Phytotoxic Metabolites Produce by Fusarium oxysporum f. sp. cubense Race 2

Banana is a major tropical fruit crop but banana production worldwide is seriously threatened due to Fusarium wilt. Fusarium oxysporum f. sp. cubense (Foc), the causal agent of Fusarium wilt of banana (also referred as Panama disease) is an asexual, soil inhabiting facultative parasite. Foc isolates can be classified into three races that are not defined genetically, but for their pathogenicity to different banana cultivars. Despite mycotoxins being some of the best studied virulence factors of phytopathogenic fungi and these have been useful for the prediction of Foc virulence on banana plants, toxins produced by Foc race 2 strains have not been previously identified. The aim of this contribution was to identify the phytotoxic metabolites closely related to banana wilt caused by a Foc race 2 strain. We used an in vitro bioassay on detached banana leaves to evaluate the specificity of the microbial culture filtrates before a partial purification and further identification of Foc race 2 phytotoxins. A 29-day-old host-specific culture filtrate was obtained but specificity of culture filtrate was unrecovered after partial purification. The non-specific phytotoxins were characterized as fusaric acid, beauvericin, and enniatin A. Whereas some, if not all, of these phytotoxins are important virulence factors, a proteinaceous fraction from the specific 29-day-old culture filtrate protected the leaves of the resistant banana cultivar from damage caused by such phytotoxic metabolites.

Effect of available space and previous contact in the social integration of Saint Croix and Suffolk ewes

Reproduction in tropical sheep is not affected by season, whereas the reproductive cycle of temperate-climate breeds such as Suffolk depends on the photoperiod. Close contact with tropical ewes during the anestrous period might induce Suffolk ewes to cycle, making the use of artificial light or hormonal treatments unnecessary. However, the integration of both breeds within the social group would be necessary to trigger this effect, and so the aim of the experiment was to determine the speed of integration of 2 groups of Saint Croix and Suffolk ewes into a single flock, according to space allowance and previous experience. For this, 6 groups of 10 ewes (half from each breed) from both breeds, housed at 2 or 4 m/ewe (3 groups/treatment) and with or without previous contact with the other breed, were monitored for 3 d. Each observation day, the behavior, movement, and use of space of ewes were collected during 10 min at 1-h intervals between 0900 and 1400 h. Generalized linear mixed models were used to test the effects of breed, space allowance, and previous experience on behavior, movement, and use of space. Net distances, interbreed farthest neighbor distance, mean interbreed distance, and walking frequencies were greater at 4 m/ewe ( < 0.05). Intrabreed nearest neighbor, mean intrabreed neighbor, and interbreed nearest neighbor distances and minimum convex polygons at 4 m/ewe were greatest for Saint Croix ewes, whereas the opposite was found for lying down ( < 0.05). Experienced ewes showed larger intrabreed nearest neighbor distances, minimum convex polygons, and home range overlapping ( < 0.05). Experienced ewes at 4 m/ewe showed longest total distances and step lengths and greatest movement activity ( < 0.05). Experienced ewes walked longer total distances during Day 1 and 2 ( < 0.05). Lying down frequency was greater for Day 3 than Day 1 ( < 0.05), and Suffolk ewes kept longer interindividual distances during Day 1 ( < 0.05). After 3 d of cohabitation, Suffolk and Saint Croix ewes did not fully integrate into a cohesive flock, with each breed displaying specific behavioral patterns. Decreasing space allowance and previous experience resulted in limited benefits for the successful group cohesion. Longer cohabitation periods might result in complete integration, although practical implementation might be difficult.

