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.     

Antifolate resistance in a HeLa cell line associated with impaired transport independent of the reduced folate carrier.

Prior studies from this laboratory documented the prevalence of methotrexate (MTX) transport activity with a low pH optimum in human solid tumor cell lines. In HeLa cells, this low pH activity has high affinity for pemetrexed [PMX (Alimta)] and is reduced folate carrier (RFC)-independent because it is not diminished in a RFC-null subline (R5). R5 cells also have residual transport activity, with high specificity for PMX, at neutral pH. In the current study, a R5 subline, R1, was selected under MTX selective pressure at a modest reduction in pH. There was markedly decreased MTX and PMX transport at both pH 5.5 and pH 7.4. When MTX was removed, there was a slow return of transport activity, and when MTX was added back, there was loss of transport at both pH values within 8 weeks. In R1 cells, there was a marked decrease in accumulation of PMX, MTX, and folic acid along with a decrease in growth inhibition by these and other antifolates that require a facilitative process to gain entry into cells. These data demonstrate that (i) RFC-independent transport in HeLa cells at low and neutral pH contributes to antifolate activity (in particular, to PMX activity) and can be diminished by antifolate selective pressure and (ii) the loss of these activities results in marked resistance to PMX, an agent for which there is little or no loss of activity when transport mediated by RFC is abolished. These observations suggest that transport activity in RFC-null HeLa R5 cells at neutral and low pH may reflect the same carrier-mediated process.     

Efficacy of preoperative intracavitary brachytherapy and surgery in patients with stage ⅠB2 and ⅡA bulky cervical cancer

Objective To analyze the outcomes of preoperative intracavitary brachytherapy plus sur-gery in patients with stage ⅠB2 and ⅡA bulky cervical cancer. Methods From January 2001 to January 2007, 77 patients with stage ⅠB2 and ⅡA bulky cervical cancer were included. The diameter of primary tumor was greater than 4 cm. Preoperative intracavitary brachytherapy with the total dose of 20-30 Gy (0.5 cm below the vaginal mucosa) was delivered by 2-3 fractions, one fraction per week. After an interval of 10-14 days, the efficacies of radiotherapy were evaluated and radical hysterectomy with pelvic lymphade-nectomy was performed. Then the treatment complications, clinicopathological characteristics, survival and recurrence were analyzed. Results The tumor shrinkage was observed in all the patients after intracavitary brachytherapy. The CR, PR and SD were 5% (4/77), 36% (28/77) and 58% (45/77), respectively. Radical hysterectomy was successfully performed in all patients. The complications of the combined therapy were mild and only 5 patients had grade Ⅱ or less hematological or gastrointestinal toxicities. The 5-year o-verall survival rate and pelvic recurrence rate were 83% and 12%, respectively. Conclusions Preoperative intracavitary brachytherapy of 20-30 Gy plus surgery is effective in the treatment of stage ⅠB2 and ⅡA bulky cervical cancer without increasing the treatment complications.     

Bipartite parietal bone: A rare cause of plagiocephaly

A case of an infant with an asymmetrical head is presented. On clinical assessment the patient displayed features of deformational plagiocephaly. With the aid of three‐dimensional CT imaging of the skull, a bipartite parietal bone was diagnosed. The prevalence and possible aetiology of a bipartite parietal bone is discussed as well as a brief overview of the common causes of plagiocephaly.     

肾恶性横纹肌样瘤临床病理分析及超微结构观察

目的:探讨肾恶性横纹肌样瘤(MRTK)的临床病理表现及超微结构特点。方法:用光镜、免疫组化及电镜等方法观察其病理组织学特点、免疫组化表达及超微结构。结果:光镜的典型特点是肿瘤细胞弥漫性排列,呈圆形、椭圆形及不规则形,胞质丰富,嗜酸性,部分胞质内可见透明状小体,细胞核圆形或椭圆形,核膜厚,核仁清楚,有的细胞核呈空泡状。部分核偏向一侧似浆细胞样。细胞内外见红染的包涵体。免疫组化显示肿瘤可表达多种抗原。电镜观察特异性表现是胞质内见中间丝及圆形不规则形纤维状或轮状小体。结论:肿瘤细胞弥漫排列呈浆细胞样,免疫组化多方向表达,可向神经性、上皮性、肌性等方向分化。电镜下胞质内中间丝及纤维轮状小体是特异性诊断标志。     

影响贲门癌手术患者预后的相关因素分析

目的：探讨影响贲门癌患者生存时间的影响因素。方法：收集236例贲门癌患者临床资料和随访资料，使用单因素Log-rank检验、Cox比例危险模型对影响预后的因素进行单因素、多因素回归分析。结果：肿瘤长度、淋巴结转移、组织病理学类型和TNM分期对患者的预后有影响。结论：早发现、早治疗是提高患者生存率的关键。     

Effects of Imbalance of Apoptosis and Proliferation on Large Bowel Carcinogenesis in Mice

