Investigating the transfer rate of waterpipe additives to smoke as an integral part of toxicological risk assessments

Waterpipe, also known as hookah, narghile or narghila, shisha or hubbly bubbly, is a tobacco-smoking device. Waterpipe tobacco is heated and consumed by a process of inhaling tobacco smoke, that bubbles through water before being inhaled. To date, limited studies have examined the transfer of waterpipe additives from tobacco to smoke. This study was designed to investigate the filtration ability of water in the waterpipe’s bowl to define exposure to additives in waterpipe smoke, which is an essential requirement to perform toxicological risk assessments of waterpipe additives. Within this study, a standard smoking protocol (ISO 22486) was used to evaluate the transfer of > 40 additives from experimental and commercially available samples. These results are the first to provide such an extensive dataset of information showing transfer rates varying between 6% and 61% depending on the additive. Various physicochemical parameters of the additives including water solubility, partition coefficient, molecular weight, boiling point, and vapor pressure were also evaluated to seek to identify any correlation to transfer rate that may be later used to predict transfer. The amount of additive transfer from waterpipe tobacco to the smoke was found to be moderately correlated to vapor pressure (Pearson correlation coefficient = 0.33) with subsequent multivariate analysis using step-wise selection indicating 39% of the transfer rate variance can be explained collectively by the additive boiling point, molecular weight, vapor pressure and water solubility. These findings underscore the complexity of additive transfer and highlight the necessity of exposure assessment for meaningful waterpipe additive risk assessments.

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Additive transfer evaluated using ISO 22486 plus charcoal to reflect consumer use

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First provision of extensive results showing varying transfer rates between 6–61%.

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39% of the transfer rate variance explained by four physiochemical properties.

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Findings underscore the complexity of additive transfer for waterpipe.

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Results show the necessity of exposure assessment for additive risk assessments.

Methods of improving the quality of life in patients with stable maculopathy-pilot results of a new study

PURPOSE

To present pilot results of the project in which the primary goal is to optimize way how to increase the quality of life of patients with the stable maculopathy by implanting intraocular Scharioth macular lens (SML) and modulating visual plasticity by a transcranial electrical stimulation (tES) together with a visual rehabilitation.

MATERIALS AND METHODS

The study will include 20 patients with stable maculopathy (mainly age-related macular degeneration - AMD) who underwent cataract surgery in past and are eligible for SML implantation. The duration of the project is 3 years. During the first year of the project 17 patients were screened, SML implantation was recommended to 4 of them. They met the indication criteria of SML implantation and SML was implanted into the better seeing eye. The third postoperative day, the tES sessions started and were applied 20 times in the first month after SML implantation. The stimulation was delivered in double blind design (a stimulated and a shame group). Visual exercises and rehabilitation took place during the tES. The patients were examined ophthalmologically and also using electrophysiological methods.

RESULTS

Before the implantation, the best corrected distance visual acuity was 0.23. At near it was Jaeger number 15 uncorrected, with +3.0 sphere dioptres J.No.10.5 and with +6.0 sph dpt J.No. 4.5. After the surgery and visual rehabilitation BCVA was 0.13 after 3 weeks, 0.2 after 2 months and 0.14 after 6 months. At near it was uncorrected J.No.7.5 after 3 weeks, J.No.7 after 2 months and J.No.5 after 6 months.

CONCLUSION

According to a few participants, the impact of SML implantation together with intensive visual rehabilitation on vision at near and on satisfaction of patients with AMD could not be significantly established. Nevertherless, these patients are limited in their daily activities and SML is one of the solutions for them. The project is ongoing and blinded still, there is also a need of more participants to assess the effect of tES on vision, the results will be presented. We have proven the safety of methods used in the project.

Analysis of gastrointestinal metastasis of primary lung cancer: Clinical characteristics and prognosis

The prevalence of gastrointestinal metastasis of lung cancer is low. The aim of the present study was to analyze the frequency and clinical characteristics of metastases to the gastrointestinal tract by retrospectively assessing the clinical records of 2,066 patients with lung cancer. A total of 7 patients (0.33%) were diagnosed with gastrointestinal metastasis, including 4 patients with adenocarcinoma, 1 patient with large cell carcinoma and 2 patients with pleomorphic carcinoma. Furthermore, 3 of the patients presented with small bowel metastases, 2 with gastric metastases, 1 with large bowel metastasis and 1 with metastasis of the appendix. The mean time between the diagnosis of the lung tumors and the identification of gastrointestinal metastasis was 13.5 months (range, 3-49 months). The mean time between the identification of the gastrointestinal metastasis and mortality was 100.6 days (range, 21-145 days). In conclusion, the prognosis of patients with recurrence in distant organs, including the gastrointestinal tract, may be worse than patients with recurrence in distant organs, excluding the gastrointestinal tract, particularly those with symptomatic gastrointestinal metastasis. Therefore, the presence of clinical gastrointestinal metastasis may be life threatening; comprehensive evaluations are required to detect and monitor gastrointestinal metastasis during follow-up.

