Optimal treatment sequencing of abiraterone acetate plus prednisone and enzalutamide in patients with castration-resistant metastatic prostate cancer: A systematic review and meta-analysis

PURPOSE

To evaluate the impact of the hormonal treatment sequencing including abiraterone acetate plus prednisone (AAP) and enzalutamide (ENZ) in mCRPC, and determine which sequence provides more benefits for patients.

METHODS

Studies published in English between 1 January 2013 and 30 September 2017 were identified in PubMed and EMBASE electronic databases. Studies assessing the efficacy of treatment sequences, based on AAP and ENZ, in mCRPC patients, were eligible for analysis.

RESULTS

Seventeen studies met the inclusion criteria. Two assessed both treatment sequences AAP → ENZ and ENZ → AAP; it was found that sequence of AAP → ENZ showed a statistically significantly longer PSA-PFS than the observed in ENZ → AAP (pooled HR: 0,54; 95% CI; 0,36-0,82; p < 0,05). The nine studies analysing Doc → AAP → ENZ sequence, revealed favourable results in terms of PFS. The 5 studies which analysed AAP → ENZ sequence, show a decrease in PSA levels ≥ 50% in 11-41% of patients treated with enzalutamide after previous treatment with AAP. In the two studies that analysed the Doc → ENZ → AAP sequence, PSA response rates were much lower than those reported with Doc → AAP → ENZ, with decreases in PSA ≥ 30 of 3-18% and PSA ≥ 50 of 8-11%.

CONCLUSION

Significant clinical efficacy of AAP administered as the first-line treatment in mCRPC patients followed by enzalutamide, delaying disease progression, compared with the ENZ → AAP sequence. However, more studies and randomized trials are needed, to validate the best treatment sequencing.

Diagnostic challenges in von Willebrand disease. Report of two cases with emphasis on multimeric and molecular analysis

Identification of qualitative variants of von Willebrand disease (VWD) can be a diagnostic challenge because of discrepant results obtained in the multiple laboratory tests available for its appropriate classification. We report two cases of infrequent inherited variants of VWD with unclear preliminary results with the test panel available at the time of first consultation and that were finally diagnosed as a VWD type 2A/IID with a c.8318 G > C, p.Cys2773Ser mutation and a VWD type 2M with c.4225 T > G, p.Val1409Phe mutation, respectively. The description of these two cases highlights that despite the limited diagnostic panel for the evaluation of von Willebrand Factor (VWF) functionality, the multimeric analysis and genetic family studies were fundamental tools to achieve the final diagnosis.

Advanced cell-based modeling of the royal disease: characterization of the mutated F9 mRNA

Essentials The Royal disease (RD) is a form of hemophilia B predicted to be caused by a splicing mutation. We generated an iPSC-based model of the disease allowing mechanistic studies at the RNA level. F9 mRNA analysis in iPSC-derived hepatocyte-like cells showed the predicted abnormal splicing. Mutated F9 mRNA level was very low but we also found traces of wild type transcripts.

SUMMARY

Background The royal disease is a form of hemophilia B (HB) that affected many descendants of Queen Victoria in the 19th and 20th centuries. It was found to be caused by the mutation F9 c.278-3A>G. Objective To generate a physiological cell model of the disease and to study F9 expression at the RNA level. Methods Using fibroblasts from skin biopsies of a previously identified hemophilic patient bearing the F9 c.278-3A>G mutation and his mother, we generated induced pluripotent stem cells (iPSCs). Both the patient's and mother's iPSCs were differentiated into hepatocyte-like cells (HLCs) and their F9 mRNA was analyzed using next-generation sequencing (NGS). Results and Conclusion We demonstrated the previously predicted aberrant splicing of the F9 transcript as a result of an intronic nucleotide substitution leading to a frameshift and the generation of a premature termination codon (PTC). The F9 mRNA level in the patient's HLCs was significantly reduced compared with that of his mother, suggesting that mutated transcripts undergo nonsense-mediated decay (NMD), a cellular mechanism that degrades PTC-containing mRNAs. We also detected small proportions of correctly spliced transcripts in the patient's HLCs, which, combined with genetic variability in splicing and NMD machineries, could partially explain some clinical variability among affected members of the European royal families who had lifespans above the average. This work allowed the demonstration of the pathologic consequences of an intronic mutation in the F9 gene and represents the first bona fide cellular model of HB allowing the study of rare mutations at the RNA level.

Natural history and clinical characteristics of inhibitors in previously treated haemophilia A patients: a case series

BACKGROUND

Development of inhibitors is the most serious complication in haemophilia A treatment. The assessment of risk for inhibitor formation in new or modified factor concentrates is traditionally performed in previously treated patients (PTPs). However, evidence on risk factors for and natural history of inhibitors has been generated mostly in previously untreated patients (PUPs). The purpose of this study was to examine cases of de novo inhibitors in PTPs reported in the scientific literature and to the EUropean HAemophilia Safety Surveillance (EUHASS) programme, and explore determinants and course of inhibitor development.

