Gene Mutation Profiles in Primary Diffuse Large B Cell Lymphoma of Central Nervous System: Next Generation Sequencing Analyses

The existence of a potential primary central nervous system lymphoma-specific genomic signature that differs from the systemic form of diffuse large B cell lymphoma (DLBCL) has been suggested, but is still controversial. We investigated 19 patients with primary DLBCL of central nervous system (DLBCL CNS) using the TruSeq Amplicon Cancer Panel (TSACP) for 48 cancer-related genes. Next generation sequencing (NGS) analyses have revealed that over 80% of potentially protein-changing mutations were located in eight genes (CTNNB1, PIK3CA, PTEN, ATM, KRAS, PTPN11, TP53 and JAK3), pointing to the potential role of these genes in lymphomagenesis. TP53 was the only gene harboring mutations in all 19 patients. In addition, the presence of mutated TP53 and ATM genes correlated with a higher total number of mutations in other analyzed genes. Furthermore, the presence of mutated ATM correlated with poorer event-free survival (EFS) (p = 0.036). The presence of the mutated SMO gene correlated with earlier disease relapse (p = 0.023), inferior event-free survival (p = 0.011) and overall survival (OS) (p = 0.017), while mutations in the PTEN gene were associated with inferior OS (p = 0.048). Our findings suggest that the TP53 and ATM genes could be involved in the molecular pathophysiology of primary DLBCL CNS, whereas mutations in the PTEN and SMO genes could affect survival regardless of the initial treatment approach.

The possible benefit from total tumour resection in primary diffuse large B-cell lymphoma of central nervous system - a one-decade single-centre experience

BACKGROUND AND METHODS

The aim of the study was to evaluate retrospectively clinical course of 27 patients with primary central nervous system lymphoma (PCNSL) diagnosed and treated by different surgical approaches. Initial therapy-diagnostic approach included surgery with total tumour reduction (TTR) performed in 12 patients (44.4%), while partial reduction and biopsy were performed in 8 (29.7%) and 7 (25.9%) patients, respectively. All patients were treated with chemotherapy based on high-dose methotrexate (HD-MTX) with/without whole-brain radiotherapy (WBRT).

RESULTS

The median overall survival (OS) and event-free survival were 37 and 31 months, respectively, with overall response rate of 74%. The patients who underwent an open surgery with TTR had significantly longer OS (median not reached), comparing with partial tumour reduction or biopsy only (Log-Rank χ(2) 6.08, p = 0.014) when median OS was 23 months. In patients with performance status according to Eastern Cooperative Oncology Group (ECOG PS) ≥ 3, OS was 23 months, contrary to ECOG PS 1-2 when median was not reached. The International Extranodal Lymphoma Study Group score (low, intermediate and high) also influenced OS between three risk groups (Log-Rank χ(2) 12.5, p = 0.002).

CONCLUSION

The treatment of PCNSL still remains doubtful, however possible benefit from the TTR followed with HD-MTX with/without WBRT should be reconsidered.

Correlation between oxidative stress and G6PD activity in neonatal jaundice

Fetal distress represents a pathophysiological condition in which oxygen is not available to the fetus in sufficient quantities. In cases of glucose 6-phosphate dehydrogenase (G6PD) deficiency, under conditions of oxidative stress, the residual G6PD and complimentary antioxidant mechanisms may become insufficient to neutralize the large amounts of ROS and to prevent severe hemolysis. Alteration in the oxidant-antioxidant profile is also known to occur in neonatal jaundice. The study group included 22 neonates presented with fetal distress during labor and 24 neonates with no evidence of fetal distress (control group). Umbilical cord blood samples were taken immediately after delivery, and the following blood tests were carried out after birth and at discharge from the hospital: erythrocyte count, total bilirubin, G6PD activity, and parameters presenting oxidative status [thiobarbituric acid reactive substances (TBARS), NO, O2 (-), H2O2, SOD, CAT, O2 (-)/SOD, and H2O2/CAT]. There were no significant differences in TBARS and NO values among neonates with or without fetal distress. However, the values of O2 (-), H2O2, SOD, O2 (-)/SOD, and H2O2/CAT among neonates born after fetal distress were significantly higher than in neonates without fetal distress (p < 0.01). In neonates with fetal distress, the total number of RBCs at delivery was significantly lower, accompanied with higher bilirubin content. Also neonates with fetal distress had lower activity of G6PD and lower CAT activity. Higher values of oxidative stress parameters in newborns delivered after fetal distress do not indicate strictly what occurred first-oxidative stress or basic lower G6PD activity.

