Cardiovascular and Subjective Effects of the Novel Adenosine A(2A) Receptor Antagonist SYN115 in Cocaine Dependent Individuals

A(2A) receptor antagonists have been proposed as therapeutic tools for dopaminergically-relevant diseases, including Parkinson's disease and substance dependence. The acute subjective and cardiovascular effects of a novel, selective adenosine A(2A) receptor antagonist (SYN115) were examined. Across an 8-hour experimental testing day, 22 non-treatment seeking cocaine-dependent subjects received either placebo capsules (PO) at both the AM and PM dosing times (Plc/Plc, N = 9), or placebo in the AM and 100 mg SYN115 in the PM (Plc/SYN115, N =13). Cardiovascular measures (HR, BP) were obtained across the test day, and subjective effects (ARCI, VAS) were obtained once before and once after the AM and PM doses (four time points total). There were no between-group effects on cardiovascular function, however subjective effects consistent with stimulation were observed on the VAS scales in the SYN115 group. In cocaine-dependent subjects, SYN115 may produce stimulant-like effects through a unique mechanism of action. Due to known monoamine dysfunction related to chronic cocaine use, these effects may be specific to this population relative to healthy control or other patient populations.

Adoptive immunotherapy for postoperative hepatocellular carcinoma: a systematic review

The high risk of recurrence in post-operative hepatocellular carcinoma (HCC) highlights the need for an effective adjuvant treatment. A systematic review of randomised controlled trials (RCTs) was performed to evaluate the clinical efficacy of adjuvant adoptive immunotherapy (AIT) for post-operative HCC patients. Electronic (MEDLINE, EMBASE and Cochrane Library databases) and manual searches were conducted throughout May 2011 to identify RCTs evaluating postoperative AIT for patients with HCC. Methodological quality was assessed in accordance with the QUOROM statement. Four RCTs totalling 423 patients met the eligibility criteria. All RCTs reported significantly improved disease-free survival rate or reduced recurrence rate after treating with adjuvant AIT (p < 0.05). The overall survival rates of AIT group are slightly higher than those of the control group in one study. Moreover, AIT was a safe treatment, with fever as the main adverse effects. This study adds to the evidence that postoperative HCC patients treated with adjuvant AIT show an improvement in disease-free survival rate or recurrence rate.

Measuring tumor hypoxia with ¹⁸F-FETNIM PET in esophageal squamous cell carcinoma: a pilot clinical study

The purpose of this study was to evaluate hypoxia in esophageal squamous cell carcinoma (SCC) with (18)F-fluoroerythronitroimidazole positron emission tomography/computed tomography ((18)F-FETNIM PET/CT). We determined an imaging threshold for hypoxia, quantified the spatiotemporal variability of hypoxia in untreated tumor, and evaluated the ability of (18)F-FETNIM PET to predict clinical response following concurrent chemoradiotherapy (CCRT). Twenty-eight consecutive patients with inoperable SCC of the esophagus were consecutively accrued between April 2007 and June 2010. The first 10 patients received two pretreatment (18)F-FETNIM PET/CT scans on separate days. The remaining 18 patients only underwent (18)F-FETNIM PET/CT once before CCRT. The ratio of the maximum standardized uptake value (SUV(max) ) of 336 normal tissue regions (i.e. heart, lung, brain, or muscle) to the mean standardized uptake value (SUV(mean)) of the respective patient's spleen was calculated, and the imaging threshold for hypoxia defined as the level of uptake demonstrated by less than 5% of tissue regions. Among the patients with two pretreatment scans, each pair of scans was compared with respect to location and intensity of uptake to assess for baseline spatiotemporal variability. Logistic regression analysis was used to determine whether pretreatment imaging characteristics are predictive of clinical response. The mean and median ratios of the SUV(max) of tissue : SUV(mean) of spleen were nearly identical, and 95% of the ratios fell below 1.3. The mean Dice similarity coefficient for the hypoxic volumes on pretreatment PET scans acquired in the same patient on different days was 0.12 (range, 0.05-0.21). Individuals' tumor SUV(max) and SUV(mean) did not vary significantly, but on average, the geometric centers of hypoxic regions shifted 15 mm (range, 8-20 mm) from the first pretreatment scan to the second. SUV(max) was the imaging characteristic most predictive of treatment response (P= 0.041), with high SUVmax associated with poor clinical response. (18)F-FETNIM PET/CT can depict hypoxia in esophageal SCC. Prior to CCRT, tumor hypoxia demonstrates spatial variability on different days, although overall (18)F-FETNIM uptake remains similar. Baseline SUV(max) may be predictive of treatment response.