METHODS

We used a case series study design and developed a case report form to collect patient level data; including detection, inhibitor course, treatment, factor VIII products used and events that may trigger inhibitor development (surgery, vaccination, immune disorders, malignancy, product switch).

RESULTS

We identified 19 publications that reported 38 inhibitor cases and 45 cases from 31 EUHASS centres. Individual patient data were collected for 55/83 (66%) inhibitor cases out of 12 330 patients. The median (range) peak inhibitor titre was 4.4 (0.5-135.0), the proportion of transient inhibitors was 33% and only two cases of 12 undergoing immune tolerance induction failed this treatment. In the two months before inhibitor development, surgery was reported in nine (22%) cases, and high intensity treatment periods reported in seven (17%) cases.

CONCLUSIONS

By studying the largest cohort of inhibitor development in PTPs assembled to date, we showed that inhibitor development in PTPs, is on average, a milder event than in PUPs.

Biotransformation of Endocrine-Disrupting Compounds in Groundwater: Bisphenol A, Nonylphenol, Ethynylestradiol and Triclosan by a Laccase Cocktail from Pycnoporus sanguineus CS43

The biodegradation of organic compounds present in water at trace concentration has become a critical environmental problem. In particular, enzymatic oxidation by fungal laccases offers a promising alternative for efficient and sustainable removal of organic pollutants in water. In this work, the biocatalytic ability of laccases from the Pycnoporus sanguineus CS43 fungus was evaluated. A filtered culture supernatant (laccase cocktail) evidenced an enhanced biotransformation capability to remove common endocrine-disruptor compounds (EDCs), such as bisphenol A, 4-nonylphenol, 17-α-ethynylestradiol and triclosan. A biodegradation of around 89-100 % was achieved for all EDCs using synthetic samples (10 mg L^-1) and after the enzymatic treatment with 100 U L^-1 (50.3 U mg ^-1). The biodegradation rates obtained were fitted to a first order reaction. Furthermore, enzymatic biocatalytic activity was also evaluated in groundwater samples coming from northwestern Mexico, reaching biotransformation percentages between 55 and 93 % for all tested compounds. As far as we know this is the first study on real groundwater samples in which the enzymatic degradation of target EDCs by a laccase cocktail from any strain of Pycnoporus sanguineus was evaluated. In comparison with purified laccases, the use of cocktail offers operational advantages since additional purification steps can be avoided.

Structural characterization, optical properties and photocatalytic activity of MOF-5 and its hydrolysis products: implications on their excitation mechanism

Hydrolysis of MOF-5 gives place to a mixture of two compounds: MOF-5W and zinc terephthalate dihydrate. The analysis of optical and photochemical properties allows to infer the preeminence of a ligand to ligand charge-transfer.

Acción letal de la hiperluteinización ovárica y del exceso de progesterona sobre embriones y fetos

El exceso de progesterona y la hiperluteinización ovárica al parecer producen muerte embrionaria, no sólo en gestaciones que se inician concomitantemente al exceso endógeno o exógeno, de progesterona, sino también, en gestaciones que existían desde antes de producirse la sobretasa hormonal.

Prospecting metal-resistant plant-growth promoting rhizobacteria for rhizoremediation of metal contaminated estuaries using Spartina densiflora

In the salt marshes of the joint estuary of Tinto and Odiel rivers (SW Spain), one of the most polluted areas by heavy metals in the world, Spartina densiflora grows on sediments with high concentrations of heavy metals. Furthermore, this species has shown to be useful for phytoremediation. The total bacterial population of the rhizosphere of S. densiflora grown in two estuaries with different levels of metal contamination was analyzed by PCR denaturing gradient gel electrophoresis. Results suggested that soil contamination influences bacterial population in a greater extent than the presence of the plant. Twenty-two different cultivable bacterial strains were isolated from the rhizosphere of S. densiflora grown in the Tinto river estuary. Seventy percent of the strains showed one or more plant growth-promoting (PGP) properties, including phosphate solubilization and siderophores or indolacetic acid production, besides a high resistance towards Cu. A bacterial consortium with PGP properties and very high multiresistance to heavy metals, composed by Aeromonas aquariorum SDT13, Pseudomonas composti SDT3, and Bacillus sp. SDT14, was selected for further experiments. This consortium was able to two-fold increase seed germination and to protect seeds against fungal contamination, suggesting that it could facilitate the establishment of the plant in polluted estuaries.

