently unmet need. Based on the efficacy and tolerability of S and B in prostate cancer, and the clinical synergy noted between chemotherapy and B, a phase II trial of the combination was conducted. Methods: Metastatic CRPC patients, with prior docetaxel based chemotherapy were eligible to receive S 80 mg/m2 orally for days 1–5, and B 10 mg/kg on day 1, and 15mg/kg on day 15 of each 35 day cycle. Prednisone was administered at a dose of 5 mg twice daily. Response was assessed every 2 cycles. Toxicity was assessed weekly during cycle 1 and on days 1 and 15 of each subsequent cycle. Primary endpoint was time to progression defined as a skeletal event, new areas of metastases on bone scans or per RECIST criteria for measurable disease. Results: 19 of 28 patients have been enrolled to date; 7 African American and 12 Caucasian,, with median age of 68.5 years and median pretherapy PSA of 137.8 ng/mL (range 16.8–994 ng/mL). 7 (44%) had bone pain, Gleason score of 7 and ≥ 8 in 7 and 12 patients respectively. Measurable disease progression was noted in 5 patients, bone scan progression in 6 patients, progression of both in 3 patients, and PSA only progression in 5 patients. 76 cycles have been administered; 7 patients continued on therapy beyond 6 cycles. The only grade 4 toxicity noted was pulmonary embolism in 2 patients, after 2 and 6 cycles of therapy. Grade 3 neutropenia, gastrointestinal toxicity, and electrolyte abnormalities were noted in 1 patient each. There were no treatment related deaths. 16/19 patients are response evaluable. 7 patients had a PSA decline of which 4 patients had a ≥30% PSA decline. 3 of 6 patients had a measurable disease response. 11 of 16 patients have progressed to date after median of 6 cycles of therapy. Time to progression and survival data will be reported. Conclusions: The combination was well tolerated, and revealed preliminary evidence of clinical efficacy in docetaxel pretreated metastatic CRPC.

[Table: see text]

Expression of EGFR, HER-2 and p53 predictive of prognosis in muscle-invasive bladder cancer

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Background: The significance of over expression of Erb-1 (epidermal growth factor receptor/ EGFR) and Erb-2 (Her-2) has been reported in various tumors. The aim of this study was to investigate the correlation of the expression of EGFR, Her-2 and p53 with relapse free survival (RFS) and over all survival (OS) in patients with muscle invasive bladder cancer Methods: All patients with muscle invasive bladder cancer diagnosed at our institution between1993and 2004 were considered for the study. Immunohistochemical staining for EGFR, Her2 and p53 performed on formalin-fixed paraffin-embedded archival tissue was evaluated as positive or negative without knowledge of clinical outcome. Survival data determined by reviewing patients medical records were correlated with the staining results. Results: Of the 46 patients who qualified for the study, 40 had slides interpretable for Her 2 and p 53 staining and 38 had slides interpretable for EGFR staining. 35 of 38 were EGFR +ve, 22/40 were Her-2 +ve and 12/40 were p53+ve. The median age of the 46 patients was 67.5 years with a male/female ratio of 60% and 40%. 83% had clinical Stage 2; of those 42%, 23%, and 35% had pathological stages T2, T3 and T4 respectively. Six of 46 (13%), received adjuvant therapy. Tumor histology was pure transitional carcinoma in 56%, or with other components (squamous or adenocarcinoma) in 44%. Median follow-up was 48.8 months for RFS and 44.9 months for OS. Patients with positive EGFR had a median RFS of 34.8 months and median OS of 59.8 months. In patients with negative EGFR, median RFS and OS were not yet reached. Her 2 positive patients had median RFS of 19.2 months compared to 63.8 months in Her-2 negative patients. Her-2 negative patients had median OS of 59.7 months while median was not reached in Her 2 positive patients. Conclusions: While the differences are not statistically significant, the trends observed warrant prospective investigation of the prognostic significance of these markers in a larger population of muscle invasive bladder cancer patients.

No significant financial relationships to disclose.

