NHLRC1 homozygous dodecamer expansion in a Newfoundland dog with Lafora disease

Lafora disease is a genetic disease caused, in humans, by mutations in EPM2A and NHLRC1 genes, resulting in accumulation of polyglucosan bodies within neurons. Affected subjects present progressive neurological signs characterised primarily by myoclonic epilepsy. In dogs, Lafora disease has been described mainly in miniature wire-haired Dachshunds, where a dodecamer expansion in NHLRC1 gene has been identified. The same mutation has then been detected in the Basset Hound, Beagle, Chihuahua and Pembroke Welsh Corgi breeds. This is the first case of a Newfoundland dog with myoclonic epilepsy diagnosed with Lafora disease based on confirmed dodecamer expansion in the NHLRC1 gene. Lafora disease is being progressively recognised in different unrelated breeds suggesting a wider distribution in the canine population than previously thought.

Path-Dependent Supercooling of the ^{3}He Superfluid A-B Transition

We examine the discontinuous first-order superfluid ^{3}He A to B transition in the vicinity of the polycritical point (2.232 mK and 21.22 bar). We find path-dependent transitions: cooling at fixed pressure yields a well-defined transition line in the temperature-pressure plane, but this line can be reliably crossed by depressurizing at nearly constant temperature after transiting T_{c} at a higher pressure. This path dependence is not consistent with any of the standard B-phase nucleation mechanisms in the literature. This symmetry breaking transition is a potential simulator for first order transitions in the early Universe.

Gravity steam reprocessing in healthcare facilities for the reuse of N95 respirators

BACKGROUND

Coronavirus disease 2019 (COVID-19) has significantly impacted the health of millions of people around the world. The shortage of personal protective equipment, including N95 respirators, in hospital facilities has put frontline healthcare professionals at high risk for contracting this virus.

AIM

To develop a reproducible and safe N95 respirator reprocessing method that satisfies all presented regulatory standards and that can be directly implemented by hospitals using existing available equipment.

METHODS

A non-toxic gravity steam reprocessing method has been developed for the reuse of N95 respirators consisting of 30 min of steam treatment at 121°C followed by 30 min of heat drying. Samples of model number 1860, 1860s, 1870+, and 9105 N95 respirators were either collected from hospitals (for microbiology testing) or purchased new (for functionality testing), with all functionality tests (i.e. filter efficiency, fit evaluation, and strap integrity) performed at the Centers for Disease Control and Prevention using standard procedures established by the National Institute for Occupational Safety and Health.

FINDINGS

All tested models passed the minimum filter efficiency of 95% after three cycles of gravity steam reprocessing. The 1870+ N95 respirator model is the most promising model for reprocessing based on its efficient bacterial inactivation coupled with the maintenance of all other key functional respirator properties after multiple reprocessing steps.

CONCLUSIONS

The gravity steam method can effectively reprocess N95 respirators over at least three reprocessing cycles without negatively impacting the functionality requirements set out by regulators. Enabling the reuse of N95 respirators is a crucial tool for managing both the current pandemic and future healthcare crises.

Thermal transport of helium-3 in a strongly confining channel

The investigation of transport properties in normal liquid helium-3 and its topological superfluid phases provides insights into related phenomena in electron fluids, topological materials, and putative topological superconductors. It relies on the measurement of mass, heat, and spin currents, due to system neutrality. Of particular interest is transport in strongly confining channels of height approaching the superfluid coherence length, to enhance the relative contribution of surface excitations, and suppress hydrodynamic counterflow. Here we report on the thermal conduction of helium-3 in a 1.1 μm high channel. In the normal state we observe a diffusive thermal conductivity that is approximately temperature independent, consistent with interference of bulk and boundary scattering. In the superfluid, the thermal conductivity is only weakly temperature dependent, requiring detailed theoretical analysis. An anomalous thermal response is detected in the superfluid which we propose arises from the emission of a flux of surface excitations from the channel.

