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Tissue. A mediastinoscopy with biopsy was performed, and the pathology revealed mixed cellularity-type Hodgkin's lymphoma Fig. 1 ; . A gallium scan was positive in the mediastinal, left axillary, and right inguinal nodes. A bone marrow biopsy revealed Hodgkin's lymphoma, and the patient was considered to have clinical-stage IVB disease Fig. 2 ; . He underwent treatment with adriamycin, bleomycin, vincristine, and dacarbazine ABVD ; chemotherapy for four cycles. Restaging gallium scan was negative for nodal uptake, and a CT scan showed significant decrease in the lymphadenopathy. After four additional cycles of ABVD, repeat staging revealed new gallium-avid disease in the right paratracheal region, with stable disease upon CT scan. Repeat bone marrow biopsy was negative. The patient was considered to have refractory disease and underwent salvage therapy with rituximab, ifosfamide, carboplatin, and etoposide. After two cycles, he had a negative gallium.
James jakub, surgical oncologist at lakeland regional cancer center, is listed as a co-author of a report on randomized phase ii study of dacarbazine emea indicates that genasense r ; approval in melanoma will require.
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TA, Parker P, Slovak ML, Nagasawa LS, Blume KG, Forman SJ: Importance of bone marrow cytogeneticevaluation before autologous bone marrow transplantation for Hodgkin's disease. J Clin Oncol9: 1575, 1991 4 Soutar R L Acute myeloblasticleukaemia and recombinant 1 granulocytecolony stimulating factor. BMJ 303: 123, 199 letter ; 42. Chopra R, Linch DC, McMillan AK, BlairS , Patterson KG, Moir D, Richards JDM, Cervi P, Kinsey S, Goldstone AH: MiniBEAM followed by BEAM ABMT for very poor risk Hodgkin's and disease. Br J Haematol8 1 : 197, 1992 43.Pfreundschuh MC, SchoppeWD, Fuchs R, Pfluger KH, Loeffler M, Diehl V: Lomustine, etoposide, vindesine, and dexamethasone CEVD ; in Hodgkin's lymphoma refractory to cyclophosphamide, vincristine, procarbazine, and prednisone COPP ; and doxorubicin, bleomycin, vinblastine, and dacarbazine ABVD ; : A multicenter trial of the German Hodgkin Study Group. Cancer Treat Rep 7 1 : 1203, I987 44. Santoro A, Viviani S, Valagussa P, Bonfante V, Bonadonna G: CCNU, etoposide and prednimustine CEP ; in refractory Hodgkin'sdisease. Semin Oncol13: 23, 1986 suppl 1 ; 45. Tseng Jr A, Jacobs C, Coleman CN, Homing SJ, Lewis BJ, Rosenberg SA: Third-line chemotherapy for resistant Hodgkin's disease with lomustine, etoposide and methotrexate. Cancer Treat Rep71: 475, 1987 46. Gianni AM, Siena S, BregniM, Lombardi F, Gandola L, Valagussa P, Bonadonna G: Prolonged disease-free survival after high-dose sequential chemo-radiotherapyand haemopoieticautologous transplantation in poor prognosis Hodgkin's disease. Ann Oncol 2: 645, 1991 Gulati SC, Bennett C L factor GM-CSF ; adjunct therapy in relapsed Hodgas kin disease. Ann Intern Med I16: 177, 1992 48. Taylor KM, Jagannath S, Spitzer G, Spinolo JA, Tucker SL, Fogel B, Cabanillas FF, Hagemeister Souza LM: Recombinant FB, human granulocyte colony-stimulatingfactor hastens granulocyte recovery after highdose chemotherapy and autologous bone marrow transplantation in Hodgkin's disease. J Clin Oncol 7: 1791, 1989 VogelsangGB, Jones RJ, Farmer ER, Altomonte V, Hess AD, Santos G W Induction of cutaneous graft-versus-host disease by administration of cyclosporine to patients undergoing autologous bone marrow transplantation for acute myeloid leukemia. Blood 79: 303 1992 Redman J, Hagemeister F, McLaughlin P, Swan F, Velasquez W, Rodriguez M, Cabanillas F a-interferon treatment of Hodgkin'sdisease HD ; . Proc SOCClinOncol9: 256, 1990 abstr ; 5 1. NaglerA, Ackerstein A, Or R, Morecki S, Naparstek E, Harden Y, Drakos P, Kapelushnik Y, Slavin S: Immunotherapy by recombinant alpha interferon uIFN ; and recombinant human interleukin-2 IL-2 ; of lymphoma patients post-autologous bone marrow transplantation ABMT ; . Blood 8068a, 1992 abstr, suppl.