Bioinspired locomotion and grasping in water: the soft eight-arm OCTOPUS robot

The octopus is an interesting model for the development of soft robotics, due to its high deformability, dexterity and rich behavioural repertoire. To investigate the principles of octopus dexterity, we designed an eight-arm soft robot and evaluated its performance with focused experiments. The OCTOPUS robot presented here is a completely soft robot, which integrates eight arms extending in radial direction and a central body which contains the main processing units. The front arms are mainly used for elongation and grasping, while the others are mainly used for locomotion. The robotic octopus works in water and its buoyancy is close to neutral. The experimental results show that the octopus-inspired robot can walk in water using the same strategy as the animal model, with good performance over different surfaces, including walking through physical constraints. It can grasp objects of different sizes and shapes, thanks to its soft arm materials and conical shape.

Phase II study of concurrent thoracic radiotherapy in combination with weekly paclitaxel plus carboplatin in locally advanced non-small cell lung cancer: LOGIK0401

OBJECTIVES

Concurrent chemoradiotherapy for regionally advanced stage III non-small cell lung cancer is the standard treatment method. However, the clinical implications of consolidation chemotherapy following chemoradiation have been unclear. Therefore, we conducted a phase II study of concurrent weekly carboplatin plus paclitaxel treatment in combination with radiotherapy followed by vinorelbine monotherapy. The primary endpoint was the 1-year survival rate.

PATIENTS AND METHODS

Chemonaive PS 0-1 patients with stage IIIA/B NSCLC were enrolled. During the concurrent chemoradiation phase, patients were treated with weekly paclitaxel 40 mg/m(2) plus carboplatin AUC 2. The primary tumor and involved nodes received 60 Gy in 2-Gy fractions over 6 weeks. During the consolidation phase, vinorelbine 25 mg/m(2) on days 1 and 8 was repeated for three cycles.

RESULTS

A total of 40 eligible patients (72.5 % male; median age, 63 years; range 29-74 years) were analyzed for efficacy. Squamous cell carcinoma was the most common histology (47.5 %), and more patients had clinical stage IIIB (55 %) cancer. The average radiation dose was 56.5 Gy, and the average number of carboplatin plus paclitaxel cycles was 4.93. Seventeen patients proceeded to the consolidation chemotherapy phase, and 14 completed three cycles of vinorelbine monotherapy. The objective response rate was 75.0 %, including 1 patient who achieved a complete response. Progression-free survival and overall survival (OS) were 46 weeks [95 % confidence interval (CI) 31-64 weeks] and 110 weeks (95 % CI 90-184 weeks), respectively. The OS rate at 1 and 2 years was 85.0 % (95 % CI 69.6-93.0 %) and 53.9 % (95 % CI 37.1-68.0 %), respectively.

CONCLUSION

Concurrent chemoradiation with weekly carboplatin and paclitaxel followed by vinorelbine consolidation is effective for stage III non-small cell lung cancer and shows a generally mild toxicity profile.

Gender impact on electrophysiological activity of the brain

Gender is presumed to be one of the factors causing interindividual variability in the brain's electrophysiological parameters. Our aim was to characterize the role of gender in visual evoked potentials (VEPs), event-related potentials (ERPs), visual mismatch negativity (vMMN) and the spectral characteristics of the EEG. We examined 42 healthy volunteers (21 women and 21 men, aged 20-29 years). We measured VEPs in response to pattern-reversal and motion-onset stimulation, ERPs in an oddball paradigm and vMMN in response to a combination of motion directions presented in the visual periphery. P100 peak latency for 40' reversal VEPs was significantly shorter in women than in men as determined using a non-parametric Wilcoxon signed-rank test. In addition, women showed higher relative EEG spectral power in the alpha band (p=0.023) and lower power in the theta band (p=0.004). Our results in this small but homogeneous group of subjects confirm previously reported gender influences on pattern-reversal VEPs and the EEG frequency spectrum. Gender should be taken into consideration in establishing norms on these measures. We found no statistically significant differences between women and men for any of the other stimuli presented.

Efficacy and safety of voriconazole in the treatment of chronic pulmonary aspergillosis: experience in Japan

BACKGROUND

Though various clinical conditions of aspergillosis can occur, depending essentially on the host's immunological status, the focus of research in North American and European countries has mainly been on invasive pulmonary aspergillosis in immunocompromised patients. There are, however, also many problems to overcome in chronic forms of aspergillosis. One of those problems is that there are no codified treatment guidelines for chronic pulmonary aspergillosis (CPA). Especially in Japan, this issue is more serious, because there are more cases with CPA due to the many aged people with past history of tuberculosis. Several clinical cases and case series have reported the usefulness of the various antifungal agents that are available. The new triazole, voriconazole, in particular, seems to be effective in the treatment of CPA. The aim of the present study is to evaluate the efficacy and safety of voriconazole in the treatment of CPA in non-immunocompromised patients.

PATIENTS AND METHODS

We conducted a prospective, open-label, non-comparative, multicenter study over a 2-year period. For inclusion in the study, patients with confirmed or probable CPA were recruited in 11 hospitals of the National Hospital Organization in Japan. Clinical, radiological, serological, and mycological data were collected at baseline and 12 weeks after treatment or at the end of treatment.

