FP therapy for controlling malignant ascites in advanced pancreatic cancer patients

BACKGROUND/AIMS: Malignant ascites is one of the poor prognostic factors for pancreatic cancer, and causes serious symptoms and treatment-related toxicity. We conducted a retrospective analysis to evaluate the efficacy of 5-fluorouracil (5-FU) plus cisplatin (FP therapy) for controlling malignant ascites in patients with advanced pancreatic cancer. METHODOLOGY: This analysis was based on 28 consecutive chemotherapy-naive advanced pancreatic cancer patients with cytologically proven malignant ascites who were treated with FP therapy from November 1991 to April 2003. RESULTS: No patients achieved measurable tumor responses. The objective improvement of ascites was seen in 35.7% of the patients (N = 10/28, 95% confidence interval, 18.0 to 53.4%), but there was no patient with complete disappearance of ascites. The median time to disease progression and the median survival time were 1.7 months and 2.7 months, respectively. In all pretreatment variables, the presence of distant metastasis other than peritoneal dissemination was an unfavorable predictive factor for the objective improvement of ascites (Fisher's exact test: P = 0.002). CONCLUSIONS: FP therapy was modestly effective for controlling malignant ascites but insufficient in shrinking for measurable metastatic lesions. Systemic chemotherapy for controlling malignant ascites might be worth while for palliative management in advanced pancreatic cancer patients, especially in patients without distant metastasis.     

Three-dimensional delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) for in vivo evaluation of reparative cartilage after matrix-associated autologous chondrocyte transplantation at 3.0T: Preliminary results

PURPOSE: To use a 3D gradient-echo (GRE) sequence with two flip angles for delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) to evaluate relative glycosaminoglycan content of repair tissue after matrix-associated autologous chondrocyte transplantation (MACT). MATERIALS AND METHODS: In a phantom study, T1-mapping based on a 3D-GRE sequence with different flip angle combinations was compared with a standard inversion recovery (IR) sequence at 3.0T. Fifteen patients were examined after MACT in the knee at "3-13 months" (group I) and "19-42 months" (group II). The delta relaxation rate (deltaR1) calculated for repair tissue and normal hyaline cartilage was measured and mean values were compared in different postoperative intervals using analysis of variance. RESULTS: The flip angle combination 35/10 degrees provided the best agreement with IR sequence for short and long T1 values. The mean deltaR1 for repair tissue was 2.49 versus 1.04 at the intact control site in group I and 1.90 compared with 0.81 in group II. Differences from repair tissue to control sites showed statistically significance for both groups; no significant difference was found between groups. CONCLUSION: The 3D dual flip angle dGEMRIC technique optimized for cartilage imaging is comparable to standard T1 IR technique for T1 mapping. Furthermore, the preliminary in vivo study demonstrates the feasibility of the technique in the evaluation of MACT patients.     

T2 mapping of hip articular cartilage in healthy volunteers at 3T: a study of topographic variation

PURPOSE: To perform baseline T2 mapping of the hips of healthy volunteers, focusing on topographic variation, because no detailed study has involved hips. T2 mapping is a quantitative magnetic resonance imaging (MRI) technique that evaluates cartilage matrix components. MATERIALS AND METHODS: Hips of 12 healthy adults (six men and six women; mean age = 29.5 +/- 4.9 years) were studied with a 3.0-Tesla MRI system. T2 measurement in the oblique-coronal plane used a multi-spin-echo (MSE) sequence. Femoral cartilage was divided into 12 radial sections; acetabular cartilage was divided into six radial sections, and each section was divided into two layers representing the superficial and deep halves of the cartilage. T2 of these sections and layers were measured. RESULTS: Femoral cartilage T2 was the shortest (-20 degrees to 20 degrees and -10 degrees to 10 degrees, superficial and deep layers), with an increase near the magic angle (54.7 degrees ). Acetabular cartilage T2 in both layers was shorter in the periphery than the other parts, especially at 20 degrees to 30 degrees. There were no significant differences in T2 between right and left hips or between men and women. CONCLUSION: Topographic variation exists in hip cartilage T2 in young, healthy adults. These findings should be taken into account when T2 mapping is applied to patients with degenerative cartilage.     

