A randomized, phase II study of ATN-224 in patients with biochemically relapsed, hormone-naive prostate cancer: A DOD/PCF Prostate Cancer Clinical Trials Consortium trial

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Background: ATN-224 (choline tetrathiomolybdate) is an orally active, small molecule that has antiangiogenic and antitumor effects in prostate cancer (PCa) models. ATN-224 targets Cu2+/Zn2+superoxide dismutase 1 (SOD1) and suppress the generation of H2O2 leading to activation of a number of phosphatases, a group of negative growth regulatory enzymes. We hypothesized that ATN-224 may induce antitumor effect as an antiangiogenic (at 30 mg dose level) and possesses direct antitumor activity at higher dose (300 mg/day). Methods: PCa pts with PSA doubling time (PSADT) of < 12 months, no radiographic evidence of metastasis, no hormonal therapy within 6 months were enrolled. All pts had testosterone > 150 ng/dL at baseline. ATN-224 was administered at 2 dose levels. PSA progression was defined as at least a 50% increase in PSA and >5 ng/mL increase from baseline or post-treatment nadir and confirmed. Endpoints included the proportion of pts who did not have PSA progression for 24 weeks, change in PSA slope/PSADT, and assessment of safety and tolerability. The study was not powered to detect difference between the two groups. Results: 52 pts were enrolled at 6 centers. Fourteen of 27 (52%) in the low dose and 6/25 (24%) in the high dose cohort were PSA progression free for 24 weeks. One patient in high dose cohort showed PSA >50% decrease of 40 days duration. Pre- and on-treatment PSA kinetics are shown below. Median duration on study was 134 days in both groups. ATN-224 was well tolerated with a few reversible Grade 3/4 neutropenia and Grade 3 skin rash (both 4%). Conclusions: ATN-224 may have biologic activity in men with androgen-dependent PCa at low doses, as demonstrated by > 50% of pts being PSA progression free at 6 month and a significant decrease in mean PSA slope. The implication of this study is not clear without a comparative design and ceruloplasmin correlation which is still pending.

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A comparison of the fabrication times of all-ceramic partial crowns: Cerec 3D vs IPS Empress

Apart from precision, the time factor plays a decisive role in the fabrication of all-ceramic dental restorations. Therefore, the aim of this study was to compare two all-ceramic systems with regard to the time required for the fabrication of partial crowns [MODB]. The null hypothesis tested was that the fabrication times of CAD/CAM generated partial crowns are shorter than the fabrication times of partial crowns manufactured in the laboratory.

MATERIALS AND METHODS

In sixteen model pairs mounted in the articulator, which corresponded to different clinical situations, tooth 36 was prepared for an all-ceramic partial crown [MODB]. With the Cerec3D method [CHAIR], the fabrication of the restoration was simulated directly on the "phantom patient". The IPS Empress system [LAB] was used forthe indirectfabrication method via an impression of the phantom patient. Both methods were used for each preparation. The adhesive luting procedure was not simulated and, therefore, not measured.

RESULTS

The mean processing times [hh:mm:ss] were 00:35:05 (SD +/- 03:27 min) for the Cerec method and 04:17:54 (SD +/- 26:01 min) for the Empress method. The mean time on the phantom patient for process-induced activities was 11:47 minutes (SD +/- 02:08 min) for the Cerec method and 03:58 minutes (SD +/- 02:50 min) for the Empress method.

DISCUSSION

Time expenditure for fabrication is only one aspect in order to assess the suitability of a restoration system. Both methods enable the dentist to provide high quality all ceramic restorations. Although the Empress method showed a time advantage of 65% during the fitting phase and occlusal grinding-in on the phantom patient in comparison to the Cerec method, the time spent during the laboratory phase has to be considered as well.

Marginal Fit of Heat-pressed vs CAD/CAM Processed All-ceramic Onlays Using a Milling Unit Prototype

The marginal fit of all-ceramic restorations has an important influence on the clinical performance and lifetime of adhesively luted restorations. In proximal boxes, an average marginal gap of less than 100 μm is claimed. These clinical requirements are fulfilled by both processing procedures.