Epstein-Barr virus-specific CD8(+) T lymphocytes from diffuse large B cell lymphoma patients are functionally impaired

Epstein-Barr virus (EBV) is a persistent virus with oncogenic capacity that has been implicated in the development of aggressive B cell lymphomas, primarily in immunosuppressed individuals, although it can be present in immunocompetent individuals. Changes in the function and clonal diversity of T lymphocytes might be implied by viral persistence and lymphoma development. The aim of the present study was to evaluate the frequency, phenotype, function and clonotypical distribution of EBV-specific T cells after peripheral blood stimulation with a virus lysate in newly diagnosed patients with diffuse large B cell lymphoma (DLBCL) aged more than 50 years without prior histories of clinical immunosuppression compared with healthy controls. Our results showed impaired EBV-specific immune responses among DLBCL patients that were associated primarily with decreased numbers of central and effector memory CD8(+) T lymphocytes. In contrast to healthy controls, only a minority of the patients showed CD4(+)/tumour necrosis factor (TNF)-α(+) T cells expressing T cell receptor (TCR)-Vβ17 and CD8(+)/TNF-α(+) T cells with TCR-Vβ5·2, Vβ9 and Vβ18 in response to EBV. Notably, the production of TNF-α was undetectable among TCR-Vβ5·3(+), Vβ11(+), Vβ12(+), Vβ16(+) and Vβ23(+) CD8(+) T cells. In addition, we observed decreased numbers of CD4(+)/TNF-α(+) and CD8(+)/TNF-α(+), CD8(+)/interleukin (IL)-2(+) and CD8(+)/TNF-α(+)/IL-2(+) T lymphocytes in the absence of T cells capable of producing TNF-α, IL-2 and IFN-γ after EBV stimulation simultaneously. Moreover, DLBCL patients displayed higher IL-10 levels both under baseline conditions and after EBV stimulation. These findings were also observed in patients with positive EBV viral loads. Prospective studies including a large number of patients are needed to confirm these findings.

On the prediction of Hodgkin lymphoma treatment response

PURPOSE

The cure rate in Hodgkin lymphoma is high, but the response along with treatment is still unpredictable and highly variable among patients. Detecting those patients who do not respond to treatment at early stages could bring improvements in their treatment. This research tries to identify the main biological prognostic variables currently gathered at diagnosis and design a simple machine learning methodology to help physicians improve the treatment response assessment.

METHODS

We carried out a retrospective analysis of the response to treatment of a cohort of 263 Caucasians who were diagnosed with Hodgkin lymphoma in Asturias (Spain). For that purpose, we used a list of 35 clinical and biological variables that are currently measured at diagnosis before any treatment begins. To establish the list of most discriminatory prognostic variables for treatment response, we designed a machine learning approach based on two different feature selection methods (Fisher's ratio and maximum percentile distance) and backwards recursive feature elimination using a nearest-neighbor classifier (k-NN). The weights of the k-NN classifier were optimized using different terms of the confusion matrix (true- and false-positive rates) to minimize risk in the decisions.

RESULTS AND CONCLUSIONS

We found that the optimum strategy to predict treatment response in Hodgkin lymphoma consists in solving two different binary classification problems, discriminating first if the patient is in progressive disease; if not, then discerning among complete and partial remission. Serum ferritin turned to be the most discriminatory variable in predicting treatment response, followed by alanine aminotransferase and alkaline phosphatase. The importance of these prognostic variables suggests a close relationship between inflammation, iron overload, liver damage and the extension of the disease.

Pharmacokinetics of enrofloxacin after multiple subcutaneous and intramuscular administrations in adult ostriches

1. The objective of the study was to evaluate the comparative pharmacokinetic behaviour of enrofloxacin in adult ostriches after single and multiple intramuscular (IM) and subcutaneous (SC) administrations. In addition, tissue tolerance was evaluated. 2. Enrofloxacin was well absorbed, but showed a short permanence after both administration routes. After multiple dose administrations the maximum and minimum peak plasma concentrations were very similar for both routes, obtaining a steady state phase from the second dose that extended until the last evaluated administration. 3. There was no significant accumulation after multiple IM or SC doses; however, there were differences in a fluctuation index after multiple intramuscular administrations that could be related to muscle damage. 4. The different microbiological efficacy indicators (PK/PD indices) obtained, the pharmacokinetic behaviour and CK serum concentrations suggest that subcutaneous enrofloxacin administration of 15 mg/kg every 12 h produce and maintain an efficient concentration of antibiotic that is a safer and more effective therapeutic option than intramuscular administration.

The effect of single-file reciprocating systems on Substance P and Calcitonin gene-related peptide expression in human periodontal ligament

AIM

To quantify the effect of two single-file reciprocating root canal preparation systems on Substance P (SP) and Calcitonin gene-related peptide (CGRP) expression in healthy human periodontal ligament (PDL).

