The prognostic significance of lymphovascular invasion on biopsy specimens in lung cancer treated with definitive chemoradiotherapy

PurposeThis study aims to determine prognostic factors for patients who have non–small-cell lung cancer (NSCLC) that is treated with definitive chemoradiation therapy.Materials and MethodsSeventy-eight patients has been treated with radiation therapy and concomitant or sequential chemotherapy between 2000 and 2005. Paraffin-embedded biopsy specimens were obtained before treatment from 73 patients and reviewed by two independent pathologists. Complete follow-up data were collected. The impact of clinical and pathological factors and treatment modality on survival was studied using the χ² and Fisher exact tests. A multivariate analysis was performed using the Cox proportional hazard model.ResultsSeventy-three patients were evaluated, 58 men and 15 women. Median age was 62 years. Most had locally advanced disease (42 stage IIIB and 24 stage IIIA), whereas 7 were medically inoperable stage I-II patients. Lymphovascular invasion (LVI) was identified in 20 biopsy specimens (27.4 %). Radiotherapy delivered a median dose of 66 Gy (range, 60 to 70 Gy). The median overall survival was 20.5 months. Relapse-free and overall survival were significantly higher in the concomitant arm than in the sequential arm (P = .025 and P = .031, respectively). We found an independent association between the presence of LVI and both the risk of death with an adjusted hazard ratio (HR) of 2.69 (95% confidence interval [CI] 1.50-4.83) and the risk of metastatic progression (adjusted HR = 3.01; 95% CI 1.58-5.72).ConclusionThe presence of LVI on stage III NSCLC biopsy specimens was the only independent prognostic factor for poor outcome and may, therefore, be helpful in identifying patients at high risk of metastatic disease.     

Effects of music therapy on depression compared with psychotherapy

This paper reports a study testing the effects of music on depression and compares them with the effects of psychotherapy. There are mainly three conventional treatments for depression: psychotherapy, pharmaceutical treatments, and electroconvulsive therapy. Because conventional treatment has proven to be poorly successful, new means of treatment must be found that might improve depression when used together with other therapies. A randomized controlled clinical trial was performed with a convenience sample of 79 patients aged 25–60 years with low- and medium-grade depression. The Zung Depression Scale was employed for selection purposes. Patients were randomly assigned to the music-therapy group (classical and baroque music) (n = 41), or the psychotherapy group based on conductive-behavioral therapy (n = 38). The music therapy was applied for 50 min a day, every day, for eight weeks. At the end, the music-therapy group had less depressive symptoms than the psychotherapy group, and this was proven to be statistically significant with the Friedman test. We propose that patients with low- and medium-grade depression can use music to enhance the effects of psychological support.     

Fever-induced QTc prolongation and ventricular arrhythmias in individuals with type 2 congenital long QT syndrome

Type 2 congenital long QT syndrome (LQT-2) is linked to mutations in the human ether a-go-go-related gene (HERG) and is characterized by rate-corrected QT interval (QTc) prolongation, ventricular arrhythmias, syncope, and sudden death. Recognized triggers of these cardiac events include emotional and acoustic stimuli. Here we investigated the repeated occurrence of fever-induced polymorphic ventricular tachycardia and ventricular fibrillation in 2 LQT-2 patients with A558P missense mutation in HERG. ECG analysis showed increased QTc with fever in both patients. WT, A558P, and WT+A558P HERG were expressed heterologously in HEK293 cells and were studied using biochemical and electrophysiological techniques. A558P proteins showed a trafficking-deficient phenotype. WT+A558P coexpression caused a dominant-negative effect, selectively accelerated the rate of channel inactivation, and reduced the temperature-dependent increase in the WT current. Thus, the WT+A558P current did not increase to the same extent as the WT current, leading to larger current density differences at higher temperatures. A similar temperature-dependent phenotype was seen for coexpression of the trafficking-deficient LQT-2 F640V mutation. We postulate that the weak increase in the HERG current density in WT-mutant coassembled channels contributes to the development of QTc prolongation and arrhythmias at febrile temperatures and suggest that fever is a potential trigger of life-threatening arrhythmias in LQT-2 patients.     

全髋关节置换术中钴-铬股骨头不同磨损部位的摩擦学特性

 通过使用原子力显微镜检查(atomic force microscopy,AFM)计算表面粗糙度和摩擦系数的方法,对工程和生物材料的摩擦学特性进行研究。尽管之前的大量研究对全髋关节置换术中不同承重材料的摩擦系数进行了报告,但却没有关于全髋关节置换术术中轴承材料的表面粗糙度和摩擦系数的关系的报道。此外,钴-铬股骨头不同磨损部位的摩擦学特性尚不明确。因此,本研究对全髋关节置换术后 10年钴-铬股骨头发生严重磨损及轻微磨损部位的表面粗糙度、摩擦系数和硬度之间的关系进行研究。钴-铬股骨头的平均维氏硬度为(380.7±11.3) HV。在 AFM扫描的 25滋m伊25滋m面积内,严重磨损和轻微磨损部位的摩擦系数分别为 0.229±0.054和 0.243±0.059,两者差异无统计学意义(P=0.449)。严重磨损部位的表面粗糙度[Rq=(96.5±26.2) nm]与轻微磨损部位[Rq=(17.7±4.2) nm]的差异有统计学意义(P <0.0001)。本研究结果显示院钴-铬股骨头的摩擦特性与其表面粗糙度没有明显关系,为金属植入材料表面特性的改善提供了依据。     

Clinical and genetic studies of families with the tau N279K mutation (FTDP-17)

The tau N279K mutation was identified in four separately ascertained families in the United States, Japan, and France and in another recently discovered affected individual in Japan. The authors analyzed genealogical and clinical records and DNA samples. Average age at onset was 43 years; survival time was 7 years. All families exhibited similar clinical features, with parkinsonism, dementia, and supranuclear palsy uniformly seen. A founder effect indicated by a shared disease haplotype was seen only in two Japanese families. The N279K mutation can develop independently in different parts of the world.