Telescopically retained removable partial dentures on CAD/CAM generated all-ceramic primary telescopes

The provision of patients with removable partial dentures on all-ceramic primary crowns with electroplated gold secondary parts is described as an alternative worthy of consideration in dental journals, lectures and in further training courses. The mode of operation is based on a precise, frictionless, passive fit between female and male components. To guarantee this even over large spans, intraoral joining of the individual components is necessary. However, this requires a different sequence of the treatment steps. The different procedures (conventional, procedure by Weigl, modified concept) are described in the following article. Clinical considerations, design principles, and special characteristics involved in producing the partial denture are explained.

Phonon softening in individual metallic carbon nanotubes due to the Kohn Anomaly

We have studied the line shape and frequency of the G band Raman modes in individual metallic single walled carbon nanotubes (M-SWNTs) as a function of Fermi level (epsilonF) position, by tuning a polymer electrolyte gate. Our study focuses on the data from M-SWNTs where explicit assignment of the G- and G+ peaks can be made. The frequency and line shape of the G- peak in the Raman spectrum of M-SWNTs is very sensitive to the position of the Fermi level. Within +/- variant Planck's over 2piomega/2 (where variant Planck's over 2piomega is the phonon energy) around the band crossing point, the G- mode is softened and broadened. In contrast, as the Fermi level is tuned away from the band crossing point, a semiconductinglike G band line shape is recovered both in terms of frequency and linewidth. Our results confirm the predicted softening of the A-symmetry LO phonon mode frequency due to a Kohn anomaly in M-SWNTs.

Fit of surgical guides--manufactured by InLab 3D

Based on an exclusively virtual implant planning and positioning concept, the fit of surgical-guide-like workpieces was evaluated in an in-vitro pilot study, manufactured with the InLab 3D system. From 85 maxillary casts, 8 were randomly selected. The first right maxillary incisor was removed. After optical impression of the maxillary anterior teeth, a drilling template was designed by the use of the InLab software, version 3.0. The mode "bridge" "dental database" was applied. The guidance was milled from a methacrylate block and braced on the adjacent teeth. After milling, they were checked for proper seat (without rocking). The discrepancies between the inner surface of the template and the opposing tooth surface was shown with a silcone based material, which rested on the casts after removing the template. The difference between the thickness of the silicone layer and the subjacent tooth surface was measured with a high resolution scanner. In order to characterize the fit of the 8 workpieces the average mean, average maximum and average minimum values of the fit were calculated in the buccal, incisal and palatinal area using the program Match 3D (W. Gloger, LMU): average mean: buccal: 65 microm; incisal: 116 microm; palatinal: 94 microm; average maximum: buccal: 162 microm; incisal: 202 microm; palatinal:190 microm; average minimum: buccal: 5 microm; incisal: 14 microm; palatinal: 15 microm. In the present study it was possible to produce drilling templates with the already commercially available InLab system. The results were presented at the Annual Meeting of the German Society of Computerized Dentistry 2007 as a short presentation.

Raman spectroscopy of single-wall boron nitride nanotubes

Single-wall boron nitride nanotubes samples synthesized by laser vaporization of a hexagonal BN target under a nitrogen atmosphere are studied by UV and visible Raman spectroscopy. We show that resonant conditions are necessary for investigating phonon modes of BNNTs. Raman excitation in the UV (229 nm) provides preresonant conditions, allowing the identification of the A1 tangential mode at 1370 cm(-1). This is 5 cm(-1) higher than the E(2g) mode in bulk h-BN. Ab initio calculations show that the lower frequency of bulk h-BN with respect to large diameter nanotubes and the single sheet of h-BN is related to a softening of the sp2 bonds in the bulk due to interlayer interaction.

