Hypertension and overall survival in metastatic colorectal cancer patients treated with bevacizumab-containing chemotherapy.

BACKGROUND: Hypertension (HTN) is a common toxicity of anti-VEGF (vascular endothelial growth factor) antibody treatment. It may be a marker of VEGF signalling pathway inhibition and therefore represent a cancer biomarker in metastatic colorectal cancer (mCRC) patients treated with chemotherapy and bevacizumab. METHODS: A total of 101 consecutive patients with mCRC were treated with standard chemotherapy combined with bevacizumab at dose of 2.5 mg kg(-1) per week in a single centre. The median follow-up time of the patients alive was 64 months. Blood pressure was measured before each bevacizumab infusion, and HTN was graded according to common toxicity criteria for adverse events version 3.0. RESULTS: Overall, 57 patients (56%) developed ≥grade 1 HTN (median blood pressure 168/97 mm Hg), whereas 44 (44%) remained normotensive when treated with bevacizumab-containing chemotherapy regimen. Overall response rate was higher among patients with HTN (30 vs 20%; P=0.025). Hypertension was associated with improved progression-free survival (10.5 vs 5.3 months; P=0.008) and overall survival (25.8 vs 11.7 months; P<0.001), and development of HTN within 3 months had an independent, prognostic influence in a multivariate landmark survival analysis together with other known mCRC prognostic factors (P=0.007). There was no association between HTN and development of thromboembolic complications. CONCLUSION: Hypertension may predict outcome of bevacizumab-containing chemotherapy in mCRC. These data require confirmation in prospective studies including pharmacodynamic and pharmacokinetic analyses.

Docetaxel versus docetaxel alternating with gemcitabine as treatments of advanced breast cancer: final analysis of a randomised trial.

BACKGROUND: Alternating administration of docetaxel and gemcitabine might result in improved time-to-treatment failure (TTF) and fewer adverse events compared with single-agent docetaxel as treatment of advanced breast cancer. PATIENTS AND METHODS: Women diagnosed with advanced breast cancer were randomly allocated to receive 3-weekly docetaxel (group D) or 3-weekly docetaxel alternating with 3-weekly gemcitabine (group D/G) until treatment failure as first-line chemotherapy. The primary end point was TTF. RESULTS: Two hundred and thirty-seven subjects were assigned to treatment (group D, 115; group D/G, 122). The median TTF was 5.6 and 6.2 months in groups D and D/G, respectively (hazard ratio 0.85, 95% confidence interval 0.63-1.16; P = 0.31). There was no significant difference in time-to-disease progression, survival, and response rate between the groups. When adverse events were evaluated for the worst toxicity encountered during treatment, there was little difference between the groups, but when they were assessed per cycle, alternating treatment was associated with fewer severe (grade 3 or 4) adverse effects (P = 0.013), and the difference was highly significant for cycles when gemcitabine was administered in group D/G (P < 0.001). CONCLUSION: The alternating regimen was associated with a similar TTF as single-agent docetaxel but with fewer adverse effects during gemcitabine cycles.

Occupational exposure to radiofrequency fields in antenna towers.

Exposure of workers to radiofrequency fields was assessed in two medium-sized antenna towers. Towers had transmitting antennas from different networks, e.g. mobile phone networks, radio and digital TV sub-stations and amateur radio. The levels of radiofrequency fields were measured close to the ladders of the towers. All measured values were below ICNIRP occupational reference levels.

Repeated intratumoral administration of ONCOS-102 leads to systemic antitumor CD8+ T-cell response and robust cellular and transcriptional immune activation at tumor site in a patient with ovarian cancer.

