Progression-Free Survival in Patients with WHO-2 Meningioma Undergoing Active Surveillance Based on DOTATATE PET Evidence of Gross Total Resection: Prospective Observational Study

PURPOSE/OBJECTIVE(S)

MRI is the standard of care for meningioma radiotherapy planning, but lacks sensitivity for postoperative small volume disease and osseous or parenchymal invasion. NRG-BN003 (NCT03180268) randomizes patients with WHO-2 meningiomas and MRI-determined gross total resection (GTR) to observation or 60 Gy IMRT to the resection bed. More sensitive and specific imaging biomarkers than MRI may improve clinical outcomes in meningioma by limiting unnecessary irradiation of normal tissues and improving radiotherapy targeting. [68Ga]-DOTATATE, a PET radiotracer targeting somatostatin receptor 2 (SSTR2) is a highly sensitive and specific meningioma biomarker. Our dedicated DOTATATE brain PET/MRI and PET/CT protocol allows meningioma differentiation from post-treatment change, using SUV analysis and Patlak modeling. Our prospective IRB-approved observational trial (NCT04081701) has imaged >100 patients with meningioma. In the sub-analysis presented here, we prospectively evaluated PFS in patients with WHO-2 tumors and postoperative GTR as determined by [68Ga]-DOTATATE brain PET/MRI or PET/CT who were managed solely with active surveillance. We hypothesized that the PFS of patients with GTR by PET managed with active surveillance would be higher than reported PFS data for patients with MRI-determined GTR, using NRG-BN003's observation arm (randomized trial comparing observation to fractionated RT) as a reference standard.

MATERIALS/METHODS

From the cohort of >100 patients with SSTR2-positive brain neoplasms enrolled between 9/2019 and 10/2022 and imaged according to our previously published protocol, a sub-cohort of patients were selected with WHO-2 meningioma, postoperative findings of GTR, and postoperative active surveillance with periodic MRI every 3-6 months. Kaplan-Meier survival analysis was performed.

RESULTS

A total of 12 patients met inclusion criteria. Mean patient age was 64 years and 5 (42%) were female. Mean follow up period was 23.4 months (range: 7-38). 83% (10/12) patients underwent postoperative PET/MRI and 17% (2/12) underwent PET/CT. 2 patients (17%) progressed, at 22 and 34 months, respectively; the remainder remain progression-free. Both patients who had progression were successfully salvaged with focal fractionated radiosurgery. Kaplan-Meier analysis demonstrated PFS at almost 3 years to be 75%, which is substantially higher than the reported 3-year PFS of 60% in the literature. Overall survival was 100%.

CONCLUSION

[68Ga]-DOTATATE PET can improve the specificity of imaging-based assessment of the extent of resection of WHO-2 meningiomas, thereby improving clinical outcomes. In this cohort of patients with completely resected WHO-2 meningiomas (as assessed by postoperative gadolinium-enhanced MRI and DOTATATE PET) who are conservatively managed, recurrences have been rare and amenable to radiosurgical salvage.

Electron field emitters made of 3-D CuO nanowires on flexible silicon substrate fabricated by heating Cu rods with through silicon via process

Cu rods with a diameter of 10 μm on a flexible silicon substrate were fabricated using the through silicon via (TSV) process and chemical mechanical polishing (CMP).

Evaluation of dose conversion coefficients for external exposure using Taiwanese reference man and woman

Reference man has been widely used for external and internal dose evaluation of radiation protection. The parameters of the mathematical model of organs suggested by the International Commission of Radiological Protection (ICRP) are adopted from the average data of Caucasians. However, the organ masses of Asians are significantly different from the data of Caucasians, leading to potentially dosimetric errors. In this study, a total of 40 volunteers whose heights and weights corresponded to the statistical average of Taiwanese adults were recruited. Magnetic resonance imaging was performed, and T2-weighted images were acquired. The Taiwanese reference man and woman were constructed according to the measured organ masses. The dose conversion coefficients (DCFs) for anterior-posterior (AP), posterior-anterior (PA), right lateral (RLAT) and left lateral (LLAT) irradiation geometries were simulated. For the Taiwanese reference man, the average differences of the DCFs compared with the results of ICRP-74 were 7.6, 5.1 and 11.1 % for 0.1, 1 and 10 MeV photons irradiated in the AP direction. The maximum difference reached 51.7 % for the testes irradiated by 10 MeV photons. The size of the trunk, the volume and the geometric position of organs can cause a significant impact on the DCFs for external exposure of radiation. The constructed Taiwanese reference man and woman can be used in radiation protection to increase the accuracy of dose evaluation for the Taiwanese population.

Xanthogranulomatous inflammation of terminal ileum: report of a case with small bowel involvement

Xanthogranulomatous inflammation is a rare pathological condition most frequently detected in the kidney and gallbladder. Reported herein is a case of xanthogranulomatous inflammation in a 51-year-old male presenting as a mass-forming lesion in the terminal ileum with mucosal ulceration. Diagnostic laparoscopy followed by ileocecectomy was performed due to intra-operative suspicion of carcinoma of appendix. This is a report of the condition involving the terminal ileum with mucosal ulceration and full-thickness involvement of bowel wall which are uncommon features of xanthogranulomatous inflammation in previously reported lower gastro-intestinal tract lesions.

