Suboccipital lateral injection of intrathecal chemotherapy in a patient with mantle cell lymphoma

Background: Even today patients who suffer from mantle cell lymphoma have a poor prognosis, especially when the CNS is involved. To confirm the diagnosis of meningeosis lymphomatosa, asservation of the liquor cerebrospinalis is necessary. During this procedure, intrathecal chemotherapy may be given if there is clinical evidence of meningeosis. If lumbar puncture cannot be performed, a lateral suboccipital puncture may be an alternative approach. Patient and Methods: We report the case of a 65-year-old patient who suffered from mantle cell lymphoma stage IV. The patient presented with symptoms of progressive paraparesis of both legs and incontinence, with tumor mass intradural from the 12th thoracic vertebra to the level of S1. During irradiation, the patient developed symptoms of diffuse meningiosis lymphomatosa. The conventional lumbar puncture was impossible, because of tumor present in the thoracico-lumbar junction. Results: A suboccipital puncture was performed for both collecting cerebrospinal fluid and application of chemotherapy ( cytosine arabinoside/dexamethasone). This lead to remarkable improvement of the patient's clinical symptoms. Conclusion: The suboccipital cervical puncture was performed without complications. A variation of the intrathecal approach is described, which may serve as alternative when conventional lumbar puncture is not possible

The 13 years of TRMM Lightning Imaging Sensor: From Individual Flash Characteristics to Decadal Tendencies

How often lightning strikes the Earth has been the object of interest and research for decades. Several authors estimated different global flash rates using ground-based instruments, but it has been the satellite era that enabled us to monitor lightning thunderstorm activity on the time and place that lightning exactly occurs. Launched into space as a component of NASA s Tropical Rainfall Measuring Mission (TRMM) satellite, in November 1997, the Lighting Imaging Sensor (LIS) is still operating. LIS detects total lightning (i.e., intracloud and cloud-to-ground) from space in a low-earth orbit (35deg orbit). LIS has collected lightning measurements for 13 years (1998-2010) and here we present a fully revised and current total lightning climatology over the tropics. Our analysis includes the individual flash characteristics (number of events and groups, total radiance, area footprint, etc.), composite climatological maps, and trends for the observed total lightning during these 13 years. We have identified differences in the energetics of the flashes and/or the optical scattering properties of the storms cells due to cell-relative variations in microphysics and kinematics (i.e., convective or stratiform rainfall). On the climatological total lightning maps we found a dependency on the scale of analysis (resolution) in identifying the lightning maximums in the tropics. The analysis of total lightning trends observed by LIS from 1998 to 2010 in different temporal (annual and seasonal) and spatial (large and regional) scales, showed no systematic trends in the median to lower-end of the distributions, but most places in the tropics presented a decrease in the highest total lightning flash rates (higher-end of the distributions)

Planning the Future of U.S. Particle Physics (Snowmass 2013): Chapter 6: Accelerator Capabilities

These reports present the results of the 2013 Community Summer Study of the APS Division of Particles and Fields ("Snowmass 2013") on the future program of particle physics in the U.S. Chapter 6, on Accelerator Capabilities, discusses the future progress of accelerator technology, including issues for high-energy hadron and lepton colliders, high-intensity beams, electron-ion colliders, and necessary R&D for future accelerator technologies.Comment: 26 page

Procedures and Accuracy Estimates for Beta-Beat Correction in the Lhc.

The LHC aperture imposes a tight tolerance of 20% on the maximum acceptable beta-beat in the machine. An accurate knowledge of the transfer functions for the individually powered insertion quadrupoles and techniques to compensate beta-beat are key prerequisites for successful operation with high intensity beams. They perform realistic simulations to identify quadrupole errors in LHC and explore possible ways of correction to minimize beta-beat below the 20% level

Suboccipital lateral injection of intrathecal chemotherapy in a patient with mantle cell lymphoma

Background: Even today patients who suffer from mantle cell lymphoma have a poor prognosis, especially when the CNS is involved. To confirm the diagnosis of meningeosis lymphomatosa, asservation of the liquor cerebrospinalis is necessary. During this procedure, intrathecal chemotherapy may be given if there is clinical evidence of meningeosis. If lumbar puncture cannot be performed, a lateral suboccipital puncture may be an alternative approach. Patient and Methods: We report the case of a 65-year-old patient who suffered from mantle cell lymphoma stage IV. The patient presented with symptoms of progressive paraparesis of both legs and incontinence, with tumor mass intradural from the 12th thoracic vertebra to the level of S1. During irradiation, the patient developed symptoms of diffuse meningiosis lymphomatosa. The conventional lumbar puncture was impossible, because of tumor present in the thoracico-lumbar junction. Results: A suboccipital puncture was performed for both collecting cerebrospinal fluid and application of chemotherapy ( cytosine arabinoside/dexamethasone). This lead to remarkable improvement of the patient's clinical symptoms. Conclusion: The suboccipital cervical puncture was performed without complications. A variation of the intrathecal approach is described, which may serve as alternative when conventional lumbar puncture is not possible

