Bevacizumab and chemotherapy for recurrent glioblastoma: a single-institution experience

OBJECTIVE

Bevacizumab has been shown to be effective in the treatment of recurrent glioblastoma in combination with chemotherapy compared with historic controls but not in randomized trials.

METHODS

We conducted a retrospective analysis of patients treated for recurrent glioblastoma with bevacizumab vs a control group of patients, comparing progression-free survival (PFS) and overall survival (OS) between the two groups, and performed subgroup analysis based on age and performance status. Expression of vascular endothelial growth factor (VEGF) based on age was examined using DNA microarray analysis. We also evaluated the impact of bevacizumab on quality of life.

RESULTS

We identified 44 patients who received bevacizumab and 79 patients who had not been treated with bevacizumab. There was a significant improvement in PFS and OS in the bevacizumab-treated group. Patients of older age (> or =55 years) and poor performance status (Karnofsky Performance Status < or =80) had significantly better PFS when treated with bevacizumab, and bevacizumab-treated older patients had significantly increased OS. VEGF expression was significantly higher in older glioblastoma patients (aged > or =55 years). Patients treated with bevacizumab also required less dexamethasone use and maintained their functional status longer than the control group.

CONCLUSIONS

Bevacizumab in combination with chemotherapy may be a more effective treatment for recurrent glioblastoma and warrants further randomized prospective studies to determine its effect on survival. Bevacizumab also has more effect in those with older age and might reflect biologic differences in glioblastoma in different age groups as seen with the expression of vascular endothelial growth factor.

Possible involvement of brain tumour stem cells in the emergence of a fast-growing malignant meningioma after surgical resection and radiotherapy of high-grade astrocytoma: case report and preliminary laboratory investigation

The case of a 62-year old man diagnosed with radiation-induced meningioma (RIM) after treatment for astrocytoma with an unusually short latency period of 7 months is reported. The patient first presented with a 2-month history of memory decline. Magnetic resonance imaging (MRI) showed a tumour in the left parieto-temporal lobe. Gross total resection was performed and the tumour was confirmed to be an astrocytoma. The patient received cranial radiotherapy 2 weeks later, however 7 months after radiation treatment the patient presented with headache and vomiting. MRI showed massive meningeal enhancement in the left frontal lobe, which progressively enlarged. The patient's clinical condition deteriorated and a second craniotomy was performed with complete removal of the secondary tumour, which was shown to be a malignant meningioma. Immunohistochemical staining identified CD133-positive cells in both tumours. A rare fraction of brain tumour stem cells (BTSC) was isolated from the primary astrocytoma using a serum-free culture system, suggesting that BTSC may have been involved in the rapid emergence of RIM after resection and radiation of the primary astrocytoma.

Dentine bond strength and microleakage of flowable composite, compomer and glass ionomer cement

BACKGROUND

To assess in vitro the dentine bond strength and microleakage of three Class V restorations viz. flowable composite, compomer and glass ionomer cement.

METHODS

Eighteen dentine specimens were prepared and randomly distributed among three groups. Three kinds of restoration materials were each bonded on prepared dentine surfaces in three groups as per the manufacturers' instructions. Group Aelite: Tyrian SPE (a no-rinse, self-priming etchant) + One Step Plus (an universal dental adhesive) + Aeliteflo (a flowable composite); Group Dyract: Prime & Bond NT (a no-rinse, self-priming dental adhesive) + Dyract AP (a compomer); Group GlasIonomer: GlasIonomer Type II (a self-cured restorative glass ionomer). Fifteen dentine/restoration microtensile bond test specimens were prepared from each group and were subjected to microtensile bond strength testing. The bond interfaces were observed morphologically using a scanning electron microscope (SEM). Twenty-four cervical cavities of 4.0 mm mesiodistal length, 2.0 mm occlusogingival height and 1.5 mm depth were prepared at the cemento-enamel junction (CEJ) on both buccal and lingual surfaces of each tooth. The cavities were each filled with flowable composite (Group Aelite), compomer (Group Dyract) and glass ionomer cement (Group GlasIonomer) using the same material and methods as for the microtensile bond tests. Microleakage of each restoration was evaluated by the ratio of the length of methylene blue penetration along the tooth-restoration interface and the total length of the dentine cavity wall on the cut surface.