Clinical characteristics of African-American men with hereditary prostate cancer: the AAHPC study

INTRODUCTION

The African-American Hereditary Prostate Cancer (AAHPC) Study was designed to recruit African-American families fulfilling very stringent criteria of four or more members diagnosed with prostate cancer at a combined age at diagnosis of 65 years or less. This report describes the clinical characteristics of a sample of affected AAHPC family members.

METHODS

In all, 92 African-American families were recruited into the study between 1998 and 2002. Complete clinical data including age and PSA at diagnosis, number of affected per family, stage, grade, and primary treatment were available on 154 affected males. Nonparametric Wilcoxon two-sample tests and Fisher's exact test (two-tailed), were performed to compare families with 4-6 and >6 affected males with respect to clinical characteristics.

RESULTS

The mean number of affected men per family was 5.5, with a mean age at diagnosis of 61.0 (+/-8.4) years. Age at diagnosis, PSA and Gleason score did not show significant differences between the two groups of families. Based on the Gleason score, 77.2% of affected males had favorable histology. Significantly, there were marked differences between the two groups in the frequency of node-positive disease (P=0.01) and distant metastases (P=0.0001). Radical prostatectomy was the preferred primary therapy for 66.2% of all affected men followed by 20.8% who chose radiation therapy.

CONCLUSIONS

Our findings suggest that affected males who carry the highest load of genetic factors are at the highest risk for early dissemination of disease, thus efforts at early diagnosis and aggressive therapeutic approaches may be warranted in these families. Since the primary therapy choices in our study favored definitive treatment (87.0%) when compared to the 1983 and 1995 SEER data in which 28 and 64% received definitive treatment, respectively, it appears that affected African-American men in multiplex families may be demonstrating the reported psycho-social impact of family history on screening practices and treatment decisions for prostate cancer.

High-grade intra-epithelial neoplasia and prostate cancer in Dibombari, Cameroon

High-grade prostatic intra-epithelial neoplasia (HGPIN) occurs a decade earlier in men of African descent in the US and Brazil, compared to white men. Prostate cancer incidence and mortality is worse in the African-American than in US white men. Sub-Saharan Africa was thought to be a low incidence area. This disparity has been attributed to lifestyle factors such as diet. We report the results of prostatic biopsies, from an ongoing national prostate cancer survey. One hundred and eleven men aged 40 y and over were recruited for medical interview (AUA symptom score), prostate specific antigen (PSA) assay and digital rectal examination (DRE). Between six and 10 cores of random digitally guided needle biopsies were performed on 24 subjects that had either suspicious prostates on digital rectal examination +/ or PSA > or =4 ng/ml. All lesions of the prostate were described on routine histopathology. The Gleason score and proportion of tissue involved with cancer, was determined. Eight men had benign prostatic hyperplasia (BPH), six had cancer, another six had low grade intra-epithelial neoplasia, two had HGPIN, there was one case of BPH and chronic prostatitis and one case of chronic prostatitis only. The cancer patients were aged 58-75 y (mean 66.93 y). Gleason scores ranged from 5 to 9, there was one score of 3. Cancer made up 20-80% tissue samples. HGPIN was found in two cases (mean age 58 y). Significant prostate cancer and the pre-cancerous lesion HGPIN exist in Dibombari, Cameroon. The purported low incidence of prostate cancer may reflect cultural and economic barriers to health care.

Trends in falls, poisoning, drowning, and burns Wisconsin: 1986-1996

Falls, poisoning, drowning, and burns comprise the four most common causes of unintentional injury death not related to motor vehicles. We examine mortality trends for these causes of injury in Wisconsin over a 10-year period (1986-1996). While national age-adjusted rates for fall mortality have remained relatively stable, Wisconsin has experienced a sharp 38% increase. The greatest increase in fall mortality was seen in the aged. Nationally, poisoning mortality rose by approximately 50% during this same period while Wisconsin saw almost no increase in mortality (3%) from poisoning. Wisconsin did experience an increase in deaths from poisoning in middle-aged adults. Mortality from drowning decreased by about 28% both in Wisconsin and in the United States, with much of the progress occurring in children and young adults. Burn mortality also declined nationally and within Wisconsin by 30% to 35%. The Wisconsin Public Health Department's "Healthier People in Wisconsin" objectives for the year 2000 will likely be met for drowning and burns, but not for falls. Overall, unintentional injury mortality in Wisconsin is decreasing. However, specific subpopulations are not reaping the benefits of this decline, suggesting a possible focus for future efforts aimed at lowering unintentional injury mortality.

