Using health-related quality of life measures to predict cardiac function in survivors exposed to anthracyclines.

PURPOSE: As the number of pediatric cancer survivors increases, so does the number of survivors previously exposed to anthracyclines as part of their cancer therapy. Because screening is costly, some have suggested that health-related quality of life (HRQL) measures might be useful in focusing screening tests on those patients with cases most likely to display positive findings. This study reports on the predictive ability of HRQL measures to detect patients with abnormalities on serial cardiac testing. METHODS: Using 127 patients from the ACE-Inhibitor after Anthracycline (AAA) Trial, this study compared serial measures of the Short Form-36 (SF-36; for ages > 13 years) and Child Health Questionnaire-Child Form 87 (CHQ-CF87; for ages < or = 13 years) to serial cardiac performance tests including echocardiographic shortening fraction, left ventricular end systolic wall stress (LVESWS), LVESWS-index, and maximal cardiac index (MCI; a measure of cardiac output at peak exercise). RESULTS: Generally, there was no clinically or statistically significant correlation between any HRQL measure and any cardiac function measure except between MCI and vitality and physical functioning. For each of these measures, the correlation between MCI was statistically significant (P < .006), but each HRQL subscale could explain no more than 7% of the variation in MCI. HRQL measures were not predictive of any other cardiac function measure. CONCLUSION: HRQL measures should not be used in isolation as a screen for cardiac function abnormalities in patients exposed to anthracylines who already have a mild degree of ventricular dysfunction. Patient history appears to be no substitute for cardiac testing in this cohort.     

Immunohistochemical expression of cyclooxygenase isoenzymes and downstream enzymes in human lung tumors.

PURPOSE:Prostanoids are important mediators of pulmonary vaso- and bronchotone regulation and strongly influence inflammatory reactivity. The product of cyclooxygenase (Cox), prostaglandin H(2), is further metabolized via downstream enzymes into the different effective metabolites. The specific cellular equipment with certain downstream enzymes crucially determines the cellular reactivity by generation of functionally different prostanoid metabolites. EXPERIMENTAL DESIGN: To elucidate the role of arachidonic acid metabolism via the cyclooxygenase pathway in different human lung tumors, expression of cyclooxygenase isoenzymes (Cox-1 and Cox-2) and downstream enzymes of prostanoid metabolism was investigated in human non-small cell lung cancer and normal human lung tissue by immunohistochemical techniques. RESULTS: In comparison to strong Cox-1 reactivity in airways and endothelial cells of normal lung specimens, only 4 of 15 adenocarcinomas showed infrequent Cox-1 expression. All lung cancer specimens displayed an increased Cox-2 immunostaining pattern with strong reactivity in adenocarcinomas and lower reactivity in squamous cell carcinomas. Adenocarcinomas and squamous cell carcinomas were also positive for thromboxane A(2) synthase, prostaglandin D(2) synthase, and prostaglandin E(2) synthase, but not for prostacyclin synthase. Endothelial cells of vessels found within or near the tumor show extensive immunostaining of Cox-2 and thromboxane A(2) synthase, whereas endothelial cells of normal lung specimens, in contrast, expressed Cox-1 and prostacyclin synthase. CONCLUSIONS: We conclude that non-small cell lung cancer shows a specific Cox-/downstream-enzyme expression pattern, which is specifically altered in lung tumor cells and tumor supplying vessels in contrast to normal lung tissue. This may have major impact on tumor progression and tumor-associated inflammation via an altered prostanoid metabolism with consecutive tumor-associated blood flow distribution.     

Phase III study of second-line chemotherapy for advanced non-small-cell lung cancer with weekly compared with 3-weekly docetaxel.