Conductive microcapsules for self-healing electric circuits

Well dispersed conductive microcapsules can be processed directly with inorganic-based Ag paste and perform high restoration efficiency for as-cast electrical circuits.

Effects of humidity and ultraviolet characteristics on β-Ga2O3 nanowire sensor

Monoclinic gallium oxide (β-Ga₂O₃) nanowires (NWs) were synthesized via a vapor–liquid–solid mechanism by heating a GaN/sapphire template.

Improvements on a patient-specific dose estimation system in nuclear medicine examination

The purpose of this paper is to develop a patient-specific dose estimation system in nuclear medicine examination. A dose deposition routine to store the deposited energy of the photons during their flights was embedded in the widely used SimSET Monte Carlo code and a user-friendly interface for reading PET and CT images was developed. Dose calculated on ORNL phantom was used to validate the accuracy of this system. The ratios of S value for (99m)Tc, (18)F and (131)I computed by this system to those obtained with OLINDA for various organs were ranged from 0.93 to 1.18, which were comparable to that obtained from MCNPX2.6 code (0.88-1.22). Our system developed provides opportunity for tumor dose estimation which cannot be known from the MIRD. The radiation dose can provide useful information in the amount of radioisotopes to be administered in radioimmunotherapy.

Design and testing of a uniformly solar energy TIR-R concentration lenses for HCPV systems

In this paper, total internal reflection-refraction (TIR-R) concentration (U-TIR-R-C) lens module were designed for uniformity using the energy configuration method to eliminate hot spots on the surface of solar cell and increase conversion efficiency. The design of most current solar concentrators emphasizes the high-power concentration of solar energy, however neglects the conversion inefficiency resulting from hot spots generated by uneven distributions of solar energy concentrated on solar cells. The energy configuration method proposed in this study employs the concept of ray tracing to uniformly distribute solar energy to solar cells through a U-TIR-R-C lens module. The U-TIR-R-C lens module adopted in this study possessed a 76-mm diameter, a 41-mm thickness, concentration ratio of 1134 Suns, 82.6% optical efficiency, and 94.7% uniformity. The experiments demonstrated that the U-TIR-R-C lens module reduced the core temperature of the solar cell from 108 °C to 69 °C and the overall temperature difference from 45 °C to 10 °C, and effectively relative increased the conversion efficiency by approximately 3.8%. Therefore, the U-TIR-R-C lens module designed can effectively concentrate a large area of sunlight onto a small solar cell, and the concentrated solar energy can be evenly distributed in the solar cell to achieve uniform irradiance and effectively eliminate hot spots.

Dose point kernel simulation for monoenergetic electrons and radionuclides using Monte Carlo techniques

Monte Carlo (MC) simulation has been commonly used in the dose evaluation of radiation accidents and for medical purposes. The accuracy of simulated results is affected by the particle-tracking algorithm, cross-sectional database, random number generator and statistical error. The differences among MC simulation software packages must be validated. This study simulated the dose point kernel (DPK) and the cellular S-values of monoenergetic electrons ranging from 0.01 to 2 MeV and the radionuclides of (90)Y, (177)Lu and (103 m)Rh, using Fluktuierende Kaskade (FLUKA) and MC N-Particle Transport Code Version 5 (MCNP5). A 6-μm-radius cell model consisting of the cell surface, cytoplasm and cell nucleus was constructed for cellular S-value calculation. The mean absolute percentage errors (MAPEs) of the scaled DPKs, simulated using FLUKA and MCNP5, were 7.92, 9.64, 4.62, 3.71 and 3.84 % for 0.01, 0.1, 0.5, 1 and 2 MeV, respectively. For the three radionuclides, the MAPEs of the scaled DPKs were within 5 %. The maximum deviations of S(N←N), S(N←Cy) and S(N←CS) for the electron energy larger than 10 keV were 6.63, 6.77 and 5.24 %, respectively. The deviations for the self-absorbed S-values and cross-dose S-values of the three radionuclides were within 4 %. On the basis of the results of this study, it was concluded that the simulation results are consistent between FLUKA and MCNP5. However, there is a minor inconsistency for low energy range. The DPK and the cellular S-value should be used as the quality assurance tools before the MC simulation results are adopted as the gold standard.

GaN epitaxial layers prepared on nano-patterned Si(001) substrate

We report the growth of GaN epitaxial layer on Si(001) substrate with nano-patterns prepared by dry etching facility used in integrated circuit (IC) industry. It was found that the GaN epitaxial layer prepared on nano-patterned Si(001) substrate exhibits both cubic and hexagonal phases. It was also found that threading dislocation observed from GaN prepared on nano-patterned Si(001) substrate was significantly smaller than that prepared on conventional unpatterned Si(111) substrate. Furthermore, it was found that we can reduce the tensile stress in GaN epitaxial layer by about 78% using the nano-patterned Si(001) substrate.

A ZnO-nanowire phototransistor prepared on glass substrates

The fabrication of a phototransistor via the bridging of two prefabricated electrodes with a laterally grown ZnO nanowire is reported. It was found that the fabricated device is an n-channel enhancement-mode phototransistor with a dark carrier concentration of 6.34 × 10(17) cm(-3) when the gate voltage is biased at 5 V. With an incident-light wavelength of 360 nm and a zero gate bias, it was found that the noise equivalent power and normalized detectivity (D*) of the fabricated ZnO phototransistor were 6.67 × 10(-17) W and 1.27 × 10(13) cm Hz(0.5) W(-1), respectively. It was also found that the current in the device can be modulated efficiently by tuning the wavelength of the excitation source.