Adenoviruses are excellent immunotherapeutic agents with a unique ability to prime and boost immune responses. Recombinant adenoviruses cause immunogenic cancer cell death and subsequent release of tumor antigens for antigen presenting cells, resulting in the priming of potent tumor-specific immunity. This effect may be further enhanced by immune-stimulating transgenes expressed by the virus. We report a case of a 38-year-old female with Stage 3 metastatic micropapillary serous carcinoma of the ovary. She was treated in a Phase I study with a granulocyte-macrophage colony stimulating factor (GMCSF)-expressing oncolytic adenovirus, Ad5/3-D24-GMCSF (ONCOS-102). The treatment resulted in progressive infiltration of CD8+ lymphocytes into the tumor and concomitant systemic induction of several tumor-specific CD8+ T-cell populations. The patient was alive at the latest follow up more than 20 months after initiation of the study.

Transforming growth factor beta1 induces apoptosis in normal melanocytes but not in nevus cells grown in type I collagen gel.

We used type I collagen gel cultures to compare the growth requirements of melanocytes and dermal nevus cells. Melanocytes but not nevus cells undergo apoptosis in collagen unless supplied with growth stimulators such as fibroblast growth factor 2. To characterize the mechanism of melanocyte apoptosis in collagen, we tested the effects of transforming growth factor beta1, known to be functionally active in the skin. When picomolar amounts of transforming growth factor beta1 were added to normal melanocytes grown in type I collagen gel, their apoptosis was dramatically accelerated. In contrast, the apoptotic rate of nevus cells and melanoma cells grown under similar conditions was not affected by transforming growth factor beta1. The increased apoptosis of normal melanocytes was effectively counteracted by addition of either neutralizing transforming growth factor beta1 antibodies or fibroblast growth factor 2 to the collagen gel. Interestingly, the background apoptosis of normal melanocytes was also inhibited by transforming growth factor beta1 antibodies. By Western blotting we detected transforming growth factor beta-like immunoreactivity in melanocyte, nevus cell, and melanoma cell lysates. A sensitive bioassay confirmed that their medium contained considerable amounts of heat-activatable growth inhibitory activity that could partly be neutralized by transforming growth factor beta1 antibodies. It is evident that apoptosis of melanocytes grown in type I collagen gel can be mediated by both endogenous and exogenous transforming growth factor beta. We suggest that the balance between inhibitory growth factors such as transforming growth factor beta and stimulatory growth factors like fibroblast growth factor 2 has the potential to regulate the growth, localization, and survival of normal melanocytes also in vivo. The resistance of nevus cells to transforming-growth-factor-beta-mediated apoptosis may facilitate their ability to grow in the dermal compartment of the skin.

FGF expression allows nevus cells to survive in three-dimensional collagen gel under conditions that induce apoptosis in normal human melanocytes.

Melanocytes, the pigment forming cells of the skin, form an almost nonproliferating cell population located to the lowermost part of the epidermis. Normally melanocytes are not found higher in the epidermis or in the dermis. Nevi consist of melanocytes with altered growth characteristics and localization. The common pigmented nevus, a benign skin lesion, develops when melanocytes proliferate in the dermo-epidermal junction or in the dermis. Here we report growth characteristics of in vitro cultured normal human melanocytes and dermal nevus-derived melanocytes. As previously reported, nevus cells have a moderate to high FGF-2 expression level. Here we demonstrate that dermal nevus cells are able to survive in three-dimensional type 1 collagen culture, while normal human melanocytes rapidly undergo apoptosis. Melanocytes also, however, survive in collagen cultures in the presence of exogenous FGF-2. The survival of nevus cells in collagen is suppressed by protamine, an inhibitor of FGF-mediated cell stimulation. The in vivo growth environment of dermal nevus cells consists largely of type I and type III collagens. The results suggest that FGF-2 expression by nevus cells allows them to adapt to grow in the dermis. FGF-2 obviously has importance as a melanocyte survival factor and probably also in the development of malignant melanoma.

Lactic acid and pH as indicators of spoilage for vacuum-packed cooked ring sausages.