Recruitment experience in the first phase of the African American Hereditary Prostate Cancer (AAHPC) study

The African American Hereditary Prostate Cancer (AAHPC) Study is an ongoing multicenter genetic linkage study organized by Howard University and the National Human Genome Research Institute (NHGRI), with support from the Office for Research on Minority Health and the National Cancer Institute. The goals of the study are to: (i) look for evidence of involvement of chromosome 1q24-25 (HPC1) in African American men with hereditary prostate cancer (HPC) and (ii) conduct a genome-wide search for other loci associated with HPC in African American men. To accomplish these goals, a network has been established including Howard University, the NHGRI, and six Collaborative Recruitment Centers (CRCs). The CRCs are responsible for the identification and enrollment of 100 African American families. To date, 43 families have been enrolled. Recruitment strategies have included mass media campaigns, physician referrals, community health-fairs/prostate cancer screenings, support groups, tumor registries, as well as visits to churches, barber shops, and universities. By far, the most productive recruitment mechanisms have been physician referrals and tumor registries, yielding a total of 35 (81%) families. Approximately 41% (n = 3400) of probands initially contacted by phone or mail expressed interest in participating; the families of 2% of these met the eligibility criteria, and 75% of those families have been enrolled in the study, indicating a 0.5% recruitment yield (ratio of participants to contacts). As the first large-scale genetic linkage study of African Americans, on a common disease, the challenges and successes of the recruitment process for the AAHPC Study should serve to inform future efforts to involve this population in similar studies.

Measurement of femtosecond Polarization Mode Dispersion (PMD) using biased p-shifted low-coherence interferometry

Conventional low-coherence interferometry (LCI) can be employed in the measurement of polarization mode dispersion (PMD) of fiber-optic components and fibers. However, the smallest PMD, which can be measured using this technique, is limited by the coherence length of the source. We propose a biased p-shifted Michelson interferometer where a birefringent crystal is inserted in front of the interferometer to introduce a bias differential group delay (DGD) larger than the coherence time of the source. In this way, the limitation imposed by the source coherence time has been overcome and PMDs much smaller than the source coherence time, in the order of several femtoseconds, can be measured. Experimental results for the PMD have been shown and compared with Jones matrix eigen-analysis. The theoretical model confirms the experimental observations.

Employment of reverse optimization to relax manufacturing tolerances imposed on system constructional parameters associated with complex optical systems

I describe a practical method for facilitating the construction of a complex optical arrangement that was extremely sensitive to manufacturing defects. I discuss dealing with the actual tolerancing process employed and outline the reverse optimization technique adopted to take the necessary corrective action with regard to the lens to yield the performance specified. The optical design to which the techniques are addressed is that of a high-performance color-corrected scanner lens, capable of resolving 200 line pairs/mm over a 10-mm(2) object.

Effect of neoadjuvant androgen deprivation on circulating prostate cells in the bone marrow of men undergoing radical prostatectomy

Our objective was to determine the effect of neoadjuvant hormonal therapy on the presence of circulating prostate cells in patients undergoing radical prostatectomy for prostate cancer. A total of 60 patients at high risk for extraprostatic disease were analyzed for the presence of circulating prostate cells using reverse transcriptase PCR (RTPCR) amplification of the prostate-specific antigen mRNA. Twenty-nine patients underwent radical prostatectomy for a clinical T2b-c tumor or a stage T1c-T2a tumor and a serum prostate-specific antigen level > or =10ng/ml (radical prostatectomy alone), and 31 similarly staged patients received neoadjuvant hormonal therapy before radical prostatectomy (neoadjuvant). Bone marrow samples were used for RTPCR analysis. Twenty-four percent and 58% of the radical-prostatectomy-alone patients and neoadjuvant patients had organ-confined disease, respectively (P = 0.007). In the radical-prostatectomy-alone group, 77% and 14% of patients with extraprostatic and organ-confined disease were RTPCR positive, respectively (P = 0.03). However, in the neoadjuvant group, 46% and 28% of patients with extraprostatic and organ-confined disease were RTPCR positive, respectively (P = 0.29). For patients that were RTPCR positive, 45 % of the neoadjuvant patients had organ-confined disease compared with 6% in the radical-prostatectomy-alone patients (P = 0.018). These data suggest that a subset of the neoadjuvant patients are converted to organ confined disease without eliminating the prostate cells in the bone marrow. Our data suggest that hormonal therapy before radical prostatectomy decreases the occurrence of extraprostatic disease but, to a lesser degree, the incidence of circulating prostate cells. This may partially explain why hormonal therapy before radical prostatectomy has not improved disease-free survival.