RESULTS

One-way ANOVA and least significant difference (LSD) tests revealed statistically significant differences among the dentine bond strength for Group Aelite (28.4 MPa), Group Dyract (15.1 MPa) and Group GlasIonomer (2.5 MPa). SEM images showed intimate adaptation in the restoration/dentine interfaces of Group Aelite and Group Dyract. All of the systems tested in this study presented microleakage. However, both Group Aelite (0.808) and Group Dyract (0.863) had significantly less microleakage than Group GlasIonomer (0.964). There were no statistically significant microleakage differences between Group Aelite and Group Dyract, and no statistically significant microleakage differences between the occlusal margin and gingival margin.

CONCLUSIONS

None of the systems tested in this study completely eliminated microleakage. However, both the flowable composite and compomer provided stronger dentine bond strengths and better margin sealing than the conventional glass ionomer cement. Occlusal forces exerted the same effects on microleakage of the occlusal margin and gingival margin in cervical cavities.

[Research on short-term biological stability and cytotoxicity of allogenic arteries cross-linked by dye-mediated photooxidation in vivo]

This study evaluated the biological stability and cytotoxicity of rabbit thoracic aorta cross-linked by dye-mediated photooxidation in vivo environment of blood flow. Rabbits, whose allogenic thoracic aorta was cross-linked by dye-mediated photooxidation (DMP, n=6) and glutaraldehyde (GA, n=6), were in the DMP group and GA group, respectively; rabbits, whose homogenic abdominal aorta was orthotopic transplanted (OT, n=6), were in the OT group. Then the donor arteries were transplanted into the position of the abdominal arteries of rabbits. After operation, the animals were fed for 1 month, then each of graft arteries was removed for observation. Biological stability was evaluated through histological analysis under optical microscope. Cytotoxicity was evaluated through ratio of coverage of endothelial cell (ES) under scanning-electron microscope. The results showed that no statistically significant difference was noted between DMP group and OT group (P>0.05); however, there was a significant difference between DMP group and GA group (P<0.01). The stability index in DMP group was much higher than that in GA group. There was a statistically significant difference between DMP group and GA group (P<0.01). Ratio was much higher in DMP group than in GA group. In conclusion, the arteries cross-linked by dye-mediated photooxidation treatment appeared to have higher biological stability and lower cytotoxicity in rabbit allogenic transplation model.

Heart rate variation and electroencephalograph--the potential physiological factors for thermal comfort study

Human thermal comfort researches mainly focus on the relation between the environmental factors (e.g. ambient temperature, air humidity, and air velocity, etc.) and the thermal comfort sensation based on a large amount of subjective field investigations. Although some physiological factors, such as skin temperature and metabolism were used in many thermal comfort models,they are not enough to establish a perfect thermal comfort model. In this paper,another two physiological factors, i.e. heart rate variation (HRV) and electroencephalograph (EEG), are explored for the thermal comfort study. Experiments were performed to investigate how these physiological factors respond to the environmental temperatures, and what is the relationship between HRV and EEG and thermal comfort. The experimental results indicate that HRV and EEG may be related to thermal comfort, and they may be useful to understand the mechanism of thermal comfort.

