Testing a theory for health-related quality of life in cancer patients: a structural equation approach.

The purpose of this study was to test a Roy Adaptation Model-based theory of health-related quality of life in patients with newly diagnosed cancer. Using a structural equation model, health-related quality of life (HRQOL) was regarded as a latent variable measured by 4 empirical indicators representing the 4 biopsychosocial response modes of the Roy Adaptation Model (RAM). The response modes are physiologic, self-concept, interdependence, and role function. These were empirically represented by physical symptoms, affective status, social support, and functional support, respectively. In this secondary analysis, 3 RAM propositions were tested in a sample of 375 newly diagnosed postsurgical cancer patients 60 years and over. These were: (a) that the 4 response modes are interrelated; (b) that environmental stimuli of gender, race, age, income, marital status, cancer treatment, and severity of illness influence the biopsychosocial response modes; and (c) that the biopsychosocial responses soon after diagnosis predict biopsychosocial responses 3 months later. The analyses did not support the proposition that all 4 response modes were interrelated. The results, however, revealed that severity of illness and adjuvant cancer treatment had the strongest association with the biopsychosocial responses and should be considered the focal environmental stimuli. The remaining environmental stimuli can be considered contextual. Also, the proposition that initial biopsychosocial responses predicted later responses was supported.     

人参皂甙诱导的造血细胞内信号传递途径的研究

目的探讨人参皂甙（ＧＳ）刺激造血祖细胞增殖有关的细胞内信号传递途径。方法采用Ｎｏｒｔｈｅｒｎ印迹杂交法、电泳带移动阻滞实验、抗体胶结合移动实验和紫外放射交联实验。结果ＮｏｒｔｈｅｒｎＢｌｏｔ显示经ＧＳ诱导的人巨核细胞株ＣＨＲＦ２８８、Ｍｅｇ０１和ＭＯ７ｅ细胞的ＧＡＴＡ２ｍＲＮＡ水平增高,分别是未经处理细胞的１．８４,２．４３和１．５２倍。但ＧＡＴＡ１ｍＲＮＡ表达水平低,且ＧＳ处理前后也无明显变化。电泳带移动阻滞实验提示ＧＳ诱导的细胞核内ＧＡＴＡ转录调控蛋白与特定的ＤＮＡ序列结合的活性增高。抗体胶结合移动实验证实与ＤＮＡ结合的主要成分为ＧＡＴＡ２蛋白,紫外放射交联实验确定该复合物的相对分子质量约为５０×１０３,符合ＧＡＴＡ２转录调控蛋白。结论ＧＳ诱导细胞内的信号传递途径与转录因子ＧＡＴＡ２有关,ＧＡＴＡ２有介导ＧＳ刺激造血细胞增殖的作用。     

Multiple mechanisms underlie metastasis suppressor function of NM23-H1 in melanoma

nm23-h1 was the first metastasis suppressor gene to be identified in humans, with early studies demonstrating its ability to inhibit the metastatic potential of breast carcinoma and melanoma cell lines. This report outlines recent findings from our laboratory indicating that the metastasis suppressor function of NM23-H1 in human melanoma involves a spectrum of molecular mechanisms. Analysis of NM23-H1-dependent profiles of gene expression in human melanoma cell lines has identified a host of target genes that appear to mediate suppression of directional motility. Of particular interest is a subset of motility-suppressing genes whose regulation by NM23-H1 is independent of its known kinase and 3??C5?? exonuclease activities. In parallel, we have recently observed that NM23-H1 expression appears to be required for genomic stability and for optimal repair of DNA damage produced by ultraviolet radiation and other agents. Thus, NM23-H1 might oppose not only the motile and invasive characteristics of metastatic cells but also the acquisition of mutations that drive malignant progression to the metastatic phenotype itself.     

Development and use of a web-based data management system for a randomized clinical trial of adolescents and young adults

Recent advances in technology provide support for multisite, Web-based data-entry systems and the storage of data in a centralized location, resulting in immediate access to data for investigators, reduced participant burden and human entry error, and improved integrity of clinical trial data. The purpose of this article was to describe the development of a comprehensive, Web-based data management system for a multisite randomized behavioral intervention trial. Strategies used to create this study-specific data management system included interdisciplinary collaboration, design mapping, feasibility assessments, and input from an advisory board of former patients with characteristics similar to the targeted population. The resulting data management system and development strategies provide a template for other behavioral intervention studies.     

Fertility among testicular cancer survivors: a case-control study in the U.S.

Introduction

Testicular germ cell tumors (TGCT) disproportionately affect men between the ages of 15 and 49 years, when reproduction is typical. Although TGCT treatment directly affects gonadal tissues, it remains unclear whether there are long-term effects on fertility.

Methods

To examine post-TGCT treatment fertility, study participants in a previously conducted case-control study were contacted. The men were initially enrolled in the US Servicemen’s Testicular Tumor Environmental and Endocrine Determinants (STEED) study between 2002 and 2005. A total of 246 TGCT cases and 236 controls participated in the current study and completed a self-administered questionnaire in 2008–2009.

Results

TGCT cases were significantly more likely than controls to experience fertility distress (OR 5.23; 95% CI 1.99–13.76) and difficulty in fathering children (OR 6.41; 2.72–15.13). Cases were also more likely to be tested for infertility (OR 3.65; 95% CI 1.55–8.59). Cases, however, did not differ from controls in actually fathering children (OR 1.37; 95% CI 0.88–2.15). These findings were predominantly observed among nonseminoma cases and cases treated with surgery only or surgery-plus-chemotherapy.

Discussion

While expressing greater fertility distress, higher likelihood of fertility testing, and difficulty fathering children, these data suggest that TGCT survivors are no less likely to father children than are other men. It is possible that treatment for TGCT does not permanently affect fertility or, alternatively, that TGCT survivors attempt to father children with greater persistence or at younger ages than do other men.