Unconventional valley-dependent optical selection rules and landau level mixing in bilayer graphene

Selection rules are of vital importance in determining the basic optical properties of atoms, molecules and semiconductors. They provide general insights into the symmetry of the system and the nature of relevant electronic states. A two-dimensional electron gas in a magnetic field is a model system where optical transitions between Landau levels (LLs) are described by simple selection rules associated with the LL index N. Here we examine the inter-LL optical transitions of high-quality bilayer graphene by photocurrent spectroscopy measurement. We observed valley-dependent optical transitions that violate the conventional selection rules Δ|N| = ± 1. Moreover, we can tune the relative oscillator strength by tuning the bilayer graphene bandgap. Our findings provide insights into the interplay between magnetic field, band structure and many-body interactions in tunable semiconductor systems, and the experimental technique can be generalized to study symmetry-broken states and low energy magneto-optical properties of other nano and quantum materials.

CMAH genotyping survey for blood types A, B and C (AB) in purpose-bred cats

In domestic cats, the AB blood group system consists of the three types A, B and C (also called AB). Mismatches can cause acute hemolytic transfusion reactions and hemolysis of the newborn (neonatal isoerythrolysis, NI). As blood types B and C are inherited recessively to A, breeders need to know the genotype to predict blood types in offspring and avoid NI. Several CMAH variants have been described as being associated with the b and a^c alleles, and different genotyping schemes exist. Here, we genotyped 2145 cats with the original SNV panel, including SNVs c.142G>A and ∆-53, and our new scheme, with SNVs c.179G>T, c.268T>A and c.1322delT, to differentiate types A and B and added the SNV for the common a^c (c.364C>T). Based upon the new scheme, all samples were assigned the correct genotype. No discordances appeared for the A allele, and new breed-specific SNVs (c.179G>T, c.1322delT) for the b allele were discovered. Furthermore, the genotypes A/a^c (type A), a^c /a^c (C) and a^c /b (C) could be detected. We found the variant c.179G>T in additional breeds: Ragdoll, Siberian, Scottish Fold, Chartreux, Neva Masquerade, British Shorthair and Highlander. Also, the variant c.364C>T was detected in additional breeds: Bengal, British Shorthair, Maine Coon, and Scottish Fold. We conclude that our new SNV panel is superior in genotyping cats than the original SNV panel and assures correct assignments of types A, B and C to assist veterinary clinicians and breeders to recognize, confirm and avoid blood incompatibilities such as acute hemolytic transfusion reactions and NI.

Development, preclinical evaluation and validation of a novel quick vascular closure device for transluminal, cardiac and radiological arterial catheterization

Following percutaneous coronary intervention, vascular closure devices (VCDs) are increasingly used to reduce time to ambulation, enhance patient comfort, and reduce potential complications compared with traditional manual compression. Newer techniques include complicated, more or less automated suture devices, local application of pads or the use of metal clips and staples. These techniques often have the disadvantage of being time consuming, expensive or not efficient enough. The VCD failure rate in association with vascular complications of 2.0-9.5%, depending on the type of VCD, is still not acceptable. Therefore, the aim of this study is to develop a self-expanding quick vascular closure device (QVCD) made from a bioabsorbable elastic polymer that can be easily applied through the placed introducer sheath. Bioabsorbable block-co-polymers were synthesized and the chemical and mechanical degradation were determined by in vitro tests. The best fitting polymer was selected for further investigation and for microinjection moulding. After comprehensive haemocompatibility analyses in vitro, QVCDs were implanted in arterial vessels following arteriotomy for different time points in sheep to investigate the healing process. The in vivo tests proved that the new QVCD can be safely placed in the arteriotomy hole through the existing sheath instantly sealing the vessel. The degradation time of 14 days found in vitro was sufficient for vessel healing. After 4 weeks, the remaining QVCD material was covered by neointima. Overall, our experiments showed the safety and feasibility of applying this novel QVCD through an existing arterial sheath and hence encourage future work with larger calibers.