Lactic acid production and pH changes of 206 vacuum-packed cooked ring sausages stored at 2, 4 and 12 degrees C from 21 different production runs were monitored as a function of time and of microbial growth. The total lactic acid concentrations and pH values were first at a constant level, starting to increase sharply after the lactobacilli count reached about 5 x 10(7) or 6 x 10(7) cfu/g, respectively. The lactic acid and pH changes as a function of the lactobacilli count were similar at 4 and 12 degrees C. The sharp increase at high lactobacilli counts was observed in both L-lactic acid and D-lactic acid. The variation was lesser and the increase greater in D-lactic acid formation than in L-lactic acid. Above a level of 3-4 mg lactic acid/g most of the samples were deemed unfit. The pH started to decrease from a level of approx. 6.3; below 5.8-5.9 the samples were deemed unfit. The lowest pH value observed was 4.58. Both a high lactic acid content and a low pH indicated that the sausage was spoiled. These changes, however, took place at later stages of storage, and do not give information about the early phase of spoilage.

Shelf-life of vacuum-packed cooked ring sausages at different chill temperatures.

Microbiological and sensory changes in 313 vacuum-packed cooked ring sausages from 28 different production runs and stored at 2, 4, 8 or 12 degrees C were monitored as a function of time. The sensory scores started to decrease at a level of approx. 10(7) lactobacilli/g. The judges began considering the samples unfit for human consumption when the lactobacilli counts were between 10(7) and 10(8) cfu/g; above a level of 10(8) cfu/g most of the samples were deemed unfit. At 2 degrees C, however, spoilage did not always seem to be microbiological, and four out of six different production runs were deemed unfit without any marked increase in microbial counts. In such cases, the judges described the sensory defects as a 'musty' rather than a sour aroma and taste. The sausages were deemed unfit when the lactobacilli were in a stationary growth phase which was considerably later than the point when the bacterial counts exceeded 10(7) cfu/g. The mean length of this delay was 30, 19, 16 and 7 days at 2, 4, 8 and 12 degrees C, respectively. The average shelf-lives were 55, 43, 29 and 17 days at 2, 4, 8 and 12 degrees C, respectively. The dependence of shelf-life on temperature can be formulated as follows: Shelf-life = 10(1.835 - 0.048 X temperature) The maximal shelf-life of this product, including nonmicrobiological spoilage, is assessed as approx. 10-11 weeks. A lactobacilli count greater than 10(7) cfu/g indicates that either the spoilage process has started or the product is already spoiled. When the lactobacilli count exceeds 10(8) cfu/g it is highly probable that the sausage sample is unacceptable.

Spectrophotometric determination of nitrate in baby foods: collaborative study.

A collaborative study was conducted of a spectrophotometric method for determination of nitrate after cadmium reduction to nitrite in baby foods containing meat. Thirty-one municipal and 2 industrial food laboratories participated in the study. The study design involved 2 baby food matrices. Samples of both matrices were prepared at 3 concentration levels between 52 and 309 mg NaNO3/kg as blind duplicates. A blank without added nitrate was also included. The outlier percentage of the results was very low (4.3%). It was typical for the method that recoveries were slightly > 100%. Recoveries for baby foods varied between 113.3 and 116.9%, and were acceptable for control purposes. The relative standard deviations for repeatability were 5.0-18.1%. The relative standard deviations for reproducibility were 8.3-21.6%. Three collaborators also evaluated liquid chromatographic technique for nitrate determinations. These preliminary results are presented but are not analyzed statistically. The spectrophotometric method was adopted first action by AOAC INTERNATIONAL.

Validation of the microbiological methods hygicult dipslide, contact plate, and swabbing in surface hygiene control: a Nordic collaborative study.

