Recent Advances in Treatment of Primary Central Nervous System Lymphoma

Opinion statement Therapeutic options are limited in primary central nervous system lymphoma (PCNSL) with no uniform consensus on optimal management and few published, randomized trials. High-dose methotrexate in combination with other chemotherapeutic agents forms the mainstay of treatment. There hasn’t been much progress beyond high-dose methotrexate in this disease, and although results from trials using high-dose chemotherapy and autologous stem-cell transplant seem promising, these need to be further validated. Moreover, the role of whole brain radiation in the upfront setting remains to be determined. However, international efforts in this direction are underway, with ongoing randomized trials in newly diagnosed PCNSL, more research on the molecular pathogenesis and biomarkers, and the use of novel agents in salvage therapy. There also is emphasis on quality of life parameters and neurocognitive status. Future treatment options should optimize high-efficacy rates while minimizing the risk of neurotoxicity

Treatment Of Chronic Kidney Disease Patients With A Supplemented Low Protein Diet And A Supplemented Very Low Protein Diet

The primary results of the Modification of Diet in Renal Disease were inconclusive and did confuse a lot of physicians about the dietary approach to CKD management. The study design was flawed and thus compromised the results and conclusions. Re-analysis of the MDRD study however clearly showed the benefits of dietary protein restriction and also more importantly an additional benefit by ketoanalogue supplementation in delaying progression of CKD. Despite the obvious benefits of protein restriction, concern has been raised recently especially patients on very low dietary protein (very-low-protein diets; VLPDs), which could lead to deterioration in the nutritional status of CKD patients. To address this particular issue of whether a sVLPD diet induces malnutrition the present study has been taken up 132adult patients with Stage 3 to Stage 5 (Predialysis) were initiated on a protein restricted ketoanalogue supplemented diet after informed consent and the necessary Institutional Ethics Committee approvals. Based on their affordability, 92 patients randomly were assigned to the sLPD group whereby they received 0.6G/Kg BW of dietary proteins supplemented by ketoanalogues at a dosage of one tablet per 10Kg body weight. 40 patients received 0.3G/Kg BW supplemented by ketoanalogues at a dose of one tablet per 5Kg body weight. Renolog® tablets manufactured by La Renon Healthcare Ltd, Ahmebabad, India were prescribed as the ketoanalogue supplements. Renal, Metabolic, Nutritional parameters and Anthropometric analysis were done in both groups at the start of the study and at the end of 6 months of follow up. The mean blood urea in the SLPD group showed a decrease from 81.17+_ 00mg/dl to 74.45+_30.75mg/dl (p< 0.05) and in the SVLPD from 78.35+_00mg/dl to 66.50+_34.50mg/dl (p>0.05) at the end of six months indicating an improvement in renal function . The serum creatinine also showed a decrease from 3.52+_00mg/dl to 3.30 +_1.63mg/dl(p>0.05) in the SLPD group and a decrease from 3.74+_00mg/dl to 3.55+_1.67mg/dl(p>0.05) in the SVLPD group though not statistically significant. The eGFR showed improvement from 26.76+_00ml/min to 30.75+_17.31ml/min (p<0.05) at end of six months in the SLPD group and an increase from 23.62+_00ml/min to 26.35+_10.58ml/min(p>0.05) in the SVLPD group. Serum albumin increased from 3.85+_00gm/dl to 4.00+_0.56gm/dl (p<0.05) in the SLPD group and an increase from 4.03+_00gm/dl to 4.07+_0.47gm/dl in the SVLPD group indicating an improvement in nutrition in SVLPD group (p>0.05) . Blood hemoglobin increased from 11.18+_2.02gm/dl to 11.48+_2.14gm/dl in the SLPD group and an increase from 11.35+_0.96gm/dl to 13.22+_1.03gm/dl in the SVLPD group. Combined analysis of both the study groups together(SLPD +SVLPD) showed a statistically significant decrease in blood urea from 80.32+_0.0 mg/dl to 73.70+_31.81mg/dl(p<0.05), decrease in serum creatinine from 3.59+_0.0mg/dl to 3.38+_1.64mg/dl (0>0.05) and increase in eGFR from 25.82+_ 0.0ml/min to 29.42+_ 15.67ml/min(<0.05) at the end of six months of therapy which was statistically significant indicating an improvement in renal function. The serum albumin increased from 3.91+_0.0gm/dl to 4.02+_0.53gm/dl (p<0.05) indicating a statistically significant improvement in nutrition. The protein restricted ketoanalogue treated patients in this large series showed significant improvement in their renal function, metabolic status and their extensively investigated nutritional parameters over a period of 6 months. The key here is to use the right dosage of the ketoanalogue supplements in addition to ensuring strict compliance of dietary restrictions. It is strongly recommended that ketoanalogues be routinely used in the conservative management of CKD