Effects of pig antibacterial peptides on growth performance and intestine mucosal immune of broiler chickens

Currently, substitutions for antibiotic growth promoters in animals are attracting interest. This study investigated the effects of pig antibacterial peptides (PABP) on growth performance and small intestine mucosal immune responses in broilers. Three hundred 1-d-old Arbor Acre male broiler chickens were randomly allocated to 5 groups with 60 birds per group. The groups were control group; PABP administered in drinking water at 20 and 30 mg/L of water; or PABP supplemented in feed at 150 and 200 mg/kg of diet. The birds were fed a corn-soybean based diet for 6 wk. Chickens were weighed weekly and killed after 42 d of feeding, and growth performance was measured. Samples of the duodenum and jejunum were collected. The villus height, mucosa thickness, alkaline phosphatase activity, and numbers of secreting IgA and goblet cells were evaluated. The PABP-treated groups had greater BW and average daily gain, greater height of villus and thickness of gut mucosa, greater activity of alkaline phosphatase, higher ratio of secreting IgA, and a greater number of goblet cells compared with the control group (P<0.05). In conclusion, PABP can improve the growth performance, increase the intestinal ability to absorb nutrients, and improve the mucosal immunity of the intestine.

Elevated expression of transmembrane IL-15 in immune cells correlates with the development of murine lupus: a potential target for immunotherapy against SLE

Presentation in trans by the Interleukin-15 receptor alpha chain (IL-15Ralpha) has been suggested as the main mechanism for IL-15 anchoring to the cell surface, but it is also evident that IL-15 can exist as a transmembrane protein. We herein demonstrate that replacement of the first 41 residues of human IL-15 (hIL-15) with Igkappa chain leader sequence resulted in secretion of most of the recombinant hIL-15 expressed in transfectant cells, thus identifying the transmembrane region of IL-15. A fusion protein (hIL-15Ralpha-Fc) between the extracellular domain of hIL-15Ralpha and the Fc fragment of IgG1 was prepared and shown to be able to bind with transmembrane IL-15 (tmIL-15). The level of tmIL-15 expression in macrophages, activated T cells and B cells from 6-month-old BXSB male mice, an animal model for systemic lupus erythematosus (SLE), was significantly increased compared with that from BXSB females or young males. In addition, hIL-15Ralpha-Fc was able to block the T cell stimulating and anti-apoptotic effect of the tmIL-15-positive BXSB macrophages in vitro. Intravenous administration of hIL-15Ralpha-Fc reduced the titre of autoantibodies against dsDNA and also proteinuria in aged BXSB males, implying that neutralization of IL-15 activity in vivo may be an effective way of treating SLE.

Development of a magnetic Single Cell Micro Array

Experiments using single cells are valuable for revealing individual cell behaviour, which is of interest to many biomedical researchers. In such experiments, various types of devices capable of aligning cells into organized arrays are often used. In this paper, we present a novel Single Cell Micro Array device that makes use of magnetic forces. Prototypes of this device have been fabricated, and successfully tested using Jurkat cells that have been labelled with nano-magnetic particles. Experimental results show that the prototypes are effective on capturing and placing the labelled cells in an array.

Development and feasibility study of a sensory-enhanced robot-aided motor training in stroke rehabilitation

Functional impairment of the upper limb is a major challenge faced by many stroke survivors. The present study aimed at developing a novel sensory-enhanced robot-aided motor training program and testing its feasibility in stroke rehabilitation. A specially designed robot handle was developed as an attachment to the Inmotion2 robotic system. This handle provided sensory stimulation through pins connected to small servo motors inside the handle. Vibration of the pins was activated during motor training once pressure on the handle reached a certain threshold indicating an active motion of the study subject. Nine chronic stroke survivors were randomly assigned to either a sensory-enhanced robot-aided motor training group (SERMT) or robot-aided motor training only group (RMT). All participants underwent a 6-week motor training program, performing target reaching movements with the specialized handle with or without vibration stimulation during training. Motor Status (MS) scores were measured for functional outcome prior to and after training. The results showed significant improvement in the total MS scores after training in both experimental groups. However, MS sub-scores for the shoulder/elbow and the wrist/hand increased significantly only in the SERMT group (p<0.05). Future studies are required to confirm these preliminary findings.

