[Clinical characteristics and ketogenic diet therapy of glucose transporter type 1 deficiency syndrome in children: a multicenter clinical study]

Objective: To explore the clinical characteristics of pediatric glucose transporter type 1 deficiency syndrome (GLUT1 DS), evaluate the efficacy and safety of ketogenic diet therapy (KDT). Methods: Clinical data of 19 children with GLUT1 DS admitted to Children's Hospital of Fudan University, Tianjin Children's Hospital, Shenzhen Children's Hospital, Children's Hospital of Nanjing Medical University and Jiangxi Provincial Children's Hospital between 2015 and 2019 were collected retrospectively. The first onset symptom, main clinical manifestations, cerebrospinal fluid features and genetic testing results of patients were summarized, the efficacy and safety of ketogenic diet treatment were analyzed. Results: Among the 19 cases, 13 were males and 6 females. The age of onset was 11.0 (1.5-45.0) months,the age of diagnosis was 54.0 (2.8-132.0) months. Epilepsy was the first onset symptom of 13 cases. Different forms of tonic-clonic seizures were the most common types of epilepsy (7 cases with generalized tonic-clonic seizures, 5 cases with focal tonic or clonic seizures, 4 cases with generalized tonic seizures). Antiepileptic drugs were effective in 4 cases. Paroxysmal motor dysfunction was present in 12 cases and ataxia was the most common one. All patients had different degrees of psychomotor retardation. Among 17 patients received cerebrospinal fluid examination, cerebrospinal fluid (CSF) glucose level was lower than 2.2 mmol/L and CSF glucose/glycemic index was<0.45 in 16 cases, only 1 case presented normal CSF glucose level (2.3 mmol/L) and normal CSF glucose/glycemic index(0.47). SLC2A1 gene mutations were found in 16 patients, missense, frameshift and nonsense mutations were the common types with 5 cases, 5 cases and 3 cases respectively. All 19 patients were treated with ketogenic diet, which was effective in 18 cases in seizure control, 11 cases in dyskinesia improvement and 18 cases in cognitive function improvement. No serious side effects were reported in any stage of KDT. Conclusions: The diagnosis of GLUT1 DS is often late. It is necessary to improve the early recognition of the disease and perform CSF glucose detection and genetic testing as early as possible. The KDT is an effective and safe treatment for GLUT1 DS, but a small number of patients have not response to diet therapy.

First Measurement of the g Factor in the Chiral Band: The Case of the ^{128}Cs Isomeric State

The g factor of the 56 ns half-life isomeric state in ^{128}Cs has been measured using the time-differential perturbed angular distribution method. This state is the bandhead of the positive-parity chiral rotational band, which emerges when an unpaired proton, an unpaired neutron hole, and an even-even core are coupled such that their angular momentum vectors are aplanar (chiral configuration). g-factor measurements can give important information on the relative orientation of the three angular momentum vectors. The measured g factor g=+0.59(1) shows that there is an important contribution of the core rotation in the total angular momentum of the isomeric state. Moreover, a quantitative theoretical analysis supports the conclusion that the three angular momentum vectors lie almost in one plane, which suggests that the chiral configuration in ^{128}Cs demonstrated in previous works by characteristic patterns of electromagnetic transitions appears only above some value of the total nuclear spin.

Treatment of postparotidectomy Frey syndrome with the interposition of temporalis fascia and sternocleidomastoid flaps

OBJECTIVES

This study was performed to evaluate the effectiveness of overlapping the temporalis fascia flaps (TFFs) and the sternocleidomastoid muscle flaps (SCMFs) as physical barriers to treat established Frey syndrome and concavity after parotidectomy.

STUDY DESIGN

We retrospectively reviewed 17 patients who underwent corrective procedures with simultaneous TFF and SCMF interposition for the treatment of Frey syndrome. The affected areas of the cheek skin were identified with starch-iodine tests. The facial contours of the patients were classified as bilaterally symmetric (BS), with a slightly shallow (SS) contour on the surgical side, or with a conspicuously shallow (CS) contour on the surgical side.

RESULTS

The sample was followed up for a mean of 22 months. The average area of gustatory-sweating positive skin was reduced from 12.80 to 1.32 square centimeters postoperatively. The facial asymmetry secondary to parotidectomy was greatly improved.

CONCLUSIONS

The authors concluded that this technique was efficacious in ameliorating Frey syndrome and facial concavity secondary to parotidectomy.