METHODOLOGY

Forty PDL samples were obtained from healthy premolars where extraction was indicated for orthodontic reasons. Prior to extraction, 20 of these premolars were divided equally in two groups, and then, root canals were prepared using one of two different single-file systems: WaveOne and Reciproc. Ten premolars were prepared with hand files and served as a positive control group. The remaining 10 premolars where extracted without treatment and served as a negative control group. All PDL samples were processed, and SP and CGRP were measured by radioimmunoassay.

RESULTS

Greater SP and CGRP expression were found in the hand instrumentation group (1.220 pmol SP and 0.084 pmol CGRP per mg of PDL), followed by the WaveOne group (0.908 pmol SP and 0.046 pmol CGRP per mg of PDL) and the Reciproc group (0.511 pmol SP and 0.022 pmol CGRP per mg of PDL). The lower SP and CGRP values were associated with the intact control group (0.453 pmol SP and 0.018 pmol CGRP per mg of PDL). The Kruskal-Wallis test revealed significant differences between groups (P < 0.001). Post hoc Tukey HSD tests revealed significant differences in SP and CGRP expression between intact teeth in the control group and all the other groups (P < 0.001) except with the Reciproc group (P = 0.165 and P = 0.42 for SP and CGRP, respectively). Hand instrumentation was associated with significant differences with all the other groups (P < 0.001). Differences between the WaveOne and Reciproc groups were also significant (P < 0.001).

CONCLUSION

Substance P and CGRP expression in PDL cells increased when teeth were prepared with WaveOne as well as with hand instrumentation. Reciproc maintained SP and CGRP levels in line with the negative control group.

[Antimicrobial drugs errors: the silent epidemic in patient safety]

INTRODUCTION

Prescribed drugs and the mistakes in the administration to patient is the first cause of adverse events in the hospitals. The aim of this study has been to evaluate antimicrobial drug mistakes in one of our hospital wards in a two year period 2005 and 2006.

METHODS

All the errors were reported through the National Health Service IR2 form (England) on a voluntary basis and classified by means of process, type of errors, their causes and contributory factors, as well as the severity. We analyzed the economic costs.

RESULTS

. A 1.3% of the inpatients had an antimicrobial error in the administration to the patient (0.84 by 1,000 prescribing orders). Classified by processes, the administration (32.4%) and dispensation (44.1%) were the most frequent errors. By type of error: the erroneous medication (32.4%), the main root cause the human factors (58.8 %) and the contribution factor due to design of tasks (55.9 %). The 5.9% of errors were severe events, mainly in the group of the betalactamic drugs, and mainly by parenteral administration (50%). Conclusions. Antimicrobial drug errors, frequent and sometimes severe, suppose a silent epidemic not being detected without the patient safety methodology. They represent a high cost for a hospital.

Design of a continuous wave blood flow bi-directional Doppler system

This paper describes the design of a continuous wave blood flow bi-directional Doppler system based on an open, high-resolution architecture that is portable and low cost. The system incorporates the advantages of expensive systems with dedicated hardware. The system is composed of a flow detector probe, a signal conditioning stage, a direction detection module, a signal processing stage and a graphic user interface. The direction detection of the signal is achieved using a fast digital phasing filter. The Doppler signal is processed using a short-time Fourier transform-based algorithm. This is commonly used as a reference. Nevertheless, the system allows us to incorporate alternative high-resolution spectral estimation methods that might offer more precise information to the specialist.

[Suspicion of metastases in laryngeal carcinomas]

OBJECTIVE

To look for models predicting metastasis in laryngeal/hypopharyngeal carcinomas.

DESIGN

Prospective study.

PATIENTS

Sixty patients bearing laryngeal squamous cell carcinoma who were treated with curative purposes were followed prospectively with at least 10-year follow-up.

PARAMETERS

Clinical (Staging, site, age, alcohol and smoking intake, surgery on the primary tumor, neck surgery) and pathological (size, number of metastatic lymph nodes, T and N staging, degree of differentiation, Jakobsson's and Glanz's scoring of malignancy, both scores in biopsies and surgical specimens) parameters were recorded in each case.