Dielectric behavior of epoxy/BaTiO₃ composites using nanostructured ceramic fibers obtained by electrospinning

Composite materials made of epoxy resin and barium titanate (BT) electrospun nanostructured fibers were prepared. BT fibers were synthesized from a sol based on barium acetate, titanium isopropoxide, and poly(vinyl pyrrolidone). The fibers were heat-treated at different temperatures and characterized by X-ray diffraction, scanning electron microscopy (SEM), and Raman spectroscopy. Mats of BT fibers heat-treated at 800 °C were embedded in epoxy resin into suitable molds. The composites were characterized by SEM, and dielectric measurements were performed by means of dielectric spectroscopy. The dielectric permittivity and dielectric modulus of epoxy resin/BT-fiber composites were measured for two types of samples: with the electrodes parallel and perpendicular to the BT fiber layers. Interestingly, composite samples with electrodes perpendicular to the fiber layers and a BT content as low as 2 vol % led to dielectric permittivities three times higher than that of pure epoxy resin.

Is on-demand treatment effective in patients with severe haemophilia?

On-demand therapy enables stopping haemorrhages rapidly, reducing joint pain and restoring joint mobility, but does not prevent the beginning and subsequent development of haemophilic arthropathy. The main objective of this study was to identify the clinical and orthopaedic status of severe haemophilic patients with bleeding phenotype receiving on-demand treatment in Spain. We conducted an epidemiological, observational, retrospective study, recruiting 167 patients from 36 centres (92% of them with haemophilia A), median age at enrolment of 35 years. Forty per cent of the patients received a combination of on-demand and short-term prophylaxis regimen; the rest was under on-demand treatment. One hundred and forty-five patients (87%) reported at least one bleeding episode and 22 (13%) of the biologically severe patients had no bleeding phenotype. Seventy-one per cent of the studied population presented established haemophilic arthropathy, reaching 80% if we exclude patients without bleeding phenotype. Forty-three per cent of these patients had one or two joints affected, 28% of them had three or four affected joints, 20% reported five or six affected joints and 9% more than six injured joints. An increase in established haemophilic arthropathy with age was observed. Forty-six patients underwent orthopaedic surgery at least once. These data show that on-demand therapy is not effective in preventing the development of haemophilic arthropathy in severe haemophilic population with bleeding phenotype. Therefore, we suggest that the optimal treatment in these patients should be based on prophylaxis. We recommend analysing the reasons for ending prophylaxis, in case its reinstatement should be necessary.

The study of the effect of splicing mutations in von Willebrand factor using RNA isolated from patients' platelets and leukocytes

BACKGROUND

In von Willebrand factor (VWF) the effect of mutations potentially affecting mRNA processing or splicing is less predictable than that of other mutations (e.g. nonsense or missense substitutions). Bioinformatic tools can provide a valuable means to determine the consequences of potential splice site mutations (PSSM), but functional studies are mandatory to elucidate the true effect of the variation detected.

OBJECTIVES, PATIENTS AND METHODS

After identification of PSSM in VWD patients, we began a systematic study of their in vivo effect in RNA extracted from the patients' platelets and leukocytes.

RESULTS AND CONCLUSIONS

Thirteen pairs of primers were designed for full amplification of VWF mRNA by RT-PCR that, after sequencing of aberrant products, enabled elucidation of the PSSM consequences for mRNA processing. This procedure was used to study seven different PSSM identified in four patients demonstrating diverse molecular mechanisms such as exon skipping (c.533-2A>G and c.8155+3G>C) and the activation of a cryptic splice site (c.7730-1G>C). No visible effect was evident for c.1533+15G>A and c.5170+10C>T and the consequence of c.[546G>A;7082-2A>G] was hidden by nonsense-mediated mRNA decay (NMD). Results were compared with in silico predictions of four splice-site analysis tools. We demonstrate selective degradation of VWF mRNA bearing PSSM by NMD for several mutations, which suggests that NMD represents a general mechanism for truncating mutations in VWF. Furthermore, because NMD efficiency varies between cell types, use of RNA from both platelets and leukocytes for in vivo study of VWF PSSM offers complementary results, particularly in cases in which NMD occurs in the allele carrying the mutation.

Modelling the relationship between environmental factors, transcriptional genes and deoxynivalenol mycotoxin production by strains of two Fusarium species

The effect of changes in temperature/water activity (a(w)) on growth, deoxynivalenol (DON) production and trichothecene gene cluster expression (18 genes) for strains of Fusarium culmorum and Fusarium graminearum was studied. The expression data for six key transcription genes (TRI4, TRI5, TRI6, TRI10, TRI12 and TRI13) were analysed using multiple regression analyses to model the relationship between these various factors for the first time. Changes in a(w) and temperature significantly (p = 0.05) affected growth and DON. Microarray data on expression of these genes were significantly related to DON production for both strains. Multi-regression analysis was done and polynomial models found to best fit the relationship between actual/predicted DON production relative to the expression of these TRI genes and environmental factors. This allowed prediction of the amounts of DON produced in two-dimensional contour maps to relate expression of these genes to either a(w) or temperature. These results suggest complex interactions between gene expression (TRI genes), environmental factors and mycotoxin production. This is a powerful tool for understanding the role of these genes in relation to environmental factors and enables more effective targeted control strategies to be developed.

