Defining the optimal dose of radiation in leukemic patients with extramedullary lesions

<p>Abstract</p> <p>Background</p> <p>Analysis of the clinical response of extramedullary lesions in leukemic patients treated with radiation therapy (RT) and defining the optimal dose of radiation.</p> <p>Methods</p> <p>Forty-two extramedullary lesions found in 24 leukemic patients treated with RT were reviewed. The radiation was delivered usually 2 Gy/day, up to a median of 20 Gy (range: 18.0-40.8). The clinical response and symptom palliation effect were analyzed. The factors affecting the response were also included in the analysis.</p> <p>Results</p> <p>After a median time of 7.9 weeks, the overall response rate was 76.2%. A complete response (CR) was achieved in 35.7%, a partial response in 40.5%. The symptom was relieved in 85.7% sites. The overall response rate was better in patients whose initial tumor size was smaller than 10 cm²(<it>p = 0.010</it>) or who were treated with more than 25 Gy (<it>p = 0.031</it>). The overall CR rate was also higher in those who had smaller tumors (smaller than 6 cm or 30 cm²) (<it>p = 0.015)</it>, or when the tumor was located in soft tissue (<it>p = 0.029</it>).</p> <p>Conclusions</p> <p>Extramedullary lesions in leukemic patients can be successfully treated with RT. The tumor response rate was excellent and symptom relief was achieved in almost all patients. There was a better response to treatment when the tumor was small or it was located in soft tissue. Although, there was no definite correlation between volume reduction and total dose, it seems that higher total dose more of than 25 Gy is needed for better response.</p

Short-Term Synaptic Plasticity in the Dentate Gyrus of Monkeys

The hippocampus plays an important role in learning and memory. Synaptic plasticity in the hippocampus, short-term and long-term, is postulated to be a neural substrate of memory trace. Paired-pulse stimulation is a standard technique for evaluating a form of short-term synaptic plasticity in rodents. However, evidence is lacking for paired-pulse responses in the primate hippocampus. In the present study, we recorded paired-pulse responses in the dentate gyrus of monkeys while stimulating to the medial part of the perforant path at several inter-pulse intervals (IPIs) using low and high stimulus intensities. When the stimulus intensity was low, the first pulse produced early strong depression (at IPIs of 10–30 ms) and late slight depression (at IPIs of 100–1000 ms) of field excitatory postsynaptic potentials (fEPSPs) generated by the second pulse, interposing no depression IPIs (50–70 ms). When the stimulus intensity was high, fEPSPs generated by the second pulse were depressed by the first pulse at all IPIs except for the longest one (2000 ms). Population spikes (PSs) generated by the second pulse were completely blocked or strongly depressed at shorter IPIs (10–100 or 200 ms, respectively), while no depression or slight facilitation occurred at longer IPIs (500–2000 ms). Administration of diazepam slightly increased fEPSPs, while it decreased PSs produced by the first pulse. It also enhanced the facilitation of PSs produced by the second stimulation at longer IPIs. The present results, in comparison with previous studies using rodents, indicate that paired-pulse responses of fEPSPs in the monkey are basically similar to those of rodents, although paired-pulse responses of PSs in the monkey are more delayed than those in rodents and have a different sensitivity to diazepam

The additional value of patient-reported health status in predicting 1-year mortality after invasive coronary procedures: A report from the Euro Heart Survey on Coronary Revascularisation

Objective: Self-perceived health status may be helpful in identifying patients at high risk for adverse outcomes. The Euro Heart Survey on Coronary Revascularization (EHS-CR) provided an opportunity to explore whether impaired health status was a predictor of 1-year mortality in patients with coronary artery disease (CAD) undergoing angiographic procedures. Methods: Data from the EHS-CR that included 5619 patients from 31 member countries of the European Society of Cardiology were used. Inclusion criteria for the current study were completion of a self-report measure of health status, the EuroQol Questionnaire (EQ-5D) at discharge and information on 1-year follow-up, resulting in a study population of 3786 patients. Results: The 1-year mortality was 3.2% (n = 120). Survivors reported fewer problems on the five dimensions of the EQ-5D as compared with non-survivors. A broad range of potential confounders were adjusted for, which reached a p<0.10 in the unadjusted analyses. In the adjusted analyses, problems with self-care (OR 3.45; 95% CI 2.14 to 5.59) and a low rating (≤ 60) on health status (OR 2.41; 95% CI 1.47 to 3.94) were the most powerful independent predictors of mortality, among the 22 clinical variables included in the analysis. Furthermore, patients who reported no problems on all five dimensions had significantly lower 1-year mortality rates (OR 0.47; 95% CI 0.28 to 0.81). Conclusions: This analysis shows that impaired health status is associated with a 2-3-fold increased risk of all-cause mortality in patients with CAD, independent of other conventional risk factors. These results highlight the importance of including patients' subjective experience of their own health status in the evaluation strategy to optimise risk stratification and management in clinical practice