Simultaneous measurement of all thermoelectric properties of bulk materials in the temperature range 300-600 K

Thermoelectric materials can directly convert heat into electrical energy. The characterization of different materials is an important part in thermoelectric materials research to improve their properties. Usually, different methods and setups are combined for the temperature dependent determination of all thermoelectric key quantities - Seebeck coefficient, electrical conductivity, and thermal conductivity. Here, we present a measurement system for the simultaneous determination of all of these quantities plus the direct determination of the figure of merit by means of the Harman method (zT)H in a temperature range from room temperature up to 600 K. A simultaneous measurement saves time and reduces the measurement error, and the change of all material properties can be monitored even for unstable materials. Thermal conductivity measurements are inherently affected by undesired thermal losses, in particular, through radiation at higher temperatures. We show a simple experimental approach to measure radiation losses and correct for those. Comparative measurements on traditional systems show good agreement for all measured quantities.

Analysis of variants and mutations in the human winged helix FOXA3 gene and associations with metabolic traits

BACKGROUND/OBJECTIVES

The forkhead factor Foxa3 is involved in the early transcriptional events controlling adipocyte differentiation and plays a critical function in fat depot expansion in response to high-fat diet regimens and during aging in mice. No studies to date have assessed the potential associations of genetic variants in FOXA3 with human metabolic outcomes.

SUBJECTS/METHODS

In this study, we sequenced FOXA3 in 392 children, adolescents and young adults selected from several cohorts of subjects recruited at the National Institute of Child Health and Human Development of the National Institutes of Health based on the availability of dual-energy X-ray absorptiometry data, magnetic resonance imaging scans and DNA samples. We assessed the association between variants present in these subjects and metabolic traits and performed in vitro functional analysis of two novel FOXA3 missense mutations identified.

RESULTS

Our analysis identified 14 novel variants and showed that the common single-nucleotide polymorphism (SNP) rs28666870 is significantly associated with greater body mass index, lean body mass and appendicular lean mass (P values 0.009, 0.010 and 0.013 respectively). In vitro functional studies showed increased adipogenic function for the FOXA3 missense mutations c.185C>T (p.Ser62Leu) and c.731C>T (p.Ala244Val) compared with FOXA3-WT.

CONCLUSIONS

Our study identified novel FOXA3 variants and mutations, assessed the adipogenic capacity of two novel missense alterations in vitro and demonstrated for the first time the associations between FOXA3 SNP rs28666870 with metabolic phenotypes in humans.

The impact of diurnal sleep on the consolidation of a complex gross motor adaptation task

Diurnal sleep effects on consolidation of a complex, ecological valid gross motor adaptation task were examined using a bicycle with an inverse steering device. We tested 24 male subjects aged between 20 and 29 years using a between-subjects design. Participants were trained to adapt to the inverse steering bicycle during 45 min. Performance was tested before (TEST1) and after (TEST2) training, as well as after a 2 h retention interval (TEST3). During retention, participants either slept or remained awake. To assess gross motor performance, subjects had to ride the inverse steering bicycle 3 × 30 m straight-line and 3 × 30 m through a slalom. Beyond riding time, we sophisticatedly measured performance accuracy (standard deviation of steering angle) in both conditions using a rotatory potentiometer. A significant decrease of accuracy during straight-line riding after nap and wakefulness was shown. Accuracy during slalom riding remained stable after wakefulness but was reduced after sleep. We found that the duration of rapid eye movement sleep as well as sleep spindle activity are negatively related with gross motor performance changes over sleep. Together these findings suggest that the consolidation of adaptation to a new steering device does not benefit from a 2 h midday nap. We speculate that in case of strongly overlearned motor patterns such as normal cycling, diurnal sleep spindles and rapid eye movement sleep might even help to protect everyday needed skills, and to rapidly forget newly acquired, interfering and irrelevant material.