P5-08-02: Mammographic Breast Texture Predicts Benign Biopsy Results and Composition

Purpose: Investigate the relationship between pathology diagnosis, biopsy composition, and breast texture measured in digital mammogram in women who have had previous benign findings in their breast. The long-term goal of this project is to determine whether or not global breast texture is associated with tissue composition and biopsy results. Such a finding would be of interest because it would provide evidence that mammography images contain information related to breast biology beyond average density.

Materials and Methods: A total of 124 women who had previously received benign biopsies underwent an additional dual-energy/low dose full-field digital mammography (DXA) scan of the unaffected breast. Three measures of breast density (percent dense area (PD), percent fibroglandular volume (%FGV), absolute fibroglandular volume (FGV) from mammogram, 15 biopsy types including apocrine metaplasia and non-secretory pituitary adenoma, and four tissue compositions (collagen percent area, fat percent area, ductal percent area, epithelial percent area) were estimated from biopsies for each participant. In addition 45 breast texture features were measured on each screening image taken during the dual-energy mammography using custom software. Tissue composition at the biopsy location was estimated based on the average percent area of stained collagen, fat, ductal, and epithelial from up to 3 slides taken from the biopsy. Pathology results from the three slides were taken to indicate the tissue type.

Results: Neither mammographic percent density, %FGV, nor FGV showed significant association with either biopsy type or tissue composition. However, some of breast texture features were significantly associated with tissue type and tissue composition. The strongest associations were found between collagen percent area and the neighborhood gray tone difference matrix texture strength (R=0.26, P=0.005) and ductal percent area and the gray level contrast matrix homogeneity (GLCM HOM) (R=-0.30, P=0.001). When classified according to biopsy type, the univariate association between ductal percent area and GLCM HOM for apocrine metaplasia increased. (R=-0.55, P=0.007)

Conclusion: 10 breast texture features of the unaffected breast were significantly associated with local tissue composition and biopsy type. Further study will be required to determine whether this association is related to masking effects related to breast complexity or changes in breast biology driving changes in breast morphology.

CLINICAL RELEVANCE The use of texture measures as biomarkers of variations in breast biology is potentially clinically significant. This work indicates that texture measures are associated with some biological outcomes. It is possible that this work could be used to improve diagnostic utility of computer-aided diagnosis by weighting the probability of various benign outcomes according to the measured breast texture.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-08-02.

Homozygous carriers of the G allele of rs4664447 of the glucagon gene (GCG) are characterised by decreased fasting and stimulated levels of insulin, glucagon and glucagon-like peptide (GLP)-1

AIMS/HYPOTHESIS

The glucagon gene (GCG) encodes several hormones important for energy metabolism: glucagon, oxyntomodulin and glucagon-like peptide (GLP)-1 and -2. Variants in GCG may associate with type 2 diabetes, obesity and/or related metabolic traits.

METHODS

GCG was re-sequenced as a candidate gene in 865 European individuals. Twenty-nine variants were identified. Four variants that were considered to have a likelihood for altered functionality: rs4664447, rs7581952, Ile158Val and Trp169Ter, were genotyped in 17,584 Danes.

