Clinical Significance of Cancer Stem Cell Markers CD133 and CXCR4 in Osteosarcomas.

OBJECTIVE: Osteosarcomas (OS) is one the most common primary bone malignancy in humans with the lungs metastasis in most cases. Metastasis and recurrence of OS is attributed to cancer stem cells (CSCs). Our study aimed to evaluate the clinical significance of CD133 and C-X-C chemokine receptor type 4 (CXCR4) as the frequently applied markers for CSCs in OS patients. METHODS: In this cross-sectional, a total of 50 tissue samples from the patients with primary OS were immunohistochemically examined to detect the expression of CD133 and CXCR4. The associations of the relative expression and clinical significance of each marker were also evaluated. RESULTS: High level expression of CD133 was detected in 26% of OS patient tissues. Of the 12 patients who showed lung metastasis, 5 cases showed high expression of CD133 with marginal trend correlation (P=0.06). No significant correlation was observed between CD133 expression and clinicopathological factors. Only 36% of cases showed CXCR4 expression which was not significantly correlated with gender, age, tumor size, necrosis, stage and metastasis (P>0.05). Clinically, patients with concomitant CD133/CXCR4 expression had significant association with lung metastasis (P=0.05). CONCLUSION: Our findings showed that concomitant expression of CSC markers CD133/CXCR4 might had a synergistic effect on the OS poor prognosis. These markers could be considered as potential therapeutic candidates of OS targeted therapy.
.

Retinal anaplastic pleomorphic xanthoastrocytoma unassociated with phakomatosis.

PURPOSE: To present a rare anaplastic form of retinal pleomorphic xanthoastrocytoma (PXA) unassociated with phakomatosis. METHODS: A 9-year-old girl, presented with a rapidly growing unilateral intraocular white mass unresponsive to intra-arterial chemotherapy, underwent enucleation with the clinical suspicion of retinoblastoma versus malignant astrocytoma. RESULTS: Histopathology revealed pleomorphic cells with rosenthal fibers, mitosis, and necrosis. Immunohistochemistry confirmed the diagnosis of anaplastic pleomorphic xanthoastrocytoma (aPXA). The patient had no signs of phakomatosis. CONCLUSION: Retinal PXA may occur in patients without phakomatosis and rarely progress toward malignant transformation.

Safety of granulocyte colony-stimulating factor (G-CSF) administration for postrehabilitated motor complete spinal cord injury patients: an open-label, phase I study.

Granulocyte colony-stimulating factor (G-CSF) is a major growth factor in the activation and differentiation of granulocytes. This cytokine has been widely and safely employed in different conditions over many years. In this translational study, G-CSF is administered to 19 patients with chronic motor complete spinal cord injury, and outcomes are reported. All 19 patients received subcutaneous G-CSF (5 µg/kg per day) for 5 days and were followed for at least 6 months. The American Spinal Injury Association (ASIA) scale was used for motor and sensory assessment, and the International Association of Neurorestoratology-Spinal Cord Injury Functional Rating Scale (IANR-SCIFRS) and the Spinal Cord Independence Measure (SCIM) III were used to assess improvements in the ability to perform basic daily tasks. At the 6-month follow-up, upper extremity motor scores improved by 10, which was statistically significant (p = 0.007), whereas there were no significant changes in lower extremity motor scores. Also, the median of light touch sensory scores improved by 5 (p = 0.001). Pinprick sensory scores significantly improved (p = 0.002). The median increment in SCIM III total score was 7 (p = 0.001). The improvements in bladder and bowel management as well as moderate distance mobility subscales were also significant (p < 0.05). Total IANR-SCIFRS scores changed from 17 to 32, which was statistically significant (p = 0.001); again the bladder and bowel management subscale improvements were statistically significant (p < 0.05). Mild side effects of the G-CSF treatment such as bone pain, rash, fever, neuropathic pain, and spasticity were noted in a few patients; all of them resolved after 1 week. Our results indicate that G-CSF administration is a safe process and is associated with neurological as well as functional improvement. This manuscript is published as part of the International Association of Neurorestoratology (IANR) supplement issue of Cell Transplantation.

Translation and validation of the EORTC brain cancer module (EORTC QLQ-BN20) for use in Iran.

BACKGROUND: The aim of this study was to translate the EORTC quality of life questionnaire for brain cancer, the QLQ-BN20, into Persian, and to evaluate its psychometric properties when used among brain cancer patients in Iran. METHODS: A standard backward and forward translation procedure was used to generate the Persian language version of the QLQ-BN20. The QLQ-BN20 was administered together with the QLQ-C30 to 194 patients diagnosed with primary brain cancer. Multitrait scaling and confirmatory factor analysis (CFA) were used to evaluate the hypothesized scale structure of the questionnaire. Internal consistency reliability was estimated with Cronbach's alpha. The ability of the QLQ-BN20 to distinguish between patient subgroups formed on the basis of performance status and cognitive status was evaluated, as was the responsiveness of the questionnaire to changes in performance status over time. RESULTS: Multitrait scaling and CFA results confirmed the hypothesized scale structure. The measurement model was consistent across men and women. Internal consistency reliability of the multi-item scales ranged from 0.74 to 0.89. The QLQ-BN20 distinguished clearly between patients with relatively good versus poor performance and cognitive status, and changes in scores over time reflected changes observed in performance status ratings. CONCLUSIONS: These results support the validity and reliability of the QLQ-BN20 for use among Iranian patients diagnosed with primary brain cancer. Future studies should examine the psychometrics of the questionnaire when used in patients with brain metastasis.

Misunderstanding prescription physician's oral instructions in patients with low back pain.

Medication errors and adverse drug events can bring about hospitalization, permanent injury, or death. Patients due to lack of adequate understanding of instruction may unintentionally misuse a prescribed medicine. The aims of the study were to examine whether patients with low back pain were correctly able to understand physician's instructions regarding drug use and also to identify influencing factors in patient's misunderstanding. The sample of the study included patients with low back pain who had been referred to five clinics in order to follow their treatment procedure. The patients completed a questionnaire to assess understanding of physician's instructions by the patients. Afterwards, physician provided them oral instructions on how they must use medications. Once the physician finished the oral instruction, he was asked patients to repeat whatever he said about the instructions. This procedure repeated frequently until the patients described correctly Instructions of the medications use. One hundred and five patients participated in the study. The mean age of the participants was 57.5 (± 13.9) years. Thirty three patients were female (31.4%) and 75.2 percent were married. Almost 80% of the patients misunderstood the oral prescription instructions at first time of presentation instruction. Gender, educational level, back pain history and drug use history were risk factors for misunderstanding prescription medication oral instructions for patients. The study affirmed that patients with low back pain suffered from a poor understanding of oral instruction.

An overview of pharmacological approaches for management and repair of spinal cord injuries.

Spinal cord injury (SCI) leads to loss of nervous tissue and consequently to catastrophic neurological deficits. Up to now there is no definite treatment available that restores the loss of function to a degree that an independent life can be guaranteed.This justifies the cost of research into the new modalities for a treatment of SCIs. In current paper, recent developments and new approaches in pharmacological therapy have been reviewed.