Creatine kinase BB and neuron specific r-enolase as biomarkers for lung cancer

The serum concentrations of both CK-BB and NSE in patients with various lung carcinoma have been determined by the enzyme immunoassay. Serum CK-BB levels were found to be significantly increased (less than 1.0 ng/ml) in patients with a small cell carcinoma (51 cases, 74.5%), adenocarcinoma (77 cases, 36.5%), and a squamous cell carcinoma (68 cases, 39.7%). The serum NSE levels also were increased (less than 6.0 ng/ml) in cases of small cell carcinoma (72.5%), adenocarcinoma (27.3%), and squamous cell carcinoma (26.5%). Since the serum concentrations of bos CK-BB and NSE changed in parallel with the clinical course, they may be useful biomarkers for monitoring the clinical course of patients with lung cancer, especially in cases of small cell carcinoma.     

New intraoperative cardioprotective strategies for myocardial protection

Three clinical techniques providing significant changes in the approach to myocardial protection have been reported recently. These techniques deviate from conventional practice, and they infer that normothermia is superior to hypothermia, retrograde cardioplegia is more advantageous than antegrade administration, and continuous cardioplegic delivery is preferable to intermittent dosage. Encouraging preliminary clinical results with warm-blood cardioplegia are reported, but rigid clinical and experimental testing against conventional methods is not yet available for evaluation. The ideal cardioprotective strategy has yet to be determined, but these preliminary data suggest strongly that incorporation of these techniques with conventional methods will improve intraoperative myocardial protection and provide the cardiac surgeon with an augmented arsenal of strategies that can be employed to provide increased flexibility.     

Positron emission tomography (PET) in "pure akinesia".

Positron emission tomography (PET) studies on regional cerebral glucose metabolism and [18F]fluorodopa uptake were performed on 3 patients with "pure akinesia without rigidity and tremors", 3 progressive supranuclear palsy (PSP) patients, and 5 patients with Parkinson's disease. The "pure akinesia" and PSP patients showed a marked decrease in glucose metabolism in the frontal cortex and striatum, and a decreased uptake of [18F]fluorodopa in the striatum. While the Parkinson's disease patients had a decreased uptake of [18F]fluorodopa in the striatum but no abnormality in the glucose metabolism. Magnetic resonance imaging (MRI) showed atrophy of the pretectum and dorsal pons in "pure akinesia" and PSP patients, but there was no such abnormality in the Parkinson's disease patients. As described above, patients with "pure akinesia" and PSP patients revealed similar findings on PET and MRI studies, while Parkinson's disease patients showed substantially different results.     

Granuloma formation and hemopoiesis induced by C36-48-mycolic acid-containing glycolipids from Nocardia rubra

As previously reported (I. Yano, I. Tomiyasu, S. Kitabatake, and K. Kaneda, Acta Leprologica 2:341-349, 1984), Nocardia rubra, one of the nonpathogenic actinomycetes, possesses three classes of mycolic acid-containing glycolipid, i.e., glucose mycolate, trehalose dimycolate, and trehalose monomycolate. The carbon chain length of their mycolic acids is shorter (C36-48) than that in mycobacteria (longer than C70), and the glycolipid consists of only alpha-mycolic acid. One intravenous administration of 500 micrograms of each purified glycolipid to ICR mice in the form of water-in-oil-in-water emulsion without any protein antigens caused prominent granuloma formation in the lungs, spleen, and liver. The lung index in the treated mice was about 3.5 times larger than that in the control mice (given water-in-oil-in-water emulsion only) at 1 week after the injection and then rapidly declined, while spleen and liver indices peaked at 2 weeks after the injection and persisted longer. The granuloma consisted of macrophages, some of which phagocytized glycolipid micelles, lymphocytes, monocytes, and neutrophils. In addition, many small hemopoietic islands were observed in the liver sinusoids, where various immature blood cells were trapped by the prominent cytoplasmic projections of Kupffer cells. The granuloma formation and hemopoiesis observed here are considered to be the most characteristic morphological expression of macrophage activation in these organs. This is the first report to show that such histological changes can be induced by chemically defined and homogeneous mycolic acid-containing glycolipids other than those of mycobacteria.     

Reduced-intensity unrelated cord blood transplantation for patients with advanced malignant lymphoma.

We report the results of reduced-intensity unrelated cord blood transplantation (RI-UCBT) in patients with advanced malignant lymphoma. Twenty patients (median age, 46.5 years; range, 27-66 years) underwent RI-UCBT with a preparative regimen consisting of fludarabine 125 mg/m2 , melphalan 80 mg/m 2 , and 4 Gy of total body irradiation. The median infused total cell dose was 2.75 x 10(7)/kg (range, 2.3-3.4 x 10(7)/kg). Graft-versus-host disease (GVHD) prophylaxis was composed of cyclosporine or tacrolimus alone. Fifteen patients achieved primary neutrophil engraftment after a median of 20 days. Eight patients developed grade II to IV acute GVHD, and 2 developed chronic GVHD. Of the 16 patients with evaluable disease, 10 achieved a complete response. Primary disease recurred in 1 patient, and transplant-related mortality within 100 days occurred in 8 of 20 patients. The estimated 1-year probability of progression-free survival was 50%. These data suggest that RI-UCBT is a feasible option for patients with refractory lymphoma who lack an HLA-matched donor.