Prognostic factors for survival in adult patients with cerebral low-grade glioma.

PURPOSE: To identify prognostic factors for survival in adult patients with cerebral low-grade glioma (LGG), to derive a prognostic scoring system, and to validate results using an independent data set. PATIENTS AND METHODS: European Organization for Research and Treatment of Cancer (EORTC) trial 22844 and EORTC trial 22845 are the largest phase III trials ever carried out in adult patients with LGG. The trials were designed to investigate the dosage and timing of postoperative radiotherapy in LGG. Cox analysis was performed on 322 patients from EORTC trial 22844 (construction set), and the results were validated on 288 patients from trial 22845 (validation set). Patients with pilocytic astrocytomas were excluded from this prognostic factor analysis. RESULTS: Multivariate analysis on the construction set showed that age > or = 40 years, astrocytoma histology subtype, largest diameter of the tumor > or = 6 cm, tumor crossing the midline, and presence of neurologic deficit before surgery were unfavorable prognostic factors for survival. The total number of unfavorable factors present can be used to determine the prognostic score. Presence of up to two of these factors identifies the low-risk group, whereas a higher score identifies high-risk patients. The validity of the multivariate model and of the scoring system was confirmed in the validation set. CONCLUSION: In adult patients with LGG, older age, astrocytoma histology, presence of neurologic deficits before surgery, largest tumor diameter, and tumor crossing the midline were important prognostic factors for survival. These factors can be used to identify low-risk and high-risk patients.     

Evaluation of lung scintigraphy using N-isopropyl-p-[123I]-iodoamphetamine

N-isopropyl-p-[123I]-iodoamphetamine (123I-IMP) was examined for its relevancy as a labeling medium of lung scintigraphy in 30 patients with lung diseases and 20 healthy subjects. Lung diseases were classified into carcinoma and diffuse lung disease, and the all subjects with normal lung were classified into smokers and nonsmokers. To assess the reduction curve of 123I-IMP, mean transit time was calculated. Forced spirography was performed and spirographic values were analyzed. Spirographic parameters examined were vital capacity percent (%VC), forced expiratory volume in 1 sec divided by forced vital capacity (%) (FEV1.0%), and blood gas data. In the correlation matrix, the mean transit time was correlated with blood gas data, and not with %VC or FEV1.0%. In patients with lung diseases, the mean transit time was significantly prolonged; however, the difference was not significant between groups of carcinoma and benign disease, and between groups of smokers and nonsmokers. Wash-out images were obtained by the subtraction technique using the first frame image and 100-min delayed image. In patients with lung carcinoma, 87.5% of the tumors were depicted on wash-out images. The lesions were also depicted well in benign lung diseases. But among findings of wash-out image by 123I-IMP, air trapping image by 133Xe study and XCT study, there are some discordances to be clarified.     

Pulse feeding with nitrate and phosphate in relation to tissue composition and nutrient uptake by some macroalgae from the Red Sea at Ghardaqa (Egypt)

This investigation aimed at determining the effects of experimental enrichment with either N or P or both elements on the tissue nutrient levels, and on the internal N: P molar ratios of three macroalgal species collected in the vicinity of Ghardaqa, Red Sea, Egypt The results obtained showed that the rates of nutrient (nitrate and phosphate) uptake were highly species dependent. Uptake rates of both nutrients were significantly higher for Codium than for either Dictyota or Galaxaura. For the three algae, uptake, except nitrate by Galaxaura, was rapid during the first 6 h of immersion and declined during the rest of the experiment. The observed increases in N levels after 6 h of enrichment decreased sharply after 24 h of enrichment. The fluctuations in tissue-N were accompanied by fluctuations in protein levels. Total carbohydrate content of the three macroalgae was decreased in seawater treatments enriched with either N or N+P for 24 h compared with non-enriched plants or plants enriched with P only. For the three macroalgae, enrichment with P resulted in consistent increases in tissue-P levels over the experimental period. The changes in the N:P ratios of the three plants were significantly correlated with the increases in tissue -P as compared to tissue -N. G. rugosa appeared to be the most strongly nutrient - limited of the three algal species studied and D. dichotoma was the least.     

