Iron enriched quinoa biochar enhances Nickel phytoremediation potential of Helianthus annuus L. by its immobilization and attenuation of oxidative stress: implications for human health

The present study was performed to assess Ni-immobilization and the phytoremediation potential of sunflower by the application of quinoa stalks biochar (QSB) and its magnetic nanocomposite (MQSB). The QSB and MQSB were characterized with FTIR, SEM, EDX, and XRD to get an insight of their surface properties. Three-week-old seedlings of sunflower were transplanted to soil spiked with Ni (0, 15, 30, 60, 90 mg kg-1), QSB and MQSB (0, 1, and 2%) in the wire house under natural conditions. The results showed that increasing Ni levels inhibited sunflower growth and yield due to the high production of reactive oxygen species (ROS) and lipid peroxidation. Enzyme activities like superoxide dismutase (SOD), catalase (CAT), ascorbate peroxidase (APX), and peroxidase (POX) also increased as Ni levels increased. However, the application of QSB and MQSB reduced Ni uptake, root-shoot, and shoot-seed translocation and decreased the generation of ROS, and lowered the activity of SOD, CAT, APX, and POX, leading to improved growth and yield, especially with MQSB. This was verified through SEM, EDX, XRD, and FTIR. It can be concluded that QSB and MQSB can effectively enhance Ni-tolerance in sunflowers and mitigate oxidative stress and human health risks.

Enzyme activity profiling for physiological phenotyping within functional phenomics: plant growth and stress responses

High-throughput profiling of key enzyme activities of carbon, nitrogen, and antioxidant metabolism is emerging as a valuable approach to integrate cell physiological phenotyping into a holistic functional phenomics approach. However, the analyses of the large datasets generated by this method represent a bottleneck, often keeping researchers from exploiting the full potential of their studies. We address these limitations through the exemplary application of a set of data evaluation and visualization tools within a case study. This includes the introduction of multivariate statistical analyses that can easily be implemented in similar studies, allowing researchers to extract more valuable information to identify enzymatic biosignatures. Through a literature meta-analysis, we demonstrate how enzyme activity profiling has already provided functional information on the mechanisms regulating plant development and response mechanisms to abiotic stress and pathogen attack. The high robustness of the distinct enzymatic biosignatures observed during developmental processes and under stress conditions underpins the enormous potential of enzyme activity profiling for future applications in both basic and applied research. Enzyme activity profiling will complement molecular -omics approaches to contribute to the mechanistic understanding required to narrow the genotype-to-phenotype knowledge gap and to identify predictive biomarkers for plant breeding to develop climate-resilient crops.

Identification of Root-Associated Bacteria That Influence Plant Physiology, Increase Seed Germination, or Promote Growth of the Christmas Tree Species Abies nordmanniana

Abies nordmanniana is used for Christmas tree production but poor seed germination and slow growth represent challenges for the growers. We addressed the plant growth promoting potential of root-associated bacteria isolated from A. nordmanniana. Laboratory screenings of a bacterial strain collection yielded several Bacillus and Paenibacillus strains that improved seed germination and produced indole-3-acetic acid. The impact of three of these strains on seed germination, plant growth and growth-related physiological parameters was then determined in greenhouse and field trials after seed inoculation, and their persistence was assessed by 16S rRNA gene-targeted bacterial community analysis. Two strains showed distinct and significant effects. Bacillus sp. s50 enhanced seed germination in the greenhouse but did not promote shoot or root growth. In accordance, this strain did not increase the level of soluble hexoses needed for plant growth but increased the level of storage carbohydrates. Moreover, strain s50 increased glutathione reductase and glutathione-S-transferase activities in the plant, which may indicate induction of systemic resistance during the early phase of plant development, as the strain showed poor persistence in the root samples (rhizosphere soil plus root tissue). Paenibacillus sp. s37 increased plant root growth, especially by inducing secondary root formation, under in greenhouse conditions, where it showed high persistence in the root samples. Under these conditions, it further it increased the level of soluble carbohydrates in shoots, and the levels of starch and non-structural carbohydrates in roots, stem and shoots. Moreover, it increased the chlorophyll level in the field trial. These findings indicate that this strain improves plant growth and vigor through effects on photosynthesis and plant carbohydrate reservoirs. The current results show that the two strains s37 and s50 could be considered for growth promotion programs of A. nordmanniana in greenhouse nurseries, and even under field conditions.

