The use of microarray technologies in clinical oncology

Purpose

Based on previous studies that demonstrated the safety profile and preliminary clinical activity of prostate specific antigen (PSA) targeted therapeutic vaccines, as well as recent laboratory data supporting the value of the addition of co-stimulatory molecules B7-1, ICAM-1, and LFA-3 (designated TRICOM?) to these vaccines, we conducted a Phase I study to evaluate the safety and immunogenicity of a novel vaccinia and fowlpox vaccine incorporating the PSA gene sequence and TRICOM.

Methods

In this study, ten patients with androgen independent prostate cancer with or without metastatic disease were enrolled. Patients were treated with 2 × l0⁸ pfu of a recombinant vaccinia virus vaccine (PROSTVAC-V) followed by 1 × 10⁹ pfu of the booster recombinant fowlpox virus (PROSTVAC-F) both with gene sequences for PSA and TRICOM. The mean age of patients enrolled in the study was 70 (range 63 to 79). The mean PSA at baseline was 434 (range 9 – 1424).

Results

There were no deaths, and no Grade 3 or 4 adverse events. The most commonly reported adverse events, regardless of causality, were injection site reactions and fatigue. One serious adverse event (SAE) occurred that was unrelated to vaccine; this patient developed progressive disease with a new sphenoid metastasis. PSA was measured at week 4 and week 8. Four patients had stable disease (with less than 25% increase in PSA) through the week 8 study period. Anti-PSA antibodies were not induced with therapy: however, anti-vaccinia titers increased in all patients.

Conclusion

This study demonstrated that vaccination with PROSTVAC-V and PROSTVAC-F combined with TRICOM is well-tolerated and generated an immune response to vaccinia. Therefore, PROSTVAC-VF/TRICOM represents a feasible therapeutic approach for further phase II and III study in patients with prostate cancer.     

Clinical “case series”: a concept analysis

Objectives

To analyze the concept of “case series” in the medical literature compared with case reports.

Methods

A PubMed search for articles published during 2009 which had “case series” in their title was performed. A total number of 621 articles were retrieved. 586 papers were included in the analysis and 35 were excluded (18 were commentary letters, 5 were not in English, and twelve could not be retrieved by our Library). The number of patients and category of these articles were analyzed.

Results

The median (range) of the number of cases of articles having “case series” in their title was 7 (1–6432) cases. 186/ 586 articles had less than 5 cases (31.7%, 95% CI (28.3–35.1%)). The median (range) of the number of cases of articles having “case report” as their publication type was 4 (1–178) cases. Out of the 219 articles categorized as case reports 114 (52.1%, 95% CI (45.6–58.6%)) had less than five cases.

Conclusions

The concept of “case series” is not well defined in the literature and does not reflect a specific research design. We suggest that a case series should have more than four patients while four paitents or less should be reported individually as case reports.     

HPLC和络合-UV法测定特非那丁颗粒剂的含量

目的：用ＨＰＬＣ和电荷转移络合ＵＶ法分别测定特非那丁粒剂的含量,并对测定结果进行比较,方法：ＨＰＬＣ法,色谱柱：ＳｐｈｅｒｉｓｏｒｂＣ８（１５０＊４．６ｍｍ,５μｍ）;流动相：甲醇－０．１ｍｏｌ／Ｌ三乙胺磷酸缓冲液（８０：２０）,检测波长２３５ｎｍ。电荷转移络合ＵＶ法,利用碘与ＴＦＮ在氯仿中形成电荷转移络合物的原理,在紫外２９４ｎｍ的波长处测定ＴＦＮ的含量。结果：两法测定的线性范围和平均回收率分别     

Mycosis fungoides and Sézary syndrome: Current challenges in assessment,management and prognostic markers

Mycosis fungoides and Sézary syndrome are the most common variants of the cutaneous T‐cell lymphomas. Assessment of a patient with a suspected diagnosis requires thorough history taking and physical examination, in combination with skin biopsy. In some cases flow cytometry, molecular studies and imaging are also required in order to diagnose and stage the disease. Staging is derived from the tumour‐node‐metastasis‐blood classification and is currently our best attempt to stratify prognosis and hence guide management in this complex disease. Many other clinical, biological and pathological factors may help to distinguish groups at risk and predict prognosis more accurately. Management remains heavily guided by staging, such that patients with early‐stage disease generally begin treatment with skin‐directed or local therapies and those with advanced‐stage disease have many treatment options, including chemotherapy, the use of biological agents, local and total body radiotherapy, as well as haematopoietic stem cell transplantation. Besides staging, many other patient‐related factors influence the treatment strategy, particularly where symptom relief is paramount. There are many challenges remaining in the study of Mycosis fungoides and Sézary syndrome and, given the rarity of the disease, concerted worldwide efforts are required to conduct efficient and effective research.     