METHODS

A multivariate analysis was performed to find out those parameters independently related to presence of metastases.

RESULTS

The prospective study rendered tumor burden and Glanz's scoring from biopsies to be independently related with the presence of metastases.

CONCLUSIONS

Malignancy grading systems must be included in laryngeal carcinoma patients' planning of neck treatment.

Estudio de la estancia tras laringuectomía total: análisis retrospectivo multivariable de 442 laringuectomías totales

INTRODUCTION

Pharyngocutaneous salivary fistula is the most common complication following total laryngectomy. Fistulae can lead to prolonged hospitalization and increased patient morbidity.

OBJECTIVE

To investigate those factors related to increased length of stay following total laryngectomy. To further analyze those related with fistula after surgery.

MATERIAL AND METHODS

Retrospective study on 442 patients who undenwent total laryngectomy. Study of the covariance (ANCOVA). Uni and multivariate analysis of factors related to salivary fistula.

RESULTS

We identified alcohol intake, year of surgery and salivaly fistula as factors independently related with increased length of stay at the hospital. Factors independently related with fistula were alcohol intake, tumors affecting tongue base or pyriform sinus, surgeon, fever in the inmediate postoperative period, or wound closure using fibrin blue (negative association with the later).

CONCLUSIONS

Pharyngocutaneous salivary fistula increases three times hospital length of stay in patients undergoing total laryngectomy. We identified the surgeon as the factor more closely related with this complication, and we suggest the need to create well-defined head and neck cancer groups to deal with these surgical procedures.

The effect of social rank on the physiological response during repeated stressful handling in Zebu cattle (Bos indicus)

Although the order of entry to a handling chute is related to social rank, it is still not clear what the consequences are for Zebu cattle of occupying different ranks when being exposed repeatedly to a stressful handling procedure. Eighteen Brahman cows were observed for 243 h to obtain information on social interactions. From that information, indices of success in displacing other individuals of the herd were calculated to reflect social status of each cow. One week after behavioral observations, the cows were forced 19 times to enter a handling chute where they were palpated and 7 ml of blood was collected from their caudal vein. To have an adrenal activity profile along the experimental period, five blood samples (Days 2, 6, 10, 15, and 19) were chosen for cortisol determination. On each sampling day, the average time in the chute, the order of entry, and a value of entrance consistency were calculated. On average, the high-ranking cows entered the chute before the medium- and low-ranking cows. Medium-ranking cows showed higher consistency when entering the race than high- and low-ranking cows. Low-ranking cows had significantly lower cortisol levels than the other two groups since the second sample (Day 6 in the race), and had higher cortisol levels the first time handled than at subsequent sampling days. It is suggested that low-ranking cows adopt a passive strategy that allows them to have a better control over the stressful event, while high-ranking cows respond with higher cortisol levels perhaps because of the need to become aroused to deal with challenges. It was concluded that the herd (a) habituated to repeat handling in a squeeze chute and (b) low-ranking cows responded with lower cortisol concentration to handling.

Treatment of neuroendocrine tumours in adults with 131I-MIBG therapy

This is a retrospective review of 131I-MIBG therapy for metastatic neuroendocrine tumours in 25 adult patients. The tumours comprised 17 carcinoids, six paragangliomas, one somatostatinoma and one intestinal smooth muscle sarcoma. All patients (age range 28-84 years) had stage IV disease and a positive diagnostic 123I-MIBG scan. Patients received 11.1 GBq (300 mCi) of 131I-MIBG given in three cycles at 3-monthly intervals. The mean cumulative dose was 27.7 GBq (751 mCi). Symptomatic response was observed in 80%, hormonal response in 55% and tumour response in 48% (WHO criteria). Of the 25 patients, 40% are still under follow-up. Death was due to disease progression in all except one. The median survival time was 48 months from diagnosis of metastatic disease, and 17 months from the last 131I-MIBG therapy. The 5-year survival rate was 59% (95% confidence interval, 34%-78%). There was no statistical difference in survival between previously treated (chemo/radiotherapy) and treatment-naive patients. Side-effects were minimal and commonly include nausea (in the first 24 h) and a transient fall in platelet count. 131I-MIBG provides a good therapeutic response in patients with metastatic neuro-endocrine tumours.