Foregut fermentation in the hoatzin, a neotropical leaf-eating bird

The only known case of an avian digestive system with active foregut fermentation is reported for the hoatzin (Opisthocomus hoazin), one of the world's few obligate folivorous (leaf-eating) birds. Hoatzins are one of the smallest endotherms with this form of digestion. Foregut fermentation in a flying bird may be explained by increased digestive efficiency by selection of highly fermentable and extremely patchy resources, coupled with microbial nutritional products and secondary compound detoxification. This unexpected digestive system gives a new perspective to the understanding of size limitations of vertebrate herbivores and to the evolution of foregut fermentation.

Haemophilia in Spain

To determine the prevalence of haemophilia A and B and their complications in Spain, and to characterize the health care network providing support to haemophiliac patients. The study examines clinical and genetic characteristics, treatment options, and complications observed during the course of the disease. Cross-sectional multi-centre study. The study population were patients with HA and HB in active follow-up at any Spanish hospital by December 2006. We studied 2400 haemophiliacs, 2081 (86.7%) HA and 319 (13.3%) HB patients. Illness was severe in 32.3% of patients, moderate in 16.4%, and mild in 51.3%. Genetic screening was carried out in 32.6% of the patients. Treatment administered in 2006 consisted of coagulation factor concentrates in 60% of patients. Until December 2006, 45.8% of severely ill patients were taking prophylaxis. The mean number of bleeding episodes in 2006 was four for patients not receiving primary prophylaxis and 1.3 for those taking primary prophylaxis. Thirty percent of patients had established haemophiliac arthropathy in at least one joint; 16.8% of patients were HIV-infected and 34.8% HCV-infected. Inhibitors were detected in 10% of severe HA patients and in 6.5% of severe HB patients. Immune tolerance induction therapy was started in 34 patients. This is the first comprehensive study on the epidemiology of haemophilia in Spain. It will enable us to draw comparisons with neighbouring countries, to assess the quality of care provided to haemophiliacs in Spain, and to provide evidence-based guidance for the even provision and improvement of such care.

Transient phytoextraction agents: establishing criteria for the use of chelants in phytoextraction of recalcitrant metals

The phytoremediation of recalcitrant metals such as lead and uranium rely on soil amendments to enhance metal availability within the rhizosphere. Because these amendments may persist in soils, agents that not only biodegrade rapidly but also are effective in triggering metal uptake in plants are needed for metals phytoextraction to be considered as an accepted practice. In this study, several biodegradable organic acids and chelating agents were assessed to determine if these amendments can be used in an effective manner, and if their activity and use is consistent with a proposed class of soil amendments for phytoextraction, here termed transient phytoextraction agents (TPAs). A TPA is proposed as an agent that would exhibit both effectiveness in triggering plant accumulation of the targeted metal while minimizing the risk of migration through rapid degradation or inactivation of the soluble complex. Eleven candidate TPAs (acetic acid, ascorbic acid, citric acid, malic acid, oxalic acid, succinic acid, ethylenediaminedisuccinic acid, dicarboxymethylglutamic acid, nitrilotriacetic acid, BayPure CX 100, and the siderophore desferrioxamine B) were tested in batch studies to evaluate their complexation behavior using contaminated soils, with uranium and lead as the target metals. A growth chamber study was then conducted with Brassica juncea (Indian mustard), Helianthus annuus (sunflower), and Festuca arundinacea (tall fescue) grown in a lead-contaminated soil that was treated with the candidate TPAs to assess phytoextraction effectiveness. For the soils tested, citric acid, oxalic acid, and succinic acid were found to be effective complexing agents for uranium phytoextraction, whereas Baypure CX 100 and citric acid exhibited effectiveness for lead phytoextraction.

Testicular adrenal rest tumors and Leydig and Sertoli cell function in boys with classical congenital adrenal hyperplasia

CONTEXT

Infertility observed in adult males with congenital adrenal hyperplasia (CAH) has been associated with testicular adrenal rest tumors (TART) that may originate during childhood.

OBJECTIVE

Our objective was to describe the prevalence of TART and Sertoli and Leydig cell function in a group of boys aged 2-10 yr with CAH and to compare prevalence with that of a control group.

DESIGN

From August 2005 to January 2007, 19 patients with classical CAH (CAH group) were referred from seven endocrinology centers.