A novel semi-quantitative method for measuring tissue bleeding

In this study, we describe a new semi-quantitative method for measuring the extent of bleeding in pathohistological tissue samples. To test our novel method, we recruited 120 female patients in their first trimester of pregnancy and divided them into three groups of 40. Group I was the control group, in which no dilation was applied. Group II was an experimental group, in which dilation was performed using classical mechanical dilators. Group III was also an experimental group, in which dilation was performed using a hydraulic dilator. Tissue samples were taken from the patients' cervical canals using a Novak's probe via energetic single-step curettage prior to any dilation in Group I and after dilation in Groups II and III. After the tissue samples were prepared, light microscopy was used to obtain microphotographs at 100x magnification. The surfaces affected by bleeding were measured in the microphotographs using the Autodesk AutoCAD 2009 program and its "polylines" function. The lines were used to mark the area around the entire sample (marked A) and to create "polyline" areas around each bleeding area on the sample (marked B). The percentage of the total area affected by bleeding was calculated using the formula: N = Bt x 100 / At where N is the percentage (%) of the tissue sample surface affected by bleeding, At (A total) is the sum of the surfaces of all of the tissue samples and Bt (B total) is the sum of all the surfaces affected by bleeding in all of the tissue samples. This novel semi-quantitative method utilizes the Autodesk AutoCAD 2009 program, which is simple to use and widely available, thereby offering a new, objective and precise approach to estimate the extent of bleeding in tissue samples.

Optimization of immobilization of strontium and uranium by the solid matrix

One of the basic physical parameters which defines: (1) the capacity of the solid matrix for the incorporation (sorption) of the impurity and (2) the stability of the solid matrix -impurity system, is the ion-ion interaction potential, representing the main term of the cohesive energy. Using this parameter determined in the frame of the pseudopotential theory and pseudoatomic approximation we have investigated the systems HAP-Sr and HAP-UO2. In analysis, the hydroxyapatite (HAP, Ca10(PO4)6(OH)2) was selected as a model solid matrix since insoluble phosphates, phosphate ceramic and apatite-like materials are candidates for the immobilization of radionuclides. The substitution of calcium atoms by different impurities in HAP can be presented by the formula: Ca10-xMx(PO4)6(OH)2, where 0 ≤ x ≤ 10 and M = Sr2+, UO22+. It has been shown that (1) Sr can be safely immobilized by HAP, natural apatites and phosphate rocks in the whole range of its concentrations, and (2) that HAP is not an appropriate solid-matrix for immobilization of UO22+ because its incorporation in the low concentration results in a decrease of the matrix stability, stimulating formation of the inhomogeneous structure containing isolated clusters of the UO2- apatite solid phase.

Theoretical assessment of phosphate amendments for stabilization of (Pb+Zn) in polluted soil

Contamination of the environment with toxic metals, such as lead (Pb), represents a serious concern for human health. Most of the studies on Pb stabilization were performed using various phosphorus-containing amendments that can reduce Pb mobility and bioavailability by the sorption and precipitation of new, stable pyromorphite-type minerals, presenting very low solubility and bioaccessibility. However, the presence of competing ions, such as zinc (Zn), can reduce stabilization efficacy. The role of chemical composition on the stability of immobilization products of Pb and Zn by the addition of hydroxyapatite (HAP) or fluoroapatite (FAP) has been examined in this paper. In this analysis we used a theoretical criterion which is based on calculation of the ion-ion interaction potential, representing the main term of the cohesive energy of the matrix/pollutant system. It has been demonstrated that the stability of the HAP matrix decreases and that the stability of the FAP matrix increases with the Pb immobilization in the presence of Zn. The results of this analysis point out FAP as an advantageous amendment for the immobilization of Pb in the presence of Zn.

Some Aspects of Social Phobia and its Relationship with Substance use Disorder

Social Phobia (SP) is one of the most prevalent anxiety disorder, characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations. People with social phobia have an intense, persistent, and chronic fear of being watched and judged by others and of doing things that will embarrass them. This excessive anxiety usually leads to avoidance behavior that can severely affect normal daily living. SP usually begins in childhood or early adolescence. There is some evidence that genetic factors are involved.