Anti-inflammatory and mutagenic evaluation of medicinal plants used by Venda people against venereal and related diseases

Ethnopharmacology relevance

Inflammation is a major risk factor for various human diseases including venereal diseases, often resulting in treatment complications. Plants have been traditionally used for treatment of many different diseases and have been successfully proven to be an alternative source in treatment of infectious diseases.

Aim of the study

This study was aimed at evaluating the anti-inflammatory activities and the mutagenic properties of 12 medicinal plants used by the Venda people against venereal and related diseases.

Materials and methods

The plants were evaluated for their anti-inflammatory activity against the cyclooxygenase (COX-1 and -2) enzymes and genotoxicity using the Ames test, with and without S9 (metabolic activation) against Salmonella typhimurium tester strain TA98.

Results

DCM and PE extracts of Adansonia digitata bark, Bolusanthus speciosus bark, Pterocarpus angolensis bark and Pappea capensis leaves and EtOH and water extracts of Bolusanthus speciosus stem and Ekebergia capensis bark showed the best anti-inflammatory activity in both COX-1 and -2 assays at 250 μg/ml. These were further evaluated at three other concentrations (31.25, 62.5, and 125 μg/ml) to determine IC₅₀ values. Water extracts of Ekebergia capensis bark showed the best IC₅₀ value towards COX-1. The Ames test revealed that all plant extracts were non-mutagenic towards Salmonella typhimurium strain TA98 except for Elephantorrhiza burkei and Ekebergia capensis that showed weak mutagenicity.

Conclusion

The active plants may offer a new source of chemicals for the effective treatment of anti-inflammatory conditions related to venereal diseases.     

Does a reduced glucose intake prevent hyperglycemia in children early after cardiac surgery? a randomized controlled crossover study

Introduction

Hyperglycemia in children after cardiac surgery can be treated with intensive insulin therapy, but hypoglycemia is a potential serious side effect. The aim of this study was to investigate the effects of reducing glucose intake below standard intakes to prevent hyperglycemia, on blood glucose concentrations, glucose kinetics and protein catabolism in children after cardiac surgery with cardiopulmonary bypass (CPB).

Methods

Subjects received a 4-hour low glucose (LG; 2.5 mg/kg per minute) and a 4-hour standard glucose (SG; 5.0 mg/kg per minute) infusion in a randomized blinded crossover setting. Simultaneously, an 8-hour stable isotope tracer protocol was conducted to determine glucose and leucine kinetics. Data are presented as mean ± SD or median (IQR); comparison was made by paired samples t test.

Results

Eleven subjects (age 5.1 (20.2) months) were studied 9.5 ± 1.9 hours post-cardiac surgery. Blood glucose concentrations were lower during LG than SG (LG 7.3 ± 0.7 vs. SG 9.3 ± 1.8 mmol/L; P < 0.01), although the glycemic target (4.0-6.0 mmol/L) was not achieved. No hypoglycemic events occurred. Endogenous glucose production was higher during LG than SG (LG 2.9 ± 0.8 vs. SG 1.5 ± 1.1 mg/kg per minute; P = 0.02), due to increased glycogenolysis (LG 1.0 ± 0.6 vs. SG 0.0 ± 1.0 mg/kg per minute; P < 0.05). Leucine balance, indicating protein balance, was negative but not affected by glucose intake (LG -54.8 ± 14.6 vs. SG -58.8 ± 16.7 μmol/kg per hour; P = 0.57).

Conclusions

Currently recommended glucose intakes aggravated hyperglycemia in children early after cardiac surgery with CPB. Reduced glucose intake decreased blood glucose concentrations without causing hypoglycemia or affecting protein catabolism, but increased glycogenolysis.

Trial registration

Dutch trial register NTR2079.