PURPOSE: A phase III study to determine whether a weekly docetaxel schedule improves the therapeutic index compared with the classic 3-weekly schedule. PATIENTS AND METHODS: Patients with stage IIIB-IV non-small-cell lung cancer (NSCLC) were randomly assigned to docetaxel 75 mg/m2 on day 1 every 3 weeks (3-weekly) and 35 mg/m2 on days 1, 8, and 15 (weekly) for < or = eight cycles. End points included survival (primary), toxicity, and response. RESULTS: Of 215 patients enrolled, 208 (103 in the 3-weekly arm and 105 in the weekly arm) were assessable for response. At baseline, 24.5% of patients (51 out of 208) had received prior paclitaxel therapy and 43.3% of patients (90 out of 208) had been progression-free for more than 3 months after first-line therapy. After 12 months' follow-up, median survival was 6.3 months (95% CI, 4.68 to 7.84 months) with 3-weekly docetaxel and 9.2 months (95% CI, 5.83 to 12.59 months) with weekly docetaxel (P = .07) after a median of four (range, one to eight) and two (range, one to eight) treatment cycles, respectively. Overall, response rates were 12.6% v 10.5% with 3-weekly versus weekly docetaxel. Significantly fewer patients reported grade 3 to 4 toxicities with weekly docetaxel versus 3-weekly docetaxel (P < or = .05). There were significantly lower rates of grade 3 to 4 anemia (P < or = .05), leucopenia (P < .0001), and neutropenia (P < or = .001) with weekly versus 3-weekly treatment. No grade 3 to 4 thrombocytopenia or mucositis was reported. CONCLUSION: Weekly docetaxel 35 mg/m2 demonstrated similar efficacy and better tolerability than standard 3-weekly docetaxel 75 mg/m2 and can be recommended as a feasible alternative second-line treatment option for patients with advanced NSCLC.     

A direct anastomosis between the stems of celiac trunk and left colic artery by an anomalous fourth celiac trunk branch: First cadaveric study

Coeliac trunk (CT) is a ventral branch of abdominal aorta (AA) supplying the foregut through its three main branches, left gastric (LGA), common hepatic (CHA) and splenic artery (Standring et al., 2009). Branching pattern of CT may vary from above mentioned classical three to four, five or six. Additional branches include inferior phrenic artery, dorsal pancreatic artery, middle colic or accessory middle colic artery (Hamilton and Mossman, 1972; Amonoo‐Kuofi et al., 1995). Anastmosis between CT and Superior mesenteric artery (SMA) which supplies the midgut derivatives in the form of Bühler's arcade (1‐2%) is present posterior to the body of pancreas (Douard et al., 2006; McNulty et al., 2001). Anastomoses between SMA and Inferior mesenteric artery (IMA) which supplies hindgut derivatives are also documented (Lange et al, 2007; Van Damme and Bonte, 1990). Until recently no communications between arteries of foregut and hindgut were reported (Manoharan et al., 2010; Patel et al., 2010; Stimec et al., 2011). We report the first cadaveric finding demonstrating a direct communication between the stems of CT and left colic artery (LCA) via a fourth anomalous CT branch in the absence of any co‐existing stenosis or aneurysm in the main vessels. Clin. Anat. 26:984–986, 2013. © 2012 Wiley Periodicals, Inc.     

Imprinting Technology for Effective Sorbent Fabrication: Current State-of-Art and Future Prospects

In the last 10 years, we have witnessed an extensive development of instrumental techniques in analytical methods for determination of various molecules and ions at very low concentrations. Nevertheless, the presence of interfering components of complex samples hampered the applicability of new analytical strategies. Thus, additional sample pre-treatment steps were proposed to overcome the problem. Solid sorbents were used for clean-up samples but insufficient selectivity of commercial materials limited their utility. Here, the application of molecularly imprinted polymers (MIPs) or ion-imprinted polymers (IIPs) in the separation processes have recently attracted attention due to their many advantages, such as high selectivity, robustness, and low costs of the fabrication process. Bulk or monoliths, microspheres and core-shell materials, magnetically susceptible and stir-bar imprinted materials are applicable to different modes of solid-phase extraction to determine target analytes and ions in a very complex environment such as blood, urine, soil, or food. The capability to perform a specific separation of enantiomers is a substantial advantage in clinical analysis. The ion-imprinted sorbents gained interest in trace analysis of pollutants in environmental samples. In this review, the current synthetic approaches for the preparation of MIPs and IIPs are comprehensively discussed together with a detailed characterization of respective materials. Furthermore, the use of sorbents in environmental, food, and biomedical analyses will be emphasized to point out current limits and highlight the future prospects for further development in the field.