A phase I-II study of paclitaxel, ifosfamide, and vinorelbine with filgrastim (rhG-CSF) support in advanced non-small-cell lung cancer

PURPOSE: We designed a phase I-II trial of three active agents, paclitaxel, ifosfamide, and vinorelbine, in advanced non-small-cell lung cancer (NSCLC) to: 1) define the dose-limiting toxicities (DLT) and maximum tolerated dose (MTD) of paclitaxel with filgrastim (G-CSF) support; and 2) determine the overall response rate and median survival of patients treated on this regimen. PATIENTS AND METHODS: We treated cohorts of patients with stage IIIB or IV NSCLC with ifosfamide 1.2-1.6 g/m2/day x 3 and vinorelbine 20-25 mg/m2/day x 3 and escalating doses of paclitaxel at 100-175 mg/m2 on day 2 with G-CSF support on a 21-day cycle. One prior experimental single-agent chemotherapy regimen was allowed. RESULTS: Fifty-six patients, were enrolled on this trial: 27 on the phase I portion of the study and an additional 29 at the recommended phase II dose (RPTD). Thirteen patients had received prior chemotherapy. Paclitaxel doses of 175 mg/m2 and 150 mg/m2 produced dose-limiting myelosuppression, and the RPTD was determined to be paclitaxel 135 mg/m2 with ifosfamide 1.2 g/m2/day on days 1-3 and vinorelbine 20 mg/m2/ day on days 1-3 with G-CSF support. The overall response rate was 18%, with a median survival of 6.1 months. Six of 35 patients (17%) treated at the RPTD achieved a partial response to therapy. Grade IV neutropenia was observed in 19 of 35 patients at this dose, with eight patients suffering febrile neutropenia. CONCLUSIONS: This non-cisplatin-containing three-drug regimen has substantial toxicity and low activity in advanced NSCLC, and does not seem to improve on prior regimens. It is unclear whether the lack of efficacy relates to an antagonistic reaction between the specific drugs, administration schedule, or to subtherapeutic doses of the individual agents.     

Sacrospinous colpopexy in the management of uterovaginal prolapse

The tet(M) genes were characterized from 84 isolates of 10 different bacterial species isolated from the periodontal pockets of 16 patients with periodontal disease. A 740 bp polymerase chain reaction product from the hypervariable region of the tet(M) structural gene was cleaved with the restriction enzymes AluI and HinfI. Three different restriction patterns were identified for each of the two enzymes. By DNA sequencing, using a direct solid-phase automated sequencing method, the isolates could be grouped into 3 different clusters of tet(M) subtypes. The internal DNA homology within each subtype was 98-100%; the homology between clusters was 89-94%. Two different subtypes were identified in 9 of 10 bacterial species, and the remaining species had 3 different subtypes. One of the subtypes (M3) was seen mainly in the anaerobic isolates. This subtype was different from all earlier sequenced structural tet(M) genes present in the Genbank. Most patients had two different subtypes of tet(M), and a third subtype was seen in the 3 patients who exhibited the greatest variety of tetracycline-resistant bacterial species. It appears that the presence of one subtype of the tet(M) gene within a patient or bacterial species does not prevent the acquisition of another subtype of the same gene. This study identified a new subtype of the tet(M) gene and grouped it into 3 distinct yet highly homologous genetic subtypes.     

Dialogue as the interplay of otherness and shared humanity.

Presents a reply by B. Fowers and B. Davidov to Islam's comments (see record 2007-14606-019) regarding their article (see record 2006-11202-002). Islam noted that virtues are often presented as universally valid character strengths, yet formulations of virtues are always embedded in a particular cultural context, a point we took pains to make in our article. We focus our response on Islam's important suggestion that this tension between universal human characteristics and the particulars of cultural context is indissoluble. Whereas he suggested this tension leads to contradiction and paradox, we see it as a fertile dialectic. The virtue of openness to the other is also subject to the same tension of abstract formulation and particular application. Although we formulated this virtue in a very general way, any instantiation of it would be shaped by the particulars of the cultural context and the situation in which it is exercised. We introduced the concept of dialogue because it is constituted not only by differences between individuals or groups but even more fundamentally by the dialectical relationship between those differences in cultural particularities and the universal human capacities for reason, curiosity, and social engagement, among others. Dialogue acknowledges the indissoluble otherness one finds in those culturally different from oneself, and yet real interchange can only occur because participants in dialogue exercise the cognitive flexibility characteristic of human beings and recognize a shared humanity with the other. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Concordant but different: Cognitive function, cerebral anatomy, and metabolism in monozygotic twins with Alzheimer's disease.