Laser augmented by brachytherapy versus laser alone in the palliation of adenocarcinoma of the oesophagus and cardia: a randomised study

BACKGROUND

Many patients with advanced malignant dysphagia are not suitable for definitive treatment. The best option for palliation of dysphagia varies between patients. This paper looks at a simple technique for enhancing laser recanalisation.

AIM

To assess the value of adjunctive brachytherapy in prolonging palliation of malignant dysphagia by endoscopic laser therapy.

PATIENTS

Twenty two patients with advanced malignant dysphagia due to adenocarcinoma of the oesophagus or gastric cardia, unsuitable for surgery or radical chemoradiotherapy.

METHODS

Patients able to eat a soft diet after laser recanalisation were randomised to no further therapy or a single treatment with brachytherapy (10 Gy). Results were judged on the quality and duration of dysphagia palliation, need for subsequent intervention, complications, and survival.

RESULTS

The median dysphagia score for all patients two weeks after initial treatment was 1 (some solids). The median dysphagia palliated interval from the end of initial treatment to recurrent dysphagia or death increased from five weeks (control group) to 19 weeks (brachytherapy group). Three patients had some odynophagia for up to six weeks after brachytherapy. There was no other treatment related morbidity or mortality. Further intervention was required in 10 of 11 control patients (median five further procedures) compared with 7/11 brachytherapy patients (median two further procedures). There was no difference in survival (median 20 weeks (control), 26 weeks (brachytherapy)).

CONCLUSIONS

Laser therapy followed by brachytherapy is a safe, straightforward, and effective option for palliating advanced malignant dysphagia, which is complementary to stent insertion.

Observation of color-transparency in diffractive dissociation of pions

We have studied the diffractive dissociation into dijets of 500 GeV/c pions scattering coherently from carbon and platinum targets. Extrapolating to asymptotically high energies (where t(min)-->0), we find that when the per-nucleus cross section for this process is parametrized as sigma = sigma0Aalpha, alpha has values near 1.6, the exact result depending on jet transverse momentum. These values are in agreement with those predicted by theoretical calculations of color-transparency.

Direct measurement of the pion valence-quark momentum distribution, the pion light-cone wave function squared

We present the first direct measurements of the pion valence-quark momentum distribution which is related to the square of the pion light-cone wave function. The measurements were carried out using data on diffractive dissociation of 500 GeV/c pi(-) into dijets from a platinum target at Fermilab experiment E791. The results show that the /q&q> light-cone asymptotic wave function describes the data well for Q2 approximately 10 (GeV/c)(2) or more. We also measured the transverse momentum distribution of the diffractive dijets.

Search for rare and forbidden Charm Meson decays D0 --> Vl+l- and hhll

We report results of a search for flavor-changing neutral current (FCNC), lepton flavor, and lepton-number violating decays of the D0 (and its antiparticle) into three and four bodies. Using data from Fermilab charm hadroproduction experiment E791, we examine modes with two leptons (muons or electrons) and a rho(0), K( *0), or straight phi vector meson or a nonresonant pi(pi), Kpi, or KK pair of pseudoscalar mesons. No evidence for any of these decays is found. Therefore, we present branching-fraction upper limits at 90% confidence level for the 27 decay modes examined (18 new).

Some effects of repeated handling and the use of a mask on stress responses in zebu cattle during restraint