45 DEVELOPMENT OF BOVINE NUCLEAR TRANSFER EMBRYOS DERIVED FROM ADULT MARROW STROMAL CELLS AND FETAL MUSCLE CELLS

The use of less differentiated cells, such as marrow stromal cells (MSCs), as the nuclear donor may increase the efficiencies of somatic cell cloning in cattle. Healthy offspring was produced from bovine MSCs (Kato et al. 2004 Biol. Reprod. 70, 415–418); however, there is little information that directly compared the post-implantation survival among the clones originated from MSCs and other somatic cells. The objective of this study was to evaluate the developmental potential in vitro and in vivo of bovine NT embryos derived from adult MSCs and fetal muscle cells (FMCs). Primary cell populations of MSCs and FMCs were obtained from the femurs of 8- and 12-months-old Holstein cows (MSC1 and MSC2 groups, respectively) and a Holstein fetus at 8 months of gestation (FMC group), respectively. They were used as donor cells for the NT procedure (Murakami et al. 2005 Cloning Stem Cells 7, 77–81) at passages 1 to 3. Briefly, oocytes collected from cow ovaries were enucleated at 20 h post-in vitro maturation (IVM), and the donor cell was placed into the perivitelline space. The couplets were fused electrically, activated (10 μg mL–1 cycloheximide; 4 h), and cultured in CR1aa medium. Development in vitro of these embryos is summarized in Table 1. Data were analyzed by ANOVA. The fusion rates were higher in the MSC groups than in the FMC group. The rate of cleaved embryos was significantly lower (P < 0.05) in the MSC1 group than in the other groups. However, there were no significant differences among the groups in the rates of development into morulae/blastocysts on Day 6. A total of 8 and 3 fresh good quality Day 6 embryos in the MSC1 and FMC groups, respectively, were nonsurgically transferred to 6 naturally cycling Holstein females 6 days after estrus (3 recipients/group, 1–3 embryos/female). On Day 30 of gestation, none of the recipients were pregnant in the FMC group, while 2 recipients in the MSC1 group were diagnosed as pregnant via ultrasonography; they remained pregnant on Day 80 of gestation. In addition, a total of 4 Day 7 embryos cryopreserved in 1.8 m ethylene glycol plus 0.05 m trehalose were directly transferred to 4 synchronized recipients after thawing (1 embryo/female) in the MSC1 group. Of those, 2 females were pregnant on day 30 of gestation. These results indicate that the developmental potential in vitro of bovine NT embryos derived from adult MSCs was comparable to that of the embryos derived from fetal muscle cells, and that pregnancies were produced after transfer of the fresh and frozen–thawed NT embryos derived from the MSC, but the sample size was small. Further studies with more replicates are needed to evaluate viability in vivo of these cloned embryos for comparative purposes. Table 1.Development in vitro of bovine NT embryos derived from different cell types

A study for maternal thyroid hormone deficiency during the first half of pregnancy in China

BACKGROUND

Maternal thyroid hormone deficiency is the most common disorder of thyroid function during pregnancy and can influence the outcome for mother and foetus. The purpose of this study was to investigate the prevalence of thyroid hormone deficiency during the first half of pregnancy in iodine sufficient areas of China.

MATERIALS AND METHODS

Four thousand eight hundred pregnant women from 10 hospitals during the first 20 weeks of gestation were enrolled in this study. All sera obtained from pregnant women were measured for thyrotropin, free thyroxine and thyroid peroxidase antibody. Screening for thyroid hormone deficiency was performed on pregnant women using gestational age-specific reference intervals or non-pregnant population reference intervals.