Current evidence supporting obstetric fistula prevention strategies in sub Saharan Africa: a systematic review of the literature

Obstetric fistula has been eliminated in developed countries, but remains highly prevalent in sub-Saharan Africa. The End fistula campaign is the first concerted effort to eradicate the disease. The objective of this review is to retrieve and link available evidence to obstetric fistula prevention strategies in sub-Saharan Africa, since the campaign began. We searched databases for original research on obstetric fistula prevention. Fifteen articles meeting inclusion criteria were assessed for quality, and data extraction was performed. Grey literature provided context. Evidences from the articles were linked to prevention strategies retrieved from grey literature. The strategies were classified using an innovative target-focused method. Gaps in the literature show the need for fistula prevention research to aim at systematically measuring incidence and prevalence of the disease, identify the most effective and cost-effective strategies for fistula prevention and utilise innovative tools to measure impact of strategies in order to ensure eradication of fistula.

Non-Abelian braiding of lattice bosons

We report on a numerical experiment in which we use time-dependent potentials to braid non-Abelian quasiparticles. We consider lattice bosons in a uniform magnetic field within the fractional quantum Hall regime, where ν, the ratio of particles to flux quanta, is near 1/2, 1, or 3/2. We introduce time-dependent potentials which move quasiparticle excitations around one another, explicitly simulating a braiding operation which could implement part of a gate in a quantum computation. We find that different braids do not commute for ν near 1 and 3/2, with Berry matrices, respectively, consistent with Ising and Fibonacci anyons. Near ν=1/2, the braids commute.

Salzburg Skiing for the Elderly Study: changes in cardiovascular risk factors through skiing in the elderly

Numerous studies have shown that treatment of the modifiable cardiovascular risk factors (CVRF) results in a decreased risk to suffer from stroke or myocardial infarction. Despite the fact that exercise training is a potent treatment choice for CVRF, this is the first randomized study to assess the effects of alpine skiing on CVRF in elderly skiers. Subjects (n=42) were randomized into an intervention group (IG; n=22; 12 males/10 females; age: 66.6 ± 2.1 years) completing 12 weeks of guided skiing or a control group (CG; n=20; 10 males/10 females; age: 67.3 ± 4.4 years). CVRF were assessed before and after the intervention period. No cardiovascular event occurred within a total of 795.1 h of skiing. A significant increase in exercise capacity in IG (ΔVO(2 max) : +2.0 mL/kg/min, P=0.005) but not in CG (ΔVO(2 max) : -0.1 mL/kg/min, P=0.858; IG vs CG: P=0.008) as well as a decrease in body fat mass [IG: -2.3%, P<0.0001; CG: ± 0.0%, P=0.866; IG vs CG: P<0.0001] was achieved. Blood pressure, blood lipids, heart rate and everyday physical activity remained essentially unchanged. Alpine skiing in the elderly is safe with respect to cardiovascular events, and improves some, but not all CVRF.

Load-sensitive adhesion factor expression in the elderly with skiing: relation to fiber type and muscle strength

We hypothesized that 12 weeks of downhill skiing mitigates the functional deficits of knee extensor muscles in elderly subjects due to the specific recruitment of fast motor units during forceful turns on the slope. Downhill skiing led to a 1.4-fold increase in the mean cross-sectional area of slow (P=0.04)- and fast (P=0.08)-type muscle fibers. Fold changes in the expression of the structural component of focal adhesions, gamma-vinculin, were correlated with alterations in concentric force (r=0.64). Hypertrophy of fast fibers was more pronounced in women than in men (1.7 vs 1.1). Gender-specific structural-functional adjustments of knee extensor muscles and attached patellar tendon were reflected by altered expression of pro- vs de-adhesive proteins and a number of correlations. The de-adhesive protein tenascin-C was selectively increased in women compared with men (1.7 vs 1.1) while the content of the adhesive collagen XII was specifically reduced in women. The pro-adhesive focal adhesion kinase showed a specific increase in men compared with women (1.9 vs 1.1). Our findings indicate that quantitatively matched adaptations in slow and fast motor units of extensor muscle underlie the preventive effect of skiing against sarcopenia and support that hypertrophy and reinforcement of fiber adhesion operate in the improvement of muscle strength.