Absolute figure measurements with a liquid-flat reference

We describe a variation of the liquid-flat technique fordetermining the absolute flatness of a 240-mm-diameter optical surfaceto an accuracy better than 1/100lambda in both its horizontal(three-point support) and vertical orientations. Using theappropriate mathematics to calculate the surface deformation of a diskdue to gravity, we achieved verification of the method by comparingmeasurements carried out on a pair of optical flats and a liquidreference surface.

Design and testing of a two-monochromator reference spectrofluorimeter for high-accuracy total radiance factor measurements

A two-monochromator reference spectrofluorimeter has been developed at the National Research Council of Canada in accordance with International Commission on Illumination and American Society for Testing and Materials colorimetry standards to permit high-accuracy total spectral radiance factor measurements of fluorescent materials. This fully automated instrument employs a xenon-arc light source, all-reflective optics, two grating monochromators with order-sorting filters, a cooled photomultiplier tube analyzing detector, and a calibrated silicon photodiode monitor detector. The instrument operating range is 250-1050 nm with a selectable bandpass (optimized for a 5-nm resolution), and the measurement geometry is 45 degrees annular illumination and 0 degrees viewing (45/0). We describe the instrument's design, testing, and verification procedures. Systematic errors that have been determined and corrected for include instrument polarization, beam nonuniformity, wavelength shifts, stray light, and system drift. The wavelength accuracy and reproducibility are estimated to better than +/-0.1 and +/-0.03 nm, respectively. The photometric short-term repeatability and long-term reproducibility are estimated to be better than +/-0.15% and +/-0.5%, respectively. The overall photometric accuracy is better than 1% of the value over a wide range of reflectances, and the reproducibility of the color specification of a fluorescent material is better than 0.25 DeltaE(ab) units.

D65 simulation with a xenon arc

A new Commission Internationale de l'Eclairage daylight D65 filter has been developed for a xenon arc. The filter comprises a pair of multilayer stacks, and excellent agreement is obtained between the spectral power distribution associated with this filter-source combination and that of daylight for the entire wavelength range from 300 to 800 nm.

Design study of an infrared panoramic optical system

A design study was undertaken on an infrared, 3-5-μm, panoramic optical system for a particular monitoring application. The different types of systems investigated covered the conventional fish-eye lens system, a panoramic block arrangement, and a new type of configuration based on a panoramic shell. Examples of these systems are included, and their advantages and disadvantages are discussed.

Design of single-element laser-beam shape projectors

The design and fabrication of several single-element laser-beam projectors are described. These projectors take a Gaussian laser beam and expand it into a uniform intensity diverging shape, which can be either a single line, circle, cross, star, or a D. Each element consists of a single segmented surface designed so as to produce the required projected shape.

Pupil exploration and wave-front-polynomial fitting of optical systems

Pupil exploration and wave-front-polynomial fitting algorithms are tools that are often employed in image-quality evaluation techniques, such as optical-transfer-function and point-spread-function calculations. These techniques require that aberration data be determined for a large number of points across the pupil. With optical systems increasing in complexity, it is necessary that these algorithms become more sophisticated to ensure that the proper pupil shapes and aberration maps are used to represent the wave fronts. Such algorithms are described. These algorithms can handle systems that not only lack the symmetry found with the more conventional lens systems but those that also have apertures with unusual shapes. As practical demonstrations the treatments employed in the pupil exploration and the wave-front-polynomial fitting have been applied to various lens arrangements and the results discussed.