A number of studies have emphasized the high co-morbidity of social phobia with a number of other psychiatric disorders, including substance use disorders. Though clearly elevated there is much debate as to the nature of this relationship. Substance abuse may develop if people try to self-medicate their anxiety and make thamselves more comfortable in social situations. Anxiety may be a result of alcohol or drug abuse due to a substance's anxiogenic effects or through protracted withdrawal syndromes. Substance abusers incur more pathological and unstable life circumstances, making them more susceptible to future stress and anxiety; and there may be a genetic susceptibility in some people which makes them vulnerable to both disorders.

The purpose of this article is to summarize research findings on SP and its complex relationship with substance use disorder. Clinical anxiety and substance abuse both warrant treatment and in all likelihood, each helps perpetuate the other.

LAMOTRIGIN as Psyhostabilisation by Drug Addicts with Psychiatric Comorbidity (Personality Disorder)

Poster shows attempt to reduce aggressive and impulsive behavior to drug addicts who have co morbidity, by using medication.

At he Special Hospital on Addictions in Belgrade, Serbia, for the past two years LAMOTRIGIN was introduced as a medicament in prevention of impulsive behavior and aggressive behavior by patients who are diagnosed with F60. 2,F19. 2 Test group that didn't use this medication had 35 patients, same as experimental group, All patients, both groups were given Antaxon, opioid antagonist, anti-depressive from SSRI group of medication, also Alprozalam was given for the duration of 24 weeks. By using Barratt's scale for the evaluation of impulsivity and Stuart's scale for the evaluation of aggressiveness, noted results show that LAMOTRIGIN is medication of choice for this kind of dependency. For the efficient evaluation, questionnaires were completed about eventual interventions (pharmacological treatment, psychotherapy).

After all, the question remains, was the addiction one that caused personal disorder or the other way around but the is less important, most important is neutrlised addiction and destructive behavior.

Theoretical stability assessment of uranyl phosphates and apatites: selection of amendments for in situ remediation of uranium

Addition of an amendment or reagent to soil/sediment is a technique that can decrease mobility and reduce bioavailability of uranium (U) and other heavy metals in the contaminated site. According to data from literature and results obtained in field studies, the general mineral class of apatites was selected as a most promising amendment for in situ immobilization/remediation of U. In this work we presented theoretical assessment of stability of U(VI) in four apatite systems (hydroxyapatite (HAP), North Carolina Apatite (NCA), Lisina Apatite (LA), and Apatite II) in order to determine an optimal apatite soil amendment which could be used for in situ remediation of uranium. In this analysis we used a theoretical criterion which is based on calculation of the ion-ion interaction potential, representing the main term of the cohesive energy of the matrix/pollutant system. The presented results of this analysis indicate (i) that the mechanism of immobilization of U by natural apatites depends on their chemical composition and (ii) that all analyzed apatites represent, from the point of view of stability, promising materials which could be used in field remediation of U-contaminated sites.

In situ stabilization of toxic metals in polluted soils using phosphates: theoretical prediction and experimental verification

The in situ (in place) immobilization of toxic metals, using inexpensive "reactive" amendments, is considered as a simple and cost-effective approach for the treatment of soils, contaminated by the presence of heavy metals, when these soils are difficult or costly to be removed and treated ex situ. Several application studies have demonstrated that the stabilization of contaminated soils and groundwaters by the addition of apatite minerals has the potential to be a successful and widely applicable remediation strategy for the case of Pb, Cd, as well as for other toxic metals, existing in polluted soils. On the other hand, the specific immobilization mechanism(s) of these toxic metals remains rather elusive. The present work involves an interdisciplinary theoretical and experimental approach, designed to gain at the fundamental (molecular) level the understanding of respective mechanisms, considering the immobilization of Pb and Cd by the addition of apatites. The theoretical analysis of stability, regarding the apatite/Pb or apatite/Cd systems and the relevant results of sorption experiments, pointed out two different mechanisms for the immobilization of Pb or Cd by the use of apatites. The possible practical consequences of these findings for the selection/application of natural apatites for the remediation of contaminated soils by the presence of heavy metals have been also discussed.