Quaternary ZnCdSeTe nanowires

We report the growth of needle-like high density quaternary ZnCdSeTe nanowires on oxidized Si(100) substrate using vapor-liquid-solid mechanism by molecular beam epitaxy with an Au-based nanocatalyst. It was found that average length and average diameter of the nanowires were 1.3 microm and 91 nm, respectively. It was also found that the as-grown ZnCdSeTe nanowires exhibit mixture of cubic zinc-blende and hexagonal wurtzite structures. Energy depersive results indicate that composition ratio of our nanowire should be Zn0.87Cd0.13Se0.98Te0.02, which agrees excellently with the designated composition ratio of Zn0.87Cd0.13Se0.98Te0.02.

Structural characteristic, Raman analysis and optical properties of indium-doped ZnO nanoparticles prepared by sol-gel method

Un-doped and indium (0-9 at.%) doped ZnO nanoparticles were prepared by the sol-gel method. The nanoparticles were heated at 700 degrees C-800 degrees C for 1 hour in air and then analyzed by X-ray diffraction (XRD), scanning electron microscopy (SEM), energy dispersive X-ray (EDS), Raman spectra and photoluminescence (PL). The results were compared to investigate the structural characteristics and physical properties. XRD patterns of the Indium-doped ZnO (IZO) nanoparticles were similar to those of the ZnO nanoparticles. Notably, the crystalline quality of the ZnO nanoparticles had reduced with increasing the concentration of indium doping. The In2O3 phase of IZO and the crystallized structures affected the UV emission band and the green emission band of PL. The Indium-doped (5 at.% - 7 at.%) ZnO nanoparticles possessed higher crystalline quality and better optical properties.

Role of HPV DNA testing for detection of high-grade cervical lesions in women with atypical squamous cells of undetermined significance: a prospective study in a Korean population

OBJECTIVE

The purpose of this study was to determine if HPV DNA testing improves the accuracy of detecting possible high-grade cervical lesions in women with atypical squamous cells of undetermined significance (ASC-US).

METHODS

Cervical cytology and Hybrid Capture II (HCII) assay for HPV DNA detection was performed in 10,526 women from July 2005 to July 2007. Two hundred and sixty women with ASC-US underwent colposcopy-directed biopsy to determine the final histologic diagnosis. They were divided into two groups according to the positivity of the HPV DNA test, and the respective biopsy results were compared.

RESULTS

Positive HCII was significantly more associated with CIN 2, CIN 3, and invasive cancer than negative HCII (p < 0.001). The odds ratio of positive HPV DNA testing in detecting high-grade lesions was 7.0 (95% CI; 2.8-17.7).

CONCLUSION

The HPV DNA test is useful for predicting the severity of lesions of the uterine cervix and formulating decisions with regard to treatment plans.

Accuracy of preoperative magnetic resonance imaging in assessing lymph node metastasis and myometrial invasion in patients with uterine cancer

OBJECTIVES

Our aim was to know preoperative magnetic resonance imaging (MRI) can accurately predict lymph node metastasis (LNM) and deep myometrial invasion (DMI, > or = 50%) in patients with uterine cancer.

METHODS

From January 1997 to December 2006, 99 patients who were diagnosed with uterine cancer and surgically staged at our institution were retrospectively analyzed. Preoperative clinicopathologic characteristics and MRI findings were reviewed and compared with LNM status and DMI observed in the final pathology.

RESULTS

The sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV) for MRI in determination of pelvic LNM were 77.7%, 85.6%, 35.0%, and 94.7%, respectively. MRI failed to detect the presence of paraaortic LNM in all of the three patients with positive paraaortic lymph nodes. The sensitivity, specificity, PPV, and NPV for MRI in determining DMI were 46.6%, 84.5%, 35%, and 89.8%, respectively.

CONCLUSION

Preoperative evaluation of uterine cancer by MRI does not accurately predict the LNM and DMI.

Erratum: ZnO-based MIS photodetectors

[This corrects the article DOI: 10.1016/j.sna.2007.06.006.].

Analysis of colonoscopic findings in the differential diagnosis between intestinal tuberculosis and Crohn's disease

BACKGROUND AND STUDY AIMS

Intestinal tuberculosis and Crohn's disease are chronic inflammatory bowel disorders that are difficult to differentiate from one another. This study aimed to evaluate the diagnostic value of various colonoscopic findings in the differential diagnosis between intestinal tuberculosis and Crohn's disease.

PATIENTS AND METHODS

Colonoscopic findings on initial work-up were prospectively recorded in patients with an initial diagnosis of either intestinal tuberculosis or Crohn's disease. These findings were analyzed after a final diagnosis of intestinal tuberculosis (n = 44) or Crohn's disease (n = 44) had been made after follow-up.