RESULTS

Among 77 patients enrolled in the study, 71 patients (mean age 65.9 years, 56 males and 15 females) were eligible for the study. All of the eligible patients presented with underlying lung diseases, including sequelae of tuberculosis (n = 35), non-tuberculous mycobacterial lung disease (n = 8), chronic obstructive pulmonary disease (COPD) (n = 8), interstitial pneumonia (n = 7), cystic lung disease (n = 4), pneumothorax (n = 3), bronchial cancer (n = 1), and others (n = 5). Voriconazole was indicated in 48 cases (68 %) as the first-line treatment for CPA and 23 patients previously received other antifungal therapies. Based on a composite of clinical, radiologic, serological, and mycologic criteria, good response was seen in 43 patients (60.6 %), no response was observed in 19 patients (26.8 %), and 4 cases (5.6 %) got worse. Five patients (7.0 %) were unassessable for efficacy. The common adverse events were visual disturbances (17 patients, 23.9 %), abnormal liver function test results (12 patients, 16.9 %), adverse psychological effects (3 patients, 4.2 %), and others (10 patients, 14.0 %). Treatment with voriconazole had to be stopped in 2 cases (2.8 %) because of serious adverse events (abnormal liver function test results). There was no association between adverse effects and trough voriconazole levels in serum.

CONCLUSIONS

In Japan, voriconazole provides effective therapy of CPA in non-immunocompromised patients with an acceptable level of toxicity.

Visual evoked potentials to pattern, motion and cognitive stimuli in Alzheimer's disease

The aim of our study was to verify reported visual dysfunctions of patients with Alzheimer disease with the use of several variants of VEPs and visual ERPs and to learn whether these methods can be useful in diagnostics of AD. We tested 15 patients (6 women and 9 men, aged from 58 to 87) with mild to moderate Alzheimer disease (12-23 points of Mini Mental State Examination) and 15 age, gender and education level matched controls. The examination consisted of VEPs to pattern-reversal and motion-onset stimulation (to translational and radial movement) and of visual ERPs recorded during an odd-ball test. The subjects were instructed to signalize target stimuli by pressing of a button, which enabled to evaluate also the reaction time. While pattern-reversal VEPs were comparable in patients and controls, there were significantly smaller N2 peak amplitudes of motion-onset VEPs in patients with AD (in particular in radial moving stimuli outside the central 20 deg of the visual field), which suggests a dysfunction of the motion-processing (magnocellular) system or the dorsal cortical stream. ERPs, having significantly longer latencies in patients than in controls, distinguished well both groups. However, the individual AD diagnostics based on ERPs seems to be limited by rather high inter-individual variability of the ERP latencies. The ERPs might, however, be useful in disease progress and therapy effect estimation. Electrophysiological parameters did not correlate with neuropsychological ADAS cog test (Alzheimer Disease Assessment Scale--cognitive part).

Addison's disease due to tuberculosis that required differentiation from SIADH

A 77-year-old man was admitted to our hospital complaining of general fatigue. Serum sodium was 116 mEq/l and serum antidiuretic hormone (ADH) was elevated. Radiologic examination revealed nodules in the brain as well as in both adrenal glands. Based on the findings of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET), we had considered that the cause of the hyponatremia was syndrome of inappropriate secretion of antidiuretic hormone (SIADH) due to active extrapulmonary tuberculosis. Against our expectations, the patient's condition got worse just after he began antituberculous therapy; we finally diagnosed Addison's disease by additional hormonal tests. His condition recovered immediately with the administration of high-dose hydrocortisone, and the tuberculous lesions became smaller with antituberculous medications. Although tuberculous Addison's disease has been decreasing markedly in recent years, we have to consider the possibility of adrenal insufficiency when hyponatremia is observed in patients with active tuberculosis or those having a past history of tuberculosis.

[Visual functions in premature children after posthemorrhagic hydrocephalus surgery]

The aim of this study was to evaluate the visual functions in premature children, who had posthemorrhagic hydrocephalus surgery. The visual acuity, refractive error, strabismus, and evoked potentials of the optic nerve (VEP) were examined at the age 7 - 8 years of life. The normal visual acuity was found in 37.50% of children. The refractive error was found in 62.50% of patients. Hyperopia was found, and in the same percentage of cases the strabismus appeared. In all cases, the pathological VEP were found.

CONCLUSION

From the results it is clear, that regular follow-up controls in premature children with posthemorrhagic hydrocephalus and compensation of their visual handicap are of necessity.

Hydrogen bonding in sodium alanate: a muon spin rotation study

We have detected the occurrence of hydrogen bonding involving an interstitial positive muon situated between hydrogen atoms of two independent alanate anions in sodium alanate (NaAlH4). Ti doping, which is known to dramatically improve the hydrogen cycling performance of NaAlH4, reduces the kinetic barrier of the transition of the muon from the muon-dialanate state to a mobile interstitial state. This observation strongly suggests that hydrogen bonding is the primary bottleneck for hydrogen release or uptake in sodium alanate, which might be common to other complex hydrides.