Burkholderia Phytofirmans PsJN Stimulate Growth and Yield of Quinoa under Salinity Stress

One of the major challenges in agriculture is to ensure sufficient and healthy food availability for the increasing world population in near future. This requires maintaining sustainable cultivation of crop plants under varying environmental stresses. Among these stresses, salinity is the second most abundant threat worldwide after drought. One of the promising strategies to mitigate salinity stress is to cultivate halotolerant crops such as quinoa. Under high salinity, performance can be improved by plant growth promoting bacteria (PGPB). Among PGPB, endophytic bacteria are considered better in stimulating plant growth compared to rhizosphere bacteria because of their ability to colonize both in plant rhizosphere and plant interior. Therefore, in the current study, a pot experiment was conducted in a controlled greenhouse to investigate the effects of endophytic bacteria i.e., Burkholderia phytofirmans PsJN on improving growth, physiology and yield of quinoa under salinity stress. At six leaves stage, plants were irrigated with saline water having either 0 (control) or 400 mM NaCl. The results indicated that plants inoculated with PsJN mitigated the negative effects of salinity on quinoa resulting in increased shoot biomass, grain weight and grain yield by 12%, 18% and 41% respectively, over un-inoculated control. Moreover, inoculation with PsJN improved osmotic adjustment and ion homeostasis ability. In addition, leaves were also characterized for five key reactive oxygen species (ROS) scavenging enzyme in response to PsJN treatment. This showed higher activity of catalase (CAT) and dehydroascobate reductase (DHAR) in PsJN-treated plants. These findings suggest that inoculation of quinoa seeds with Burkholderia phytofirmans PsJN could be used for stimulating growth and yield of quinoa in highly salt-affected soils.

Bacillus licheniformis FMCH001 Increases Water Use Efficiency via Growth Stimulation in Both Normal and Drought Conditions

Increasing agricultural losses due to biotic and abiotic stresses caused by climate change challenge food security worldwide. A promising strategy to sustain crop productivity under conditions of limited water availability is the use of plant growth promoting rhizobacteria (PGPR). Here, the effects of spore forming Bacillus licheniformis (FMCH001) on growth and physiology of maize (Zea mays L. cv. Ronaldinho) under well-watered and drought stressed conditions were investigated. Pot experiments were conducted in the automated high-throughput phenotyping platform PhenoLab and under greenhouse conditions. Results of the PhenoLab experiments showed that plants inoculated with B. licheniformis FMCH001 exhibited increased root dry weight (DW) and plant water use efficiency (WUE) compared to uninoculated plants. In greenhouse experiments, root and shoot DW significantly increased by more than 15% in inoculated plants compared to uninoculated control plants. Also, the WUE increased in FMCH001 plants up to 46% in both well-watered and drought stressed plants. Root and shoot activities of 11 carbohydrate and eight antioxidative enzymes were characterized in response to FMCH001 treatments. This showed a higher antioxidant activity of catalase (CAT) in roots of FMCH001 treated plants compared to uninoculated plants. The higher CAT activity was observed irrespective of the water regime. These findings show that seed coating with Gram positive spore forming B. licheniformis could be used as biostimulants for enhancing plant WUE under both normal and drought stress conditions.