RESULTS

Four parameters (anorectal lesions, longitudinal ulcers, aphthous ulcers, and cobblestone appearance) were significantly more common in patients with Crohn's disease than in patients with intestinal tuberculosis. Four other parameters (involvement of fewer than four segments, a patulous ileocecal valve, transverse ulcers, and scars or pseudopolyps) were observed more frequently in patients with intestinal tuberculosis than in patients with Crohn's disease. We hypothesized that a diagnosis of Crohn's disease could be made when the number of parameters characteristic of Crohn's disease was higher than the number of parameters characteristic of intestinal tuberculosis, and vice versa. Making these assumptions, we calculated that the diagnosis of either intestinal tuberculosis or Crohn's disease would have been made made correctly in 77 of our 88 patients (87.5 %), incorrectly in seven patients (8.0 %), and would not have been made in four patients (4.5 %).

CONCLUSIONS

A systematic analysis of colonoscopic findings is very useful in the differential diagnosis between intestinal tuberculosis and Crohn's disease.

Proliferating trichilemmal cysts of the scalp on CT

Proliferating trichilemmal cysts, also known as pilar tumors, are slow-growing lobulated masses most commonly found on the scalp of elderly women. We present the case of a 69-year-old woman with a 25-year history of multiple enlarging scalp masses. The patient was evaluated for surgical consultation after the dominant mass presented with malignant degeneration. A CT of the head revealed multiple large, subcutaneous, cystic masses with calcifications.

Preparation of nano-sized particles from collagen II by a high-voltage electrostatic field system

The pilot study describes a novel method for preparing nano-sized particles from collagen II using a high-voltage electrostatic field system. Observations from transmission electron microscopy showed that, in one of the cases, the nano-sized collagen II particles exhibited good sphericity, and the particles were in the range of 23.3+/-1.7 nm in diameter at the experimental setting of 3 kV cm(-1), for a 3 h treatment period and at 25 degrees C (with a collagen concentration of 0.2 mg ml(-1)). When the treatment temperature increased to 30 degrees C, the collagen II began to lose the tendency to form individually separated spherically shaped nano-particles. Moreover, a fibrous structure of collagen II was formed instead of a nano-particle shape at the temperature of 37 degrees C. This result is probably contributed to by an entropy-driven process that is termed fibrillogenesis, a larger force causing the collagen molecules to self-assemble and then form collagen fibrils. It is interesting to note that this is practically the first attempt to produce nano-particles directly from collagen II solution under the treatment of a high-voltage electrostatic field, together with a set of working parameters for the collagen concentration and low-temperature setting.

Effects of supplemental vitamin E during the mature period on the reproduction performance of Taiwan Native Chicken cockerels

One-day-old Taiwan native male chicks were fed with maize-soybean rearing diets without supplemental vitamin E to 23 weeks of age. From 23 to 52 weeks of age, the cockerels (n = 90) were assigned at random to 5 dietary treatments and fed with maize-soybean diets supplemented with 0, 20, 40, 80 and 160 mg/kg of vitamin E (dl-alpha-tocopherol acetate). Pullets (225) of the same age were fed with standard diets throughout. They were artificially inseminated with one dose of 0.04 ml/bird intact and 5-fold diluted pooled semen at 31 to 43 weeks of age and at 49 weeks of age, respectively. The criteria evaluated included: semen quality, fertility and maximum and effective duration of fertility, blood characteristics, body and testes weight. Supplemental vitamin E did not affect cockerels' effective duration of fertility and percentage of fertility. However, when pullets were inseminated with diluted semen, supplementing 160 mg/kg vitamin E increased the maximum duration of fertility at 49 weeks of age. Cockerels receiving 40 to 160mg/kg supplements had higher sperm viability and motility after 39 weeks of age and those fed 80 mg/kg had higher sperm concentration at 39 weeks of age. Cockerels receiving supplements of more than 40 mg/kg vitamin E had higher body weight gain. Plasma cholesterol and testosterone were not affected by supplemental vitamin E. However, plasma luteinising hormone (LH) concentration was lower in cockerels fed 160 mg/kg. Lack of supplemental vitamin E over 39 weeks was associated with lower semen quality but did not reduce the proportion of fertile eggs laid by inseminated hens, perhaps because the insemination dose compensated for low sperm quality. We found that the maximum duration of fertility might be improved by supplementing 160 mg/kg vitamin E at 49 weeks of age.

Prevalence and risk factors associated with dyslipidaemia in children and adolescents among ethnic groups in Taiwan

BACKGROUND

The mortality rates of cerebral and cardiovascular diseases are higher for aborigines than non-aborigines in Taiwan. Hypertriglyceridaemia and hypercholestolaemia are risk factors for cardiovascular diseases.

OBJECTIVES

To investigate the prevalence of dyslipidaemia and its associated risk factors in aborigine (Atayal, Paiwan and Bunun tribes) and non-aborigine (Fukein and Hakka Chinese) children and adolescents in Taiwan.

STUDY DESIGN

This was a cross-sectional study.

METHODS

In total, 718 males and 721 females, below 20 years of age, were recruited. Our study defined dyslipidaemia as serum triglyceride and cholesterol levels greater than 200 and 240 mg/dl, respectively.