Motion-onset VEPs: characteristics, methods, and diagnostic use

This review article summarises the research on the motion-onset visual evoked potentials (VEPs) and important motion stimulus parameters which have been clarified. For activation of the visual motion processing system and evocation of the motion-onset specific N2 peak (with latency of 160-200ms) from the extra-striate temporo-occipital and/or parietal cortex, the following stimulus parameters can be recently recommended: low luminance (<ca. 20cd/m(2)) and low contrast (<ca. 10%-sinusoidally modulated) of a moving structure with low velocity and temporal frequency (<ca. 6Hz). A short (up to 200ms) duration of motion and a long (at least 1s) inter-stimulus interval reduce adaptation to motion and predominance of a pattern-related P1 peak. Radial motion (with increasing velocity and decreasing spatial frequency towards the periphery) produces larger reactions as compared to a unidirectional translation. In view of the slow maturation (up to the age of 18 years) and early ageing of the visual motion processing system, the use of age-dependent latency norms may be necessary. Since early or selective involvement of the motion processing system is suspected in some CNS disorders, we suggest an evaluation of the utility of motion-onset VEPs as part of the electrophysiological CNS examination since this method may recognise motion processing involvement better than other methods. Motion-onset VEPs might increase the sensitivity of this examination for diagnosing CNS diseases including Multiple Sclerosis, Neuroborreliosis, Glaucoma, Dyslexia and Encephalopathies.

Motion-onset VEPs: Characteristics, methods, and diagnostic use

This review article summarises the research on the motion-onset visual evoked potentials (VEPs) and important motion stimulus parameters which have been clarified. For activation of the visual motion processing system and evocation of the motion-onset specific N2 peak (with latency of 160-200ms) from the extra-striate temporo-occipital and/or parietal cortex, the following stimulus parameters can be recently recommended: low luminance (<ca. 20cd/m(2)) and low contrast (<ca. 10%-sinusoidally modulated) of a moving structure with low velocity and temporal frequency (<ca. 6Hz). A short (up to 200ms) duration of motion and a long (at least 1s) inter-stimulus interval reduce adaptation to motion and predominance of a pattern-related P1 peak. Radial motion (with increasing velocity and decreasing spatial frequency towards the periphery) produces larger reactions as compared to a unidirectional translation. In view of the slow maturation (up to the age of 18 years) and early ageing of the visual motion processing system, the use of age-dependent latency norms may be necessary. Since early or selective involvement of the motion processing system is suspected in some CNS disorders, we suggest an evaluation of the utility of motion-onset VEPs as part of the electrophysiological CNS examination since this method may recognise motion processing involvement better than other methods. Motion-onset VEPs might increase the sensitivity of this examination for diagnosing CNS diseases including Multiple Sclerosis, Neuroborreliosis, Glaucoma, Dyslexia and Encephalopathies.

Phase II study of irinotecan combined with carboplatin in previously untreated small-cell lung cancer

To determine the efficacy and toxicity of irinotecan combined with carboplatin, we conducted a phase II trial. Eligibility criteria were: chemotherapy-naïve, small-cell lung cancer (SCLC), good performance status (PS: 0-2), age Collapse

Key Words

• small-cell lung cancer
• chemotherapy
• clinical trial
• irinotecan
• carboplatin

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MESH Headings

• Aged
• Antineoplastic Combined Chemotherapy Protocols/therapeutic use
• Camptothecin/administration & dosage
• Camptothecin/analogs & derivatives
• Carboplatin/administration & dosage
• Carcinoma, Small Cell/drug therapy
• Disease Progression
• Female
• Humans
• Irinotecan
• Lung Neoplasms/drug therapy
• Male
• Middle Aged
• Survival Analysis
• Treatment Outcome

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Grants Collapse

Affiliation(s)

A Kinoshita National Nagasaki Medical Center, Nagasaki, Japan
M Fukuda Kawasaki Medical School, Division of Respiratory Diseases, Department of Medicine, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan
H Soda Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan
S Nagashima Sasebo General Hospital, Nagasaki, Japan
M Fukuda Japanese Red-Cross Nagasaki Atomic Bomb Hospital, Nagasaki, Japan
H Takatani Nagasaki Municipal Hospital, Nagasaki, Japan
M Kuba National Okinawa Hospital, Okinawa, Japan
Y Nakamura Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan
J Tsurutani Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan
S Kohno Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan
M Oka Kawasaki Medical School, Division of Respiratory Diseases, Department of Medicine, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan

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Motion-onset VEPs reflect long maturation and early aging of visual motion-processing system

Pattern-reversal and motion-onset visual evoked potentials (VEPs) were simultaneously tested in a group of 70 healthy subjects between the ages of 6-60 years to verify suspected differences in maturation and aging dynamics of the pattern and motion processing subsystems of the visual pathway. The motion-onset VEPs displayed dramatic configuration development and shortening of latencies up to 18 years of age (correl. coeff. -0.85; p < 0.001) and systematic prolongation from about 20 years of age (correl. coeff. 0.70; p < 0.001). This confirms long-lasting maturation of the magnocellular system and/or motion processing cortex and their early age related changes. Less significant changes of pattern-reversal VEPs in the tested age range can be interpreted as a sign of early maturation of the parvocellular system and its enhanced functional endurance in the elderly.