Role of Cytokinins for Interactions of Plants With Microbial Pathogens and Pest Insects

It has been recognized that cytokinins are plant hormones that influence not only numerous aspects of plant growth, development and physiology, including cell division, chloroplast differentiation and delay of senescence but the interaction with other organisms, including pathogens. Cytokinins are not only produced by plants but are also by other prokaryotic and eukaryotic organism such as bacteria, fungi, microalgae and insects. Notably, cytokinins are produced both by pathogenic and also beneficial microbes and are known to induce resistance in plants against pathogen infections. In this review the contrasting role of cytokinin for the defence and susceptibility of plants against bacterial and fungal pathogen and pest insects is assessed. We also discuss the cross talk of cytokinins with other phytohormones and the underlying mechanism involved in enhancing plant immunity against pathogen infections and explore possible practical applications in crop plant production.

Identification of Root-Associated Bacteria That Influence Plant Physiology, Increase Seed Germination, or Promote Growth of the Christmas Tree Species Abies nordmanniana

Abies nordmanniana is used for Christmas tree production but poor seed germination and slow growth represent challenges for the growers. We addressed the plant growth promoting potential of root-associated bacteria isolated from A. nordmanniana. Laboratory screenings of a bacterial strain collection yielded several Bacillus and Paenibacillus strains that improved seed germination and produced indole-3-acetic acid. The impact of three of these strains on seed germination, plant growth and growth-related physiological parameters was then determined in greenhouse and field trials after seed inoculation, and their persistence was assessed by 16S rRNA gene-targeted bacterial community analysis. Two strains showed distinct and significant effects. Bacillus sp. s50 enhanced seed germination in the greenhouse but did not promote shoot or root growth. In accordance, this strain did not increase the level of soluble hexoses needed for plant growth but increased the level of storage carbohydrates. Moreover, strain s50 increased glutathione reductase and glutathione-S-transferase activities in the plant, which may indicate induction of systemic resistance during the early phase of plant development, as the strain showed poor persistence in the root samples (rhizosphere soil plus root tissue). Paenibacillus sp. s37 increased plant root growth, especially by inducing secondary root formation, under in greenhouse conditions, where it showed high persistence in the root samples. Under these conditions, it further it increased the level of soluble carbohydrates in shoots, and the levels of starch and non-structural carbohydrates in roots, stem and shoots. Moreover, it increased the chlorophyll level in the field trial. These findings indicate that this strain improves plant growth and vigor through effects on photosynthesis and plant carbohydrate reservoirs. The current results show that the two strains s37 and s50 could be considered for growth promotion programs of A. nordmanniana in greenhouse nurseries, and even under field conditions.

5-Fluorouracil-Induced Severe but Reversible Cardiogenic Shock: A Case Report

5-fluorouracil cardiotoxicity is increasingly recognized with variable presentation. We report a patient who developed cardiogenic shock due to high-dose 5-fluorouracil infusion (1,000 mg/m2 every 24 hr for 96 hr). There was no evidence of myocardial necrosis. The patient recovered completely without any residual cardiac dysfunction. The exact cause of 5-fluorouracil toxicity remains to be determined. The case highlights the need for careful monitoring of patients who receive high-dose 5-fluorouracil for the development of cardiotoxicity.

Short-term Impacts of Tillage and Fertilizer Treatments on Soil and Root Borne Nematodes and Maize Yield in a Fine Textured Cambisol