Exact parent Hamiltonian for the quantum Hall states in a lattice

We study lattice models of charged particles in uniform magnetic fields. We show how longer range hopping can be engineered to produce a massively degenerate manifold of single-particle ground states with wave functions identical to those making up the lowest Landau level of continuum electrons in a magnetic field. We find that in the presence of local interactions, and at the appropriate filling factors, Laughlin's fractional quantum Hall wave function is an exact many-body ground state of our lattice model. The hopping matrix elements in our model fall off as a Gaussian, and when the flux per plaquette is small compared to the fundamental flux quantum one only needs to include nearest and next-nearest neighbor hoppings. We suggest how to realize this model using atoms in optical lattices, and describe observable consequences of the resulting fractional quantum Hall physics.

Improvement of spatial resolution for local Seebeck coefficient measurements by deconvolution algorithm

A potential Seebeck microprobe apparatus is described such that a profile of Seebeck coefficients can be detected on a material sample surface for thermopower investigations. Due to its spatially resolved limit on detecting small inhomogeneities of dopants or composition changes, we here propose a constructive combination of numerical modeling and practical measurement to improve the spatial resolution by deconvolution algorithm. The relevant transfer function, obtained from numerical calculations, was successfully applied on real measurement data. Besides, an improvement in detecting the 1.5 microm inhomogeneity has been achieved by applying one transfer function of the known tip setup on a set of Seebeck line scan signals, obtained with 6 microm tip-sample contact length, 3 micros signal capture time after contact, and 0.75 microm scan period. The result showed that a system theoretical approach in terms of deconvolution algorithm could theoretically enhance the spatial resolution anyway, but is practically limited by the systemic preconditions (tip size, signal capture time, and scan period) and the signal to noise ratio of the captured thermovoltages. Therefore, we provide a clear understanding of systemic preconditions and their impacts on the detection of small inhomogeneities and thus the performance in the thermopower analysis.

One Europe, one neurologist?

In recent years, there has been a major shift in emphasis within neurology from being a largely diagnostic discipline to one much more actively involved in treating disease. There have been major scientific advances leading to new and effective treatments. There is also a much greater awareness of the burden of neurological disease (Olesen J, Leonardi M. European Journal of Neurology 2003; 10: 471) and informed sufferers are requesting specific intervention. There is wide variation in the delivery of neurological services throughout Europe. This is reflected in manpower levels, the place of neurology related to other medical specialties and different mixes of hospital and private office practice. These differences have been thrown into sharper focus by the recent expansion of the European Union (EU). Initial training in neurology is given to undergraduate/pre-graduate students. Post-graduate education is delivered within a residency program leading to specialist qualification and certification. We now recognize that this is only the beginning of a life long program of continuous education and development (CME/CPD). National and international exchange programs facilitate the growth of knowledge and promote professional harmony and cooperation. The free migration of medical specialists has been an aspiration but remains limited by cultural, linguistic, personal, professional, political and economic factors. Two bodies, the European Board of Neurology (EBN-UEMS) http://www.uems-neuroboard.org (Union Européenne des Médecins Spécialistes) and the European Federation of Neurological Societies (EFNS) http://www.efns.org are actively involved in harmonising and developing neurology at the European level.

Ermittlung des Immunstatus bei Pferden mit bzw. ohne equine Keratokonjunktivitis unter besonderer Berücksichtigung einer EHV-2-Infektion