RESULTS

When examined in 5,760 treatment-naive individuals, homozygous carriers of the low frequency (minor allele frequency 2.3%) G allele of rs4664447, predicted to disrupt an essential splice enhancer binding site, had lower levels of fasting plasma glucose (mean ± SD, 4.8 ± 1.2 vs 5.5 ± 0.8 mmol/l, p = 0.004); fasting serum insulin (22 ± 14 vs 42 ± 27 pmol/l, p = 0.04); glucose-stimulated serum insulin (159 ± 83 vs 290 ± 183 pmol/l, p = 0.01) and adult height (165 ± 10 vs 172 ± 9 cm, p = 0.0009) compared with A allele carriers. During oral glucose tolerance and hyperglycaemic arginine stimulation tests, the plasma AUC for GLP-1 (730 ± 69 vs 1,334 ± 288 pmol/l × min, p = 0.0002) and basal and stimulated levels of serum insulin and plasma glucagon were ∼50% decreased (p < 0.001) among three homozygous carriers compared with nine matched wild-type carriers. rs7581952, Ile158Val and Trp169Ter (where 'Ter' indicates 'termination') variants of GCG did not significantly associate or co-segregate with the metabolic traits examined.

CONCLUSIONS/INTERPRETATION

Re-sequencing of GCG revealed a low frequency intronic variant, rs4664447, and follow-up physiological studies suggest that this variant in homozygous form may cause decreased fasting and stimulated levels of insulin, glucagon and GLP-1. Overall, our findings suggest that variation in GCG has no major impact on carbohydrate metabolism in the study populations examined.

The association of metabolic syndrome with reflux esophagitis: a case-control study

BACKGROUND

Obesity has been associated with reflux esophagitis. However, the association of metabolic syndrome with reflux esophagitis remains unknown.

METHODS

A case-control study of 372 subjects undergoing upper endoscopy during health checkups was conducted (182 patients with reflux esophagitis vs 190 age and gender-matched controls). We further measured their height, weight, waist circumference, hip circumference, blood pressure, triglyceride, high-density lipoprotein, and fasting blood glucose. Multivariable linear regression analysis was used to identify the independent risk factors associated with the presence of reflux esophagitis.

KEY RESULTS

Reflux esophagitis cases showed higher mean waist circumference (81.37 ± 0.68 vs 79.36 ± 0.70, P < 0.05), waist hip ratio (0.86 ± 0.01 vs 0.84 ± 0.01, P < 0.05) and fasting blood glucose (5.59 ± 0.10 vs 5.32 ± 0.08, P < 0.05) than those in controls. When adjusted for gender and age, multivariate analysis demonstrated that there was a positive dose-response relationship between reflux esophagitis and waist hip ratio (men: OR 3.41, 95% CI 1.52-7.62, women: OR 3.37, 95% CI 1.61-7.06), triglyceride (OR 2.07, 95% CI 1.12-3.82), fasting blood glucose (OR 1.81, 95% CI 1.12-2.94), and metabolic syndrome (OR 2.01, 95% CI 1.15-3.50), there was an inverse dose-response relationship between reflux esophagitis and high-density lipoprotein for men (OR 0.36, 95% CI 0.15-0.85).

CONCLUSIONS & INFERENCES

High waist hip ratio, triglyceride, fasting blood glucose, and metabolic syndrome were associated with increased risk factors for reflux esophagitis while high high-density lipoprotein for men correlated with a reduced risk of reflux esophagitis.

Long-wavelength-pumped upconversion single-photon detector at 1550 nm: performance and noise analysis

We demonstrate upconversion-assisted single-photon detection for the 1.55-μm telecommunications band based on a periodically poled lithium niobate (PPLN) waveguide pumped by a monolithic PPLN optical parametric oscillator. We achieve an internal conversion efficiency of 86%, which results in an overall system detection efficiency of 37%, with excess noise as low as 10(3) counts s(-1). We measure the dark count rate versus the upconversion pump-signal frequency separation and find the results to be consistent with noise photon generation by spontaneous anti-Stokes Raman scattering. These results enable detailed design guidelines for the development of low-noise quantum frequency conversion systems, which will be an important component of fiber-optic quantum networks.