P5-19-07: The Effects of ABCC2 and SLCO1B3 Single Nucleotide Polymorphisms on Docetaxel-Induced Leukopenia in Breast Cancer Patients

Purpose Docetaxel-based combination treatment has known to be effective for breast cancer. Genotyping of ABCC2 and SLCO1B3 were demonstrated determining the risk of docetaxel-induced leucopenia in other ethnic. We designed this phase II trial to evaluate single nucleotide polymorphisms (SNPs) of the two genes association with docetaxel haematological toxicity in chemonaive breast cancer patients of chinese population.

Patients and Methods We selected 45 breast cancer patients who received docetaxel combination chemotherapy, Genomic DNA was isolated from peripheral blood and detected polymorphisms in ABCC2 and SLCO1B3.

Results All patients were evaluated for toxicity. 28 patients developed with grade 3 or 4 leukopenia, and 17 with grade 1 or 2 in nadir leukocyte from cycle 1 baseline. The combined analysis indicated a significant association of 9383C/G in ABCC2 (P = 0.002) and 5676A/G in SLCO1B3 (P = 0.005) with docetaxel induced ***leukopenia. Patients homozygous for the variant allele (GG) of SLCO1B3 5676A/G had significantly higher leukopenia compared to patients with AA/AG ***genotypes(P &lt;0.05). Similar trend was observed for ABCC2 (9383C/G) with heterozygotes (CG) having the highest percentage decrease compared to those with CC/GG genotypes(P = 0.06).

Conclusion The study indicating that SNPs in ABCC2 and SLCO1B3 may predict the risk of leukopenia induced by docetaxel chemotherapy in china breast cancer patients.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-19-07.

Comparisons of grey and neural network prediction of industrial park wastewater effluent using influent quality and online monitoring parameters

In this study, Grey model (GM) and artificial neural network (ANN) were employed to predict suspended solids (SSeff) and chemical oxygen demand (CODeff) in the effluent from a wastewater treatment plant in industrial park of Taiwan. When constructing model or predicting, the influent quality or online monitoring parameters were adopted as the input variables. ANN was also adopted for comparison. The results indicated that the minimum MAPEs of 16.13 and 9.85% for SSeff and CODeff could be achieved using GMs when online monitoring parameters were taken as the input variables. Although a good fitness could be achieved using ANN, they required a large quantity of data. Contrarily, GM only required a small amount of data (at least four data) and the prediction results were even better than those of ANN. Therefore, GM could be applied successfully in predicting effluent when the information was not sufficient. The results also indicated that these simple online monitoring parameters could be applied on prediction of effluent quality well.

Phase II trial of a 2-h infusion of gemcitabine plus carboplatin as first-line chemotherapy for advanced non-small-cell lung cancer

PURPOSE

To evaluate the efficacy and safety of the combination of using gemcitabine as a rate infusion of 10 mg/m(2) per min with carboplatin in front-line chemonaive patients with advanced non-small-cell lung cancer (NSCLC).

PATIENTS AND METHODS

Fifty-four chemonaive patients with stage IIIB or IV NSCLC have been included, 44 males and 10 females, with a median age 63 years (range 19-75). Thirty-two (59%) patients had adenocarcinoma, 13 (24%) squamous cell, 1 (2%) large cell carcinoma and 8 (15%) others. Eight (15%) had stage IIIB and 46 (85%) stage IV. Treatment was consisted of 1,200 mg/m(2) gemcitabine given as a 2-h continuous infusion (10 mg/m(2) per min) on days 1 and 8 of each cycle an AUC 5 carboplatin as on day 1, repeating each cycle for every 21 days. A total of 223 chemotherapy cycles were administered, with a median of four cycles per patient (range 1-6), and 15 (28%) patients received all six cycles.

RESULTS

Of the 54 patients enrolled, all were evaluated for toxicity and 51 assessed for response. The overall response rate was 41% (95% confidence interval, 28-57%) with complete and partial responses of 4 and 37%, respectively. The median time to disease progression was 5.0 months (95% CI, 3.7-6.3 months), and median overall survival time was 11.5 months (95% CI, 9.9-13.1 months). One-year survival was 42%. The main grade 3-4 toxicity (according to the WHO scale) consisted of neutropenia (56%) and thrombocytopenia (57%). Patients were required platelet transfusion in 27 cycles (12%) and hematopoietic growth factors support care in 56 (25%) cycles. No bleeding episodes were recorded. Grade 3 nausea/vomiting occurred in 6% and grade 1-2 skin rash occurred in 43%.