The objective of this investigation was to evaluate the effect of repeated handling and the use of a mask on the order of entry, temperament, cortisol concentration and heart and respiratory rates of Brahman cattle during restraint in a squeeze chute. In the first experiment, 18 cows were restrained in the chute for 10min on 19 test-days and blood samples were collected during five of the trials. Habituation to handling was reflected by a decrease in cortisol concentration as the study advanced (P<0.01). In the second experiment, conducted 6 months later, animals were randomly allotted to two groups, alternating the use of a mask over test-days while restraining the cows in the chute for 3min. Respiratory and heart rates were measured at the beginning and end of each 3min trial. A blood sample was also taken at the end of each trial. Respiratory rates decreased while the animals were restrained and this decrease tended to be greater (P=0.09) when the animals were wearing masks (3.06) than when not (2.2breaths/min). Heart rates also decreased and more so for masked animals (10.6beats/min) than for non-masked (5.0, P<0.01). Cortisol values tended to be higher (9.9 versus 4.7ng/ml, P=0.08) when animals were restrained without a mask. Temperament scores were lower (P>0.01) when cows were masked and have a relative high correlation (r=0.58) with flight distance values, (P<0.05). Finally, the order of entrance was found consistent over test-days, (P<0.01). It is concluded that Brahman cattle: (a) habituate to repeat handling in a squeeze chute; (b) are less emotionally reactive when their eyes were covered during this process and (c) establish a repeatable order of entrance to the chute.

Study of the D(+)(s)-->pi(-)pi(+)pi(+) decay and measurement of f(0) masses and widths

From a sample of 848+/-44 D(+)(s)-->pi(-)pi(+)pi(+) decays, we find gamma(D(+)(s)-->pi(-)pi(+)pi(+))/gamma(D(+)(s)-->straight phipi(+)) = 0.245+/-0.028(+0.019)(-0.012). Using a Dalitz plot analysis of this three body decay, we find significant contributions from the channels rho(0)(770)pi(+), rho(0)(1450)pi(+), f(0)(980)pi(+), f(2)(1270)pi(+), and f(0)(1370)pi(+). We also present the values obtained for masses and widths of the resonances f(0)(980) and f(0)(1370).

Experimental evidence for a light and broad scalar resonance in D(+) --> pi(-)pi(+)pi(+) decay

From a sample of 1172 +/- 61 D(+)-->pi(-)pi(+)pi(+) decays, we find gamma(D(+)-->pi(-)pi(+)pi(+))/gamma(D(+)-->K-pi(+)pi(+)) = 0.0311 +/- 0.0018(+0.0016)(-0.0026). Using a coherent amplitude analysis to fit the Dalitz plot of these decays, we find strong evidence that a scalar resonance of mass 478(+24)(-23) +/- 17 MeV/c(2) and width 324(+42)(-40) +/- 21 MeV/c(2) accounts for approximately half of all decays.

Sexual behavior of Zebu cattle (Bos indicus) following estrous induction by Syncro-Mate B, with or without estrogen injection

The effect of estrogen administered with norgestomet implants in the expression of behavioral estrous of Zebu cattle was studied in a herd of 18 cycling Brahman cows, in two trials. In the first and second trials, six different cows were treated with progestagen on successive days. In addition, in the first trial, estrogen injection was applied with the treatment. With the purpose of enhancing mounting behavior in treated and/or non-treated animals, on the third day of each trial, three other cows with an active CL were injected with 25 mg of PGF2alpha. All animals were examined three times a week by rectal ultrasound, and a blood sample was also taken for progesterone analysis. Sexual activity was monitored by a closed-circuit TV from 1500 to 0600 h. Direct observation was carried out from 0900 to 1200 h. A total of 15 cows displayed 36 mounting periods (11 with ovulation). Twenty-five annovulatory estrous periods were observed, 77% supported by large follicles. More cows (66% vs. 16%) showed mounting activity when estradiol valerate was used as part of the progestagen treatment (P=.03). Ovulation rate in response to the effect of norgestomet implant was 16%, independent of treatment. It is concluded that estrogen administered with norgestomet implants increases the expression of behavioral estrous in Bos indicus cattle but does not improve ovulation rate.

Serotonin depletion attenuates cocaine-seeking behavior in rats

RATIONALE

Alterations in serotonin (5-HT) neurotransmission during cocaine withdrawal may be involved in incentive motivation for cocaine.

OBJECTIVE

The present study examined the effects of 5-HT depletion on cocaine- and food-seeking behavior (i.e., non-reinforced operant responding).

