Improvement of cast nephropathy with plasma exchange depends on the diagnosis and on reduction of serum free light chains

Cast nephropathy is the most common cause of renal disease in multiple myeloma, however, treatment with plasma exchange remains controversial even after 3 randomized controlled studies. We sought to determine the importance of diagnostic confirmation and goal directed therapy in the treatment of cast nephropathy in forty patients with confirmed multiple myeloma and renal failure who underwent plasma exchange. A positive renal response was defined as a decrease by half in the presenting serum creatinine and dialysis independence. No baseline differences were noted between eventual renal responders and non-responders. Three quarters of the patients with biopsy proven cast nephropathy resolved their renal disease when the free light chains present in the serum were reduced by half or more but there was no significant response when the reduction was less. The median time to a response was about 2 months. In patients without cast nephropathy, renal recovery occurred despite reductions in free light chain levels of the serum. No association was found between free light chains in the serum, urinary monoclonal proteins, overall proteinuria and cast nephropathy. We found that the relationship between renal recovery and free light chain reduction was present only in patients with biopsy proven cast nephropathy showing the importance of extracorporeal light chain removal in this disease

Recent developments in planet migration theory

Planetary migration is the process by which a forming planet undergoes a drift of its semi-major axis caused by the tidal interaction with its parent protoplanetary disc. One of the key quantities to assess the migration of embedded planets is the tidal torque between the disc and planet, which has two components: the Lindblad torque and the corotation torque. We review the latest results on both torque components for planets on circular orbits, with a special emphasis on the various processes that give rise to additional, large components of the corotation torque, and those contributing to the saturation of this torque. These additional components of the corotation torque could help address the shortcomings that have recently been exposed by models of planet population syntheses. We also review recent results concerning the migration of giant planets that carve gaps in the disc (type II migration) and the migration of sub-giant planets that open partial gaps in massive discs (type III migration).Comment: 52 pages, 18 figures. Review article to be published in "Tidal effects in Astronomy and Astrophysics", Lecture Notes in Physic

Actinide analytical program for characterization of Hanford waste

The objective of this program has been to develop faster, more accurate methods for the concentration and determination of actinides at their maximum permissible concentration (MPC) levels in a controlled zone. These analyses are needed to characterize various forms of Hanford high rad waste and to support characterization of products and effluents from new waste management processes. The most acceptable methods developed for the determination of /sup 239/Pu, /sup 238/Pu, /sup 237/Np, /sup 241/Am, and /sup 243/Cm employ solvent extraction with the addition of tracer isotopes. Plutonium and neptunium are extracted from acidified waste solutions into Aliquat-336. Americium and curium are then extracted from the waste solution at the same acidity into dihexyl-N,N-diethylcarbamylmethylenephosphonate (DHDECMP). After back extraction into an aqueous matrix, these actinides are electrodeposited on steel disks for alpha energy analysis. Total uranium and total thorium are also isolated by solvent extraction and determined spectrophotometrically

Identification of gene networks modulated by activin in LßT2 cells using DNA microarray analysis

Activins, members of the TGFß family of proteins, are widely expressed in a variety of tissues. First identified based on their ability to regulate biosynthesis and secretion of follicle-stimulating hormone (FSH), activins have also been shown to modulate development, cell growth, apoptosis, and inflammation. Despite their many known functions, the precise mechanisms and downstream signaling pathways by which activins mediate their diverse effects remain unknown. We have used a DNA microarray assay to identify genes that are regulated by activin, alone or in combination with gonadotropin-releasing hormone (GnRH), another major regulator of FSH, in a murine gonadotrope-derived cell line (LßT2). We used mRNA from these cells to screen Affymetrix Mu74av2 mouse Gene Chip oligonucleotide microarrays, representing approximately 12,400 mouse genes. Treatment of LßT2 cells with activin A, a gonadotropin-releasing hormone agonist (GnRHA) or activin A plus GnRHA resulted in alterations in levels of gene expression that ranged in magnitude from 15 to 67-fold. Data analysis identified 268 transcripts that were up- or down-regulated by twofold or more. Distinct sets of genes were affected by treatment with activin, GnRHA and activin plus GnRHA, suggesting interactions between activin and GnRHA. Changes in expression of seven randomly selected representative genes identified by the microarray technique were confirmed by real-time quantitative PCR and semi-quantitative reverse transcription/PCR (RT/PCR). Modulation of expression of genes by activin suggests that activin may mediate its effects through a variety of signaling pathways

Total testosterone in young men is more closely associated than free testosterone with prostate cancer disparities

Introduction: Early adulthood has been suggested as the most relevant time to determine the influence of testosterone on prostate carcinogenesis. For a more detailed assessment of this hypothesis, the present study examined whether serum total or free testosterone in young men was more closely associated with prostate cancer disparities