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We thank Dr. D. Swallow London, UK ; for the lactase antibody, Dr. G. Holman University of Bath ; for the GLUT5 antibody, Dr. G. Gould University of Glasgow ; for the human GLUT2 cDNA, Dr. J. Hesketh University of Newcastle-upon-Tyne ; for the 18S rRNA cDNA, Dr. S. Maroux Marseilles, France ; for the sucrase antibody, and Dr. J. Ball University of Cincinnati ; for the Na -K -ATPase antibody. This work was supported in part by a University of Liverpool Research Development Fund and by Biogenesis UK Limited. AJP-Gastrointest Liver Physiol VOL.
| Dacarbazine more for_health_professionalsA 60-year-old woman presented to the emergency department with a history of palpitation and dizziness when standing, relieved only by lying flat. She had previously seen a number of physicians with similar symptoms over a six year period. Her symptoms were intermittent and would last from a few minutes to a few hours. Full endocrinological assessment had been normal and a diagnosis of POTS postural orthostatic tachycardia syndrome ; had been made after it was noticed that she had a significant increase in heart rate during a tilt test and daclizumab.
Or a 90 polypropylene suture on a CTC-6L needle would be appropriate. The latter suture represents a lower risk of late breakage and is therefore our preference. The needle is passed into the anterior chamber, over the optic, and under the haptic so that it penetrates the capsule. A second instrument ideally, an Ahmed microforceps [Microsurgical Technology, Redmond, WA] ; that supported the IOL capsule complex through a second paracentesis would facilitate this maneuver. The needle must pass through the paracentesis, or a false passage will capture corneal tissue in the suture and prevent the loop from entering the anterior chamber. After the successful passage of the suture under the haptic, we would place a 26-gauge needle, bent at the hub, into the posterior chamber at either of the lateral edges of the partial-thickness scleral incision. The tip of the suture needle is then captured in the lumen of the 26-gauge needle and externalized through the sclera. We would repeat the process with the other end of the 100 polypropylene suture, this time passing it over the haptic and externalizing the suture on the other lateral edge of the scleral incision. We would tie the suture ends in a releasable fashion to allow for the titration of tension following the placement of the second suture. The applied tension on the suture would center the capsule IOL complex, thereby facilitating visualization of the second haptic for suturing. After titrating both sutures for tension and tying them in the usual fashion, we would rotate the knots so that they were located in the posterior chamber. This technique minimizes the risk of conjunctival erosion over the knots as well as erosion of the suture through the sclera. We would close the peritomies in our usual fashion. GUILLERMO ROCHA, MD, FRCSC This patient presents with a dislocated IOL implant in the bag. Significant features are the absence of vitreous prolapse and the lack of a YAG laser posterior capsulotomy Figure 1 ; . This case is simple in concept but challenging in practice. There are two basic possibilities for management: 1 ; to remove the dislocated lens and exchange it for a new IOL or 2 ; to reposition the lens implant. Important principles in the management of such a case include the maintenance of a pressurized globe, manipulation of the lens through as closed a system as possible, and perhaps the provision of a pars plana access to facilitate maneuvering the lens. A surgeon who decides to exchange the implant should create a clear corneal paracentesis with a super blade. He can then inject a cohesive viscosurgical device behind the lens so as to displace it anteriorly through the pupil. Once the optic and haptics are in the anterior.