Quartz-halogen D65 simulation

A new CIE daylight D65 filter has been developed for a quartz-halogen source operating at a color temperature in the region of 3000 K. The filter is a serial type comprising optical filter glasses and multilayer thin-film stacks. Extremely close agreement is obtained between the spectral-power distribution associated with the filter-source combination and that of daylight D65.

Ultraviolet-visible spectrograph optics: ODIN project

We describe one of the possible designs for the UV-visible spectrograph optics to be employed in the ODIN project. The spectrograph will be used in a future satellite mission for aeronomy observations and will image a column of atmosphere just above the Earth's surface onto a two-dimensional CCD array with the spatial and spectral content aligned orthogonal to one another.

Digital rectal examinations and prostate cancer screening: attitudes of African American men

PURPOSE/OBJECTIVES

To explore the relationship between attitudes toward digital rectal examination (DRE) and participation in prostate cancer screening among African American men.

DESIGN

Survey.

SETTING

Prostate cancer screenings with a prostate-specific antigen (PSA) blood test held at churches with African American members in Detroit, MI.

SAMPLE

613 African American men between the ages of 40 and 70.

METHODS

Self-administered, structured questionnaires examining attitudes toward DRE, past experiences with DRE, and fear of cancer.

MAIN OUTCOME MEASURES

Willingness to undergo DRE.

FINDINGS

The majority of men who were screened had positive attitudes about DRE. Fear of cancer was associated with negative attitudes toward DRE. DREs were not a deterrent among men who attended the screenings.

CONCLUSION

Negative attitudes toward DRE do not necessarily deter African American men from participating in prostate cancer screenings.

IMPLICATIONS FOR NURSING PRACTICE

Prostate cancer screening programs should attempt to use both DRE and PSA. More reliable prostate cancer indicators are obtained by incorporating DRE with PSA tests.

Panoramic lens

An infrared panoramic lens system that utilizes two lens groups to project a full 3600 cylindrical field of view onto a two-dimensional annular format is described. Each lens group has its well-defined role. The first group is a lens block that converts a cylindrical field of view into a two-dimensional annular format located within the lens itself, and the second group relays this image to some accessible location downstream from the optical system.

Optical transfer function measurment facility for aerial survey cameras

The optical transfer function measurement facility developed at the National Research Council of Canada primarily for testing aerial survey cameras has been upgraded to perform the task in an appreciably more convenient manner. Modifications made to the facility, which is based on the line spread function technique, include the replacement of the cumbersome physical scanning mechanism and detector unit with a detector assembly comprising a relay lens and a linear photodiode array. While eliminating the need for physically scanning the line spread function, it did require a change of light source, a daylight filter, and a new computer software package. The new setup is described in this paper. Several aerial survey cameras have been evaluated with the system, and results are given for a fairly standard Zeiss camera.

Flow cytometric DNA analysis of fresh prostatic resections. Correlation with conventional prognostic parameters in patients with prostate cancer

BACKGROUND

DNA ploidy analysis has been investigated as a prognostic indicator in prostate cancer. Most of the data is derived from retrospective studies using paraffin-embedded tissue. This method has drawbacks related to the quality of DNA histograms and uncontrolled data collection.

METHODS

DNA ploidy analysis of freshly resected prostatic tissue was prospectively compared with conventional prognostic variables in 97 men treated with radical prostatectomy for localized prostate cancer.

RESULTS

Regarding the patients, 31.9% were African American and 66% had pathologic Stages C or D1 disease. Only 9.6% of patients with Stages A2 and B had a prostate-specific antigen (PSA) value greater than 10 ng/ml, whereas 97% of patients with PSA values greater than 20 ng/ml had pathologic Stages C and D1. PSA levels correlated with Gleason score (P = < 0.05); 51% and 100% of patients with Gleason score 5-7 and 8-10, respectively, had PSA values greater than 10 ng/ml. Twenty-two patients (23%) had DNA aneuploid tumors. Comparisons of mechanical to enzymatic cell suspensions indicated that DNA aneuploidy was better preserved in mechanical cell preparations. DNA ploidy correlated with pathologic stage (P = < 0.05) and Gleason score (P = < 0.05). Fifteen of 79 patients (18.9%) with Gleason score 5-7 had DNA aneuploid tumors versus 71.4% of patients with Gleason score 8-10. PSA groups correlated with ploidy status (P = 0.01). Although the majority of patients (19 of 22) with DNA aneuploid tumors had elevated preoperative PSA levels, none had a PSA value greater than 50 ng/ml.