OBJECTIVE To observe the pattern of changes in the proliferation and apoptosis at different stages of large bowel carcinoma in mice, and to explore the effects of the imbalance of apoptosis and proliferation at different stages of large-intestine carcinogenesis.METHODS An experimental animal model for large intestine carcinogenesis of KUNMING-strain mice was used. The carcinomas were induced by subcuteneous injection of dimethylhydrazine (DMH) and the distribution and density changes of proliferating and apoptotic cells observed through multistages toward cancer formation. The animals were killed in groups at the 12th, 18th, 24th,and 32nd weeks of carcinoma induction. The apoptotic and proliferating cells were labeled separately using TUNEL and PCNA immunohistochemical staining methodsRF, RESULTS In the normal mouse mucosa, all the apoptotic cells were situated in the superficial layers, however, the proliferating cells were situated in the basement layers, and the amount of both were small. In the early stage of carcinoma induction, the proliferation and the apoptotic cells slightly increased in amount, but there were no obvious changes in their ratio. In the medium stage, the densities of both distinctly increased, but there were no obvious changes in the ratio. In the late stage, the densities of the proliferating and the apoptotic cells in the non-carcinoma mucosa were higher than those at other stages. The proliferating cells in the dysplastic mucosa increased progressively with the increasing degree of the lesions. Although the apoptotic cells increased, their changes did not occur with the degree of the lesions. Their ratio showed a decreasing tendency with the degree of the lesions.CONCLUSIONS (①The presence of an imbalance between cell proliferation and apoptosis was confirmed in the course of large intestine carcinogenesis in a mouse model. ②In the early stage of carcinoma induction both proliferation and apoptosis were at a low level; in the medium stage, they were both at a high level; and in the late stage (that is in carcinoma), proliferation was at a very high level, while apoptosis was at a low level. ③The proliferating cells increased progressively with the degree of dysplasia. There were no obvious changes in the apoptotic cells and their ratio to the proliferating cell sshowed a progressively increasing tendency. ④In the stage of cancer formation, the most essential change was the excessive decrease in the ratio of apoptosis to proliferation. These results support the hypothesis of “Cell Selective Proliferation“, which was raised by authors previously in a study on human large bowel carcinoma.     

Targeted disruption of the mouse prosaposin gene affects the development of the prostate gland and other male reproductive organs

The prosaposin gene encodes a 65-70 kilodalton (kd) protein, which is secreted or targeted to lysosomes. In lysosomes, prosaposin is the precursor of 4 activator proteins, designated saposins A, B, C, and D, which promote by acidic hydrolases, the degradation of glycosphingolipids with short oligosaccharide chains. Mutations of the prosaposin gene have been linked to several lysosomal storage disorders. An animal model was recently developed by creating a null allele in embryonic stem cells through gene targeting in order to investigate the phenotypic diversity of prosaposin mutations, the involvement of this protein in lysosomal storage diseases, and to develop potential therapeutic approaches. Mutant homozygous mice die at 35-40 days of age and neurological disorders contribute to their early death. Secreted prosaposin is present in milk and in cerebrospinal and seminal fluids. In the nervous system, prosaposin exhibits a trophic activity. Examination of reproduc-tive organs in homozygous mutant males shows several abnormalities such as a decrease in testis size with reduced spermiogenesis, and an involution of the prostate, seminal vesicle, and epididymis, although levels of testosterone in blood remain normal. In the prostate of homozygous mutants, only basal cells appear to be present, whereas secretory cells are absent. The epithelia in efferent ducts is formed by ciliated cells, whereas heterozygotes exhibit a majority of nonciliated cells. Our data indicate that prosaposin is involved in the development and maintenance of male reproductive organs. In prostatic epithelium, targeted disruption of the prosaposin gene appears to inactivate the mitogen-activated protein kinase pathway and to interfere with differentiation of secretory cells.     

Prostatosis treated with acupuncture and herbal medicine

According to differentiation of symptoms and signs, prostatosis was divided into pattern of dampness and heat in the lower energizer, pattern of qi stagnation and blood stasis, pattern of deficiency and cold in the lower abdomen, and pattern of qi deficiency and kidney deficiency. Prostatosis were treated mainly by acupuncture, plus moxibustion and Chinese medicine, and the effect was good. Author: Zhao Chang-quan (1949-), male, junior consultant doctor Translator: Huang Guo-qi     

VEGF、KDR的表达对肝癌的血管生成、生长、转移的影响

目的　研究血管内皮生长因子 (VEGF)及其受体KDR(kinaseinsertdomaincontainingre ceptor)对肝细胞肝癌的血管生成、生长、转移等方面的影响。　方法　对 45例肝癌、2 1例肝硬化、8例正常肝标本进行了免疫组化、原位杂交染色 ,然后行图像分析 ,观察VEGF、KDR的表达与肝癌病理特点之间的关系 ,并进行统计学分析。　结果　肝细胞肝癌中VEGF高表达 ;并与肝癌的血管生成相关 ;VEGF的表达强度与表达率均与肝癌的转移、包膜形成相关 ;KDR不仅表达于血管内皮细胞 ,还表达于部分肝癌细胞。　结论　VEGF在肝癌的血管生成、癌细胞转移、包膜形成中可能起到重要作用 ,KDR在肝癌细胞的表达可能是一种自分泌行为。