Cellular Polyamine Catalogues of the Five Classes of the PhylumProteobacteria: Distributions of Homospermidine within the ClassAlphaproteobacteria, Hydroxyputrescine within the ClassBetaproteobacteria, Norspermidine within the ClassGammaproteobacteria, and Spermine within the ClassesDeltaproteobacteria and Epsilonproteobacteria

Cellular polyamines extracted from reclassified or newly validated 47 alphaproteobacteria, 46 betaproteobacteria, 96 gammaproteobacteria, 12 deltaproteobacteria and 10 epsilonproteobacteria were analyzed by high-performance liquid chromatography. Homospermidine was widely distributed within the class Alphaproteobacteria, however, homospermidine-dominant type, spermidine-dominant type and homospermidine/spermidinedominant type were found and the three triamine profiles were genus-specific. The all genera belonging to the class Betaproteobacteria, ubiquitously contained putrescine and 2- hydroxyputrescine. Triamines were absent in almost betaproteobacteria. Many genera, including psychrophilic species, of the class Gammaproteobacteria, contained putrescine and spermidine as the major polyaminenes. Diaminopropane and norspermidine were selectively distributed in several genera of the class Gammaproteobacteria. Spermidine was the major polyamine in the classes Deltaproteobacteria and Epsilonproteobacteria. Spermine was found in some thermophiles within Betaproteobacteria, Deltaproteobacteria and Epsilonproteobacteria, suggesting that the occurrence of spermine correlate to their thermophily. Additional these polyamine catalogues serve for the classification of the phylum Proteobacteria, as a chemotaxonomic marker

The effects of chemotherapy-induced alopecic experience on daily living

がん化学療法に伴う脱毛体験が患者の日常生活にもたらす影響について明らかにすることを目的に，１５名の患者に対して自由回答法による半構造化面接を実施した．同意を得て録音した面接内容の逐語録をデータとして，Krippendorff. Kの内容分析の手法を用いて分析を行った．分析の結果，がん化学療法に伴う脱毛体験が患者の日常生活にもたらす影響として，【脱毛した自分に違和感を感じながら人目を気にして生活する】【脱毛に備えて事前に準備する】【脱毛は仕方がないと捉え治療を受けることを優先させる】【予想以上の急速大量脱毛にがんであることの事実を突きつけられる】【時間をかけて脱毛の事実を受け入れ違う捉え方を見出す努力をする】【他者と距離を取りながら生活する】【立場，性差による脱毛の捉え方の違いを実感する】【脱毛した毛髪の処理を気にかけながら生活する】【脱毛のつらい経験から検診の啓蒙活動を行う】の９つが明らかとなった．脱毛に対して事前に十分な準備が行え，自分なりの対処法についてイメージできるよう具体的な情報提供を行うとともに，性差，治療効果や患者の治療への思いなどによって脱毛に対する捉え方はさまざまであることから，看護師はその人自身の脱毛の受け止め方や，脱毛が及ぼす生活への支障について把握し，必要な情報を提供することや患者の思いが表出しやすい環境を整えることが大切である．The present study aimed to clarify the effects of chemotherapy-induced alopecia on the daily lives of cancer patients. Semi-structured interviews comprising free-answer questions based on an interview guide were conducted on １５ cancer patients experiencing chemotherapy-induced alopecia. Analysis revealed the following ９ effects of chemotherapy-induced alopecia on patients’ daily lives : ‘self-consciousness accompanied by feeling strange about oneself due to hair loss’, ‘preparing for hair loss in advance’, ‘prioritizing treatment and perceiving hair loss as inevitable’, ‘come to terms with chemotherapy-induced alopecia gradually, make an effort to find out a different kind of ways for it’, ‘being hit by the reality of cancer due to greater than anticipated rapid loss of large quantities of hair’, ‘intentionally living daily life at a distance from others’, ‘recognizing the situation and the gender-based differences in perception of hair loss’, ‘worrying about disposing of the lost hair’, ‘becoming more informed about medical examinations due to the hard experience of hair loss’. The present findings indicated that chemotherapy-induced alopecia is perceived in various ways depending on gender, treatment effectiveness and patients’ feelings towards treatment. It is important for nurses to understand patients’ individual acceptance of alopecia and related difficulties in daily life while creating an environment that allows patients to express their feelings. Nurses should also provide specific information enabling patients to visualize personal coping techniques and sufficiently prepare for alopecia