CONCLUSIONS

DNA ploidy analysis correlated with established prognostic indicators in prostate cancer; however, its independent correlation with natural history and treatment outcome must be established for it to have an effect on therapeutic decisions.

GEMINI spectrograph optics

In this paper the optical system design of one of the spectrograph instruments to be employed in the General Excitation Mechanisms in Nightglow project is described. The instrument has a high throughput with a numerical aperture equivalent to ƒ/1.7 and covers the spectral range from 255 to 327.5 nm. A 3-deg line in the object space is imaged onto a two-dimensional intensified CCD array with spatial and spectral resolutions at least matching those of the detector.

Multiple medication use in the elderly. Use of prescription and non-prescription drugs in an Australian community setting

OBJECTIVE

To document the extent of polypharmacy or multiple medication use in the elderly.

DESIGN

Cross-sectional examination of an age cohort of a community.

SETTING

Community-based study in Dubbo, NSW, in 1988-1989.

SUBJECTS

All non-institutionalised residents aged 60 years and over, numbering 1237 men and 1568 women.

MAIN OUTCOME MEASURES

Assessment of use of prescription and non-prescription drugs, recent hospitalisation, years of education, psychosocial variables.

RESULTS

18% of men and 25% of women were currently using three or more classes of prescription drugs. The corresponding values for two or more classes of non-prescription drugs were 29% and 44%. Of those who were using multiple prescription drugs 56% of men and 76% of women were also using multiple non-prescription drugs. In a multiple logistic model, the following possible predictors of multiple drug use were included: hospitalisation in the last six months, age, sex, depression, life satisfaction and education. Multiple prescription drug use was significantly predicted by recent hospitalisation (odds ratio [OR] = 2.40; 95% confidence interval [CI], 1.63-3.56), increasing age (e.g. 70-79 years versus 60-69 years; OR = 2.54; CI, 1.97-3.25), female sex (OR = 1.59; CI, 1.25-2.01) and increasing depression (e.g. highest tertile of depression scale versus lowest; OR = 2.52; CI, 1.84-3.42). Multiple non-prescription drug use was significantly predicted by female sex (OR = 2.38; CI, 1.95-2.92) and increasing depression (OR = 2.77; CI, 2.16-3.56). For prescription items, non-prescription items, and both categories in combination levels of use 20% above the population average have been documented.

CONCLUSIONS

Polypharmacy in the elderly population appears to be predicted by recent hospitalisation, increasing age, female sex and increasing depression. There is potential for drug-drug interaction to occur, but the findings suggest target areas for preventive action.

Cytogenetic studies of carcinoma in situ of the bladder: prognostic implications

Carcinoma in situ of the bladder has traditionally been considered a lethal disease by most urologists and as such it has been treated most frequently in an aggressive manner. Recent investigations have suggested that carcinoma in situ of the bladder may, in fact, be a complex of diseases that exists in at least 2 distinct disease forms, 1 aggressive and 1 relatively nonaggressive. We studied the cytogenetics of 17 patients diagnosed clinically and pathologically to have carcinoma in situ, and found a positive correlation of karyotype complexity (numerical and structural changes) with disease course. Superficial tumors with normal karyotypes remained superficial throughout the study and continued to exhibit a nonaggressive course, while patients whose tumors had an abnormal karyotype at diagnosis expressed a much more aggressive course that ultimately developed into invasive disease. Nonrandom chromosomal changes involving chromosomes 1, 5, 8 and 11 were observed in these tumors. Therefore, cytogenetic evaluation may prove to be an important guide in helping to determine an appropriate treatment course for patients with carcinoma in situ of the bladder.