Study of onychomycosis

Background: Onychomycosis is one of the most common fungal nail infections caused by Dermatophytes, Non-Dermatophytic Molds (NDM) and Yeast. Though it is not life-threatening, can cause pain, discomfort, and disfigurement. It decreases the nail growth rate. Objectives: This study was carried out to document the clinico-mycological pattern and antifungal susceptibility pattern of onychomycosis.Methods: The study group included 130 consecutive patients with suspected fungal nail infections, attending Dermatology outpatient department of King George Hospital, Visakhapatnam, Andhra Pradesh during November 2012 to August 2014. The nail clippings of the patients were collected and subjected to KOH mounts for direct microscopy and fungal culture and antifungal susceptibility tests.Results: Onychomycosis was common among males (66.92%) than females (33.08%) with highest incidence was in age group 31-40 years (41.37%). Finger or toenails were exclusively involved in 32.18% and 55.18% patients respectively while these were involved concurrently in the rest of the 12.65% patients. Distal and lateral subungual onychomycosis seen in 64.36% of the patients was the most common clinical type. KOH and culture positivity were recorded in 56.92% and 48.46% cases respectively. Dermatophytes (50.58%) were predominant isolate followed by NDM (27.58%) and yeast (21.84%). Clotrimazole and ketoconazole were most effective antifungals against dermatophytes. For NDM, itraconazole, nystatin and amphotericin B and for yeast fluconazole and itraconazole were effective.Conclusions: The present study gives an insight about the aetiological agents causing onychomycosis and their anti-fungal susceptibility pattern in this region. Thus, it can help in taking adequate control measures to prevent it

教育と初期キャリアの関連について

日本教育社会学会第48回大会, 1996年10月(九州大学), 課題研究Ⅰ 大卒雇用の構造変動と大学教

Raman spectroscopy can differentiate malignant tumors from normal breast tissue and detect early neoplastic changes in a mouse model

Raman spectroscopy shows potential in differentiating tumors from normal tissue. We used Raman spectroscopy with near-infrared light excitation to study normal breast tissue and tumors from 11 mice injected with a cancer cell line. Spectra were collected from 17 tumors, 18 samples of adjacent breast tissue and lymph nodes, and 17 tissue samples from the contralateral breast and its adjacent lymph nodes. Discriminant function analysis was used for classification with principal component analysis scores as input data. Tissues were examined by light microscopy following formalin fixation and hematoxylin and eosin staining. Discriminant function analysis and histology agreed on the diagnosis of all contralateral normal, tumor, and mastitis samples, except one tumor which was found to be more similar to normal tissue. Normal tissue adjacent to each tumor was examined as a separate data group called tumor bed. Scattered morphologically suspicious atypical cells not definite for tumor were present in the tumor bed samples. Classification of tumor bed tissue showed that some tumor bed tissues are diagnostically different from normal, tumor, and mastitis tissue. This may reflect malignant molecular alterations prior to morphologic changes, as expected in preneoplastic processes. Raman spectroscopy not only distinguishes tumor from normal breast tissue, but also detects early neoplastic changes prior to definite morphologic alteration. © 2007 Wiley Periodicals, Inc. Biopolymers 89: 235–241, 2008. This article was originally published online as an accepted preprint. The “Published Online”date corresponds to the preprint version. You can request a copy of the preprint by emailing the Biopolymers editorial office at [email protected] Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/57899/1/20899_ftp.pd

Exchange bias effect in alloys and compounds

The phenomenology of exchange bias effects observed in structurally single-phase alloys and compounds but composed of a variety of coexisting magnetic phases such as ferromagnetic, antiferromagnetic, ferrimagnetic, spin-glass, cluster-glass and disordered magnetic states are reviewed. The investigations on exchange bias effects are discussed in diverse types of alloys and compounds where qualitative and quantitative aspects of magnetism are focused based on macroscopic experimental tools such as magnetization and magnetoresistance measurements. Here, we focus on improvement of fundamental issues of the exchange bias effects rather than on their technological importance