RESULTS

The serum triglyceride level and the prevalence of hypertriglyceridaemia were similar in both aborigines and non-aborigines and both sexes, but the Bunun and Paiwan tribes had the highest prevalence of hypertriglyceridaemia in males (11.8-29.4%) and females (10.9-22.8%) compared with other aboriginal tribes (5.1-10.8% for males and 7.8-9.2% for females). Serum cholesterol concentrations and the prevalence of hypercholesterolaemia were lower in the aborigines than non-aborigines for both sexes (P<0.05), with the Atayal tribe having the lowest prevalence in males (1.1%) and females (2.1%) compared with other aboriginal tribes (2.4-4.5% for males and 5.7-8.0% for females). Using multivariate-adjusted logistic regression modelling, hypertriglyceridaemia was significantly associated with the Bunun tribe (odds ratio (OR)=3.2, 95% confidence intervals (CI) 1.6-6.1), hyperuricaemia (OR=1.8, 95% CI 1.2-2.6), hypercholesterolaemia (OR=3.3, 95% CI 1.7-6.4) and alcohol use (OR=2.8, 95% CI 1.2-6.6). Hypercholesterolaemia, after controlling for age and sex, was significantly associated with the Atayal tribe (OR=0.2, 95% CI 0.1-0.5), hypertriglyceridaemia (OR=3.5, 95% CI 1.8-6.7) and hyperuricaemia (OR=3.2, 95% CI=1.7-6.0).

CONCLUSIONS

For the young people of Taiwan, hypertriglyceridaemia is associated with hyperuricaemia, hypercholesterolaemia and alcohol use, and hypercholesterolaemia is associated with hypertriglyceridaemia and hyperuricaemia. Compared with non-aborigines, the young aborigines of some tribes have a higher prevalence of hypertriglyceridaemia and a lower serum cholesterol level.

Effects of supplemental vitamin E during the laying period on the reproductive performance of Taiwan native chickens

1. One-day-old Taiwan Native Breeder female chicks were fed on maize/soybean growing diets without supplemental vitamin E from hatch to 17 weeks of age. After 17 weeks the birds (n = 300) were randomly assigned to 5 dietary treatments and fed on maize/soybean laying diets supplemented with 0, 40, 80, 120 and 160 mg/kg of vitamin E (dl-alpha-tocopherol acetate), respectively, until 46 weeks of age. The variates measured included: age at first egg, feed consumption (FC), feed efficiency (FE), egg production (EP), egg weight (EW), egg specific gravity (ESG), eggshell strength (ESS), fertility and hatchability. 2. The addition of 120mg/kg of vitamin E lowered the first EW (P<0.05); however, there was no significant difference in the age or body weight (BW) of pullets at first egg or mortality rate to 46 weeks of age among the treatments. FE and egg mass were improved (P<0.05) in pullets fed 80 mg/kg of supplemental vitamin E. A significant increase in EP was observed after peak EP in pullets given 80 mg/kg of supplemental vitamin E. However, this favourable effect decreased as supplemental vitamin E exceeded 80 mg/kg. 3. From 17 to 46 weeks of age, egg quality (ESG and ESS) decreased with age. However, there was no correlation between age and fertility or hatchability during the experimental period, suggesting that egg quality is more age-sensitive than reproductive performance for breeder pullets. 4. Compared with the control, fertility and hatchability of all eggs set for the treatment with 80 mg/kg supplemental vitamin E increased by 7.7 and 13.4%, respectively. There was no difference in the hatchability of fertile eggs. 5. These results suggest that using supplemental vitamin E during the laying period can improve the reproductive performance of breeder pullets. The addition of 80 mg/kg of vitamin E obtained the best performance in EP, egg mass, FE (feed/egg), hatchability and fertility.

Community-based study in Taiwan aborigines concerning renal dysfunction in gout patients

OBJECTIVE

To reveal the factors associated with renal dysfunction among gout patients in Taiwan aborigines.

METHODS

Social demographic data, alcohol consumption data, anthropometric measurements, blood samples, and 24-h urine samples were collected from 128 aboriginals (101 men, 27 women) suffering from gout.

RESULTS

The men displayed higher mean creatinine clearance (Ccr) values than women. Twenty-two post-menopausal women had significantly lower Ccr values compared to the five pre-menopausal women [probability (p)<0.001]. The males displayed higher 24-h urinary creatinine value than females (8.60+/-5.39 versus 5.58+/-2.14 mmol/L; p<0.05), and showed a significantly higher positive relationship between 24-h urinary creatinine and uric acid excretion [correlation coefficient (r)=0.7304; p<0.001], whereas the females did not (r=0.1144; p=0.5691). Overall, those who were older members of the Tsou tribe, or had excreted less uric acid from urine in 24 h tended to suffer renal dysfunction.

CONCLUSIONS

Gout patients displayed diversity in renal function. An exogenous source of creatinine in men was more likely than in women.