METHODS

We studied 19 subjects in the CAH group and, as a control group, 13 boys from the community that did not have testicular diseases. A complete physical exam was performed. High-resolution ultrasound was used to determine TART prevalence. Inhibin B and anti-Müllerian hormone were used as Sertoli cell markers. The ratio between basal testosterone levels and testosterone levels 72 h after beta-human chorionic gonadotropin (5000 U/m2) treatment [(T72- T0)/T0] was used to evaluate Leydig cell response.

RESULTS

CAH and control groups were comparable in chronological age (5.9 vs. 5.6 yr; P = 0.67) and bone age/chronological age ratio (1.09 vs. 1.03; P = 0.09). TART prevalence was four of 19 (21%) in the CAH group. Lower values for inhibin B (49.2. vs. 65.2 pg/ml; P = 0.018), anti-Müllerian hormone (70.1 vs. 94.2 ng/ml; P = 0.002), and (T72- T0)/T0 (5.6 vs. 13.6; P < 0.01) were observed in the CAH group.

CONCLUSION

TART in prepubertal males with classic CAH could be found during childhood. We also report differences in markers of gonadal function in a subgroup of patients, especially in those with inadequate control.

Treatment of Bolivian Mucosal Leishmaniasis with Miltefosine

BACKGROUND

Although mucosal leishmaniasis is a prominent disease, it has been studied only to a limited extent. It is classically treated with parenteral antimony or, as a last resort, amphotericin B.

METHODS

We treated Bolivian mucosal leishmaniasis due to Leishmania braziliensis with the oral agent miltefosine, 2.5 mg/kg/day for 28 days, and followed-up for 12 months.

RESULTS

Seventy-two patients were evaluable. The cure rate for the 36 patients who had "mild" disease (i.e., affecting nasal skin and nasal mucosa) was 83%. The cure rate for the 36 patients who had more extensive disease (involving the palate, pharynx, and larynx) was 58%. Patients refused to be randomized to parenteral agents, but the cure rate for an almost contemporary group who was receiving amphotericin B (45 mg/kg over 90 days) was 7 (50%) of 14.

CONCLUSIONS

In this unrandomized trial, oral miltefosine was at least as effective as heroic doses of parenteral amphotericin B. The cure rate for miltefosine was approximately equivalent to historical cure rates using parenteral pentavalent antimony for mild and extensive disease in neighboring Peru. Although gastrointestinal side reactions do occur with miltefosine, its toxicity profile is superior to that of antimony and far superior to that of amphotericin B--in part because of the inherent attractiveness of oral versus parenteral agents. Our results suggest that miltefosine should be the treatment of choice for mucosal disease in North and South America.

Stress ECG and laboratory database for the assessment of diabetic cardiovascular autonomic neuropathy

Development of a diabetic patient database in order to study Cardiovascular Autonomic Neuropathy (CAN) using as a primary source, stress ECG is presented. The selected platform (ecgML) allows user-friendly environment to analyze and interpret graphs, signals and data. It also allows the ability to perform annotations and reports done by users from different fields. In order to feed the database, the input data is codify using MatLab. The database is composed by two populations: 1) Type 2 Diabetes mellitus group and 2) a control group with no medical history of cardiovascular disease. At the present, there are 62 records available from these two groups. The database also contains laboratory parameters, concurrent medical diagnoses reports verified by cardiologists and other clinicians, automatic annotations for each beat and trend series from parameters extracted from the ECG signals such as RR intervals and ST segment measurements. All this information will become very useful for CAN investigations.

The incidence of prostate cancer in patients under the age of 60 from an urban setting

14622

Background: Although the risk for developing prostate cancer increases with age, few studies have reported the incidence of prostate cancer in men younger than 60 from an urban setting. Methods: All patients diagnosed and treated for prostate cancer at The Cancer Institute of New Jersey at Cooper University Hospital in Camden County, New Jersey from January 1, 2004 to December 31, 2004 were retrospectively identified from our tumor registry. Age comparison at diagnosis was made utilizing the Cooper registry and the National Cancer Database (NCDB), 2001. Results: A total of 141 men (88 Caucasians, 37 African Americans, 14 Hispanic, and 6 unknown) with a median age of 64 years (range, 44–88 years) were diagnosed with prostate cancer in 2004. Staging revealed Stage II (118), Stage III (3), Stage IV (4), Stage unknown (16) cases. Median Gleason score was 6. 74 patients underwent radical prostatectomy, 50 had radiation, 30 received hormone therapy and 2 received chemotherapy. At diagnosis, 19.95% of the men were under 50 and 41.84% were under 60 years of age. Our dataset from these two age groups compared to NJ and US figures are noted below. Conclusions: When comparing the respective data sets from CINJ at Cooper to NJ and US utilizing the NCDB, there are striking differences with a higher incidence of prostate cancer in younger men. These incidences parallel those seen in other urban university teaching hospitals from the Healthcare Utilization Project (2005), where more patients under the age of 60 are being diagnosed with prostate cancer when compared to community centers. Subset analysis shows that our institution had a disproportionately larger number of African American men with prostate cancer which may relate to our culturally directed screening program, accounting for the higher incidence. These data support that hospital characteristics may impact age at diagnosis of prostate cancer, and further investigation is warranted. [Table: see text]

No significant financial relationships to disclose.