Radiation Exposure by Three-Dimensional Rotational Angiography (3DRA) During Trans-catheter Melody Pulmonary Valve Procedures (TMPV) in a Pediatric Cardiac Catheterization Laboratory

This retrospective study aims to evaluate radiation exposure by three-dimensional rotational angiography (3DRA) during trans-catheter Melody pulmonary valve (TMPV) procedures. 3DRA has been reported to have added value in the management of complex congenital heart disease aiding in the performance of interventional procedures albeit with concerns of higher radiation exposure. We test the hypothesis that 3DRA does not cause additional radiation exposure during TMPV procedures. We analyzed all 81 TMPV procedures performed at St. Louis Children’s Hospital, MO, USA, from January 1, 2011 to December 31, 2014. Dose-area product (DAP), DAP indexed to body weight (DAP/BW), fluoroscopy time (FT), and weight–fluoroscopy time product of each procedure were recorded. We reviewed each procedure’s images to determine whether additional interventions were performed (e.g., pulmonary artery angioplasty or treatment of conduit pseudo-aneurysm). 3DRA was used in 36 % of the procedures. 3DRA group had a higher number of additional procedures performed. The 3DRA group did not differ from the non-3DRA group in DAP, DAP/BW, and weight–fluoroscopy time product. 3DRA does not cause greater radiation exposure during TMPV procedures.     

Developmental Expression of Eph and Ephrin Family Genes in Mammalian Small Intestine

Background  

Eph receptor tyrosine kinases EphB2 and EphB3, and ephrin-B1 ligand play a critical role in regulating small intestinal epithelial cell migration. Although well studied in developing brain, the expression pattern of Ephs/ephrins has not been delineated in the developing small intestine.     

Immunotherapy in the landscape of new targeted treatments for non-small cell lung cancer

Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related death worldwide. Active immunotherapies and molecules targeting tyrosine kinase receptors both offer new avenues for the treatment of NSCLC. Furthermore, their combinations or their administration along with standard treatments enlarges the potential for clinical benefit. Moreover, the discovery of biomarkers predicting the response to these new therapies should allow a better selection of patients susceptible to optimally benefit from these treatments. In this paper, we review the most promising active immunotherapies, antibodies and small molecules in the context of NSCLC management, focusing on compounds in phase III clinical development.     

Transcatheter Pulmonary Valve Replacement With the Melody Valve in Small Diameter Expandable Right Ventricular Outflow Tract Conduits

Objectives

This study sought to evaluate the safety, feasibility, and outcomes of transcatheter pulmonary valve replacement (TPVR) in conduits ≤16 mm in diameter.

Assessment of circulating FCεRIa in Chronic Spontaneous Urticaria patients and its correlation with clinical and immunological variables

Chronic spontaneous urticaria (CSU) is a chronic type characterized by episodes of wheals with or without angioedema. Autoantibody against the alpha subunit of Fc epsilon receptor (FcεRIa) was detected in CSU patients' sera. The study aims to evaluate the clinical utility of skin tests in CSU patients. In addition, it assesses the presence of circulating FcεRIa in CSU patients and their correlation with other clinical and immunological variables. The study includes 40 healthy controls and 40 CSU patients who had urticaria symptoms for at least 8 weeks. All subjects underwent the following tests: autologous serum skin test (ASST), autologous plasma skin test (APST), immunoglobulin E (IgE), antinuclear antibodies (ANA), antithyroid antibodies (ATA). An in-house enzyme-linked immunosorbent assay was used for FcεRIa detection. The prevalence of ANA and ATA in CSU was 7.5% and 20% respectively. Total IgE was significantly higher in CSU than in controls (p?<?0.0001). The study detected circulating antibody to FcεRIα in 2.5% of controls and 52.5% of CSU patients (p?<?0.0001). The prevalence of antibody to FcεRIa was 27.3% and 83.3% of ASST negative and positive patients respectively (p?=?0.0004). But the prevalence was 17.6% and 78.3% of APST negative and positive patients respectively (p?=?0.0002). In conclusion, Circulating antibody to FcεRIa has a role in the pathogenic mechanisms of CSU.     

Implementation of electronic Patient Reported Outcomes in pediatric daily clinical practice: the KLIK experience

Tijdschrift voor Kindergeneeskunde -