Gegenstand und Ziel: Die Rolle des in der Pferdepopulation weit verbreiteten EHV-2 als Pathogen ist umstritten, aber eine Beteiligung bei respiratorischen Infektionen und Keratokonjunktivitis mehrfach belegt. Neueste Befunde, die auf einer optimierten Probennahme und der sensitiven PCR-Technik basierten, zeigten jedoch auch bei augengesunden Pferden einen hohen Anteil an EHV-2-positiven Tupferproben. Da serologische Befunde keine diagnostische Aussagekraft bei der EHV-2-bedingten Keratokonjunktivitis haben, wurde nach einem weiteren diagnostisch verwertbaren Parameter gesucht. Material und Methoden: EHV-2 liegt in B-Zellen latent vor und hat möglicherweise eine immunsupprimierende Wirkung. Deshalb wurden Blutproben von augengesunden und augenkranken Pferden mittels PCR auf EHV-2 untersucht und zusätzlich die relativen Anteile der B- und T-Lymphozyten im peripheren Blut durchflusszytometrisch bestimmt. Die Testgruppe umfasste 10 EHV-2-positive Pferde, bei denen das Virus per PCR in peripheren Blutleukozyten oder Augentupfern nachgewiesen wurde. Die Kontrollgruppe bestand aus 21 EHV-2-negativen Pferden. Beide Gruppen beinhalteten augenkranke und augengesunde Pferde. Ergebnisse: Zwischen augenkranken und augengesunden Test- und Kontrolltieren ergaben sich bezüglich der T-Zell-Zahlen im Vergleich zum Referenzbereich keine signifikanten Unterschiede. Dagegen waren bei vier von sechs augengesunden EHV-2-positiven Pferden erniedrigte B-Lymphozyten-Zahlen zu verzeichnen. Die Häufigkeit des Vorkommens von erhöhten B-Lymphozyten-Anteilen differierte dagegen zwischen den vier Gruppen nicht signifikant. Schlussfolgerungen: Augengesunde Testtiere wiesen signifikant häufiger verminderte B-Lymphozyten- Zahlen auf als augenkranke bzw. augengesunde Kontrolltiere. Aufgrund des geringen Stichprobenumfangs sollten diese Ergebnisse jedoch nur als erste Indizien für einen möglichen Einfluss einer EHV- 2-Infektion auf den Immunstatus angesehen werden. Klinische Relevanz: Weitere Studien müssen klären, ob die Bestimmung des Immunstatus mittels Durchflusszytometrie ein hilfreicher diagnostischer und möglicherweise prognostischer Parameter bei der EHV-2-induzierten equinen Keratokonjunktivitis darstellt.

Nine months aerobic fitness induced changes on blood lipids and lipoproteins in untrained subjects versus controls

Regular endurance exercise has favorable effects on cardiovascular risk factors. However, the impact of an exercise-induced change in aerobic fitness on blood lipids is often inconsistent. The purpose of this study was to investigate the effect of nine consecutive months of training on aerobic fitness and blood lipids in untrained adults. Thirty subjects 35-55 years of age (wt: 73.1 +/- 13.6 kg, height 171.1 +/- 9.0 cm, %body fat 24.6 +/- 6.3%, 14 males and 16 females) were randomly assigned to an exercise (EG) (N = 20) and control (CG) (N = 10) group. All subjects completed an incremental treadmill test, anthropometric measurements, and venous blood sample collection before and after the 9 months of exercise. Participants in the exercise group were supervised and adjusted for improvements in running performance, whereas no change was administered for the control group. One-way and multivariate ANOVA was conducted to determine significant differences in means for time and group in selected variables [body mass, % body fat, BMI; VO(2peak), km/h at 2.0 (v-LA2) and 4.0 (v-LA4) mmol l(-1) blood lactate (LA) concentration, km/h of the last load (v-max); TC, LDL-C, HDL-C, TG, Apo B, Apo A-1, and Lp (a)]. Correlation coefficients and multivariate regression analysis was used to determine the association between aerobic fitness and blood lipids. The exercise group improved significantly (P < 0.0001) in VO(2peak), v-LA2, v-LA4, v-max and exhibited a significant decrease in Apo B (P < 0.04) compared to the control group (NS). In 9 months, E achieved 24% increase in VO(2peak) and 18% reduction in Apo B, denoting the impact of cardiovascular fitness on cardiovascular risk.