RESULTS

With gestational age-specific reference intervals as the criterion, the prevalence of subclinical hypothyroidism at 4, 8, 12,16 and 20 weeks of gestation was 4.59%, 6.15%, 4.68%, 4.53% and 5.96%, respectively, and the prevalence of hypothyroxinaemia was 3.69%, 1.11%, 2.92%, 1.29% and 2.29%, respectively. Different prevalence was obtained when non-pregnant population reference intervals was used as the criterion. If non-pregnant population reference intervals were used, the percentage of potentially misclassified cases of subclinical hypothyroidism were 0.18%, 2.85%, 4.1%, 3.24%, and 3.21%, respectively, and 3.45%, 0.66%, 2.34%, 1.29%, and 1.83%, respectively, in potentially misclassified cases of hypothyroxinaemia.

CONCLUSIONS

The percentage of potentially misclassified cases of subclinical hypothyroidism and hypothyroxinaemia in pregnant women decreased by using the gestational age-specific reference intervals as a diagnostic criteria during the first half of pregnancy.

Multi-residue determination of pesticides in vegetables by gas chromatography/ion trap mass spectrometry

To monitor possible contamination of edible vegetables by common pesticides, an analytical method using gas chromatography combined with ion trap spectrometry (GC-IT/MS) was developed to measure simultaneously up to 39 pesticide residues, belonging to organophosphors, organochlorines, pyrethroids or carbamates classes, left on four kinds of popular vegetables. The procedure entails addition of acetone, dichloromethane, and sodium chloride to a small amount of vegetable, then the mixture was shaken intensively and centrifuged for phase separation. An aliquot of the organic layer was cleanup using solid-phase extraction (SPE) cartridges filled with graphitized carbon black (GCB) in combination with acidic aluminum oxide. Gas chromatography with ion trap mass spectrometer was then used for qualitative and quantitative determination of the pesticides. The GCB combination with acidic aluminum oxide was found more suitable than florisil, aluminum oxide and silicon dioxide for sample cleanup with recoveries above 70% for most pesticides in removing the majority of co-extracted matrices. Variation coefficients of the repeatability typically smaller than 20% have been achieved for a wide range of the investigated pesticides. A set of critical instrument parameters for the GC-IT/MS Varian system in the MS mode was established. Based on optimization work conducted in this study, the 39 pesticides were separated successively with the limits of detection between 0.02 and 0.1 mg/kg.

Research on the application of horseradish peroxidase and hydrogen peroxide to the oil removal of oily water

Horseradish peroxidase (HRP) has the advantages of low cost, obtaining convenience, broad substrate specificity, etc, so it may be a suitable kind of enzyme to remove dilute emulsified oil and dissolved oil from water. The effect factors of the oil removal using HRP, such as pH, concentrations of HRP and H2O2, additives, Fe2+ ion, temperature and reaction time were researched. When the initial oil concentration was 120 mg/L, the remaining oil concentrations of the synthetic oily water and an actual oily wastewater reached 24.83 mg/L and 21.30 mg/L, respectively. The treatment of oily water using HRP and H2O2 is feasible. It has good application prospects.

Prevalence of, and factors associated with, gastroesophageal reflux disease: a population-based study in Shanghai, China

The prevalence of gastroesophageal reflux disease (GERD) in China is lower than that in the Western countries, but appears to be increasing. The aim of this pilot study was to evaluate the prevalence of GERD in Shanghai, China, and to explore which population characteristics where associated with GERD. A sample of 1200 adult inhabitants of Shanghai, selected using randomized, stratified, multi-stage sampling, completed Mandarin translations of the Reflux Disease Questionnaire and GERD Impact Scale. Potential risk factors for GERD were examined by nested case-control analysis, using Cochran-Armitage trend testing and logistic regression analysis. The response rate was 86.2%; 919 responses were suitable for analysis. The prevalence of GERD, defined as heartburn and/or regurgitation of any frequency during the previous week, was 6.2% in Shanghai. Obesity and urban dwelling were associated with GERD (odds ratio 3.4, 95% confidence interval 1.3-9.3; and odds ratio 3.6, 95% confidence interval 1.2-10.4, respectively). The prevalence of GERD in Shanghai agreed with previous Chinese studies. GERD in Shanghai was associated with obesity and residency in an urban environment.