Cannabidiol lowers incidence of diabetes in non-obese diabetic mice

Cannabidinoids are components of the Cannabis sativa (marijuana) plant that have been shown capable of suppressing inflammation and various aspects of cell-mediated immunity. Cannabidiol (CBD), a non-psychoactive cannabidinoid has been previously shown by us to suppress cell-mediated autoimmune joint destruction in an animal model of rheumatoid arthritis. We now report that CBD treatment significantly reduces the incidence of diabetes in NOD mice from an incidence of 86% in non-treated control mice to an incidence of 30% in CBD-treated mice. CBD treatment also resulted in the significant reduction of plasma levels of the pro-inflammatory cytokines, IFN-gamma and TNF-alpha. Th1-associated cytokine production of in vitro activated T-cells and peritoneal macrophages was also significantly reduced in CBD-treated mice, whereas production of the Th2-associated cytokines, IL-4 and IL-10, was increased when compared to untreated control mice. Histological examination of the pancreatic islets of CBD-treated mice revealed significantly reduced insulitis. Our results indicate that CBD can inhibit and delay destructive insulitis and inflammatory Th1-associated cytokine production in NOD mice resulting in a decreased incidence of diabetes possibly through an immunomodulatory mechanism shifting the immune response from Th1 to Th2 dominance.

Practice Parameter: diagnosis and prognosis of new onset Parkinson disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology

OBJECTIVE

To define key issues in the diagnosis of Parkinson disease (PD), to define features influencing progression, and to make evidence-based recommendations. Two clinical questions were identified: 1) Which clinical features and diagnostic modalities distinguish PD from other parkinsonian syndromes? 2) Which clinical features predict rate of disease progression?

METHODS

Systematic review of the literature was completed. Articles were classified according to a four-tiered level of evidence scheme. Recommendations were based on the evidence.

RESULTS AND CONCLUSIONS

1. Early falls, poor response to levodopa, symmetry of motor manifestations, lack of tremor, and early autonomic dysfunction are probably useful in distinguishing other parkinsonian syndromes from Parkinson disease (PD). 2. Levodopa or apomorphine challenge and olfactory testing are probably useful in distinguishing PD from other parkinsonian syndromes. 3. Predictive factors for more rapid motor progression, nursing home placement, and shorter survival time include older age at onset of PD, associated comorbidities, presentation with rigidity and bradykinesia, and decreased dopamine responsiveness. Future research into methods for earlier and more accurate diagnosis of the disease and identification and clarification of predictive factors of rapid disease progression is warranted.

Modelling the nucleation and chirality selection of carbon nanotubes

The selection of chiralities of single-walled carbon nanotubes is one of the key problems of nanotube science. We suggest that the chirality-selective growth of SWNTs could be achieved using chemical vapour deposition (CVD) by controlling the type of caps that form during the nucleation stage. As the catalyst can be solid during CVD, the formation of particular caps may be favoured by an epitaxial relationship to the catalyst surface. The corresponding tubes would then grow preferentially. We show by ab-initio calculations that the formation energy of some lattice-matched caps and tubes are 1-2 eV lower than the non lattice-matched structures.

Practice Parameter: Neuroprotective strategies and alternative therapies for Parkinson disease (an evidence-based review): [RETIRED]

OBJECTIVE

To define key issues in the management of Parkinson disease (PD) relating to neuroprotective strategies and alternative treatments, and to make evidence-based treatment recommendations.

METHODS

Two clinical questions were identified. 1) In a patient diagnosed with PD, are there any therapies that can slow disease progression? 2) Are there any nonstandard pharmacologic or nonpharmacologic therapies that have been shown to improve motor function in PD? Articles were classified according to a four-tiered level of evidence scheme. Recommendations were based on the evidence.

RESULTS AND CONCLUSIONS

1. Levodopa does not appear to accelerate disease progression. 2. No treatment has been shown to be neuroprotective. 3. There is no evidence that vitamin or food additives can improve motor function in PD. 4. Exercise may be helpful in improving motor function. 5. Speech therapy may be helpful in improving speech volume. 6. No manual therapy has been shown to be helpful in the treatment of motor symptoms, although studies in this area are limited. Further studies using a rigorous scientific method are needed to determine efficacy of alternative therapies.