Comparison of three microtube column agglutination systems for antibody screening: DG Gel, DiaMed-ID and Ortho BioVue

The aims of the present study were to evaluate the estimated diagnostic accuracy of a new microtube column agglutination system (DG Gel, Diagnostic Grifols, Barcelona, Spain), to analyse the antibody reactivity and to compare the data with the two well-established DiaMed-ID and Ortho BioVue systems. We collected 3024 consecutive samples from blood donors, transfusion recipients and pregnant women, and 100 samples containing antibodies of known specificity. All these samples were tested in parallel by the three microtube agglutination systems. The estimated sensitivity was 100% for DG Gel and Ortho BioVue and 97.58% for DiaMed-ID. The estimated specificity was 99.93% for Ortho BioVue and 100% for DiaMed-ID and DG Gel. The score mean and range of the antibody titration of DG Gel, DiaMed-ID and Ortho BioVue were 34.31 (5-119), 30.3 (3-121) and 37.38 (3-112), respectively. All three column agglutination systems work well showing a high estimated diagnostic accuracy.

Development of the high spatial resolution EMICAT2000 emission model for air pollutants from the north-eastern Iberian Peninsula (Catalonia, Spain)

Ozone (O(3)) pollution episodes take place in Catalonia (NE of the Iberian Peninsula), mainly during summertime. The complex O(3) behaviour could be understood by using a Chemical Transport Model (CTM). Emission inventories provide the spatial and temporal emissions distribution of the O(3) precursors and other pollutants required by this approach. We developed the EMICAT2000 model with high spatial (cells of 1 km(2)) and temporal (1h) resolutions, to estimate the emissions during the year 2000 from Catalonia. Total annual emissions were 107 kt yr(-1) of NO(x), 137 kt yr(-1) of NMVOC, 267 kt yr(-1) of CO, 65 kt yr(-1) of SO(2), 24 kt yr(-1) of TSP and 32,175 kt yr(-1) of equivalent CO(2). Main NO(x) sources are on-road traffic (58%) and industries (38%). Main NMVOC sources are on-road traffic (36%), vegetation (34%) and use of solvents (13%). Speciation was established according to the Carbon Bond IV mechanism. EMICAT2000 generates directly the data files required for the third generation CTM Models-3/CMAQ.

Analysis of INF-gamma, TNF-alpha and dendritic cells to predict hepatitis C virus recurrence in liver transplant patients

INTRODUCTION

Hepatitis C virus (HCV) infection is one of the leading causes of chronic liver disease and the reason for more than 50% of liver transplantations (OLT). Recurrent HCV infection occurs in almost all transplant recipients and has an unfavorable course. Although immunosuppressive agents are necessary to avoid allograft rejection, these drugs may favor viral replication facilitating viral-mediated graft injury.

METHODS

To predict the evolution of two HCV(+) patients who underwent OLT, we studied INF-gamma and TNF-alpha production and the maturation capacity of dendritic cells (DCs) at three time points: before transplantation (Pre-Tx) and at 2 (2M) and 6 (6M) months after transplantation. Cytometric bead assays were used to quantify INF-gamma and TNF-alpha production in the supernates of mixed leukocyte reactions (MLR) between spleen cells from the liver donor and CD4(+) cells from the recipients. Immature and mature DCs were generated in vitro from patient monocytes.

RESULTS

The one patient who experienced recurrent HCV showed loss of CD4(+) responses to donor antigens and INF-gamma and TNF-alpha production after OLT. In contrast, the other patient maintained detectable levels of these cytokines after OLT. It was possible to generate mature DCs from monocytes with the aid of CD40L in both cases, but decreased expression of HLA-DR, CD80, and CD86 markers was observed upon posttransplantation analyses in the patient with recurrent HCV.

CONCLUSION

Loss of the proliferative response as well as INF-gamma and TNF-alpha production, together with a decreased HLA-DR, CD80, and CD86 (markers of mature DCs), indicated an inadequate immune response to viral progression in the liver transplant recipient with relapsing HCV infection.

