Hydroxyurea-induced marked oscillations of platelet counts in patients with polycythemia vera

Two prospectively studied patients with polycythemia vera (PV) whose platelet counts showed marked periodic fluctuation during treatment with hydroxyurea (HU) are reported. Cycle lengths in both were approximately 28 to 30 days. In one patient, the cyclic process was no longer evident when treatment with HU was withheld, and it reappeared on treatment rechallenge. Circulating thrombopoietin (TPO) levels fluctuated out of phase with the platelet count despite markedly reduced TPO-receptor (c-Mpl) expression in bone marrow megakaryocytes. These observations suggest that the cyclic phenomenon may be related to both a transient state of HU-induced depletion of megakaryocytes and a concentration-dependent mitigation by TPO of the HU effect on megakaryocytes and their precursors. It is conceivable that the affected patients harbor a megakaryocyte progenitor pool whose apoptotic activity is differently modulated by either HU or high concentrations of TPO. (Blood. 2000;96:1582-1584)     

Genetics of Somatic Mammalian Cells: Biochemical Genetics of Chinese Hamster Cell Mutants with Deviant Purine Metabolism

Studies are presented on the biochemical genetics of 30 adenine-requiring mutants of the Chinese hamster ovary cell which were induced by mutagenesis and selected by the BrdU-visible light technique. Representative experiments conducted with these mutants include: hybridization with each other; hybridization with normal human cells; nutritional analysis; biochemical analysis with radioactively labeled intermediates; and measurement of reversion frequencies to wild-type phenotype occurring spontaneously and under the influence of selected mutagens. All mutants behave as if having point mutations. These experiments provide information relevant to the determination of dominant-recessive relationships, resolution into different complementation classes, localization of the human chromosomes which carry human genes required by the individual mutants, determination of the point of metabolic block for different mutants, and elucidation of the nature of the underlying DNA changes. These experiments illustrate the range of biochemical-genetic studies now possible with such a family of somatic mammalian cell mutants in vitro. Possible application to problems of human genetic disease are indicated.     

The complete optical spectrum of liquid water measured by inelastic x-ray scattering

Interaction of light with matter is of paramount importance in nature. The most fundamental property of a material in relation to light is its oscillator strength distribution, i.e., how strongly it absorbs light as a function of wavelength. Once the oscillator strength distribution is determined precisely for a wide enough energy range, the optical constants such as absorbance and reflectance as well as a number of other properties of the material, some of which are seemingly unrelated to photoabsorption, can be deduced. Most important of all is the fact that the interaction of matter with fast charged particles can be described by its complete optical spectra [Inokuti, M. (1986) Photochem. Photobiol. 44, 279-285]. Despite their importance, however, the complete optical spectra of volatile liquids including water have never been obtained accurately because of experimental difficulties inherent in vacuum UV spectroscopy. Inelastic x-ray scattering spectroscopy can provide quantitative data equivalent to those from vacuum UV absorption spectra. Herein, we show the complete optical spectrum of liquid water determined by making use of intense monochromatic x-rays supplied by the wiggler line X21 of the National Synchrotron Light Source.     

Review of stoma site and midline incisional hernias after stoma reversal

Background

The incidence of incisional hernias after stoma reversal is not well reported. The aim of this study was to systematically review the literature reporting data on incisional hernias after stoma reversal. We evaluated both the incidence of stoma site and midline incisional hernias.

Methods

A systematic review identified studies published between January 1, 1980, and December 31, 2012, reporting the incidence of incisional hernia after stoma reversal at either the stoma site or at the midline incision (in cases requiring laparotomy). Pediatric studies were excluded. Assessment of risk of bias, detection method, and essential study-specific characteristics (follow-up duration, stoma type, age, body mass index, and so forth) was done.

Results

Sixteen studies were included in the analysis; 1613 patients had 1613 stomas formed. Fifteen studies assessed stoma site hernias and five studies assessed midline incisional hernias. The median (range) incidence of stoma site incisional hernias was 8.3% (range 0%–33.9%) and for midline incisional hernias was 44.1% (range 8.7%–58.1%). When evaluating only studies with a low risk of bias, the incidence for stoma site incisional hernias is closer to one in three and for midline incisional hernias is closer to one in two.

Conclusion

Stoma site and midline incisional hernias are significant clinical complications of stoma reversals. The quality of studies available is poor and heterogeneous. Future prospective randomized controlled trials or observational studies with standardized follow-up and outcome definitions/measurements are needed.     

One-step mixing with humanized anti-mPEG bispecific antibody enhances tumor accumulation and therapeutic efficacy of mPEGylated nanoparticles

Methoxy PEGylated nanoparticles (mPEG-NPs) are increasingly used for cancer imaging and therapy. Here we describe a general and simple approach to confer tumor tropism to any mPEG-NP. We demonstrate this approach with humanized bispecific antibodies (BsAbs) that can bind to both mPEG molecules on mPEG-NPs and to EGFR or HER2 molecules overexpressed on the surface of cancer cells. Simple mixing of BsAbs with mPEG-NPs can mediate preferential binding of diverse mPEG-NPs to cancer cells that overexpress EGFR or HER2 under physiological conditions and significantly increase cancer cell killing by liposomal doxorubicin to EGFR⁺ and HER2⁺ cancer cells. BsAbs modification also enhanced accumulation of fluorescence-labeled NPs and significantly increased the anticancer activity of drug-loaded NPs to antigen-positive human tumors in a mouse model. Anti-mPEG BsAbs offer a simple one-step method to confer tumor specificity to mPEG-NPs for enhanced tumor accumulation and improved therapeutic efficacy.     

Childhood insulinoma masquerading as seizure disorder

A 9 year old girl presented with seizures, weight gain and early morning behavioural changes. She had been commenced on anticonvulsants and was subsequently diagnosed with hyperinsulinaemic hypoglycaemia. This case demonstrates the importance of blood glucose monitoring in children presenting with new‐onset seizures and/or with early morning or fasting behavioural changes, the challenges in localizing the lesion, as well as the difficulties in achieving normoglycaemia prior to, and immediately following, surgery.