Scope

Scope, later retitled Centerscope, was published by the Boston University Medical Center to report on events at and around the Center

Potential Relationships Between Physical Traits and Male Broiler Breeder Fertility

Genetic selection in primary broiler breeders may modify skeletal structure, possibly impeding semen transfer, and could alter the size and degree of fluctuating asymmetry (FA) of bilateral traits associated with fertility. Hence, we hypothesized specific morphometric traits could predict differential fertility. Sixty primary broiler breeder males from Strains A and B (n = 30/strain) were individually housed with an average of 10 females per male. Male fertility and sperm penetration (SP) through the perivitelline layer were estimated on fresh eggs. At 50 wk, BW, keel length (KL), posterior pelvic width and length (PPW, PPL), dorsal pelvic width and length (DPW, DPL), tarsometatarsal length and width (TL, TW), comb length and width (CL, CW), and wattle length, width, and area (WL, WW, WA) were measured. Results indicated that Strain A had smaller BW, KL, WL, WW, WA, CL, CW, PPL, DPL, and DPW. A higher degree of FA was found in Strain A TL and WL (P \u3c 0.05), yet DPW FA was greater for Strain B (P \u3c 0.001). In addition, DPW FA negatively correlated with Strain B fertility (r = −0.369; P \u3c 0.01); however, other FA measurements did not correlate with estimated fertility or SP. Strain A WL correlated with SP (r = 0.383; P \u3c 0.01) and fertility (r = 0.346; P \u3c 0.01). Results indicate DPW alteration may impact semen transfer upon copulation, as Strain A fertility negatively correlated with DPW (r = −0.298; P \u3c 0.05). This research provides evidence that morphometric traits might be useful to predict fertility in broiler breeders

Use of Nonsettable Eggs to Evaluate Turkey Hen Fertility

The use of nonsettable eggs (checked, cracked) to perform fresh egg breakouts to estimate true fertility and to assess the rate of sperm penetration of the perivitelline layer overlying the germinal disc was evaluated. Germinal discs and the perivitelline layer overlying the germinal disc were accessible for assessments. The stage of blastodermal development positively correlated (r = 0.65, P \u3c 0.0001) with eggshell thickness. It was also determined that the perivitelline layer of nonsettable eggs could be isolated and stained to determine the presence or absence of sperm holes. True fertility of nonsettable eggs (checked and cracked only) and settable eggs was 90 and 95%, respectively. It was concluded that checked and cracked eggs could be used to estimate the true fertility of a flock

Phenotypic Traits as Reliable Indicators of Fertility in Male Broiler Breeders

Genetic selection procedures applied to improve broiler performance may negatively impact the subsequent reproductive efficiency of breeders, particularly in males. Identification of traits that reliably indicate individual male fertility would facilitate selection for reproduction. We hypothesized that physical traits, such as comb area, relative testicular weight, and testicular weight asymmetry, may correlate with fertility in two male-selected primary broiler breeder strains (A and B). Thirty males per strain, individually housed with an average of 10 females, were evaluated at five age periods within the 30-to-50-wk breeding cycle. Flock fertility by candling eggs at Day 19 of incubation and sample fertility by visual assessment of the germinal disc were determined. Sperm penetration (SP) through the perivitelline layer was assessed. Comb area was evaluated by image analysis at 40 and 50 wk, and relative testicular weight was measured at 50 wk. Strain A sample and flock fertility (P \u3c 0.001) and SP values (P \u3c 0.0001) were significantly lower than Strain B. Both strains had a significant decline of fertility and SP with age (P \u3c 0.0001). Strain A comb area correlated with sample fertility (P \u3c 0.05), flock fertility (P \u3c 0.05), and relative testicular weight (P \u3c 0.01). Conversely, Strain B relative testicular weight correlated with sample fertility (P \u3c 0.0001) and flock fertility (P \u3c 0.001). Significant correlations were not found between testicular weight asymmetry and other reproductive traits. Results suggest comb area may be a reliable indicator of male fertility in Strain A