Estimating the biogenic emissions of non-methane volatile organic compounds from the North Western Mediterranean vegetation of Catalonia, Spain

An estimation of the magnitude of non-methane volatile organic compounds (NMVOCs) emitted by vegetation in Catalonia (NE of the Iberian Peninsula, Spain), in addition to their superficial and temporal distribution, is presented for policy and scientific (photochemical modelling) purposes. It was developed for the year 2000, for different time resolutions (hourly, daily, monthly and annual) and using a high-resolution land-use map (1-km2 squared cells). Several meteorological surface stations provided air temperature and solar radiation data. An adjusted mathematical emission model taking account of Catalonia's conditions was built into a geographic information system (GIS) software. This estimation uses the latest information, mainly relating to: (1) emission factors; (2) better knowledge of the composition of Catalonia's forest cover; and (3) better knowledge of the particular emission behaviour of some Mediterranean vegetal species. Results depict an annual cycle with increasing values in the March-April period with the highest emissions in July-August, followed by a decrease in October-November. Annual biogenic NMVOCs emissions reach 46.9 kt, with monoterpenes the most abundant species (24.7 kt), followed by other biogenic volatile organic compounds (e.g. alcohols, aldehydes and acetone) (16.3 kt), and isoprene (5.9 kt). These compounds signify 52%, 35% and 13%, respectively, of total emission estimates. Peak hourly total emission for a winter day could be less than 10% of the corresponding value for a summer day.

Modelling the effect of temperature and water activity on growth of Aspergillus niger strains and applications for food spoilage moulds

AIMS

To develop a model for the combined effect of water activity (a(w)) and temperature on growth of strains of Aspergillus niger, and comparison with data on food spoilage moulds in the literature.

METHODS AND RESULTS

An extended combined model describing the growth of two strains of A. niger, as a function of temperature (25-30 degrees C) and a(w) (0.90-0.99) was developed. The growth rate (micro) was expressed as the increase in colony radial growth per unit of time. This extends the previous square root model showing the relationship between temperature and bacterial growth rate developed by Ratkowsky et al. (1983) and the parabolic relationship between the logarithm of the growth rate and a(w) developed by Gibson et al. (1994). A good correlation between the experimental data and the model predictions was obtained, with regression coefficients (r(2)) > 0.99. In addition, the use of this model allowed predictions of the cardinal a(w) levels: a(w(min)), and a(w(opt)). The estimation of the minimum a(w) levels (a(w(min))) was in accordance with data in the literature for similar and a range of other Aspergillus and related species, regardless of the solutes used for a(w) modification. The estimation of the optimal a(w) (a(w(opt))) and the optimal growth rate (micro(opt)) were in good agreement with the experimental results and data from the literature.

CONCLUSIONS

This approach enables accurate prediction of the combined effects of environmental factors on growth of spoilage fungi for rapid prediction of cardinal limits using surface response curves.

SIGNIFICANCE AND IMPACT OF THE STUDY

This approach is a rapid method for predicting optimal and marginal conditions for growth of a wide range of spoilage micro-organisms in relation to interacting environmental conditions and will have applications for improving shelf-life of intermediate moisture foods.

Water and temperature relations of growth and ochratoxin A production by Aspergillus carbonarius strains from grapes in Europe and Israel

AIMS

This study investigated the in vitro effects of water activity (a(w); 0.85-0.987) and temperature (10-40 degrees C) on growth and ochratoxin A (OTA) production by two strains of Aspergillus carbonarius isolated from wine grapes from three different European countries and Israel on a synthetic grape juice medium representative of mid-veraison (total of eight strains).

METHODS AND RESULTS

The synthetic grape juice medium was modified with glycerol or glucose and experiments carried out for up to 56 days for growth and 25 days for OTA production. The lag phase prior to growth, growth rates and ochratoxin production were quantified. Statistical comparisons were made of all factors and multiple regression analysis used to obtain surface response curves of a(w) x temperature for the eight strains and optimum growth and OTA production by A. carbonarius. The lag phase increased from <1 day at 25-35 degrees C and 0.98 a(w) to >20 days at marginal temperatures and water availabilities. Generally, most A. carbonarius strains grew optimally at 30-35 degrees C, regardless of solute used to modify a(w), with no growth at <15 degrees C. The optimum a(w) for growth varied from 0.93 to 0.987 depending on the strain, with the widest a(w) tolerance at 25-30 degrees C. There was no direct relationship among growth, environmental factors and country of origin of individual strains. Optimum conditions for OTA production varied with strain. Some strains produced optimal OTA at 15-20 degrees C and 0.95-98 a(w). The maximum OTA produced after 10 days was about 0.6-0.7 microg g(-1), with a mean production over all eight strains of 0.2 microg g(-1) at optimum environmental conditions.

CONCLUSIONS

This work demonstrates that optimum conditions for OTA production are very different from those for growth. While growth rates differed significantly between strains, integration of the OTA production data suggests possible benefits for use of the information on a regional basis.