Conservation agriculture (CA) based on the principles of minimum soil disturbance, crop residue retention, and crop rotation has been the focus of intensive research in recent years. A study was carried out to determine the effects of tillage and fertilizer on the population densities of plant-parasitic nematodes in maize. Three tillage regimes, (i) basin planting, (ii) rip line seeding, and (iii) conventional tillage, were combined with four fertilizer regimes: (i) no-fertilizer, (ii) low fertilizer rate, (iii) medium fertilizer rate, and (iv) high fertilizer rate. The experiment was arranged as a split plot in randomized complete block design, replicated three times with tillage as the main plot factor and fertilizer as the sub-plot factor. The study was conducted on fine-textured Cambisol soils at Chinhoyi University of Technology farm, Zimbabwe, over two cropping seasons between December 2014 and April 2016. Eight plant-parasitic nematode genera were observed belonging to five groups based on their feeding sites: (i) sedentary endoparasites ( Meloidogyne and Rotylenchulus ), (ii) migratory endoparasites ( Pratylenchus ), (iii) semi-endoparasites ( Scutelonema and Helicotylenchus ), (iv) ectoparasites ( Xiphinema and Trichodorus ), and (v) algal, lichen or moss feeders ( Tylenchus ). In both cropping seasons, semi-endoparasitic nematodes were double under rip line seeding and triple under basin planting compared to conventional tillage. Basin planting had higher plant-parasitic nematode richness than rip line seeding. Nematode densities did not have a measurable effect on maize grain yield. Maize grain yield was higher in rip line seeding (37%) and planting basins (52%) than conventional tillage during 2014/15 cropping season. On the other hand, during 2015/16 cropping season, maize grain yield was 78% and 113% higher in rip line seeding and basin planting, respectively, compared to conventional tillage. The results show that under the environmental and edaphic conditions of this specific study site, semi-endoparasitic nematodes were higher under rip line seeding and basin planting compared to conventional tillage. The authors conclude that (i) plant-parasitic nematode genera exhibited differential responses to different tillage systems but were not affected by fertilizer application, and (ii) in the present study, maize grain yield response under different tillage and fertilizer regimes was overall not related to nematode population density and composition.

Enhancing salt tolerance in quinoa by halotolerant bacterial inoculation

Quinoa is a facultative halophytic seed crop of increasing interest worldwide. Its performance declines under high salinity but can be improved by using halotolerant plant growth-promoting bacteria (PGPB) containing multi-traits, i.e. ACC-deaminase activity, exopolysaccharide secretion and auxin production. This study focussed on improving the productivity of quinoa through the use of six plant growth-promoting bacterial strains (both endophytic and rhizosphere). These were screened by conducting osmoadaptation assay, and the two most halotolerant strains (Enterobacter sp. (MN17) and Bacillus sp. (MN54)) were selected. These two strains were evaluated for their effects on growth, physiological characters and yield of quinoa. At the five leaf stage plants were irrigated with saline water having either 0 or 400mM NaCl. The results indicated that saline irrigation significantly decreased the growth of quinoa, whereas inoculation of plants with MN17 and MN54 mitigated the negative effects of salinity by improving plant water relations and decreasing Na+ uptake, which consequently, reduced osmotic and ionic stress. Strain MN54 performed better than MN17, which might be because of its better growth promoting traits and higher rhizosphere colonisation efficiency than MN17. Our results suggest that growth and productivity of quinoa could be improved by inoculating with highly tolerant PGPB strain in salt-affected soils.

Interactive effect of biochar and plant growth-promoting bacterial endophytes on ameliorating salinity stress in maize

The objective of this work was to study the interactive effect of biochar and plant growth-promoting endophytic bacteria containing 1-aminocyclopropane-1-carboxylate deaminase and exopolysaccharide activity on mitigating salinity stress in maize (Zea mays L.). The plants were grown in a greenhouse under controlled conditions, and were subjected to separate or combined treatments of biochar (0% and 5%, w/w) and two endophytic bacterial strains (Burkholderia phytofirmans (PsJN) and Enterobacter sp. (FD17)) and salinity stress. The results indicated that salinity significantly decreased the growth of maize, whereas both biochar and inoculation mitigated the negative effects of salinity on maize performance either by decreasing the xylem Na+ concentration ([Na+]xylem) uptake or by maintaining nutrient balance within the plant, especially when the two treatments were applied in combination. Moreover, in biochar-amended saline soil, strain FD17 performed significantly better than did PsJN in reducing [Na+]xylem. Our results suggested that inoculation of plants with endophytic baterial strains along with biochar amendment could be an effective approach for sustaining crop production in salt-affected soils.