Incidence of Haemophilus influenzae type b and other invasive diseases in South Korean children

To determine incidence of invasive Haemophilus influenzae type b (Hib) disease in a defined population of Jeonbuk Province, Korea, children <5 years were evaluated in prospective, population-based surveillance of invasive bacterial diseases using standardized methods for patient referral, clinical evaluation and laboratory testing (optimized culture, latex agglutination, polymerase chain reaction). Vaccine utilization was assessed with vaccination histories of patients in surveillance, monthly data on Hib vaccine distribution and a coverage survey of clinic patients in study population. From September 1999 to December 2001, 2176 children were evaluated for possible meningitis, 1541 had no cerebrospinal fluid (CSF) findings of meningitis, 605 had CSF abnormalities (suspected bacterial meningitis) but no pathogen identified; six patients had probable Hib meningitis and eight had confirmed Hib meningitis. The annual suspected bacterial meningitis incidence was 258.4/100,000 <5 years and the probable/confirmed Hib meningitis incidence was 6.0/100,000 <5 years. Pneumococcal meningitis incidence was 2.1/100,000 <5 years and Group B streptococcal meningitis incidence was 0.17/1000 live births. A total of 69,589 Hib vaccine doses were distributed during the study. Hib vaccine coverage was negligible initially but increased to 16% (complete Hib immunization) and 27% (partial immunization) in final months of study. Suspected bacterial meningitis incidence was high but proven invasive Hib meningitis incidence was low. Hib was leading cause of bacterial meningitis yet bacterial pathogens were identified in only 4% of abnormal CSF. These findings may reflect truly low incidence, presumptive antibiotic treatment, partial Hib immunization, or incomplete clinical evaluations. Given the apparent Hib meningitis burden in Jeonbuk Province, additional studies to describe other invasive Hib syndromes, Hib-associated mortality and disability, and economic impact of Hib disease will be useful to guide public health decisions regarding routine Hib vaccine introduction.

Successful treatment with weekly paclitaxel in a patient with recurrent endometrial cancer. A case report

The best treatment for recurrent endometrial cancer is still uncertain, although weekly paclitaxel has shown some promise in the management of this disease. In this report we present a patient with recurrent endometrial cancer treated with weekly paclitaxel. Serial power Doppler angiography was used to assess the effects of therapy. The response was good, suggesting that recurrent endometrial cancer may be successfully treated with weekly paclitaxel and effectively monitored with power Doppler angiography.

Mutation of Ha-ras Oncogene in Rat Salivary Gland Tumors Induced by DMBA

PURPOSE

The incidence of salivary gland tumor is approximately 2% among all head and neck tumors, of which malignant cases account for only about 5%. Much research has been performed in order to clarify the mechanism of oncogene activation, however salivary gland tumors remain understudied. We performed this study in order to characterize the ras gene in these tumors.

MATERIALS AND METHODS

We treated white rats with 7, 12-dimethylbenz[a]anthracene (DMBA) and confirmed the occurrence of salivary gland tumors after ten to thirty weeks. Isolated genomic DNAs from tumor tissues were added to NIH 3T3 cells. In order to detect Ha-ras mutations, we performed a two-step PCR-RFLP and 7analyzed the mutated sequences.

RESULTS

We induced salivary gland tumors by DMBA treatment in white rats. Isolated DNAs from the tumor tissues transformed the NIH 3T3 cells. Point mutations were observed in codons 12 and 61 of the Ha-ras oncogene. The total frequency of point mutations was 13.9% in DMBA-induced salivary gland tumors in rats.

CONCLUSION

Our results demonstrate that a variety of cancers ras oncogene mutations were also found in salivary gland tumors. We confirmed that a point mutation of the Ha-ras oncogene in a DMBA-induced salivary gland tumor occurs at a frequency of 13.9%.

Effects of adhesives and permeation enhancers on the skin permeation of captopril

To formulate a transdermal drug delivery system of captopril, monolithic adhesive matrix type patches containing 20% captopril, different pressure-sensitive adhesives, and various permeation enhancers were prepared using a labcoater. The effects of the adhesives and permeation enhancers on skin permeation of captopril from the prepared patches were evaluated using Franz diffusion cells fitted with excised rat skins. The permeation rate of the drug through the excised skin was dependent on the type of polyacrylate copolymers studied. Fatty alcohols resulted in a pronounced enhancing effect on the skin permeation of captopril, while dimethyl sulfoxide, N-methyl-2-pyrrolidone, oleic acid, Transcutol, and polysorbate 20 showed no significant enhancing effect. The permeation-enhancing effect of the fatty alcohols reached the maximum at the level of 100%. Based on these results, a captopril patch may be developed with further optimization.

Two phenanthraquinones from Dendrobium moniliforme

Two phenanthraquinones were isolated from the stems of Dendrobium moniliforme. They were identified by interpretation of spectral data as 2,6-dimethoxy-1,4,5,8-phenanthradiquinone and 5-hydroxy-3,7-dimethoxy-1,4-phenanthraquinone, named moniliformin (1) and denbinobin (2), respectively. This is the first report of compound 1, which possesses a novel 1,4,5,8-diquinone moiety in the phenanthraquinone skeleton. Compound 2 showed potent antiinflammatory effects in vitro.

Prospective, randomized, placebo-controlled evaluation of the safety and immunogenicity of three lots of intranasal trivalent influenza vaccine among young children

BACKGROUND

Trivalent formulations of an experimental, cold-adapted, intranasal influenza (CAIV) vaccine have been shown to be safe, immunogenic and efficacious in young children.