High Thyroglobulin (Tg) Concentrations in Fatal Traumatic Brain Injuries

It is well known that under physiological conditions, the Tg molecule is the substrate for the hormones triiodothyronine and thyroxine. Its function outside the thyroid gland is unknown. Under certain pathologic conditions, an increase in Tg concentrations in the blood can occur, a phenomenon that is used in the clinical diagnosis of certain thyroid disorders. However, fatal traumatic brain injuries (TBI) can also produce a raised Tg concentration in blood. In such cases, mean (n=151) Tg concentrations of 405.8+/-353.3 ng/mL have been observed, with the values in 57% of these cases exceeding 200 ng/mL. Since it was possible to rule out specifically any thyroid disorders in these cases, the raised values may be explained by the effect of TSH in the spectrum of the "hypothalamic-pituitary-thyroid axis." This assumption has been substantiated by immunohistochemical tests for TSH and Tg. Compared with the controls (sudden unnatural deaths: Tg 23.3+/-27.6 ng/mL), the raised Tg values in the TBI cases were usually accompanied by a reduction in the intensity of immunohistochemical reactions relating to TSH and Tg. The hypophysis showed evidence of significant damage with morphologic changes such as edema, hemorrhages, and focal necrosis in association with reduced TSH levels.

A new sensitive short pentaplex (ShoP) PCR for typing of degraded DNA

Analysis of short tandem repeat makers has become the most powerful tool for DNA typing in forensic casework analysis. Unfortunately, typing of DNA extracted from telogen shed hairs, bones buried in the soil or from paraffin-embedded, formalin-fixed tissue often reveals no results due to the degradation of DNA. The reduction in size of the target fragments by development of new primers and their combination in multiplex approaches open a new field of DNA analysis. Here we present a new sensitive short pentaplex PCR including the loci amelogenin, TH01, VWA, D3S1358 and D8S1179. Validation tests of our new method included sensitivity, mixtures, human specificity, artificial degradation of DNA by DNase I and case work analysis on a panel of different forensic samples. The detection limit was 12.5 pg of human DNA, and mixtures of 50 pg in a total of 1000 pg were clearly detectable and revealed complete profiles. Only DNA extracts of human primates displayed a few signals, whereas other animal, fungal or bacterial DNA showed no signals. Our method proved extremely valuable in the analysis of artificially degraded DNA and in forensic cases, where only poorly preserved DNA was available. This approach and other similar methods can aid in the analysis of samples where allelic drop out of larger fragments is observed. It is highly recommended to develop more of these multiplexes to improve poor quality DNA typing.

Second-line therapy with pemetrexed after gemcitabine failure in patients with unresectable locally advanced or metastatic pancreatic cancer: A multicenter phase II trial

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Background: There is no established second-line therapy for advanced pancreatic cancer after failure of standard first-line treatment with gemcitabine. In view of the urgent need of such therapy and the observation of clinically meaningful responses with pemetrexed in previously untreated pancreatic cancer, this phase II study evaluated pemetrexed as second-line therapy. Methods: This study was planned to evaluate the efficacy and safety of pemetrexed in 54 patients (pts) with unresectable locally advanced or metastatic pancreatic cancer (stage II-IV), ECOG performance status ≤2 and estimated life expectancy of ≥12 weeks (wks) after failure of first-line gemcitabine single agent or combination therapy. Pemetrexed was started at 500 mg/m2 q3w (10 min infusion), with vitamin B12 and folic acid supplementation. Dose escalation by 100 mg/m2 every other cycle and an unlimited number of cycles were allowed. Primary endpoint was the 3-month survival rate. Results: A total of 189 treatment cycles (median 2, range 1–20) was given to 52 pts (60% male, median age 63 yrs, median time since initial diagnosis 32 wks, 89% stage IV disease). Doses were escalated in 2 pts (4%) and reduced due to toxicity in 9 pts (17%); median dose per cycle was 500 mg/m2 (range 212–700 mg/m2). The 3-month survival rate was 75% (95% CI 63.2–86.8%). At a median follow-up of 20 wks, the median overall survival estimate was 20 wks, with 9 pts alive including 1 still on pemetrexed. Median TTP was 7 wks (range 1–62 wks). The overall response rate was 3.8% (0 CR, 2 PR); 12 pts (23%) had SD for ≥6 wks, 9 of them for ≥12 wks. CA 19–9 decreased at least once by ≥ 50% in 12 pts (23%). Grade 3/4 hematological toxicity rates per pt were as follows: neutropenia 17.3% (febrile neutopenia: 3.8%), leukopenia 15.4%, thrombopenia 5.8% and anemia 3.8%. Conclusion: Pemetrexed is a feasible option for second-line therapy with mild toxicity and encouraging activity in unresectable locally advanced or metastatic pancreatic cancer after gemcitabine failure.