Collaborative study to establish a World Health Organization International genotype panel for parvovirus B19 DNA nucleic acid amplification technology (NAT)-based assays

BACKGROUND AND OBJECTIVES

The aim of the collaborative study was to evaluate a panel of plasma samples containing different genotypes of parvovirus B19 (B19V) for use in nucleic acid amplification technology (NAT)-based assays.

MATERIALS AND METHODS

The panel of samples [Center for Biologics Evaluation and Research Parvovirus B19 Genotype Panel 1; National Institute for Biological Standards and Control (NIBSC) code number 09/110] comprises four different members, i.e. Member 1, Member 2, Member 3, and Member 4 (M1-M4); these represent genotypes 1, 2, 3a B19V, and a negative plasma control, respectively. Thirty-five laboratories from 13 different countries participated in the study. Participants assayed the panel members concurrently with the 2nd World Health Organization (WHO) International Standard for B19V DNA (NIBSC code 99/802) on four separate occasions.

RESULTS

A total of 44 sets of data were returned, 34 from quantitative assays and 10 from qualitative assays. The majority of assays used were in-house and based on real-time PCR. The results showed that all three genotypes were detected consistently by the majority of participants, although a small number of assays detected genotypes 2 and 3 less efficiently, or not at all. Real-time stability studies have indicated that the panel of B19V samples is stable under normal conditions of storage, i.e. ≤-70°C.

CONCLUSIONS

The four-member panel is intended for use in evaluating the ability of NAT assays to detect different B19V genotypes (M1-M3). Based on the results of the collaborative study, the panel was established as the 1st WHO International Reference Panel for parvovirus B19 genotypes.

Clinical observation of 73 nasopharyngeal carcinoma patients treated by helical tomotherapy: the China experience

The preliminary short-term clinical outcome of 73 nasopharyngeal carcinoma (NPC) patients treated with helical tomotherapy at our cancer institute has been evaluated. Between September 2007 and September 2009, 73 newly diagnosed NPC patients were treated with helical tomotherapy. The distributions of clinical stages according to the UICC 2002 Staging System were: 6, 27, 24, and 16 for Stage I, IIa-b, III, and IVa-b, respectively. The prescription dose was 70-74 Gy/33F to planning gross tumor volume containing the primary tumor and positive lymph nodes, with 60-62.7 Gy/33F to high risk planning target volume, while delivering 52-56 Gy/33F to low risk planning target volume. Twenty-four patients were treated with radiation therapy as single modality, 25 with concurrent cisplatin-based chemotherapy with or without anti-EGFR monoclonal antibody therapy, and 24 with concurrent anti-EGFR monoclonal antibody therapy. Setup errors were analyzed. Side-effects were evaluated with the established RTOG/EORTC criteria. Average beam-on-time was 468.8 sec/F (396.7-696.1 sec). The setup errors in the lateral, longitudinal and vertical directions were 0.00 ± 1.79 mm, -0.55± 2.17 mm and 0.38 ± 1.43 mm, corresponding to 3.80 mm, 4.20 mm, and 2.46 mm as the CTV-PTV margin in these directions. The grade 0, 1, 2 and 3 acute skin toxicity was 2.7%, 76.7%, 13.8% and 6.8%; the grade 0, 1, 2 and 3 acute mucositis was 1.4%, 32.9%, 60.2% and 5.5%; and the grade 0, 1, 2 and 3 acute xerostomia was 4.0%, 45.3%, 50.7% and 0, respectively. Only 5 patients suffered from grade 3 or 4 leucopenia. Xerostomia resolved with passing of time and no grade 2 or more xerostomia was noted one year after radiation therapy. Concurrent chemotherapy significantly increased incidence of severe acute toxicities. One month after radiation therapy the remission rates of primary tumor and positive lymph nodes were 91.8% and 98.1%, respectively. The median follow-up was 14.8 months. The one-year relapse-free survival, distant metastasis-free survival and overall survival was 95.6%, 97.2% and 94.8%, respectively. In conclusion, the incidence of severe acute toxicities and late xerostomia was relatively infrequent for NPC patients treated with helical tomotherapy. The long-term clinical outcome for these patients is under investigation.