Complex extra-intestinal complications of ulcerative colitis in a patient with alpha1-antitrypsin deficiency

Ulcerative colitis (UC) can manifest with a variety of extra-intestinal disorders frequently affecting the skin, joints, and liver. An aetiologic role of alpha1-antitrypsin deficiency in chronic inflammatory bowel disease has recently been suggested. We report a patient with UC and alpha1-antitrypsin deficiency who presented with disseminated cutaneous leucocytoclastic vasculitis clinically appearing with target-like purpuric patches and haemorrhagic oedemas. In addition, he displayed acute haemorrhage of the eyes and the respiratory tract consistent with a systemic vasculitic process. Moreover, he had autoimmune haemolytic anaemia. Systemic vasculitides, such as Wegener's granulomatosis, Churg-Strauss syndrome, and microscopic polyangiitis, could widely be excluded. Systemically administered glucocorticosteroids and azathioprine led to dramatic improvement of extra-intestinal symptoms. On the basis of alpha1-antitrypsin deficiency and UC, the present patient likely developed severe systemic vasculitis with multi-organ involvement. UC should at times be viewed within the context of a more generalized immune imbalance affecting multiple organs, and not as an isolated pathological entity. Testing for alpha1-antitrypsin deficiency in UC patients may detect individuals at higher risk of severe extra-intestinal involvement.

[Systemic therapy of chronic venous diseases]

The therapy of chronic venous insufficiency is multifactorial. Compression, interventional and operative approaches are available along with the possibility of systemic treatment. The efficacy of systemic venotonic medications, mostly phytotherapeutic agents, is controversial. Nonetheless in a number of clinical and laboratory studies, an effect was seen after use for 8-12 weeks. When administered appropriately, venotonic agents can show anti-edematous, anti-inflammatory, anti-oxidative, proteolytic effects as well as reducing capillary leakage. Furthermore they increase vein tone and lymph flow. Venotonic agents should be used if compression therapy alone is either not sufficient, contraindicated or not tolerable. They can be useful as a temporizing measure until surgical intervention is performed. Some of them can even be used in pregnancy, but the indications are very strict.

[Diagnosis and management of central nervous system infections in pediatric cancer patients]

Infections of the central nervous system (CNS) are a common cause of neurological abnormalities in pediatric oncology patients apart from cancer disease of the CNS. Often symptoms do not present unequivocally, impeding a clear distinction from other differential diagnosis. Repeated neurological examinations of the patient allow selecting the necessary laboratory tests and imaging techniques. As delayed antiinfectious treatment is associated with high mortality and severe sequelae of survivors, patients do need empirical therapy using adequate doses until diagnostic results allow a more specific treatment. This article provides the recommendations of the Infectious Diseases Working Party of the German Society for Pediatric Infectious Diseases (DGPI) and the German Society for Pediatric Hematology/Oncology (GPOH) for diagnosis and treatment of infections of the CNS in immunocompromised patients.

The aesthetics of all-ceramic veneered and monolithic CAD/CAM crowns

The aim of this study was to examine whether crowns fabricated from machinable blocks would achieve acceptable aesthetics and whether these could compete with the aesthetics of restorations obtained by individual layering technique. Fourteen patients, who were to receive single anterior crown restorations, participated in this study. For each person two kinds of crowns were provided: one crown was made with the Cergogold system. The second one was produced in a Cerec machine and was additionally stained. Three independent examiners assessed the aesthetic appearance of crowns fabricated to match each subject's anterior shade. A scale of 1-6 was used to assess the aesthetic adaptation of each crown, with 1 representing excellent characteristics and 3.5 marking the threshold for clinical acceptability. The examiners' scores were averaged, and the mean values were analysed with the Wilcoxon signed rank test (P<or=0.05). Regardless of the fabrication method the crowns were aesthetically acceptable in all 14 patients. The mean values for the layering technique and for the machined restorations did not differ significantly. Within the limits of this study it was documented, that machinable blocks could attain aesthetically satisfying results.

Murine B-cell leukemia lymphoma (BCL1) cells as a target for NK cell-mediated immunotherapy

Natural killer (NK) cells are important for their ability to recognize and lyse tumor cells and virus infected cells. NK cells express triggering receptors that are specific for non-MHC ligands. This article describes the 35S release cytotoxic assay, which measures the ability of NK cells derived from spleen cells taken from polyIC-treated mice to lyse B-cell leukemia (BCL1) cells. BCL1 cells express ligands for NKp46 on the cell surface membrane and they are sensitive to allogeneic but not syngeneic IL-2 activated natural killer cells.