Prognostic factors for malignant pericardial effusion treated by pericardial drainage in solid-malignancy patients

Purpose Malignant pericardial effusion is a frequent complication of advanced incurable malignancies and requires treatment. The purpose of this study was to identify prognostic factors for cytology-positive malignant pericardial effusion in patients treated by pericardial drainage. Methods We retrospectively analyzed a series of consecutive patients diagnosed with cytologically positive malignant pericardial effusion who were treated by pericardial drainage at the National Cancer Center Hospital, Tokyo. Results A total of 88 patients with pericardial effusion were treated by pericardial drainage, 60 patients were diagnosed with cytological positive malignant pericardial effusion including 32 with non-small cell lung cancer, 13 with breast cancer, 8 with gastrointestinal cancer, and 7 with miscellaneous cancers. Subxiphoid pericardiostomy was performed in 50 of the patients and percutaneous tube pericardiostomy in the other 10 patients. Malignant pericardial effusion recurred in 14 patients, and pericardial drainage was performed again in 9 of them. The median overall survival time was 6.1 months, and the 1-year survival rate was 28%. A multivariate analysis revealed the following significant negative prognostic factors: performance status, development of malignant pericardial effusion during chemotherapy, mediastinal lymph node enlargement, and cytologic type. (P = 0.03, 0.02, 0.01, 0.001, respectively). Conclusion Patients with poor prognostic factors may be better to consider as indication of palliative therapy, even if oncologic emergency had been resolved rapidly by drainage.     

Clinical study of anterior ocular segment topography in angle-closure glaucoma using the three-dimensional anterior segment analyzer Pentacam

PURPOSE: The anterior ocular segment topography in angle-closure glaucoma was studied using the non-contact three-dimensional anterior segment analyzer Pentacam. SUBJECTS AND METHODS: The central anterior chamber (AC) depth, mid-peripheral AC depth, peripheral AC depth, AC volume, central AC depth/ocular axial length ratio and angles of a narrow angle group (47 eyes of 29 patients), a post laser iridotomy (LI) group (43 eyes of 30 patients), and an open-angle glaucoma (OAG) group (37 eyes of 21 patients) were measured and compared. In addition, changes in the parameters before and after LI (13 eyes of 9 patients) were investigated. RESULTS: The AC volume for the narrow angle group (74.5 +/- 21.1 microl) was significantly smaller than for the other groups (post LI group: 96.4 +/- 21.4 microl; OAG group: 144.2 +/- 31.6 microl, p<0.001). The most significant association was detected between AC volume and the peripheral AC depth. Only two parameters, AC volume and peripheral AC depth, increased significantly after LI (p< 0.001). DISCUSSION: Measurement of the AC volume and the peripheral AC depth using Pentacam is useful for evaluating the anterior ocular segment topography in narrow angle eyes.     

Expression of AMPA Receptor Subunit Proteins in Purified Retinal Ganglion Cells

Purpose

To determine whether α-amino-3-hydroxy-5-methylisoxazole-4-propioate (AMPA) receptor (AMPAR) subunit proteins are expressed in cultured retinal ganglion cells (RGCs).

Methods

RGCs were purified from dissociated rat retinal cells (postnatal days 6–8), using a modified two-step panning method and cultured in serum-free medium containing neurotrophic factors and forskolin. Immunohistochemistry was performed on cultured RGCs on days 1, 3, and 7 in vitro (1 DIV, 3 DIV, and 7 DIV) using specific antibodies against AMPAR subunits GluR1 to 4 and microtubule-associated protein (MAP) 2, which is a neuronal marker. Glutamate-induced Ca²⁺ influx was measured with fura-2 acetoxymethyl ester fluorescence.

Results

GluR1 to 4 proteins were expressed in the cell body of RGCs on 1 DIV. RGCs showed strong GluR1 to 4 immunoreactivity in both cell bodies and processes on 3 DIV and 7 DIV, with the gradual spreading of expression and the growth of processes. At all time points examined, GluR2 immunoreactivity was equal to that of the other subunits. Accumulation of intracellular Ca²⁺ levels in RGCs induced by glutamate occurred equally on both 3 DIV and 7 DIV.

Conclusion

All AMPAR subunits are almost equally expressed in cultured RGCs.?Jpn J Ophthalmol 2006;50:217–223 © Japanese Ophthalmological Society 2006     

A feasibility study of doxorubicin/cisplatin (AP) for postoperative chemotherapy in patients with advanced endometrial cancer

OBJECTIVE: We evaluated the feasibility of doxorubicin/cisplatin (AP) for postoperative chemotherapy in patients with advanced endometrial cancer. METHODS: Patients with newly diagnosed advanced endometrial cancer received AP (doxorubicin 60 mg/m(2), cisplatin 50 mg/m(2)) every 3 weeks. Treatment was continued until disease progression or completion of 6 courses. Toxicities were evaluated every cycle according to NCI-CTCAE Ver.3.0. RESULTS: Fifteen patients were enrolled from April 2004 through December 2005. All patients successfully completed therapy. There were two patients who needed dose reduction and nine patients with prolongation of treatment interval. Patients with over Grade 3/4 toxicity were observed to have leucopenia (47%), neutropenia (67%), anemia (26%), and vomiting (13%). No grade 3/4 cardiac and renal failure were observed. CONCLUSIONS: The doxorubicin/cisplatin (AP) regimen is tolerated and can be safely given without severe toxicity.