[Table: see text]

GENDER DIFFERENCES IN 24-HOUR URINARY DIARIES OF ASYMPTOMATIC NORTH AMERICAN ADULTS

PURPOSE

Two previously published studies from our center have described the urinary habits of asymptomatic men (284) and women (300) as revealed by 24-hour urinary diaries. Those gender specific studies found that urinary diary variables are affected by age and race. By comparing the data from those studies we determined the effect of gender on voiding habits.

MATERIALS AND METHODS

In this secondary analysis we matched each female urinary diary to that of a male of similar age and race. Diary variables were compared using paired sign tests with results considered significant at the 5% level.

RESULTS

A total of 141 matched pairs were studied. The population age ranged from 18 to 68 years and was racially diverse (56% black, 31% white, 7% Hispanic and 6% Asian). Men had higher total fluid intake and mean voided volume than women (p <0.001 and 0.04, respectively). Women voided more frequently than men (p = 0.006) and had more voids per liter of fluid intake (p <0.001). No gender differences were found for body mass index, nighttime or daytime diuresis rates, total urine volume, maximum voided volume or rates of nocturia.

CONCLUSIONS

This analysis suggests that there are significant gender effects on 24-hour diary variables, with females tending to void more often and at lower mean volumes. The results of our study may be useful in the design of research studies or for patient counseling.

Chromosomal instability in flat adenomas and carcinomas of the colon

Flat adenomas are flat or slightly elevated dysplastic lesions of the colorectal mucosa, mostly with a tubular architecture. Compared with polypoid adenomas of similar size, flat adenomas show a higher frequency of high-grade dysplasia and rapid submucosal invasion. The aim of this study was to survey whether flat colorectal lesions differ in their pattern of chromosomal aberrations from their polypoid counterparts. Six flat adenomas and 12 flat carcinomas were analysed by comparative genomic hybridization (CGH) and the pattern of chromosomal aberrations was compared with a previously published series of 112 polypoid adenomas and 82 polypoid carcinomas. In addition, multiplex ligation-dependent probe amplification (MLPA) for identifying DNA copy number changes of 25 individual genes on chromosome 20 was performed on 14 flat and 15 polypoid tumours. With CGH, flat adenomas showed on average 1.8 gains (range 1-4) and 3.2 losses (range 0-4), and the flat carcinomas 4.5 gains (range 0-8) and 3.5 losses (range 1-6). In both adenomas and carcinomas, high frequencies of 20q gain (83% and 92%, respectively) and 18q loss (83% and 92%, respectively) were found. This correlation between 20q gain and 18q loss had previously been observed in a subgroup of polypoid colorectal tumours. Both flat and polypoid colorectal tumours with 20q gains by CGH showed similar patterns of copy number ratios for the individual genes tested. TOP1, BCL2L1, and E2F1 had median copy number ratios of 2 or higher, while ZNF217 had a ratio around 3. In conclusion, flat adenomas and carcinomas of the large intestine show a similar pattern of chromosomal aberrations to that observed in a specific subgroup of polypoid lesions. The transcription factor ZNF217 is an important candidate for driving the 20q gain.