To illustrate the utility of the twin method in Alzheimer's disease (AD) research, a pair of monozygotic twins, concordant for the disease but markedly different in their clinical presentations, was studied in detail. Neuropsychological evaluation, magnetic resonance imaging (MRI), and cerebral glucose metabolic studies revealed a typical behavioral presentation for AD in Twin A. In contrast, Twin B showed prominent visuospatial impairments. Although there was no identified cause for the disparate presentations, a close correspondence was observed between the neuropsychological findings and the regional brain measures. The results suggest that the trajectory of AD may vary widely even in genetically identical individuals. Factors accounting for the variability include potential intrauterine, early developmental, and environmental differences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Granulation tissue polyposis associated with carcinoid tumours of the small intestine

We report two patients with ileal carcinoid tumours which were associated with polyps due to mucosal granulation tissue proliferation. In both cases the tumours had extensively infiltrated the small bowel wall and mesentery, and one had hepatic metastases. The mucosal surface of each specimen showed numerous, pale brown, sessile polyps which were restricted to the intestinal segment involved by carcinoid tumour, although not always closely related to neoplastic cells. The polyps were formed by the proliferation of capillaries, smooth muscle cells and myofibroblasts as demonstrated by immunohistochemistry and electronmicroscopy.     

A 16-Mbit/s adapter chip for the IBM token-ring local area network

The authors describe a 9.02×9.02-mm chip built in 1-μm CMOS with two levels of metal and an additional mask level for fabricating capacitors. It contains both analog and digital circuits and has provisions for self-test. The function includes the transmitter, receiver, protocol handler, an microprocessor, as well as interfaces for RAM/ROM storage, IBM PC bus, IBM PS/2 bus, IBM 3174 bus, and Motorola 68000 bus. The physical design terrains are formed by 24K circuits of standard cell gates, a 10K-circuit equivalent hand-honed custom microprocessor, and an analog macro. The chip operates from a single 5-V supply, and the power consumption is 0.8 W nominal at 16 Mb/s. The chip can also be operated at 4 Mb/s     

A Low-Complexity Circuit for On-Sensor Concurrent A/D Conversion and Compression

A low-complexity circuit for on-sensor compression is presented. The proposed circuit achieves complexity savings by combining a single-slope analog-to-digital converter with a Golomb-Rice entropy encoder and by implementing a low-complexity adaptation rule. The adaptation rule monitors the output codewords and minimizes their length by incrementing or decrementing the value of the Golomb-Rice coding parameter k. Its hardware implementation is one order of magnitude lower than existing adaptive algorithms. The compression circuit has been fabricated using a 0.35 muM CMOS technology and occupies an area of 0.0918 . Test measurements confirm the validity of the design.     

Laser scattering instrument for real time in-vivo measurement of ciliary activity in human fallopian tubes

Based on a laser light scattering technique and fibre optic probe, we have developed and tested a simple and practical device for real time measurements of ciliary activity in human Fallopian tubes during laparoscopy and laparotomy. A further aim was to investigate the relationship between the ciliary beat frequency (CBF) and the morphology of the ciliary epithelium. The mean +/- SE of CBF in the fimbria and in the ampulla were 5.4 +/- 0.3 Hz and 5.0 +/- 0.1 Hz respectively. Small pieces of fimbria and ampulla epithelium were taken from the same sites at which the CBF was measured, and the percentage of ciliary cells was determined by scanning electron microscopy. A high positive correlation was found between CBF and the percentage of ciliary cells in the fimbria (r = 0.84) and in the ampulla (r = 0.88). The instrument presented in this study provided, for the first time, a quantitative examination of the CBF in intact human Fallopian tubes and may be used for the investigation of ciliary activity in patients with infertility.