METHODS

Separate groups of rats were trained to lever press for cocaine infusions (0.33 mg/kg/0.1 ml, i.v.) or for food pellets (45-mg Noyes food pellets) on a fixed-ratio one schedule of reinforcement during 14 daily 2-h sessions. Half of each group then received treatment with either saline or the tryptophan hydroxylase inhibitor para-chlorophenylalanine (p-CPA; 100 mg/kg, i.p.) on post-training day 5 and day 6. Twenty-four hours after their last treatment, rats were tested for cocaine- or food-seeking behavior by measuring operant responding in the absence of reinforcement until they reached an extinction criterion of no responses for 30 min. Animals were sacrificed 24 h after testing and brain 5-HT levels in various regions were quantified.

RESULTS

In cocaine-trained animals, p-CPA treatment significantly decreased cocaine-seeking behavior and produced a trend toward a decrease in extinction latency relative to saline treatment. In food-trained animals, p-CPA treatment failed to alter any of the behavioral measures during testing, suggesting that p-CPA treatment did not alter the animals' memory or ability to perform an operant response. p-CPA significantly depleted 5-HT by 73-85% in every brain region examined.

CONCLUSION

The results suggest that decreasing 5-HT neurotransmission may decrease incentive motivation for cocaine.

How individuals' responses and attractiveness influence aggression

The influence of one's physical appearance is enormous, especially during social interactions with others. The effect of sex on aggressiveness during social encounters with confederates of different sexes and attractiveness was investigated. Undergraduate college participants, 40 men and 40 women, had water spilled on them as an aggression-provoking situation. All participants were rated for aggression by the two experimenters and by themselves. The main effect for attractiveness as observed by the experimenters was significant, with unattractive confederates having more aggression manifested toward them than toward their attractive peers. The main effect for response was significant, with confederates responding neutrally to having more aggression manifested toward them than confederates who apologized. No other main effects or interactions were significant.

[Histopathological malignancy and prognosis of laryngeal cancer]

Two series of patients with laryngeal squamous cell carcinoma who underwent surgery for curative purposes were studied. Sixty patients were analyzed prospectively and 71 were analyzed retrospectively for clinical and pathological parameters of prognostic value. Clinical parameters (tumor site, T and N stage, patient age, alcohol and tobacco use, primary tumor or neck surgery) and histological parameters (tumor size, number of metastatic lymph nodes, T and N stage, WHO differentiation, Jakobsson and Glanz malignancy scores) were recorded and analyzed by multivariate analysis to find factors related independently with death from the tumor. In the retrospective study, the presence of positive surgical margins obscured other factors. In the prospective study, T and N stage and the Glanz and Jacobsson scores (in biopsies) were independently related with prognosis. Malignancy grading systems such as those of Jakobsson and Glanz should be included in treatment planning for patients with laryngeal carcinoma.

A retrospective comparison of endoscopic stenting alone with stenting and radiotherapy in non-resectable cholangiocarcinoma

BACKGROUND AND AIMS

Radiotherapy has been reported to be of benefit in prolonging the survival of patients with cholangiocarcinoma. This study examined whether radiotherapy in addition to endoscopic stenting improved survival.

SUBJECTS

56 patients with obstructive jaundice due to histologically confirmed non-resectable cholangiocarcinoma.

METHODS

A retrospective analysis of these patients who were treated either with endoscopic biliary stenting followed by external beam radiotherapy and internal iridium-192 brachytherapy (n = 28) or with stenting alone (control group; n = 28).

RESULTS

The two groups were well matched in age, sex, and stricture type. Eighteen patients had a type I stricture (control group: 11; radiotherapy group: 7) at the time of diagnosis and 38 had a type II or III stricture (control group: 17; radiotherapy group: 21). The median (range) overall survival from diagnosis was seven (1-29) and 10 (4-75) months in the control and radiotherapy groups respectively: This difference did not reach statistical significance (p = 0.06), but survival plots indicated a survival advantage in the radiotherapy group in the first nine months after diagnosis. Approximately one third survived longer than one year in both groups. More patients in the radiotherapy group required a stent change (1.9 v 0.9: p = 0.05), and also had a longer overall inpatient stay (42 days v 19: p < 0.001). When examined on the basis of stricture type, there was a survival advantage in the first 10 months after diagnosis in those with a type II/III stricture (seven and 11 months in the radiotherapy and control groups respectively: 0.01 < p < 0.05). There was no difference in survival between the groups in those with a type I stricture. Numbers surviving longer than one year, stent survival, and number of stent changes were all similar between the two groups when examined on the basis of stricture type, but length of hospital stay remained considerably longer in all patients receiving radiotherapy.