A multicenter phase II study of carboplatin and paclitaxel with a biweekly schedule in patients with advanced non-small-cell lung cancer: Kyushu thoracic oncology group trial

PURPOSE

This multicenter phase II study was conducted to investigate the efficacy and safety of carboplatin in combination with paclitaxel administered according to a biweekly schedule as a first-line chemotherapy for advanced non-small-cell lung cancer (NSCLC).

PATIENTS AND METHODS

Eligibility criteria included histologically or cytologically confirmed NSCLC (stage IIIb or IV), no prior treatment, and measurable or evaluable disease. Paclitaxel (140 mg/m(2)) was administered intravenously on day 1, in combination with carboplatin at an area under the concentration time curve (AUC) of 3, every 2 weeks.

RESULTS

Seventy-four patients (45 men) with a median age of 62 years (range 40-74) and a median ECOG performance status of 1 (range 0-2) were enrolled. The response rate was 35.1% [95% confidence interval (CI): 24.4-47.1%], with 26 partial responses. The median survival was 357 days, and the median time to progression was 218 days. Toxicity was generally mild; National Cancer Institute-Common Toxicity Criteria (NCI-CTC) grades 3 and 4 neutropenia was observed in 50.0% of the patients, and grades 3 and 4 nausea/vomiting in 4.1%.

CONCLUSIONS

Biweekly carboplatin combined with paclitaxel demonstrated anti-tumor activity in advanced NSCLC, with response and survival rates similar to those of carboplatin combined with paclitaxel administered every 3 weeks but with a more favorable toxicity profile, and the present data indicate that the regimen is suitable for use on an outpatient basis.

Visual mismatch negativity elicited by magnocellular system activation

The processing of visual motion was tested by means of event related potentials recording (ERP) using a paradigm designed to produce a visual mismatch negativity effect. The stimuli were unattended and presented in the peripheral visual field (outside the central 15 degrees). The standard stimulus consisted of an up/down motion sequence, whilst the deviant stimulus of a down/up motion sequence. Significant ERP differences between the standard and deviant conditions were found in 8 out of 10 adult subjects already in 80 ms and prevailingly in interval 145-260 ms from the initial stimulus presentation. The results demonstrate that the magnocellular information undergoes processing capable of detecting differences in the sequence of unattended peripheral motion stimuli.

Visual evoked potentials and event related potentials in congenitally deaf subjects

The purpose was to test parameters of visual evoked potentials (VEPs) and of event-related potentials (ERPs) in deaf subjects to verify visual and cognitive CNS functions in a handicapped group of the population. Three types of visual stimuli (with dominating parvocellular or magnocellular system activation or with cognitive tasks) were used in the study. Six deaf persons (4 women, 2 men, mean age 17 years) and 6 persons with normal hearing (sex- and age-matched) were included in this pilot study. In all types of stimulation, latencies and amplitudes of main VEPs and ERPs components were evaluated. No significant latency differences were found. However, significantly reduced amplitudes were found in the occipital area for responses to motion and cognitive stimuli which might be interpreted as a part of functional reorganization of the extrastriate and cognitive cortical areas of deaf subjects.

Influence of physiological changes of glycaemia on VEPs and visual ERPs

Since hypoglycemia is known to influence cognitive functions, we checked whether the physiological changes in glycemia (after fasting or exertion) can explain the rather high intra-individual variability of event-related potentials (ERPs). Besides the ERPs to "change in coherence of a moving pattern" with reaction time (RT) recording, binocular pattern reversal VEPs and motion-onset VEPs (to linear and radial motion) were also examined in 14 healthy subjects prior to and after 24-h fasting that decreased glycemia from 5.3 to 3.9 mmol/l on the average. We only found one significant change in the latencies and amplitudes of VEPs and ERPs (with no change of RT). The N160 peak in the motion-onset VEPs to radial (expansive) motion (EM-VEPs) showed a larger amplitude at lower glycemia. For evaluation of the exertion influence, we tested glycemia prior to and after 90 min long exercise -- bicycle ergometry with the load set to 2 W/kg in women and 2.5 W/kg in men (average age-related values for W170/kg index). The changes of glycemia to exertion were, however, less distinct than those to fasting. We conclude that in healthy subjects the glycemia decrease due to 24-h fasting or intensive time-limited exercise never reaches the critical value to change the VEP, ERPs and RTs.

Visual evoked potentials and event related potentials in congenitally deaf subjects

The purpose was to test parameters of visual evoked potentials (VEPs) and of event-related potentials (ERPs) in deaf subjects to verify visual and cognitive CNS functions in a handicapped group of the population. Three types of visual stimuli (with dominating parvocellular or magnocellular system activation or with cognitive tasks) were used in the study. Six deaf persons (4 women, 2 men, mean age 17 years) and 6 persons with normal hearing (sex- and age-matched) were included in this pilot study. In all types of stimulation, latencies and amplitudes of main VEPs and ERPs components were evaluated. No significant latency differences were found. However, significantly reduced amplitudes were found in the occipital area for responses to motion and cognitive stimuli which might be interpreted as a part of functional reorganization of the extrastriate and cognitive cortical areas of deaf subjects.