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Right 13: type of membrane, membrane surface area and blood flow rate The usefulness of `biocompatible' membranes for improving morbidity and mortality of haemodialysis patients is still controversial: some studies suggest that semi-synthetic and synthetic membranes and or highflux may reduce morbidity and mortality in dialysis patients [33], while others do not find any difference in mortality and morbidity [34]. Highly permeable synthetic membranes provoke less inflammatory response on contact with blood than conventional cellulose membranes [35], and their large pores allow better convective transport of potentially toxic, medium-sized and large molecules [13]. Since the matter has not been completely clarified [36] and the evidence for lower mortality in patients treated with `biocompatible' and dactinomycin.
| FIG. 1. Chemical structure of 3- 4-fluorophenoxy ; -2-hydroxy-2-methyl-N-[4-nitro3- trifluoromethyl ; phenyl]-propanamide, denoted as S-1.
MI.016 EXPRESSION OF ALTERNATIVE SPLICE FORMS OF IL15RA IN DIFFERENT HUMAN TISSUES AND IN CELLS TREATED WITH DNA METHYLTRANSFERASE INHIBITOR Diniz SN, Pendeloski KPT, Shulzhenko N, Morgun A, Gerbase-DeLima M Setor de Imunogentica. Universidade Federal de So Paulo UNIFESP ; , So Paulo, Brazil Introduction and Objectives: Human IL15RA gene encoding the alpha chain of IL-15 receptor is expressed in a variety of immune and non-immune cell types from different tissues. Recently, it was demonstrated that IL15RA was up-regulated in cardiac transplant rejection in humans Circ. Res. 98: 74-86, 2006 ; . Splicing events of functional importance have been described for IL15RA mRNA. The objective of this study was to evaluate the expression of IL15RA and its mRNA alternative forms deletion of exon 3 ; , encoding the linker region; elimination of exon 2 ; , encoding the sushi domain, or deletion of both 2, 3 , in different human tissues. Since a CpG island was found near the IL15RA gene transcription start site we also decided to investigate role of DNA methylation on the expression of the full-length and alternative splice forms of IL15RA in peripheral blood mononuclear cell PBMC ; . Methods and Results: Fulllength, as well as at least one of the three alternative forms were detected RT-PCR ; in placenta, trachea, lung, liver, kidney, colon, testis, adrenal gland, amygdala, thymus, skeletal muscle, heart, thyroid, prostate, brain and nerve cells, whereas no expression of this gene was observed in duodenum, gallbladder, fallopian tube and vaginal mucosa. In PBMC, a novel partial exon 3-skipping alternative splice form was found. We treated PBMC cultures with 5azacitidine 5-aza ; , a DNA methyltransferase inhibitor, and detected a modest median ratio of 1.71 ; increase p 0.013 ; in IL15RA expression level for the full length form, but no difference was observed for the alternative forms 3 and 2, 3. A significant p 0.0007 ; correlation r 0.81 ; between the expression ratios, before and after 5-aza, was observed for 3 and 2, 3 isoforms. Conclusion: We observed a broad expression pattern of IL15RA splicing forms and suggested a role of DNA methylation in the regulation of IL15RA expression in mononuclear cells. Keywords: IL15RA, alternative splicing, 5-azacitidine and dalteparin.