A Magnetic Transition Probed by the Ce Ion in Square-Lattice Antiferromagnet CeMnAsO

We examined the magnetic properties of the square-lattice antiferromagnets CeMnAsO and LaMnAsO and their solid solutions La1-xCexMnAsO by resistivity, magnetic susceptibility, and heat capacity measurements below room temperature. A first-order phase transition is observed at 34.1 K, below which the ground-state doublet of the Ce ion splits by 3.53 meV. It is likely that Mn moments already ordered above room temperature are reoriented at the transition, as reported for related compounds, such as NdMnAsO and PrMnSbO. This transition generates a large internal magnetic field at the Ce site in spite of the fact that simple Heisenberg interactions should be cancelled out at the Ce site owing to geometrical frustration. The transition takes place at nearly the same temperature with the substitution of La for Ce up to 90%. The Ce moment does not undergo long-range order by itself, but is parasitically induced at the transition, serving as a good probe for detecting the magnetism of Mn spins in a square lattice.Comment: 11 pages, 5 figures, to be published in J. Phys. Soc. Jp

Euclidean Approach to the Entropy for a Scalar Field in Rindler-like Space-Times

The off-shell entropy for a massless scalar field in a D-dimensional Rindler-like space-time is investigated within the conical Euclidean approach in the manifold C_\be\times\M^N, C_\be being the 2-dimensional cone, making use of the zeta-function regularisation. Due to the presence of conical singularities, it is shown that the relation between the zeta-function and the heat kernel is non trivial and, as first pointed out by Cheeger, requires a separation between small and large eigenvalues of the Laplace operator. As a consequence, in the massless case, the (naive) non existence of the Mellin transform is by-passed by the Cheeger's analytical continuation of the zeta-function on manifold with conical singularities. Furthermore, the continuous spectrum leads to the introduction of smeared traces. In general, it is pointed out that the presence of the divergences may depend on the smearing function and they arise in removing the smearing cutoff. With a simple choice of the smearing function, horizon divergences in the thermodynamical quantities are recovered and these are similar to the divergences found by means of off-shell methods like the brick wall model, the optical conformal transformation techniques or the canonical path integral method.Comment: 17 pages, LaTex. A sign error corrected and few comments adde

Tamoxifen enhances the cytotoxic effects of nelfinavir in breast cancer cells

Introduction: The HIV protease inhibitor nelfinavir is currently under investigation as a new anti-cancer drug. Several studies have shown that nelfinavir induces cell cycle arrest, endoplasmic reticulum stress, autophagy, and apoptosis in cancer cells. In the present article, the effect of nelfinavir on human breast cancer cells is examined and potential combination treatments are investigated. Methods: The effects of nelfinavir and tamoxifen on the human breast cancer cell lines MCF7, T47 D, MDA-MB-453, and MDA-MB-435 were tested by analysing their influence on cell viability (via 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay), apoptosis (annexin binding, poly(ADP-ribose) polymerase cleavage), autophagy (autophagy marker light chain 3B expression), endoplasmic reticulum stress (binding protein and activating transcription factor 3 expression), and the occurrence of oxidative stress (intracellular glutathione level). Results: Nelfinavir induced apoptosis in all four breast cancer cell lines tested, although the extent of autophagy and endoplasmic reticulum stress varied among the cell lines. The concentration of nelfinavir needed for an efficient induction of apoptosis in breast cancer cells could be reduced from 15 mu g/ml to 6 mu g/ml when combined with tamoxifen. At a concentration of 6 mu g/ml, tamoxifen substantially enhanced the endoplasmic reticulum stress reaction in those cell lines that responded to nelfinavir with binding protein (BiP) upregulation (MCF7, T47D), and enhanced autophagy in cell lines that responded to nelfinavir treatment with autophagy marker light chain 3B upregulation (MDA-MB-453). Although tamoxifen has been described to be able to induce oxidative stress at concentrations similar to those applied in this study (6 mu g/ml), we observed that nelfinavir but not tamoxifen reduced the intracellular glutathione level of breast cancer cells within hours of application by up to 32%, suggesting the induction of oxidative stress was an early event and an additional cause of the apoptosis induced by nelfinavir. Conclusions: The results demonstrate that nelfinavir may be an effective drug against breast cancer and could be combined with tamoxifen to enhance its efficacy against breast cancer cells. Moreover, the cytotoxic effect of a tamoxifen and nelfinavir combination was independent of the oestrogen receptor status of the analysed breast cancer cells, suggesting a potential benefit of a combination of these two drugs even in patients with no hormone-responsive tumours. We therefore recommend that clinical studies on nelfinavir with breast cancer patients should include this drug combination to analyse the therapeutic efficacy as well as the safety and tolerability of this potential treatment option

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