SIGNIFICANCE AND IMPACT OF THE STUDY

Very little detailed information has previously been available on the ecology of A. carbonarius. This knowledge is critical in the development and prediction of the risk models of contamination of grapes and grape products by this species under fluctuating and interacting environmental parameters.

Optimization of gibberellic acid production by immobilized Gibberella fujikuroi mycelium in fluidized bioreactors

An orthogonal experimental design L9 (3(4)) was used to investigate effects of temperature, pH, C:N ratio (glucose-C, NH4Cl-N) and concentrations of rice flour on production of gibberellic acid by Gibberella fujikuroi in 3.5 l fluidized bioreactors. The gibberellic acid production in a fluidized bioreactor could reach 3.90 g l(-1), more than 3-times greater than previously reported for submerged and solid fermentations. pH, rice flour concentration and C:N ratio were the factors that most influenced the production of gibberellic acid; pH being the most important. The response surface of gibberellic acid production to changes in pH and C:N ratio or rice flour concentration indicated that greatest production was found with a C:N ratio of 36.8 and pH 5 while the optimum concentration for rice flour was 2 g l(-1) and production increased with increased pH. The effect of temperature on the production of gibberellic acid was also significant and greatest production was at 30 degrees C.

Does long-term finasteride therapy affect the histologic features of benign prostatic tissue and prostate cancer on needle biopsy? PLESS Study Group. Proscar Long-Term Efficacy and Safety Study

OBJECTIVES

Finasteride, a common agent used to treat benign prostatic hyperplasia (BPH), inhibits 5-alpha-reductase. Testosterone is converted by 5-alpha-reductase to the more potent dihydrotestosterone, which is the primary androgen in the prostate. Leuprolide is a stronger antiandrogen that is used to downstage prostate cancer before radical prostatectomy. Leuprolide induces marked atrophy of prostate carcinoma cells, which sometimes makes pathologic diagnosis of cancer difficult, although evaluation at radical prostatectomy is easier than at biopsy. It is unknown whether finasteride produces similar changes, which would result in greater diagnostic difficulty because such changes would be seen on biopsy to rule out cancer in men with suspicious clinical findings treated for BPH. The current study investigated the histologic effects of finasteride therapy on human prostate cancer and benign prostatic tissue on needle biopsy.

METHODS

In blinded manner, we reviewed 53 needle biopsy specimens showing prostate carcinoma (35 treated with finasteride, 18 with placebo). Also reviewed in blinded manner were 50 benign needle biopsy specimens (25 treated with finasteride, 25 with placebo). The Gleason score, number of cores involved, percentage cancer involvement in a core, percentage of atrophic changes in cancer cells, presence of mitoses, blue-tinged mucinous secretions, prominent nucleoli, and high-grade prostatic intraepithelial neoplasia were documented for each case in the cancer group. The percentage of atrophy, basal cell hyperplasia, transitional metaplasia, chronic inflammation, and stromal proliferation was documented for each case in the benign group.

RESULTS

No significant histologic differences were present in either the benign or cancer group between cases treated with finasteride and placebo.

CONCLUSIONS

We conclude that finasteride treatment for BPH does not cause difficulty in the diagnosis of cancer in prostate needle specimens. It is possible that there are severely atrophic areas resulting from finasteride treatment that are undersampled. However, the conclusion that cancer seen on needle biopsy in men treated with finasteride is unaltered and readily identified as cancer remains valid.

Secondary somatic embryogenesis and plant regeneration in myrtle (Myrtus communis L.)

Immature seeds, as well as hypocotyls and cotyledons excised from seedlings of Myrtus communis L., were cultured on media containing half-strength Murashige and Skoog macronutrients (MS/2) with combinations of auxins and cytokinins, in order to study their morphogenetic competence. Somatic embryogenesis was obtained from cotyledons, hypocotyls and 2-month-old immature seeds with 0.1 mg/l 2,4-dichlorophenoxyacetic acid (2,4-D). The percentage of explants showing this primary somatic embryogenesis ranged from 4% for hypocotyls to 12% for 2-month-old immature seeds. In the latter, somatic embryogenesis was also obtained in media containing 2,4-D plus a cytokinin, and with only a cytokinin. Somatic embryos obtained from hypocotyls, cotyledons or immature seeds were able to develop on MS/2 medium without plant growth regulators. Subculture of primary somatic embryos obtained from immature seeds on MS/2 medium without plant growth regulators gave rise to clusters with secondary somatic embryos and embryogenic calli. These clusters were subcultured every 8 weeks, and they were the source of highly embryogenic cultures. An average of 10% of the secondary somatic embryos developed into plantlets in each subculture. Therefore, the same culture on MS/2 medium without growth regulators yielded both plantlets and de novo secondary embryos.