6,510 research outputs found

    Pasireotide in an insulin-requiring diabetic acromegalic patient without worsening of hyperglycemia

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    Long-acting pasireotide is an effective treatment option for acromegaly, but it is associated with hyperglycemia, which could impact its use in patients with diabetes. We present a case of a 53-year-old man with acromegaly and type 2 diabetes mellitus (glycated hemoglobin (HbA1c): 7.5%), who refused surgery to remove a pituitary macroadenoma and enrolled in a Phase 3 clinical trial comparing long-acting pasireotide and long-acting octreotide in acromegalic patients. The patient initially received octreotide, but insulin-like growth factor 1 (IGF-1) levels remained elevated after 12 months (383.9 ng/mL; 193.0 ng/mL; reference range: 86.5–223.8 ng/mL), indicating uncontrolled acromegaly. He switched to pasireotide 40 mg and subsequently increased to 60 mg. Within 6 months, IGF-1 levels normalized (193.0 ng/mL), and they were mostly normal for the next 62 months of treatment with pasireotide (median IGF-1: 190.7 ng/mL). Additionally, HbA1c levels remained similar to or lower than baseline levels (range, 6.7% to 7.8%) during treatment with pasireotide despite major changes to the patient’s antidiabetic regimen, which included insulin and metformin. Uncontrolled acromegaly can result in hyperglycemia due to an increase in insulin resistance. Despite having insulin-requiring type 2 diabetes, the patient presented here did not experience a long-term increase in HbA1c levels upon initiating pasireotide, likely because long-term control of acromegaly resulted in increased insulin sensitivity. This case highlights the utility of long-acting pasireotide to treat acromegaly in patients whose levels were uncontrolled after long-acting octreotide and who manage diabetes with insulin

    Targeting the Epidermal Growth Factor Receptor in Epithelial Ovarian Cancer: Current Knowledge and Future Challenges

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    The epidermal growth factor receptor is overexpressed in up to 60% of ovarian epithelial malignancies. EGFR regulates complex cellular events due to the large number of ligands, dimerization partners, and diverse signaling pathways engaged. In ovarian cancer, EGFR activation is associated with increased malignant tumor phenotype and poorer patient outcome. However, unlike some other EGFR-positive solid tumors, treatment of ovarian tumors with anti-EGFR agents has induced minimal response. While the amount of information regarding EGFR-mediated signaling is considerable, current data provides little insight for the lack of efficacy of anti-EGFR agents in ovarian cancer. More comprehensive, systematic, and well-defined approaches are needed to dissect the roles that EGFR plays in the complex signaling processes in ovarian cancer as well as to identify biomarkers that can accurately predict sensitivity toward EGFR-targeted therapeutic agents. This new knowledge could facilitate the development of rational combinatorial therapies to sensitize tumor cells toward EGFR-targeted therapies

    Lifting the Veil of Dust from NGC 0959: The Importance of a Pixel-Based 2D Extinction Correction

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    We present the results of a study of the late-type spiral galaxy NGC 0959, before and after application of the pixel-based dust extinction correction described in Tamura et al. 2009 (Paper I). Galaxy Evolution Explorer (GALEX) far-UV (FUV) and near-UV (NUV), ground-based Vatican Advanced Technology Telescope (VATT) UBVR, and Spitzer/Infrared Array Camera (IRAC) 3.6, 4.5, 5.8, and 8.0 micron images are studied through pixel Color-Magnitude Diagrams (pCMDs) and pixel Color-Color Diagrams (pCCDs). We define groups of pixels based on their distribution in a pCCD of (B - 3.6 micron) versus (FUV - U) colors after extinction correction. In the same pCCD, we trace their locations before the extinction correction was applied. This shows that selecting pixel groups is not meaningful when using colors uncorrected for dust. We also trace the distribution of the pixel groups on a pixel coordinate map of the galaxy. We find that the pixel-based (two-dimensional) extinction correction is crucial to reveal the spatial variations in the dominant stellar population, averaged over each resolution element. Different types and mixtures of stellar populations, and galaxy structures such as a previously unrecognized bar, become readily discernible in the extinction-corrected pCCD and as coherent spatial structures in the pixel coordinate map.Comment: 10 pages, LaTeX2e requires 'emulateapj.cls', 'graphicx.sty', and 'natbib.sty' (included), 9 postscript figures, 1 table. Accepted for publication in AJ

    Photocatalytic Hydrogen Evolution from Sub-Stoichiometric Colloidal WO3-xNanowires

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    We report direct photocatalytic hydrogen evolution from substoichiometric highly reduced tungsten oxide (WOx) nanowires (NWs) using sacrificial alcohol. WOx NWs are synthesized via nonaqueous colloidal synthesis with a diameter of about 4 nm and an average length of about 250 nm. As-synthesized WOx NWs exhibit a broad absorption across the visible to infrared regions attributed to the presence of oxygen vacancies. The optical band gap is increased in these WOx NWs compared to stoichiometric bulk tungsten oxide (WO3) powders as a result of the Burstein\u2013Moss shift. As a consequence of this increase, we demonstrate direct photocatalytic hydrogen production from WOx NWs through alcohol photoreforming. The stable H2 evolution on platinized WOx NWs is observed under conditions in which platinized bulk WO3 and bulk WO2.9 powders either do not show activity or show very low rates, suggesting that increased surface area and specific exposed facets are key for the improved performance of WOx NWs. This work demonstrates that control of size and composition can lead to unexpected and beneficial changes in the photocatalytic properties of semiconductor materials

    Schizont transcriptome variation among clinical isolates and laboratory-adapted clones of the malaria parasite Plasmodium falciparum

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    Background: Malaria parasites are genetically polymorphic and phenotypically plastic. In studying transcriptome variation among parasites from different infections, it is challenging to overcome potentially confounding technical and biological variation between samples. We investigate variation in the major human parasite Plasmodium falciparum, generating RNA-seq data on multiple independent replicate sample preparations of merozoite-containing intra-erythrocytic schizonts from a panel of clinical isolates and from long-term laboratory-adapted clones, with a goal of robustly identifying differentially expressed genes. Results: Analysis of biological sample replicates shows that increased numbers improve the true discovery rate of differentially expressed genes, and that six independent replicates of each parasite line allowed identification of most differences that could be detected with larger numbers. For highly expressed genes, focusing on the top quartile at schizont stages, there was more power to detect differences. Comparing cultured clinical isolates and laboratory-adapted clones, genes more highly expressed in the laboratory-adapted clones include those encoding an AP2 transcription factor (PF3D7_0420300), a ubiquitin-binding protein and two putative methyl transferases. In contrast, higher expression in clinical isolates was seen for the merozoite surface protein gene dblmsp2, proposed to be a marker of schizonts forming merozoites committed to sexual differentiation. Variable expression was extremely strongly, but not exclusively, associated with genes known to be targeted by Heterochromatin Protein 1. Clinical isolates show variable expression of several known merozoite invasion ligands, as well as other genes for which new RT-qPCR assays validate the quantitation and allow characterisation in samples with more limited material. Expression levels of these genes vary among schizont preparations of different clinical isolates in the first ex vivo cycle in patient erythrocytes, but mean levels are similar to those in continuously cultured clinical isolates. Conclusions: Analysis of multiple biological sample replicates greatly improves identification of genes variably expressed between different cultured parasite lines. Clinical isolates recently established in culture show differences from long-term adapted clones in transcript levels of particular genes, and are suitable for analyses requiring biological replicates to understand parasite phenotypes and variable expression likely to be relevant in nature
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