Influence of physiological changes of glycemia on VEPs and visual ERPs

Since hypoglycemia is known to influence cognitive functions, we checked whether the physiological changes in glycemia (after fasting or exertion) can explain the rather high intra-individual variability of event-related potentials (ERPs). Besides the ERPs to "change in coherence of a moving pattern" with reaction time (RT) recording, binocular pattern reversal VEPs and motion-onset VEPs (to linear and radial motion) were also examined in 14 healthy subjects prior to and after 24-h fasting that decreased glycemia from 5.3 to 3.9 mmol/l on the average. We only found one significant change in the latencies and amplitudes of VEPs and ERPs (with no change of RT). The N160 peak in the motion-onset VEPs to radial (expansive) motion (EM-VEPs) showed a larger amplitude at lower glycemia. For evaluation of the exertion influence, we tested glycemia prior to and after 90 min long exercise -- bicycle ergometry with the load set to 2 W/kg in women and 2.5 W/kg in men (average age-related values for W170/kg index). The changes of glycemia to exertion were, however, less distinct than those to fasting. We conclude that in healthy subjects the glycemia decrease due to 24-h fasting or intensive time-limited exercise never reaches the critical value to change the VEP, ERPs and RTs.

Effect of stimulus localisation on motion-onset VEP

Reliable motion-onset visual evoked potentials (result of the dorsal stream activation) were recorded to motion stimuli with the temporal frequency of five cycles per seconds in 20 different locations with eccentricity up to 42 degrees to periphery of the visual field. Amplitudes and latencies of the positive-negative-positive (P1-N1-P2; 84-144-208 ms) complex were evaluated in occipital (OZ and two derivations 5 cm to the left and right from OZ) and central region (CZ) in 10 subjects. We observed: (1) Shortening of the N1 latency toward periphery of the visual field. (2) The N1 amplitude maximum and latency minimum moved from occipital into central region (CZ derivation) as stimulus moved from centre toward periphery of visual field. (3) The P1 and N1 peaks displayed significantly greater amplitudes and shorter latencies when the lower part of the visual field was stimulated. (4) The N1 peak changed lateralisation of its maximum amplitude in dependence on the eccentricity. Up to 17 degrees, it corresponds to striate projection of the "optic radiation" whilst more in periphery, there was paradoxical lateralisation of higher amplitude and shorter latency. The retinotopic dependence shows that the motion response includes position information and that the motion-onset VEPs are not generated solely in the higher extrastriate areas (MT or MST).

Pulmonary Dirofilariasis

OBJECTIVE

The purpose of this study was to describe the computed tomography (CT) and pathologic features of 5 nodules of pulmonary dirofilariasis in 4 patients.

METHODS

Four patients with 5 nodules of pathologically confirmed pulmonary dirofilariasis who under went CT were enrolled, and the imaging interpretations were retrospectively compared with the histopathologic characteristics.

RESULTS

Three of the 4 patients had a solitary nodule, and the remaining patient had 2 nodules. All the nodules were distributed in the right lower lobe and were attached to the pleura. They were all round or oval in shape and ranged in size from 11 to 22 mm in largest diameter (mean=17 mm). On thinner section CT, the nodules had a well-defined smooth margin with or without a shallow notch; they were connected to the arterial branch and, occasionally, to the venous branch. On contrast-enhanced CT, all the nodules contained a homogeneous low-attenuation area, which corresponded to areas of coagulative necrosis on histopathologic examination.

CONCLUSION

Although the CT findings of a pulmonary dirofilariasis nodule are nonspecific, awareness of the findings on contrast-enhanced CT and the pathologic appearance of this rare benign condition may facilitate its differentiation from a malignant nodule.

Phase II study of irinotecan combined with carboplatin in previously untreated non-small-cell lung cancer

PURPOSE

Irinotecan, a topoisomerase I inhibitor, is an effective agent for non-small-cell lung cancer (NSCLC). To determine the efficacy and toxicity of irinotecan and carboplatin, we conducted a phase II study in 61 patients with advanced NSCLC.

METHODS

Every 4 weeks, the patients received irinotecan 50 mg/m2 (days 1, 8 and 15) and carboplatin (day 1) with a target AUC of 5 mg min/ml using the Chatelut formula.

RESULTS

All patients were evaluable for toxicity, and of 59 patients evaluable for response, 20 achieved a partial response and 26 showed no change. The overall response rate was 34% (95% confidence interval 23-48%). Grade 3 or 4 anemia, leukopenia, neutropenia, thrombocytopenia and diarrhea occurred in 32%, 32%, 60%, 25%, and 7%, respectively. The median survival time and 1-year, and 2-year survival rates were 10.0 months, 37.6%, and 15.2%, respectively.

CONCLUSIONS

Irinotecan with carboplatin is effective for advanced NSCLC and safe.