Bevacizumab and Glioblastoma: Past, Present, and Future Directions

Glioblastoma (GBM) is the most common and lethal intracranial malignancy, with few advances in treatment over the last several decades. Much excitement surrounded the initial approval for bevacizumab for recurrent GBM, given the marked radiographic responses and improvement in progression-free survival observed in early studies. However, phase III studies have failed to demonstrate an overall survival advantage with the use of this agent. An overview of the mechanism of action and activity of bevacizumab in adult gliomas, a timeline of pivotal clinical trials, data on its impact on quality of life and imaging, and its role in managing the sequelae of treatment provide evidence for its current use. Investigations into combinatorial approaches utilizing bevacizumab with reirradiation and immunotherapy and ongoing work to identify biomarkers to select patient subsets who may benefit from treatment elucidate important unanswered questions that will further define the role of bevacizumab in the management of patients with GBM

The Utility of Liquid Biopsy in Central Nervous System Malignancies

PURPOSE OF REVIEW: Liquid biopsy is a sampling of tumor cells or tumor nucleotides from biofluids. This review explores the roles of liquid biopsy for evaluation and management of patients with primary and metastatic CNS malignancies. RECENT FINDINGS: Circulating tumor cell (CTC) detection has emerged as a relatively sensitive and specific tool for diagnosing leptomeningeal metastases. Circulating tumor DNA (ctDNA) detection can effectively demonstrate genetic markup of CNS tumors in the cerebrospinal fluid, though its role in managing CNS malignancies is less well-defined. The value of micro RNA (miRNA) detection in CNS malignancies is unclear at this time. Current standard clinical tools for the diagnosis and monitoring of CNS malignancies have limitations, and liquid biopsy may help address clinical practice and knowledge gaps. Liquid biopsy offers exciting potential for the diagnosis, prognosis, and treatment of CNS malignancies, but each modality needs to be studied in large prospective trials to better define their use

Pharmacoresistant seizures and IDH mutation in low-grade gliomas

BACKGROUND: Many low-grade gliomas (LGG) harbor isocitrate dehydrogenase (IDH) mutations. Although mutation is known to be epileptogenic, the rate of refractory seizures in LGG with mutation vs wild-type had not been previously compared. We therefore compared seizure pharmacoresistance in -mutated and wild-type LGGs. METHODS: Single-institution retrospective study of patients with histologic proven LGG, known mutation status, seizures, and ≥2 neurology clinic encounters. Seizure history was followed until histological high-grade transformation or death. Seizures requiring ≥2 changes in anti-epileptic drugs were considered pharmacoresistant. Incidence rates of pharmacoresistant seizures were estimated using competing risks methodology. RESULTS: Of 135 patients, 25 patients (19%) had LGGs classified as wild-type. Of those with mutation, 104 (94.5%) were R132H; only 6 were R172K. 120 patients (89%) had tumor resection, and 14 (10%) had biopsy. Initial post-surgical management included observation (64%), concurrent chemoradiation (23%), chemotherapy alone (9%), and radiotherapy alone (4%). Seizures became pharmacoresistant in 24 -mutated patients (22%) and in 3 wild-type patients (12%). The 4-year cumulative incidence of intractable seizures was 17.6% (95% CI: 10.6%-25.9%) in -mutated and 11% (95% CI: 1.3%-32.6%) in wild-type LGG (Gray\u27s -value = .26). CONCLUSIONS: 22% of the -mutated patients developed pharmacoresistant seizures, compared to 12% of the wild-type tumors. The likelihood of developing pharmacoresistant seizures in patients with LGG-related epilepsy is independent to mutation status, however, -mutated tumors were approximately twice as likely to experience LGG-related pharmacoresistant seizures

Mu-opioid receptor A118G polymorphism in healthy volunteers affects hypothalamic-pituitary-adrenal axis adrenocorticotropic hormone stress response to metyrapone