A collaborative study on total aerobic bacterial count was conducted to validate the Hygicult TPC dipslide against contact plates and swabbing, using stainless-steel surfaces artificially contaminated with different microbes at various levels. Twelve laboratories took part in the validation procedure. The total number of collaborative samples was 108. The microbial level in each sample was assessed in triplicate using the 3 above-mentioned methods under 3 different incubation conditions (at 25 +/- 1 degrees C for 48 and 72 h and at 30 +/- 1 degrees C for 48 h). Surface sampling methods detached 25-30% at the lowest (theoretical yield, 1.4 cfu/cm2), 18-20% at the middle (theoretical yield, 10.7 cfu/cm2), and 16-21% at the highest (theoretical yield, 43.6 cfu/cm2) levels of microbes from the test surfaces. The percentage of acceptable results after removing outliers was 89%. Repeatability standard deviations ranged from 27.2 to 74.6% and reproducibility standard deviations ranged from 42.1 to 97.5%. There were no significant differences between results obtained at different incubation temperatures (25 and 30 degrees C) or incubation times (48 and 72 h) for all 3 methods. The Hygicult TPC dipslide, contact plate, and swabbing methods gave similar results at all 3 microbial levels tested: 0.35-0.43 cfu/cm2 at the lowest level, 1.9-2.2 cfu/cm2 at the middle level, and 7.1-9.1 cfu/cm2 at the highest level.

Microbiological screening method for indication of irradiation of spices and herbs: a BCR collaborative study.

A BCR1 collaborative study was conducted with a microbiological screening method based on the combined use of the direct epifluorescent filter technique (DEFT) and the conventional aerobic plate count method (APC) for detection of irradiation of spices and herbs. Collaborative samples of whole allspice, whole and powdered black peppers, whole white pepper, paprika powder, cut basil, cut marjoram, and crushed cardamom irradiated with doses of 0, 5, and 10 kGy were analyzed by 8 laboratories. The total number of the collaborative samples, with arbitrarily labeled codes, was 192. The percentage of acceptable results was 95.5%. The identification of irradiated from nonirradiated spices and herbs was analyzed statistically by using explorative techniques. The average values of the differences between DEFT and APC in samples irradiated with doses of 5 and 10 kGy were 5.1 and 6.1 logarithmic units, respectively. The differences between DEFT and APC generally increased to at least 3.5 logarithmic units, whereas the difference in the case of unirradiated spices was insignificant. However, conclusive evidence of irradiation relies on the knowledge that the sample was not fumigated or heat treated. The reproducibility relative standard deviations for the differences were 12.3, 19.9, and 20.7% with the doses of 10 and 5 kGy and for unirradiated samples, respectively, indicating acceptable variabilities among laboratories.

Determination of pH in meat.

The pH of 80 beef and 120 pork muscles was determined electrometrically using different electrode systems and different presentations of samples; that is, directly from the muscle, from a meat-water mixture and from a meat homogenate. The results showed statistically significant differences (p < 0·001). Differences between electrodes appear to be greater than the differences due to the different presentations of the meat samples. Certain methods gave systematically lower or higher pH values than others. On the other hand, these differences were not very large and the repeatability of each method was low. On the basis of the results, however, no pH measurement method could be considered better than the others. Further harmonization of the methods used for pH measurement of meat is still needed.

Effect of sodium nitrite and sodium chloride on growth of lactic acid bacteria.

The effect of NaNO2 and NaCl on the growth of 24 lactic acid bacteria strains isolated from vacuum-packed cooked ring sausages were examined by analyzing different growth parameters with Bioscreen. NaNO2 had a very limited effect on the growth of lactic acid bacteria at 50 and 100 mg/l but at 400 mg/l a more pronounced inhibitory effect was found. Bacterial growth was enhanced by 1-2% (w/v) of added NaCl, while NaCl concentrations above 3% (w/v) had a clear inhibitory effect. Leuconostoc isolates seemed to be more sensitive to sodium nitrite and sodium chloride than homofermentative lactobacilli strains. Among homofermentative lactobacilli, the strains resembling Lactobacillus curvatus were more sensitive to NaCl than those resembling Lactobacillus sake.