High plasma osteopontin level and its relationship with interleukin-12-mediated type 1 T helper cell response in tuberculosis

Osteopontin (OPN, also known as Eta-1), a noncollagenous matrix protein produced by macrophages and T lymphocytes, is expressed in granulomatous lesions caused by Mycobacterium tuberculosis infection. In the present study, we compared plasma concentrations of OPN in patients with active pulmonary tuberculosis with those of healthy control subjects and patients with sarcoidosis, another disease associated with granuloma formation. Plasma OPN levels were significantly higher in patients with tuberculosis (n = 48) than in control subjects (n = 34) and patients with sarcoidosis (n = 20). OPN levels correlated well with severity of pulmonary tuberculosis, as indicated by the size of lung lesions on chest X-ray films. Furthermore, chemotherapy resulted in a significant fall in plasma OPN levels. In patients with tuberculosis, plasma OPN concentrations correlated significantly with those of interleukin (IL)-12. In vitro experiments showed that OPN production by peripheral blood mononuclear cells infected with Mycobacterium bovis bacillus Calmette-Guérin preceded the synthesis of IL-12 and interferon-gamma and that the neutralizing anti-OPN monoclonal antibody significantly reduced the production of IL-12 and interferon-gamma. Our results suggest that OPN may be involved in the pathologic process associated with active pulmonary tuberculosis by inducing IL-12-mediated type 1 T helper cell responses.

Visual event-related potentials to moving stimuli: normative data

Visual cognitive responses (P300) to moving stimuli were tested in 36 subjects with the aim to find the normal range of P300 parameters. Concomitantly, the circadian intra-individual variability of the P300 was studied in a subgroup of 6 subjects. Visual stimuli consisted of either coherent (frequent stimulus) or non-coherent motion (random stimulus). The oddball paradigm was applied for recording cognitive responses. P300 to rare stimuli had an average latency of 447.3 +/- 46.6 ms and amplitude of 12.9 +/- 6.0 microV. The average reaction time was in the range from 322 to 611 ms and there was no correlation between the reaction time and P300 latency. We did not find any significant circadian changes of the P300 parameters in the 6 subjects tested four times during the same day. Cognitive (event-related) responses (P300) displayed distinctly greater inter-individual variability (S.D. of 50 ms) when compared with pattern-reversal and motion-onset VEPs (S.D. of 6.0 ms and 14 ms, respectively). For this reason, the clinical use of P300 elicited by this kind of visual stimuli seems to be rather restricted and the evaluation of its intra-individual changes is preferable.

Model of visually evoked cortical potentials

The pattern-reversal (P-VEPs) and the motion-onset (M-VEPs) of visual evoked potentials were modeled by means of three damped oscillators (O1, O2, O3) of identical construction. The O1, assumed to simulate the response of primary visual area (V1), was driven by the firing density of the lateral geniculate nuclei. 01 contributed mainly to the N75 and P100 peaks of the P-VEPs. The O2, driven by the O1 output, mimics the activity of V2, V3a, and MT. It contributed to the negative peak N145 of the P-VEPs or to the N160 in the M-VEPs. The O3 was suggested to model late slow processes probably of an attentive origin. The model parameters were set by optimization to follow the P-VEPs and M-VEPs obtained as a grand average of four young volunteers (Pz - A2 lead). The evoked potentials were described with normalized root mean square error lower than 13%.

Phase I study of irinotecan and cisplatin with concurrent split-course radiotherapy in limited-disease small-cell lung cancer

We conducted a phase I study of irinotecan (CPT-11) and cisplatin with concurrent split-course radiotherapy in limited-disease small-cell lung cancer (LD-SCLC). This study aimed to determine the maximum tolerated dose (MTD) and dose-limiting toxicity (DLT) of this therapy. Four chemotherapy cycles of CPT-11 (days 1, 8 and 15) and cisplatin (day 1) were repeated every 28 days. Radiotherapy of 2 Gy/day commenced on day 2 of each chemotherapy cycle with 20 Gy administered from the first to the third cycles (a total of 60 Gy). 17 patients were enrolled at three dose levels (CPT-11/cisplatin: 40/60, 50/60 and 60/60 mg/m(2)), and 16 were evaluable for toxicity and outcome. 2 of 4 patients at 60/60 mg/m(2) refused continuation of therapy because of general fatigue, and the relative dose intensity of CPT-11 at 50/60 mg/m(2) was approximately 50%. These levels were considered as the MTD. Tumour responses included four complete responses (CR), 11 partial responses (PR) and one no change (NC), and the overall response rate was 93.8% (95% confidence interval: (CI) 71.7-98.9%). This combined modality is tolerable, and CPT-11/cisplatin of 40/60 mg/m(2) in this modality is recommended for phase II study.

Electrophysiological testing of dyslexia

We enlarged our previous study (Kubová Z. et al. Physiol Res 1995;44:87-89) giving an evidence about magnocellular pathway involvement (delayed motion-onset visual evoked potentials (M-VEPs)) in 70% of dyslexic children. In the new group presented here, only 48% of 25 dyslexics displayed prolonged latencies of cortical responses to motion stimuli. However, there was no correlation of this defect with the used quantification of the reading skills (reading quotients). No significant EEG frequency spectrum changes were found. 10 subjects from the former group, who were re-examined 4 years after the previous study at the mean age of 14 years, exhibited significant shortening of the M-VEP latencies compared to the original values. Also in control subjects a distinct improvement in magnocellular pathway function was proved (in M-VEP re-examination after 4 years). These results document rather late maturation of the magnocellular pathway, which is evident mainly in dyslexic children. In both groups of dyslexics an effect of colour in moving stimuli was also tested to verify the reported effect of light wavelengths onto the magnocellular pathway function. However, no latency differences among grey, green, pink, yellow and blue stimuli were observed.