METHODS

We evaluated the safety and immunogenicity of three consistency lots of CAIV in children 12 to 36 months of age randomized to one of five groups: Groups 1, 2 and 3 received separate lots containing A/Shenzhen/227/95 (H1N1), A/Wuhan/359/95(H3N2) and B/Harbin/7/94-like viral strains. Group 4 received an earlier efficacy trial lot which included a different H1N1 strain (A/Texas/36/91-like); and Group 5 received placebo. We performed strain-specific serum hemagglutination inhibition antibody levels against type A (H3N2 or H1N1) or type B as appropriate.

RESULTS

Overall 474 children received 2 doses, 2 months apart. Each lot was well-tolerated, and there were no significant group differences between consistency lots in the proportion of children with fever and local or systemic reactions after vaccination. The 3 consistency lots were not statistically different with regard to immunogenicity as measured by seroconversion or absolute geometric mean titer. Immune responses were more robust among initially seronegative children and for H3N2 and B strains than for H1N1 strains. After 2 doses of vaccine 97, 84 and 62% had hemagglutination inhibition titers > or = 1/32 against A/H3N2, B and H1N1 strains, respectively. For A/H3N2 only, immune responses after 1 dose of vaccine are similar to those seen after 2 doses.

CONCLUSIONS

Each consistency lot of CAIV is as or more immunogenic than a lot used in a large efficacy trial.

Effect of high blood flow on the expression of endothelial constitutive nitric oxide synthase in rats with femoral arteriovenous shunts

The effect of high blood flow on the expression of endothelial nitric oxide synthase has been investigated in the femoral arteriovenous shunt (AVS) rats created by inserting U-shaped polyurethane tubes in the left femoral arteries and veins. Three days after inserting the femoral AVS, the mean aortic blood flow rate in the abdominal aorta of the AVS rats was about 2.0 times higher than that in the control rats (110.0 +/- 8.4 ml/min vs 52.7 +/- 2.7 ml/min, p < 0.001). The competitive reverse transcriptase-polymerase chain reaction (RT-PCR) data revealed that the mRNA expression level of the endothelial constitutive nitric oxide synthase (ecNOS) was increased in the aortas of the femoral AVS rats compared to that in the control rats. Western blot analysis using a monoclonal antibody against ecNOS revealed that the ecNOS protein levels were markedly increased in the aortas of femoral AVS rats, but ecNOS protein levels in aortas without endothelium were not significantly increased. Inducible nitric oxide synthase (iNOS) protein was not expressed in the aortic tissues with and without endothelium in the control rats. This iNOS expression was not increased by the high blood flow in the femoral AVS rats. These findings suggest that high blood flow could up-regulate the expression levels of ecNOS mRNA and proteins in femoral arteriovenous shunt rats.

Pharmacokinetics of a new antitumor 3-arylisoquinoline derivative, CWJ-a-5

1-(4-Methylpiperazinyl)-3-phenylisoquinoline hydrochloride (CWJ-a-5) is a newly developed from benzo[c]phenanthridine alkaloids and derivative and has exhibited potent antitumor activities, in vitro and in vivo. The pharmacokinetics of this novel antitumor 3-arylisoquinoline derivative was studied after intravenous (i.v.), oral (p.o.) and hepatoportal (p.v.) administration in rats. A simple high performance liquid chromatographic method was developed to determine the concentrations of CWJ-a-5 in plasma, bile and urine. Plasma concentration profiles of CWJ-a-5 were best fitted by the two-compartment model after i.v. administration and showed a linear pharmacokinetic behavior up to 20 mg/kg doses. The half-life of CWJ-a-5 in the post-distributive phase (t1/2beta), total-body plasma clearance (CLt), and volume of distribution at steady-state (Vdss) were 86.9 min, 5.72 l/h per kilogram and 9.79 l/kg, respectively, after i.v. administration of 10 mg/kg. Biliary and urinary excretion of CWJ-a-5 was < 1% after i.v. injection of 10 mg/kg. The bioavailability of CWJ-a-5 after p.o. and p.v. administration (50 and 10 mg/kg, respectively) was 52.9 and 72.2%, respectively. Gastrointestinal bioavailability was calculated to be 73.3%. The apparent partition coefficient (log P) of CWJ-a-5 between n-octanol and water was 2.64. Plasma protein binding of CWJ-a-5 measured by the ultrafiltration method was > 95%.

Efficacy of nonwoven fabric bioreactor immobilized with porcine hepatocytes for ex vivo xenogeneic perfusion treatment of liver failure in dogs

We have developed a new bioartificial liver bioreactor filled with porcine hepatocytes immobilized on polyester nonwoven fabric (NWF). In this study, we investigated the efficacy of our hybrid bioartificial liver system incorporating the NWF bioreactors and an immunoglobulin adsorbent column for perfusion treatment in a canine liver failure model. Xenogeneic perfusion treatment for operative canine liver failure models were performed for 3 h, and survival time, intracranial pressure, and blood and cerebrospinal fluid data were documented. Treatment was carried out without obstruction by immunological rejection when immunoglobulin adsorbent columns were used with the NWF bioreactors in combination. Dogs treated with this system exhibited a restricted increase of intracranial pressure and significant compensatory effects on blood and cerebrospinal amino acid imbalances as shown by a significant improvement of Fischer's ratio. On the other hand, relatively low capacity for ammonia elimination was shown as compared with homologous direct hemoperfusion.