Research on the reactivation of Syk expression caused by the inhibition of DNA promoter methylation in the lung cancer

The aim of this study was to study the expression of Syk gene and methylation in its promoter region in the lung cancer and to investigate the relationship between silencing of the Syk gene and DNA methylation of the Syk promoter region in lung cancer cell lines. Real-time PCR and immunohistochemistry were used to examine the Syk expression in specimens from 3 lung cancer cell lines and 16 lung cancer patients (tumor tissues and adjacent normal tissues). MSP was used to analyze the methylation status of the Syk promoter region. We also investigated the role of restoring Syk expression by using a DNA methyltransferase inhibitor, 5-aza-CdR, in suppressing invasion of lung cancer cell lines. No expression of the Syk gene was detected in the 3 lung cancer cell lines. In the 16 lung cancer patient samples, Syk expression was significantly lower in the tumor tissues than that in their adjacent normal tissues (P<0.05). Consistently, immunohistochemistry analysis of Syk protein expression showed that in the lung cancer tissues Syk protein expression was also significantly lower than that in their adjacent normal tissues. In the two lung cancer cell lines (NL9980, YTMLC-9) that lack the endogenous Syk expression, 4uM demethylation agent 5-aza-CdR treatment was able to reactivate the Syk gene expression, but not NCI-H446. In conclusion, hypermethylation leads to silencing of the Syk gene in human lung carcinoma cell lines. Methylation of the Syk promoter and loss of Syk expression in lung cancer cell lines are independent biomarkers. Syk may be a potential tumor suppressor in human lung cancer.

A Two-Step Optimization Method for Improving Multiple Brain Lesion Treatments with Robotic Radiosurgery

Planning robotic radiosurgery treatments for multiple (n > 3) metastatic brain lesions is challenging due to the need of satisfying a large number of dose-volume constraints and the requirement of prescribing different dose levels to individual targets. In this study, we developed a sequential two-step optimization technique to improve the planning quality of such treatments. In contrast to the conventional approach of where all targets are simultaneously planned, we have developed a two-step optimization method. In this method, the first step was to create treatment plans for individual targets. In the second step, the 3D dose matrices associated with each plan were exported to Dicom-RT digital files and subsequently optimized. For the optimization, a singular-value-decomposition (SVD) algorithm was implemented to minimize the dose interferences among different targets. Finally, we compared the optimized treatment plans with the treatment plans created using the conventional method to determine the effectiveness of the new method. Large improvements in target dose distributions as well as normal brain sparing were found for the two-step optimization treatment plans as compared with the conventional treatment plans. The two-step optimization significantly lowered the volume of normal brain receiving relatively low doses. For example, the normal brain volume receiving 12-Gy was reduced by averaged 42% (range 34%–47%) with the two-step optimization. Such improvements generally enlarged with increasing number of targets being treated regardless of target sizes. Of note, normal brain dose was found to increase non-linearly with increasing number of targets. In summary, a two-step optimization technique is demonstrated to significantly improve the treatment plan quality as well as reduce the planning effort for multi-target robotic radiosurgery.

The phosphorus footprint of China's food chain: implications for food security, natural resource management, and environmental quality

Efficient use of phosphorus (P) for producing food, preventing water pollution, and managing a dwindling rock P reserve are major challenges for China. We analyzed P stocks and flows in the Chinese food chain to identify where P use efficiency can be improved, where P leaks to the environment, and the research, technologies, and policies needed to improve P use. We found a high degree of inefficiency; of 6652 Gg P entering the food chain, only 1102 Gg P (18%) exit as food for humans. The greatest inefficiencies were a large build-up of soil P (3670 Gg P yr; 52% of P inputs) and high P losses to the environment from animal production (1582 Gg P yr; 60% of excreted P). Improving P use in China must focus on national-scale nutrient management strategies, better animal nutrition, and adoption of technologies and policies to reduce P discharges from the animal sector and recycle P as manures in agriculture.