Ray tracing through systems containing holographic optical elements

While the subject of tracing finite rays through an optical system containing holographic optical elements (HOE's) has been widely discussed in scientific literature, the actual mechanism for determining the direction of a ray leaving a generalized HOE appears not to have been addressed in any great depth. Here a detailed description of a practical method that uses a lookup table approach for tracing finite rays through such systems is presented. Furthermore, the construction geometry is not limited to an arrangement whereby only perfect reference and object beams are used to produce the HOE.

Dubbo study of the elderly: sociological and cardiovascular risk factors at entry

A prospective study of elderly Australians commenced in 1988 in Dubbo, NSW. Its goals are to identify predictors of mortality, hospitalisation and placement in long-term care, with special focus on risk factors for cardiovascular disease. The study population were non-institutionalised subjects, comprising 1237 males and 1568 females 60 years and over. This report describes the baseline findings: demographic, educational and economic data; tobacco and alcohol usage, self-medication and other habits; medical contacts and past diagnosis; prescribed medication and in study diagnosis; psychosocial variables, functional health and social support; blood lipid and lipoprotein data; blood pressure, spirometry and glucose data; heights and weights. Where comparison has been feasible, the findings in Dubbo closely resemble those obtained from the rest of Australia. The findings presented provide the basis for aetiological studies of future outcomes.

The Dubbo study of the health of elderly: correlates of coronary heart disease at study entry

A prospective study of the health of elderly Australians recently commenced in Dubbo, NSW, the study population comprising 1,237 males and 1,568 females 60 years and older. The prevalence rates of coronary heart disease (CHD) and its associated risk factors have been examined in the baseline data. The age-standardized rate of CHD was 23.8/100 in males and 18.1/100 in females. The prevalence rate increased with age until 79 years in males, thereafter declining. The rate increased steadily with age in females. In a multiple logistic model, the following possible predictors of CHD were included: age, cigarette smoking, use of alcohol, exercise, religiosity, years of education, hypertension, diabetes, family history of CHD, body mass index, lipid and lipoprotein variables. The presence of CHD in males was significantly predicted by age, hypertension (odds ratio, OR = 1.40), family history (OR = 2.05), and high density lipoprotein (HDL) cholesterol (OR = 0.78). The significant predictors in females were age, years of education (OR = 0.82), hypertension (OR = 1.45), family history (OR = 1.77), serum triglycerides (OR = 1.30), and HDL cholesterol (OR = 0.73). Hypertension was found to be a stronger predictor of CHD in the younger age group (60-69 years), while diabetes was a predictor of CHD in older males (70-79 years). Our findings require confirmation in the prospective study now in progress.

The Dubbo study: an Australian prospective community study of the health of elderly

The proportion of Australian population over 60 years has risen progressively over the last 40 years and this growth is projected to continue. Major health problems of the elderly include coronary heart disease, cerebro-vascular disease, osteoporosis and fracture. The risk factors for coronary heart disease and stroke in middle-aged subjects have been extensively documented in prospective studies in Australia and elsewhere, and include lipid disorders, hypertension, cigarette smoking, diabetes and family history. Few prospective studies have been targeted exclusively on the elderly and information available with respect to vascular risk factors is fragmentary and contradictory. This is the background to a new prospective study of the health of elderly Australians now under way in Dubbo, NSW. The goals of the Dubbo Study are to identify predictors of mortality, hospitalisation and placement in long-term care, while specific aims are the study of risk factors for chronic diseases and disability. This report describes the study rationale, reasons for selecting Dubbo as the study site, methods and measures, participation rates and demography. The target population included all non-institutionalised subjects 60 years and over, domiciled in Dubbo, and is comprised of 1693 males and 2167 females. The attendance rate for an extensive medical and sociological baseline assessment over a 13 months' period was 73% for both sexes. The prospective study is now in place and within three to five years will be generating definitive information in the elderly.