CONCLUSION

The survival advantage of radiotherapy in those with a type II/III stricture is seen only in the first 10 months after diagnosis. The costs of radiotherapy and significantly increased time spent in hospital, however, raise doubts over its routine use in the management of non-resectable cholangiocarcinoma.

Laser and brachytherapy in the palliation of adenocarcinoma of the oesophagus and cardia

BACKGROUND

Palliation of malignant dysphagia is possible by a variety of methods although all have significant drawbacks. Laser therapy is an effective and safe treatment but has to be repeated at four to five weekly intervals to maintain palliation. A means of augmenting the benefits while reducing the need for repeat treatments would be highly beneficial to these patients.

AIMS

To prospectively explore the safety and efficacy of intraluminal radiotherapy (brachytherapy) when used to augment laser recanalisation for malignant dysphagia.

PATIENTS

Nineteen patients with dysphagia due to advanced adenocarcinoma of the oesophagus or cardia were recruited.

METHODS

All patients received laser recanalisation until able to swallow a soft diet or better, before the application of a single dose of brachytherapy (10 Gy at 1 cm from the source). Patients were followed up and treated promptly by further endoscopic means in the event of their dysphagia worsening.

RESULTS

Six patients (32%) required no further treatment until death at a median of 10 weeks (range 1-20 weeks). Further therapy was required at a median of 11 weeks (range 4-37 weeks) after brachytherapy for those 13 patients with recurrent dysphagia. Subsequent symptom control required endoscopic intervention at an average of once every nine weeks. There was no mortality associated with laser or brachytherapy. Median survival from initial treatment and including the one survivor was 36 weeks (range 5-132 weeks).

CONCLUSIONS

Laser plus brachytherapy offers a safe and effective means of palliating malignant dysphagia due to adenocarcinoma, with a longer dysphagia free interval than historical controls treated with laser alone.

Cisplatin, 5-fluorouracil, and high-dose folinic acid in patients with advanced unresectable head and neck cancer

For patients with advanced, unresectable head and neck (HN) cancer, surgery and/or radiotherapy are the standard treatments but have poor results. A phase II trial of a continuous infusion of cisplatin, 5-FU, and high dose folinic acid (PFL) as induction chemotherapy in patients with previously untreated, locally advanced HN cancer was performed in an attempt to confirm the encouraging results reported by Dana Farber investigators using an identical regimen. Forty-five consecutive patients with unresectable HN cancer were treated every 28 days with a continuous infusion of cisplatin 25 mg/m(2)/day (days 1-5), 5-FU 800 mg/m(2)/day (days 2-6), and folinic acid 500 mg/m(2)/day (days 1-6). After three courses of chemotherapy, patients were treated with surgery and/or radiotherapy. Objective responses were observed in 26 of 38(69%) evaluable patients with 14(37%) clinical complete responses. Grade III-IV toxicity was important and consisted mainly of mucositis and neutropenia that were found in 47 and 18%, respectively , of patients after the first course. There was one toxic death. PFL is an active, toxic induction regimen for far-advanced HN cancer, yielding a response rate in the range of the widely used cisplatin and 5-FU (PF) schedule; a comparative trial is warranted before concluding that PFL is superior to the latter combination.

Ultrasonography is more effective than computed tomography in excluding invasion of the carotid wall by cervical lymphadenopathies

Twelve patients with head and neck cancer, bulky lymphadenopathies, and clinical suspicion of carotid artery infiltration, had preoperative CT and US. The results of both techniques were correlated with surgical findings (one case of invasion and 11 of non-invasion), to evaluate the role of CT and US in the preoperative diagnosis of tumor invasion of the carotid wall. While CT showed a high level of failures (11 false positives and one true positive), US (one true positive, one false negative, and 10 true negatives) appears to be an easy and helpful method for predicting non-invasion of the carotid wall. However, the usefulness of US in detecting invasion cannot be evaluated, due to the limited number of positive cases.