Cell encapsulation with alginate and alpha-phenoxycinnamylidene-acetylated poly(allylamine)

In general, microcapsules prepared from alginate and polycations lack mechanical strength because the interaction between alginate and polycations is ionic instead of covalent, which represents a much stronger bond. To increase the mechanical strength of the capsule, we prepared photosensitive microcapsules that could form covalent bonds between polymers in the capsular membrane by light irradiation. Two types of photosensitive poly(allylamine), with 5% and 10% of amino groups modified by alpha-phenoxycinnamylidene acetylchloride, were synthesized. Both photopolymers exhibited an absorption maximum at 325 nm and were capable of crosslinking upon light exposure. These photosensitive polymers were used for the preparation of microcapsules. The capsules formed from this photosensitive poly(allylamine) and alginate were strengthened significantly by light irradiation. Only 28% of the microcapsules prepared from the 5%-modified photopolymer fractured after 48 h of shaking at 150 rpm. This fracture percentage is much lower when compared with the 60% of capsules fractured when prepared from the untreated poly(allylamine). By using poly(allylamine) at 10% modification, the mechanical strength was improved only slightly, with 26% of capsules fractured. Analysis of the permeability test indicated that the photo-crosslinked capsular membrane was freely permeable to cytochrome c and myoglobin, but less permeable to serum albumin. The encapsulation method was used to entrap and culture IW32 mouse leukemia cells. The cells proliferated to a density of about 1.1 x 10(7) cells/mL in the capsules after 7 days of cultivation. Concurrently, the concentration of erythropoietin in the microcapsules increased to 800 mU/mL. This new encapsulation technique has great potential in the application of a bioindustrial cell-culturing process.

The conditional survival statistics for survivors with primary supratentorial astrocytic tumors

BACKGROUND

Relative survival rates can offer a general description of tumor outcome and, traditionally, are used for surveillance and comparison purposes. However, they are not informative for individual tumor survivors. Conditional survival estimates can calculate the probability of surviving next some years given survival to a specific period of time after craniotomy for individual tumor survivors. However, clinically, they have not been used for predicting the tumor outcome.

METHODS

We calculated conditional probabilities of survival within 6 years after craniotomy in 112 patients with primary supratentorial astrocytic tumors and evaluated factors affecting the survival time more than 2 years after craniotomy.

RESULTS

Our data showed that the conditional probability of survival can predict yearly survival rate when patients survive for a specific period of time. The conditional survival rates within 6 years after craniotomy were always higher than those evaluated by relative survival rates. Overall, the longer the patients survived, the higher the conditional probabilities of surviving sixth year postoperatively were.

CONCLUSION

Our study demonstrates the conditional probabilities of survival have good availability and are important estimates for individual tumor survivors.

A local training and pruning approach for neural networks

The training of neural networks using the extended Kalman filter (EKF) algorithm is plagued by the drawback of high computational complexity and storage requirement that may become prohibitive even for networks of moderate size. In this paper, we present a local EKF training and pruning approach that can solve this problem. In particular, the by-products obtained along with the local EKF training can be utilized to measure the importance of the network weights. Comparing with the original global approach, the proposed local EKF training and pruning approach results in a much lower computational complexity and storage requirement. Hence, it is more practical in solving real world problems. The performance of the proposed algorithm is demonstrated on one medium- and one large-scale problems, namely, sunspot data prediction and handwritten digit recognition.

Immunogenicity of a Haemophilus influenzae type b-tetanus toxoid conjugate vaccine when mixed with a diphtheria-tetanus-acellular pertussis-hepatitis B combination vaccine

BACKGROUND

Combination vaccines are urgently needed to reduce the number of injections given to young children. The aim of the study was to evaluate the safety and immunogenicity of a combination vaccine that contains diphtheria and tetanus toxoids and acellular pertussis antigens (DTaP), recombinant hepatitis B surface antigen (HepB) and Haemophilus influenzae type b (Hib) polysaccharide conjugated to tetanus toxoid (PRP-T).

METHODS

Four hundred five infants were randomized equally to three groups and immunized at 2, 4 and 6 months of age with: (1) DTaP/HepB vaccine used to reconstitute lyophilized PRP-T vaccine and administered as a single injection; (2) DTaP/HepB vaccine and PRP-T vaccine administered as two separate injections; or (3) DTaP, HepB and PRP-T vaccines administered as three separate injections. Safety was closely monitored, and blood specimens were obtained to assess antibody responses to each vaccine antigen.

RESULTS

All study vaccines were well-tolerated, and the rates of systemic and injection site reactions were similar between groups. After the third dose the geometric mean antibody concentrations to Hib were significantly lower in subjects in Group 1 (1.63 microg/ml) compared with subjects in Groups 2 and 3 (6.26 and 6.15 microg/ml, respectively; P < 0.0001). Subjects with antibody concentrations <1.0 microg/ml after the third dose responded well to a booster dose of Hib conjugate vaccine given at 11 to 15 months of age (41 of 44 with anti-PRP > or = 1.0 microg/ml). Differences between groups for antibody responses to the other vaccine components were not clinically significant.

CONCLUSIONS

Infants given a combined DTaP/ HepB/PRP-T vaccine experienced a significantly lower antibody response to the PRP-T component than infants given PRP-T vaccine as a separate injection. However, the immune response to a booster dose of Hib conjugate vaccine indicated the presence of immunologic memory.