Apparent correlation of sex chromosome loss and disease course in urothelial cancer

In recent years, interest in the genetics of various solid tumours has increased dramatically. Over the last several years, our laboratory has pursued genetic studies of transitional cell carcinoma of the bladder. We have studied the cytogenetics and disease course of more than 100 patients, achieving successful cultures in more than 75%. In these patients, we observed the loss of a sex chromosome (either X or Y) with a frequency of 40%. We stratified patients with loss of sex chromosomes into three groups: 1) presence of markers or chromosome rearrangements, 2) aneuploidy without marker chromosomes, and 3) loss of a sex chromosome only. The relevancy of both the natural history and potential impact of sex chromosome loss to the disease course, including invasive potential, will be discussed in detail for each of the three groups.

Simple technique for designing teleconverters

A simple technique is described for designing lens attachments such as teleconverters without prior knowledge of the lens system's prescription. As a practical illustration of the technique the design of a x1.3 teleextender for a 10.5-105-mm f/11.4 TV zoom system is described.

Design of a laser beam line expander

The design of an optical element for laser beam line expansion is described. The element which bears some resemblance to a prism with a small radius at its apex expands the laser beam in one direction only. The technique for designing such a lens is given together with examples of lenses having different rates of divergence.

Lenses for correcting chromatic aberration of the eye

Optical systems for correcting the axial chromatic aberration of the eye are studied theoretically. Compact (cemented) doublets or triplets for this cannot avoid introducing unwanted transverse color. A new airspaced system is described which avoids this problem. Experimental results confirmed that this lens performed well over a 14-deg field of view.

Aspheric surface calibrator

A new type of aspheric surface calibrator has been developed at the National Research Council of Canada. It employs a nonmechanical contact technique for measuring rotationally symmetrical uncoated concave optical surfaces which depart from a sphere by as much as 0.5 mm with a precision of 0.3 microm. Using two precise air bearings for providing rotations about two mutually perpendicular axes, a focused laser beam is scanned across the surface under test. A fringe counting process measures the difference in sag between the surface shape and some reference sphere. Two surfaces, one spherical and the other ellipsoidal, were measured to illustrate the practicality of such an instrument.

Fibrosarcoma of kidney

A case of fibrosarcoma of the kidney is presented. Clinical and radiologic features are discussed. The arteriographic features of this tumor are indistinguishable from adenocarcinoma of the kidney. Microscopically, this tumor may be confused easily with leiomyoma or leiomyosarcoma, Special staining techniques with van Gieson and Mallory trichrome stains and electron microscopy help establish diagnosis.

New concept for a system suitable for solar simulation

A theoretical study of a new approach for a solar simulator design capable of testing solar collectors is described. The technique involved in this design requires that the source have rotational symmetry and employs a 2-D approach in the calculation of the irradiance in the image plane. Reflecting surfaces to be used with two different types of light source are computed to illustrate practical applications of this method.

Optical design and analysis program

An optical design and analysis program structured for operation on a minicomputer has been developed at NRC (National Research Council of Canada). It has been designed to be used interactively giving the user both flexibility and ease of operation. The computer on which it runs at present is a Digital PDP11 with a memory of around 28K, and this represents a great saving in computer costs when compared with those of a large computer upon which most lens design work is carried out. This program has capabilities for optimizing a lens system, for pupil exploration, for fitting the computed wavefront aberration to a polynomial, and for evaluating the diffraction optical transfer function. Although only ten finite rays are traced in the optimization routine, the aberrations computed, together with the Seidel aberrations obtained from the paraxial ray trace, provide the user with adequate control of the aberrations over both aperture and field. A Double Gauss and a Maksutov-Cassegrain system are used as practical examples to illustrate this.

Xanthogranulomatous pyelonephritis in children

Xanthogranulomatous pyelonephritis in children, contrary to adult onset, rarely is associated with non-function or calcification. The lesion is predominantly on the left side in children. There appears to be a normal humoral but temporarily impaired cellular immune response in addition to sustained depression of polymorphonuclear chemotaxis. The etiology of this is uncertain but may be attributed partially to hyperosmolarity of serum and urine, and to leukocyte specific antinuclear antibodies. The presence of leukocyte specific antinuclear antibody or cold agglutining may interfere with normal phagocyte chemotaxis requiring tissue macrophages to produce a xanthogranulomatous reaction to bacterial invasion.