Effect of saline water on seed germination and early seedling growth of the halophyte quinoa

Salinization is increasing on a global scale, decreasing average yields for most major crop plants. Investigations into salt resistance have, unfortunately, mainly been focused on conventional crops, with few studies screening the potential of available halophytes as new crops. This study has been carried out to investigate the mechanisms used by quinoa, a facultative halophytic species, in order to cope with high salt levels at various stages of its development. Quinoa is regarded as one of the crops that might sustain food security in this century, grown primarily for its edible seeds with their high protein content and unique amino acid composition. Although the species has been described as a facultative halophyte, and its tolerance to salt stress has been investigated, its physiological and molecular responses to seawater (SW) and other salts have not been studied. We evaluated the effects of SW and different salts on seed germination, seedling emergence and the antioxidative pathway of quinoa. Seeds were germinated in Petri dishes and seedlings grown in pots with SW solutions (25, 50, 75 and 100 %) and NaCl, CaCl2, KCl and MgCl2 individually, at the concentrations in which they are present in SW. Our results demonstrated that all salts, at lower concentrations, increased the germination rate but not the germination percentages, compared with control (pure water). Conversely, seedlings were differently affected by treatments in respect to salt type and concentration. Growth parameters affected were root and shoot length, root morphology, fresh and dry weight, and water content. An efficient antioxidant mechanism was present in quinoa, activated by salts during germination and early seedling growth, as shown by the activities of antioxidant enzymes. Total antioxidant capacity was always higher under salt stress than in water. Moreover, osmotic and ionic stress factors had different degrees of influence on germination and development.

First organized screening mammography programme in Saudi Arabia: preliminary analysis of pilot round

The aim of this study was to analyse results of the pilot screening round for Al-Qassim Screening Mammography Programme and compare with international standards. Analysis was conducted in the central screening office in Prince Faisal Oncology Centre, which coordinates activities of various screening units. Data were collected during the period 1 January 2007 to 30 June 2008. Organizational and functional information was obtained from policy and procedure manuals of the programme. Out of 9812 eligible women, 1766 (18%) participated and data were available for 1628 (16.6%). The median age of participants was 47 (standard deviation 8.12) years. The low uptake rate (18%) and a high recall rate (31.6%) characterized the pilot screening round. Biopsy rate was 1.5% and cancer detection rate was 0.24%. Many performance indicators in this pilot screening round were not available. Many of the available indicators did not meet international standards.

Endoscopic esophagitis and gastroesophageal flap valve

The authors studied the relationship of endoscopic esophagitis and gastroesophageal flap valve (GEFV) in patients with symptomatic gastroesophageal reflux (GER). On endoscopy, the GEFV was graded as I to IV in 138 patients with acid regurgitation and heartburn relieved by antacids, and in 54 control subjects without symptoms suggestive of GER. Grade of GEFV was correlated with the grade of esophagitis, response to medical treatment, duration of symptoms, obesity, smoking, sex, and age of the patient. Abnormal GEFV (grades III and IV) was more frequent in patients with symptomatic GER, both with and without esophagitis, compared with control subjects (p = 0.000001. p = 0.03). Abnormal GEFV was significantly more common in patients with GER with esophagitis compared with those without (p < 0.00001). There was no significant difference in the distribution of normal and abnormal GEFV in patients with grade I esophagitis. However, grade 2 and grade 3 esophagitis were associated more commonly with an abnormal GEFV (p < 0.00001, p < 0.02 respectively). Hiatal hernia is always associated with an abnormal GEFV. Abnormal GEFV correlated significantly with age (more frequent when older than 40 years). Sex, duration of symptoms (>3 years), response to medical therapy, smoking, and obesity (body mass index > 30 kg/m2) did not correlate significantly with abnormal GEFV. We conclude that endoscopic esophagitis is usually associated with abnormal GEFV. It is more frequent in grades 2 and 3 but not grade 1 esophagitis. It is also encountered more commonly after the age of 40 years.