Comparison of different pH measurement methods in meat.

The accuracy of portable pH meters and the nitrazine yellow method was compared with the reference method by determining the pH of 74 beef and 96 pork muscles. The pH was measured directly from the muscle. The results showed statistically significant differences (p less than 0.001) between the different electrometric combinations. Combinations of portable pH meters with puncture electrodes gave systematically higher pH values than the reference method. These differences were not very large but they may be of practical significance. The use of a piercing cover on the electrode to help the insertion of the electrode into the meat is not recommended, since it may cause a rise in pH values. Electrometric methods were found to be more precise than the nitrazine yellow method. On the basis of these findings there still is a need of further harmonization of the methods used for pH measurement of meat.

A statistical approach to an alcoholic drinking history.

The drinking history of a middle-aged male was analyzed statistically on the basis of eight and a half years of notes on the number of drinks consumed per day. During the period his average number of drinks per drinking day increased from about 7 in 1974 to a peak of about 16 in 1980 while the number of abstinent days varied between 23% and 54% with no clear trend. These figures are of the same magnitude as published reports on drinking among alcoholics. Time-series models of intake or drinking frequency could not describe adequately the time-structure of annual or monthly consumption. Occurrence of drinking was analyzed as a random series of events. The time-structure of the series was highly irregular and deviated greatly from the Poisson hypothesis which assumes that each day has an equal probability of becoming a drinking day independently of previous days. Instead, drinking days were clustered into sprees with an average length of 7 days, high variance and a very skew distribution, separated by abstinence periods with an average length of 4 days and a similarly shaped distribution. The entire history could be partitioned into 286 alternating drinking and abstinence intervals, one day intervals included. The drinking rhythm was very stable: no significant trends in the lengths of either type of interval could be found. The main findings are the surprising stability of the drinking rhythm, its independence of the growing amounts consumed, and the independently varying abstinence interval lengths. Even in the absence of reporting and memory bias, such a pattern of drinking may produce very inaccurate recall of the actual long-term alcohol intake, if the recall period is short. The results suggest that periods shorter than one month should be avoided when asking questions about alcohol intake, for example, in research on the effects of treatment on alcoholism or alcohol intake on health.

Liquid chromatographic determination of saccharin in beverages and sweets: NMKL Collaborative Study.

A reverse phase liquid chromatographic method for the determination of saccharin in a soft drink and a juice was collaboratively studied in 8 laboratories. Collaborators were supplied with 3 samples of the soft drink and 3 samples of the juice containing sodium saccharin levels of 40-100 mg/L. Average recoveries of sodium saccharin were 95.3% for the soft drink and 98.0% for the juice. The reproducibility coefficients of variation were 16.9% for the soft drink and 10.4% for the juice. In addition, a mini-collaborative study was conducted for the determination of saccharin in 3 samples of sweets produced commercially. Five collaborators analyzed the samples, which contained saccharin at levels of 100-600 mg/kg according to the maker's specifications. Saccharin was extracted with water and ethanol and chromatographed using a modified liquid chromatographic method. The reproducibility coefficient of variation was 12.4% for the sweets.

Spectrophotometric determination of cyclamate in foods: NMKL collaborative study.

A spectrophotometric method for the determination of cyclamate was collaboratively studied in 9 laboratories. Ethyl acetate is added to extract cyclamate from acidic aqueous solution into water, and the cyclamate is then quantitatively converted to N,N-dichlorocyclohexylamine by adding excess hypochlorite. N,N-Dichlorocyclohexylamine is determined by measuring its UV absorption at 314 nm. Six samples, 3 soft drinks with cyclamate levels of 0.36-0.47 g/kg and 3 jams with levels of 1.23-1.50 g/kg, were included in the study. Average recoveries of cyclamate were 99.7% in the soft drinks and 103.8% in the jams. Reproducibility coefficients of variation were 6.7% for the soft drinks and 4.4% for the jams.