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The emergence of fluconazole and amphotericin B resistant strains of C. albicans in cancer patients is a troubling new development Nolte et al., 1997 ; . Though over the last decade fluconazole-resistant Candida sp. infections in cancer patients were more studied than amphotericin B resistant infections, currently, the increasing incidence of development of amphotericin B resistance in patients with Candida sp. infection, and receiving antineoplastic and antifungal therapy, is a reality. In this context, the increased fungal catalase activity has been suggested as a mechanism that not only reduces the amphotericin B activity, but also protects against oxidative damage, favouring the survival of fungal cells. This may be related to the resistance mechanism for amphotericin B Sokol-Anderson et al., 1988 ; . However, since 1990, very few complete studies have demonstrated the influence of antineoplastic drugs on catalase activity, a fact that impelled this study, especially considering the failure of systemic mycosis treatment in cancer patients. To verify the antineoplastic drug influence on catalase activity, non-exposed C. albicans was used as a control in this study. Table 1 shows the levels of catalase in C. albicans not exposed to drugs and exposed to dacarbazine [8 mg ml21], cyclophosphamide [50 mg ml21], cytarabine [1 mg ml21] and methotrexate [2 mg ml21 4 mM]. Statistical analysis demonstrated no significant differences P 0?05 ; between the groups of C. albicans exposed and not exposed to dacarbazine, cyclophosphamide and cytarabine. The mean catalase activity in yeast exposed to dacarbazine [8?43?14 DE min21 mg protein ; 21] or cyclophosphamide [9?1373?6 DE min21 mg protein ; 21] was only slightly higher than in the non-exposed yeast [6?4123?73 DE min21 mg protein ; 21]. The mean catalase activity in yeast exposed to cytarabine [5?952?2 DE min21 mg protein ; 21] was slightly lower than that in the drug-free yeast. Although no statistical differences were found in the groups exposed and not exposed to dacarbazine, cyclophosphamide and cytarabine, we observed that when we took C. albicans ATCC 44373 catalase activity as a standard, the yeasts with catalase activity lower than C. albicans ATCC 44373 increased their levels of catalase, and the yeasts with levels of catalase activity higher than C. albicans ATCC 44373 decreased their levels after exposure. Extensive investigations are necessary to demonstrate the real influence of.
Figure 3. Reverse cholesterol transport, hepatic catabolism, and bile acid secretion. Nascent HDL particles are remodeled by lipoprotein-associated LCAT, CETP, and PLTP to generate CE-rich HDL, which is taken-up by the hepatic SR-BI receptor. HDL cholesterol C ; and dietary sterols P ; are secreted into the bile via ABCG5 G8 transporters, as well as converted by the CYP7A classical ; pathway to bile acids BA ; and excreted into the bile via the bile salt export pump BSEP ; . Oxysterols, such as 27-HC, generated in peripheral tissues are converted via the CYP7B alternative ; pathway to bile acids. Bile acids BA ; are secreted into the gut lumen where they emulsify cholesterol C ; for absorption. BAs are reabsorbed in the terminal ileum via the apical sodium-dependent bile salt transporter ASBT ; . In the enterocyte, BAs are bound to the ileal bile acid-binding protein IBABP ; , and are exported into the portal circulation by the multidrug resistance protein 3 MRP3 ; . Uptake of the bile acid metabolite, lithocholic acid LCA ; , is mediated by the sodiumindependent organic anion transporting peptide OATP2 ; . Dark gray boxes represent LXR target genes; light gray boxes represent FXR target genes; dark-hatched boxes represent LXR FXR target genes; light-hatched boxes represent PPAR target genes; stippled boxes represent LXR PPAR FXR target genes; checkered boxes represent PXR target genes. Inset depicts crosstalk between LXR and FXRSHP-1LRH-1 regulatory cascade. Bile acids serve as ligands for FXR, resulting in increased SHP-1 expression. SHP-1 in turn inhibits LRH-1, preventing activation of target genes that participate in bile acid and fatty acid synthesis. In the absence of bile acids, LRH-1 acts in concert with LXR to stimulate bile acid and fatty acid synthesis and damiana.
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Macrolides. In summary, a strong association between mucositis and Mycoplasma should be considered when evaluating patients with unexplained severe oral lesions.
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1. Andriole, V. T. 1998 ; . Current and future therapy of invasive fungal infections. In Current Clinical Topics in Infectious Diseases.
That bind to certain receptors; given to patients before they receive an injection, they could prevent nerve injury. Asked about medications for facial pain, Graff-Radford responded that the tricyclic antidepressants are his drugs of choice for continuous pain, but not for the lightninglike jabs typical of TN. An average dose of 80 mg. per day of a tricyclic produces about a 70 to percent reduction in continuous facial pain, he said. The symposium was sponsored by the National Institute of Neurological Disorders and Stroke NINDS ; and the Office of Rare Diseases at the National Institutes of Health NIH ; . Participants identified 11 new avenues for research, including studies of the role of estrogen and of the role exercise may play in combating hyperalgesia extreme sensitiveness to stimuli and dandelion.
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