Cancer in Al-Qassim, Saudi Arabia: A retrospective study (1987-1995)

Regional differences in the pattern of cancer are obvious in Saudi Arabia. From January 1987 to December 1995, 1106 new cases of cancer (642 males, 464 females) were seen at the King Fahd Specialist Hospital in Buraidah, Al-Qassim. Overall, lymphomas, non-Hodgkin's and Hodgkin's disease combined were the most common malignancy seen (15.10%), followed by esophageal carcinoma (7.77%). Thyroid cancer was the most common malignancy among females (12.50%), followed by breast cancer (9.48%). The majority of the patients were in the younger age group (77% were <50 years of age). Among the hematological malignancies, acute lymphoblastic leukemia was the most frequent type (36.23%). Lymphomas were the most common malignancy (66.12%) seen in the pediatric age group (0-14 years), followed by leukemias and brain tumors. The pattern of cancer in Al-Qassim is generally similar to other regions of Saudi Arabia, with few regional variations. prominent among such variations is the high frequency of non-Hodgkin's lymphomas (NHL), esophageal and thyroid carcinomas.

Efficacy of fine-needle capillary biopsy in the assessment of patients with superficial lymphadenopathy

BACKGROUND

Fine-needle aspiration biopsy (FNAB) is an important tool for the cytologic assessment of patients with lymphadenopathy. The nonaspiration method (without the use of a syringe or a handle), or fine-needle capillary biopsy (FNCB), is becoming popular for its ease of learning and use. The authors compared the two techniques of fine-needle biopsy (with and without aspiration) for identifying the cause of superficial lymphadenopathy.

METHODS

Over a 2-year period 50 cytologic examinations were conducted in patients with superficial lymphadenopathy. Both procedures were performed at the same site; the order in which they were performed was determined randomly. Slides were fixed in a similar manner and examined by a cytotechnologist and pathologists blind to the procedure. Scores were tabulated and compared and diagnosis was confirmed by histologic examination.

RESULTS

The best and the average score for the yield of cellular material was higher with FNCB (P < 0.004). Cell preservation also was superior with FNCB (P = 0.00066). However, the failure rate was lower with FNAB (P = 0.7662).

CONCLUSIONS

FNCB of superficial lymph nodes yields adequate cellular material of superior quality, which may be advantageous in certain situations. However, the diagnostic yield does not appear to be significantly increased using this technique.

Symptomatic cardiotoxicity with high-dose 5-fluorouracil infusion: a prospective study

Cardiotoxicity with 5-fluorouracil (5-FU) therapy has been reported to range from asymptomatic EKG abnormalities to fatal myocardial infarction. We report a prospective study in 100 consecutive patients receiving 5-FU infusion in combination with other chemotherapeutic agents or alone for the treatment of different malignancies with the aim of identifying patients who develop symptomatic cardiotoxicity. Patients with a history of cardiac illness, abnormal EKG or cardiac enzyme levels were excluded. Patients were observed during the total period of infusion, daily EKG was performed on asymptomatic patients, those who developed cardiotoxicity were monitored till symptom-free for 24 h. Eight patients developed symptoms suggestive of cardiotoxicity. Pain was the commonest symptom (5/8), followed by palpitation and sweating. Three patients developed EKG abnormalities and 1 went into cardiogenic shock. Time to toxicity ranged from 18 to 30 h (mean 24 +/- 3.7 h) and serial cardiac enzyme levels remained normal in all patients. The symptoms reversed immediately on cessation of the treatment in most of the patients (7/8). Time to recovery ranged from 5 to 60 min (mean 19.28 +/- 19.6 min). There was no recorded death due to toxicity. We conclude that 5-Fu infusion is associated with a significant risk of symptomatic cardiotoxicity. Concomitant chemotherapeutic agents, received by all the affected patients, may have a contributory effect too. Cardiotoxicity seems to be completely reversible, particularly in patients without underlying cardiac disease. The patients should be informed about the symptoms and the condition recognised and managed immediately.