Alterations of serum selenium concentrations in the acute phase of pathological conditions

BACKGROUND

Selenium (Se), an essential trace element, is known to be a cofactor of antioxidative selenoenzymes such as glutathione peroxidase and thioredoxin reductase.

METHODS

We assessed the pathophysiological significance of selenium (Se) by comparing the concentrations of serum Se and C-reactive protein (CRP) in healthy subjects (141; M=71, F=70) vs. patients with various pathological conditions.

RESULTS

In normal males in their 40s, peak serum Se concentrations were observed (2.03+/-0.30 microg/g of serum protein, 128%, P<0.001) vs. males in their 20s (1.59+/-0.20), whereas a peak was observed in females in their 30s (1.87+/-0.31, 119%, P<0.025) vs. those in their 20s (1.57+/-0.22). The serum Se concentrations in the high CRP value group (n=40, 1.07+/-0.29 microg/g, 64.1%), the rheumatoid arthritis (RA) test positive group (n=24, 1.37+/-0.29, 82.0%), the lung cancer group (n=16, 1.38+/-0.30, 82.6%), and the adult T-cell leukemia (ATL) group (n=22, 1.26+/-0.35, 75.4%) were significantly lower (P<0.001) than those in the healthy subjects (1.67+/-0.29 microg/g). This finding was confirmed by inducing acute phase response (APR) in rats by injection of lipopolysaccharide (LPS), which produced a significant decrease of Se in plasma and liver (69.5% and 81.6% vs. untreated rats, P<0.05). In contrast, the Se content in muscle, kidney, lung, spleen, heart, and thymus showed increases of <10%. Se mobilized from liver after LPS-challenge appeared to be translocated to muscle, and Se concentrations recovered by 80 h after APR to the control concentrations in parallel with the subsidence of APR.

CONCLUSIONS

The reduction of Se in the liver and plasma during APR may be associated with the increased CRP synthesis in the liver.

Phase I study of irinotecan and cisplatin with concurrent split-course radiotherapy in unresectable and locally advanced non-small cell lung cancer

We conducted a phase I study of irinotecan (CPT-11) and cisplatin with concurrent split-course radiotherapy in locally advanced stage III non-small cell lung cancer (NSCLC). This study aimed to determine the maximum tolerated dose (MTD) and dose-limiting toxicity (DLT) of this therapy. Two chemotherapy cycles of CPT-11 (days 1, 8 and 15) and cisplatin (day 1) were repeated with a 28-day interval. Radiotherapy of 2 Gy/day commenced on day 2 of each chemotherapy cycle, with 24 Gy and 36 Gy administered for the first and second cycle, respectively. 24 eligible patients were enrolled at five dose levels (CPT-11/cisplatin: 40/60, 50/60, 60/60, 60/70 and 60/80 mg/m(2)), and 23 patients were evaluated for toxicity and clinical outcome. Only 1 patient experienced a DLT with neutropenia and diarrhoea at 60/60 mg/m(2). Dose escalation was limited to 60/80 mg/m(2) which was the recommended dose for CPT-11/cisplatin alone in NSCLC. Tumour responses included one complete response (CR), 15 partial response (PR), and 7 no change (NC), and the overall response rate was 69.6% (95% confidence interval (CI) 47.1-86.8%). This combined modality is tolerable, and CPT-11/cisplatin of 60/80 mg/m(2) in this modality is recommended for phase II study.

[Clinical study on the cases in which INH or RFP was discontinued during treatment for pulmonary tuberculosis]

Short course regimens; 2HRZ (E)(S)/4HR (E), 6HRS (E)/3-6HR and 6-9HR have been accepted as a standard chemotherapy (SC) for initial treatment of pulmonary tuberculosis in Japan. We studied the frequency of the treatment completion, the causes of the treatment failure and the outcome of the patients in whom INH or RFP was discontinued within 6 months after starting SC. The subjects included 597 newly diagnosed culture positive pulmonary tuberculosis patients admitted to 16 national hospital in 1996. Results were as follows. 1. In 47 (7.9%) of the 597 patients, either INH (19; 3.2%) or RFP (33; 5.5%) was discontinued. These 47 cases were defined as a SC incompleted group and the other 550 as a SC completed group. 2. The patients in the SC incompleted group were seen more frequently in the ages of 20s (11.9%), 50s (10.9%), 60s (11.7%) or 70s (11.4%). 21 (13.6%) of 154 female patients and 26 (5.9%) of 443 male patients were in the SC incompleted group. 3. The causes of cessation of INH or RFP were drug side effects (33; 5.5%), drug resistance (10; 1.7%) and complications or underlying diseases (8; 1.3%). 4. Fever or eruption (19; 3.2%) and drug induced hepatitis (12; 2.0%) were frequently seen as drug related side effects causing the cessation of INH or RFP. 5. The rate of culture negative conversion of TB bacilli at 6 months after the start of the treatment was 98.9% in the SC completed and 88.9% in the SC incompleted group respectively. In the SC incompleted group, there were three cases continuously positive and two other patients who relapsed and became culture positive again. In these five patients, INH or RFP was discontinued because of drug resistance.