Patterns of serial CEA assays and their clinical use in management of colorectal cancer

Through persistent clinical research efforts, the CEA test has developed into a useful although complex disease monitor for colorectal cancer. Although improved or prolonged survival from its use has not been demonstrated, CEA monitoring may allow more knowledgeable patient management. Several reports indicate that postoperative serial CEA assays may identify patients with early recurrence, especially when assays are done frequently. Patients with elevated pretreatment CEA levels usually showed progressively rising titers before other objective evidence of recurrence was apparent. A progressively rising CEA titer correlated well with recurrent cancer, but a normal CEA could not be used as proof of its absence. Persistently elevated CEA titers post-treatment was caused either by persistent disease or by nontumor-related factors. The CEA assay was not a substitute for clinical follow-up but was an adjunct in the diagnosis of eary recurrence. Patients with elevated CEA levels caused by localized disease treated by radiation therapy demonstrated a marked fall in serial CEA levels if all CEA-producing tumor was localized within the radiation portal. The use of pretreatment CEA values plus the pattern of CEA reponse to irradiation may help in the selection of fulguration versus abdominoperineal resection as primary treatment for rectal cancer. Persistently low serial CEA titers after irradiation therapy correlated with disease control. The use of frequent serial CEA assays in patients treated with chemotherapy compared well with other parameters as a monitor of disease progression or regression. When used with other clinical parameters, serial CEA trends appeared to be a useful adjunct in assessing the effectiveness of chemotherapy. A fall in circulating CEA or the stabilization of a rising titer after starting chemotherapy usually indicated an effective regimen, whereas a rising CEA titer may signal may signal the need to initiate or to change chemotherapy.     

Acromegaly caused by pulmonary carcinoid tumours

Vascular input impedance and associated hydraulic power was measured in rabbit isolated lungs. The study was focused on changes in impedance and in pulsatile hydraulic power during relaxation and contraction of vascular smooth muscle. Pulsatile power was found to be at a minimum when smooth muscle tone was such that the pulmonary arterial pressure was in the physiological range, and increased both when the vessels were relaxed and further constricted. Input impedance was found to be determined mainly by the large, proximal ('extra-alveolar') arteries.     

Results of irradiation treatment in patients with non-resectable oesophageal cancer

Forty-eight patients with non-resectable cancer of the oesophagus and oesophagogastric junction (Group A: Stage I/II, 32; Group B: Stage III/IV, 16) underwent intraluminal Iridium-192 high dose-rate afterloading therapy (5-7 Gy/session, total dose: 5-21 Gy, mean: 12.4 Gy) and external beam irradiation (Karnofsky > or = 80% 50-60 Gy/2 Gy per day; Karnofsky 60-79%: 30 Gy/3 Gy per day). Durable satisfactory palliation (intake of at least semi-solid food) was demonstrated in 96% of patients. The mean survival for group A was 19.1 months and that for group B, 6.9 months, with a 12-month survival rate of 66% (group A) and 0% (group B) (P < 0.001). Local tumour response and complication rate were significantly dose-related with a predicted response rate of 70.5%, and a complication rate of 50% at ERD 129.3 Gy.     

Surfactant nebulization versus instillation during high frequency ventilation in surfactant-deficient rabbits

Glutamate-mediated excitotoxicity plays an important role in the degeneration of nigrostriatal dopamine (DA) neurons induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), although the role of the N-methyl D-aspartate (NMDA) receptor subtype in this process is still uncertain. We studied glutamate receptor subtype agonist-induced ionic currents in acutely dissociated DAergic neurons from the rat substantia nigra zona compacta (SNc) using the nystatin-perforated patch-clamp whole-cell recording technique. The results fall into four main categories. First, single neurons, freshly isolated from SNc, exhibited a large soma and multipolar morphology, responded to DA, and stained positively for tyrosine hydroxylase (TH). Second, rapid application of L-glutamate (> 10(-5) M) induced an inward current with minimal desensitization at a clamp voltage of -60 mV. Third, kainic acid (KA) or alpha-amino-3-hydroxy-5-methyl-isoxazole (AMPA) induced an inward current that was similar to the glutamate-induced current while, in the same neuron, NMDA (10(-4) M) failed to induce any current response in Mg2+-free solution that contained 10(-5) M glycine at a clamp voltage of -60 mV. Under the same experimental conditions, NMDA induced a clear current response in isolated substantia nigra reticulata (SNr) neurons. Fourth, the specific NMDA receptor antagonist DL-2-amino-5-phosphonovaleric acid (APV, 10(-4) M) failed to block 10(-4) M glutamate-induced inward current, while the specific KA/AMPA receptor antagonist 6-cyano-7-nitroguinoxaline-2, 3-dione (CNQX, 10(-5) M) completely blocked the glutamate-induced current. These results indicate that in single SNc DAergic neurons of 2-week-old rats, L-glutamate-induced inward current is mediated by non-NMDA receptors rather than by NMDA receptors.     

Characterization of Europium Complex-doped PMMA and PMMA-EVA Polymer Networks

Europium-β-diketone chelate doped poly(methyl methacrylate) and poly(methyl methacrylate)/poly(ethylene co-vinyl acetate) blends have been successfully prepared and characterized. The mechanical properties of the PMMA-EVA systems have been assessed in terms of tensile strength and impact strength. The thermal characteristics and the energy involved in thermal decomposition have been studied. The structural properties of the complex doped polymeric systems reveal that the complex exists in the same crystalline state in the doped systems as it does in the pure state. The orientations of the groups in the host matrix have been found to be affected by the complex loading. The optical properties of the system have been studied by photo luminescence spectroscopy. The fluorescence lifetime have been observed to decrease at greater loadings of the complex; an effect that has been attributed to concentration quenching. The complex doped PMMA/EVA polymer network developed is considered to be a potential candidate for the development of optoelectronic devices those possess superior mechanical properties.     

Influence of reaction parameters on the synthesis of hyperbranched polymers via reversible addition fragmentation chain transfer (RAFT) polymerization

The synthesis of hyperbranched poly(methyl methacrylate) (PMMA) via reversible addition fragmentation chain transfer (RAFT) polymerization was investigated by varying the ratio chain transfer agent (CTA): monomer (methyl methacrylate, MMA): brancher (ethylene glycol dimethyl methacrylate, EGDMA): free radical initiator (AIBN) at various temperatures (50, 55, 60, 65, 70 °C). The rate of polymerization was observed to increase with temperature and concentration in brancher, whilst it was lowered by an increase in chain transfer agent concentration. The molecular weight of the samples increased with the ratios brancher: CTA and monomer: CTA. The polydispersity of the samples increase with conversion, as the level of branching increases. At fixed concentration in brancher, an increase of CTA concentration led to polymers with lower PDI. The variation of enthalpy and entropy relative to the monomer reaction were calculated, and it was observed that an increase in the brancher concentration induced an increase in both and , whilst lower CTA concentrations led to an increase in . The variation in Gibbs energy for the monomer reaction was calculated at 60 °C, and results confirmed the presence of a retardation effect when increasing CTA concentration generally observed in RAFT polymerization.