Cancer in Libya--a retrospective study (1981-1985)

Between 1981 and 1985, 1124 patients with histopathologically confirmed malignant disease were registered at the sole oncology clinic of Libya, 664 (59%) were males and 460 (41%) were females. Overall, malignant lymphoma (ML) was the most common cancer (180/1124, 16%), with non-Hodgkin's lymphoma (NHL) being more common (57.2%) than Hodgkin's disease (HD) (42.8%). Considered separately, lung cancer was the most common tumour (22.4%) in males with a male to female ratio among the highest in the world (18.6:1), 85% of our male patients were smokers and more than 50% had been smoking heavily for 20 years or more. Breast cancer was the most frequent tumour (29.8%) of females and the majority of our patients were of a younger age group (72.3% below 50 years). Almost all our patients were multiparous and had breast-fed their babies. Cancer of the cervix uteri was less frequent (4.5%) than ovarian cancer (7.8%). The incidence of colorectal cancer was higher (4.6%) than other African countries. Contrarily the primary tumours of liver (1.9%) and bladder (0.5%) were less frequent. Among the children, aged less than 10 years, the common solid tumours of childhood occurred in the following frequency, ML 31.2%, nervous system 19.2%, Wilm's tumour 16.8% and bone tumours 9.6%.

A 10-year experience of tamoxifen as primary treatment of breast cancer in 100 elderly and frail patients

Between 1977 and 1983 100 elderly women (median 76.3 years) with breast cancer were treated with tamoxifen as primary therapy. The median follow-up is 59 months. Sixty-eight responded (40 CR and 28 PR) with median response durations of 47 months and 26 months respectively. Twenty-two patients had disease stabilization for a median of 15.5 months and 10 had progressive disease. The median time to best response was 13.5 weeks for patients achieving CR and 14 weeks for those with PR. Oestrogen receptor values were obtained in 37 patients of which two patients had no ER detectable. Sixty-seven per cent of ER-unknown patients responded compared with 74% of ER-rich. Likelihood of response did not appear to depend upon T-stage or age. Survival was better than that of an unmatched historical group treated with surgery/radiotherapy and compares favourably with recent reports. Although 35% have died of breast cancer, 25% died of other causes and 22% remained free of recurrence at the time of reporting or at death. Only 11% underwent subsequent mastectomy/lumpectomy and the most frequent subsequent treatments were radiotherapy to the breast (32%) and further hormonal therapies (40%). Tamoxifen is a practical primary therapy of breast cancer in elderly and frail women obviating the need for surgery in a high proportion of cases.

A double-blind randomized cross-over comparison of high-dose prochlorperazine with high-dose metoclopramide for cisplatin-induced emesis

This double-blind randomized cross-over study was conducted to compare the safety and efficacy of high-dose prochlorperazine infusion and dexamethasone (HDPD) with an effective and safe combination of high-dose metoclopramide and dexamethasone (HDMD) in controlling cisplatin-induced emesis. None of the patients entering the study had received any prior chemotherapy. High-dose cisplatin was administered on an inpatient basis. Twenty eligible patients were analyzed based on the assessment made 24 h after the chemotherapy. The parameters compared were severity and duration of nausea and vomiting, severity of retching and side effects. Significantly less vomiting and retching episodes were recorded with HDPD combination. The severity of nausea was also less with this combination. There was no significant difference in the incidence of side effects.

Prognostic factors for survival in soft tissue sarcoma

Between 1975 and 1984, 125 cases of histologically confirmed soft tissue sarcomata (STS) were registered in the Department of Clinical Oncology in Edinburgh. Of these, 100 were eligible for analysis of prognostic factors. The overall 5-year survival rate was 21.5%. Univariate analysis demonstrated that extent of surgery, radical versus palliative or no radiotherapy, mass as a presenting symptom, metastases at presentation, site, histological type, mitotic activity, grade and UICC stage all had a statistically significant effect on survival. Analysis using the proportional hazard regression model was performed on the 87 patients for whom all variables were recorded. When all histological and clinical features and treatment modalities were included in the model then radiotherapy, surgery, necrosis, sex and mitoses were identified as independent prognostic variables. When symptoms and treatment were excluded then the multivariate analysis identified sex and mitotic activity as independent parameters. For the 33 superficial STS with tumour size recorded multivariate analysis revealed size, necrosis and cellularity as independent prognostic variables. For the 31 deep STS histological type, sex, surgery and radiotherapy were identified as independent prognostic parameters.