CONCLUSIONS

Prolonged gemcitabine infusion combined with carboplatin is manageable and tolerated, and its efficacy is similar to that of other chemotherapeutic schemes used for NSCLC treatment.

[Angiotensin II type 2 receptor gene deletion does not affect renin-angiotensin system]

It has been postulated that Angiotensin II type 2 receptor (AT2) functionally antagonizes type 1 (AT1) receptor. In the present study, we investigated whether gene deletion of AT2 receptor causes the compensatory chaos of renin-angiotensin system in mice. It was shown that the concentrations of Angiotensin II in plasma and kidney tissues and the expressions of renin and AT1A receptor in the AT2 gene null mice were unchanged, as compared with those in AT2 wild-type mice. This result suggests that gene deletion of AT2 receptor does not markedly impact the stability of renin-angiotensin system and the inductive function of AT2 receptor is compensated in a way remaining to be clarified.

Pharyngeal airway changes associated with mandibular advancement

This study analyzes changes in the anteroposterior dimension of the oropharynx as determined from lateral cephalometric radiographs on 26 patients who have undergone mandibular advancement. Increases in the sagittal dimensions of the oropharynx were unpredictable and tended to decrease with time, suggesting that mandibular advancement may be an unreliable method of treating obstructive sleep apnea. The most stable long-term results were found in those cases with narrowing of the oropharynx preoperatively.

[Tumor necrosis factor alpha in IgA nephropathy]

Tumor necrosis factor alpha (TNF alpha) in serum and supernate of peripheral blood lymphocyte stimulated by PHA in 100 cases of IgA nephropathy (IgAN) was evaluated by means of ELISA with TNF alpha monoclone antibody (T5 & E6). The results show that TNF alpha content in serum and supernatant was significantly higher in IgAN than in control (P < 0.01), and was increased markedly in IgAN with sclerosis (P < 0.01). It suggests that TNF alpha play an important role in cellular immunity of IgA nephropathy.

[Effect of serum from IgA nephropathy patients on IL-1 production from P388 D1 cell lines]

The study was designed to investigate IL-1 production from P388D1 cell using serum from 40 cases with IgA nephropathy (IgAN) as stimulative factor. It was found that there was a relationship between IL-1 and renal morphological change. The result indicated that IL-1 production by P388D1 cell was much higher in the presence of the serum than that in the absence (CPM: 47597 +/- 26213 vs 36567 +/- 14377 P less than 0.05). The level of IL-1 correlated obviously to the renal morphologic changes (r = 0.406, P less than 0.05). It is suggested that in the serum of IgAN patients there are certain factors stimulating P388D1 cell to produce IL-1, which may contribute to the pathogenesis of IgAN.

[Monoclonal antibody against laminin a and b chains: preparation and its clinical application]

In present study, we developed a hybridoma cell line which secretes monoclonal antibody against Laminin (Mo-611). The MoAb produced was identified to be isotype of IgG1. It reacted with Laminin obtained from murine EHS sarcoma, the intensity of reaction declined in accompany with increment of dilution, and could be absorbed by Laminin in 1 u/ml. On western blotting, it bounded to Laminin A chain 400 KD and Laminin B chain 200 KD. On IF study of renal tissue, positive staining with Mo-611 could be detected in fetal GBM and TBM, normal adult glomerular mesangial area and cytoplasm of tubular epithelium. In case of IgA nephropathy, the amount of deposits in mesangial area increased while in membranous nephropathy deposits along the capillary loop was also abundant in amount. In conclusion, the clinical application of McAb against Laminin might be helpful in the immunopathological diagnosis of glomerular diseases.

[A new monoclonal antibody against human tubular brush border: preparation and its application in membranous nephropathy]

A new monoclonal antibody (McAb) against human tubular brush border was successfully prepared by authors using the hybridoma technique. The McAb produced was identified to be isotype of IgG1 by IF and SDS-PAGE assay. It was unique for its purity and specificity. To demonstrate the clinical usefulness, the McAb was applied for immunopathological study in 94 cases of renal biopsy of glomerular diseases. This McAb was distinguished by its specific deposition along the human tubular brush border and the subepithelial region in certain type of glomerular disease, particularly the MGN. Identification of this McAb might contribute to the immunopathological diagnosis of GN.