The mu-opioid receptor encoded by the gene OPRM1 plays a primary role in opiate, alcohol, cocaine and nicotine addiction. Studies using opioid antagonists demonstrate that the mu-opioid receptor (MOP-r) also mediates the hypothalamic-pituitary-adrenal (HPA) axis stress response. A common polymorphism in exon one of the MOP-r gene, A118G, has been shown to significantly alter receptor function and MOP-r gene expression; therefore, this variant likely affects HPA-axis responsivity. In the current study, we have investigated whether the presence of the 118AG variant genotype affects HPA axis responsivity to the stressor metyrapone, which transiently blocks glucocorticoid production in the adrenal cortex. Forty-eight normal and healthy volunteers (32 men, 16 women) were studied, among whom nine men and seven women had the 118AG genotype. The 118G allele blunted the adrenocorticotropic hormone (ACTH) response to metyrapone. Although there was no difference in basal levels of ACTH, subjects with the 118AG genotype had a more modest rise and resultant significantly lower ACTH levels than those with the prototype 118AA at the 8-hour time point (P \u3c 0.02). We found no significant difference between genders. These findings suggest a relatively greater tonic inhibition at hypothalamic-pituitary sites through the mu-opioid receptor and relatively less cyclical glucocorticoid inhibition in subjects with the 118G allele

Dynamic susceptibility contrast and diffusion-weighted MRI in posterior fossa pilocytic astrocytoma and medulloblastoma

BACKGROUND AND PURPOSE: The utility of perfusion MRI in distinguishing between pilocytic astrocytoma (PA) and medulloblastoma (MB) is unclear. This study aimed to evaluate the diagnostic and prognostic performance of dynamic susceptibility contrast (DSC)-MRI parameters and apparent diffusion coefficient (ADC) values between PA and MB. METHODS: Between January 2012 and August 2021, 49 (median, 7 years [range, 1-28 years]; 28 females) and 35 (median, 8 years [1-24 years]; 12 females) patients with pathologically confirmed PA and MB, respectively, were included. The normalized relative cerebral blood volume and flow (nrCBV and nrCBF) and mean and minimal normalized ADC (nADCmean and nADCmin) values were calculated using volume-of-interest analyses. Diagnostic performance and Pearson\u27s correlation with progression-free survival were also evaluated. RESULTS: The MB group showed a significantly higher nrCBV and nrCBF (nrCBV: 1.69 [0.93-4.23] vs. 0.95 [range, 0.37-2.28], p = .0032; nrCBF: 1.62 [0.93-3.16] vs. 1.07 [0.46-2.26], p = .0084) and significantly lower nADCmean and nADCmin (nADCmean: 0.97 [0.70-1.68] vs. 2.21 [1.44-2.80], p \u3c .001; nADCmin: 0.50 [0.19-0.89] vs. 1.42 [0.89-2.20], p \u3c .001) than the PA group. All parameters exhibited good diagnostic ability (accuracy \u3e0.80) with nADCmin achieving the highest score (accuracy = 1). A moderate correlation was found between nADCmean and progression-free survival for MB (r = 0.44, p = .0084). CONCLUSIONS: DSC-MRI parameters and ADC values were useful for distinguishing between PA and MB. A lower ADC indicated an unfavorable MB prognosis, but the DSC-MRI parameters did not correlate with progression-free survival in either group

Discordance Between Perceptions and Experience of Lumbar Puncture: A Prospective Study

BACKGROUND AND OBJECTIVES: Novel diagnostic techniques and neurologic biomarkers have greatly expanded clinical indications for CSF studies. CSF is most commonly obtained via lumbar puncture (LP). Although it is generally believed that LPs are well tolerated, there is a lack of supportive data for this claim, and patients anticipate LP to be painful. The objective of this study was to prospectively investigate discordance between patient perception and tolerability of LP. METHODS: Adult patients were surveyed before and after LP regarding their perceptions and experience of LP. Physician perceptions were gathered through a web-based survey. Relative risk and Spearman correlation were used to assess the relationship between responses. Paired binomial and paired ordinal responses were compared by McNemar and paired Wilcoxon rank-sum tests. RESULTS: A total of 178 patients completed the surveys. About half of the patients (58%) reported anxiety pre-LP, at median 3.0 of 10. Physicians overpredicted patients\u27 pre-LP anxiety (median score 5.0, \u3c 0.001). Experienced pain was significantly less than predicted pain (median scores 0 and 3.0, respectively, \u3c 0.001). Patients who predicted pain were more likely to report pain from LP (relative risk [RR] 1.3). Predicting pain was also correlated with anxiety before LP ( \u3c 0.001). DISCUSSION: LP was generally well tolerated. The majority of patients experienced minimal pain. Anticipation of pain was correlated with both feeling anxious and experiencing pain. The results of this study can be used to reassure patients and providers that LP is indeed not as painful as imagined, which may both reduce pre-LP anxiety and improve LP tolerability