Adjuvant chemotherapy for patients with gastric neuroendocrine carcinomas or mixed adenoneuroendocrine carcinomas.

BACKGROUND: The aim of this study was to evaluate whether adjuvant chemotherapy is associated with improved survival in patients with resectable gastric neuroendocrine carcinomas (G-NECs) or mixed adenoneuroendocrine carcinomas (G-MANECs). METHODS: The study included patients with G-NECs or G-MANECs who underwent surgery in one of 21 centres in China between 2004 and 2016. Propensity score matching analysis was used to reduce selection bias, and overall survival (OS) in different treatment groups was estimated by the Kaplan-Meier method. RESULTS: In total, 804 patients with resectable G-NECs or G-MANECs were included, of whom 490 (60·9 per cent) received adjuvant chemotherapy. After propensity score matching, OS in the chemotherapy group was similar to that in the no-chemotherapy group. Among patients with G-NECs, survival in the fluorouracil (5-FU)-based chemotherapy group and the non-5-FU-based chemotherapy group was similar to that in the no-chemotherapy group. Similarly, etoposide plus cisplatin or irinotecan plus cisplatin was not associated with better OS in patients with G-NECs. Among patients with G-MANECs, OS in the non-5-FU-based chemotherapy group was worse than that in the no-chemotherapy group. Patients with G-MANECs did not have better OS when platinum-based chemotherapy was used. CONCLUSION: There was no survival benefit in patients who received adjuvant chemotherapy for G-NECs or G-MANECs.

ANTECEDENTES: El objetivo de este estudio fue evaluar si la quimioterapia adyuvante mejoraba la supervivencia en pacientes con carcinomas gástricos resecables neuroendocrinos (gastric neuroendocrine carcinomas, G-NECs) y carcinomas adenoneuroendocrinos mixtos (mixed adenoneuroendocrine carcinomas, G-MANECs). MÉTODOS: Se incluyeron pacientes con G-NECs y G-MANECs tratados quirúrgicamente en 21 centros en China entre 2004 y 2016. Se utilizó un análisis de emparejamiento por puntaje de propensión para reducir el sesgo de selección y el método de Kaplan-Meier para estimar la supervivencia global (overall survival, OS) de los pacientes en los diferentes grupos de tratamiento. RESULTADOS: En total, se incluyeron en el estudio 804 pacientes con G-NECs y G-MANECs resecables y 490 pacientes (60,9%) recibieron quimioterapia adyuvante. Después del emparejamiento por puntaje de propensión, la OS del grupo con quimioterapia fue similar a la del grupo sin quimioterapia. En los pacientes con G-NECs, la supervivencia en los grupos con quimioterapia basada en 5-FU (fluorouracilo) y de quimioterapia sin 5-FU fue similar a la del grupo sin quimioterapia. Asimismo, la combinación de etopósido y cisplatino o de irinotecán y cisplatino no se asoció con una mejor OS en pacientes con G-NECs. En pacientes con G-MANECs, la OS del grupo con quimioterapia sin 5-FU fue peor que la del grupo sin quimioterapia. Los pacientes con G-MANECs no presentaron una mejor OS cuando se administró quimioterapia basada en platinos. CONCLUSIÓN: La administración de quimioterapia adyuvante en pacientes con G-NECs y G-MANECs no mejoró la supervivencia.

First report of the oil palm disease fungus Marasmius palmivorus from Taiwan causing stem rot disease on native Formosa palm Arenga engleri as new host.

Basidiomata were found on dead stems of wild native Formosa palm (Arenga engleri) in Taiwan. The fungus was identified based on morphology and internal transcribed spacer sequence comparison as the oil palm pathogen Marasmius palmivorus. A pathogenicity test with cultivated mycelium of M. palmivorus positively produced disease symptoms and death of non-wounded Formosa palm tree seedlings under excessive moisture conditions. These results indicate that mycelial inoculum may be more important for pathogenesis than spore inoculum and that the fungus does not require wounds for entry into the plant. Host records in the literature are critically revised. The extended geographical and host distribution indicate a greater risk by M. palmivorus in palm plantations than hitherto anticipated. SIGNIFICANCE AND IMPACT OF THE STUDY: Certain palm species are susceptible to disease caused by Marasmius palmivorus, particularly in oil and coconut palm plantations in tropical countries. Hitherto, there is no published information on the morphology and pathogenicity of the species in Taiwan.

The effectiveness of an integrated multicomponent program for adolescent smoking cessation in Taiwan.

If adolescents do not receive appropriate assistance in quitting smoking, they are highly likely to become regular smokers when they enter adulthood. Thus, an effective smoking-cessation program is required. A program was designed based on both the smoking-cessation barriers reported by students and effective strategies derived from the literature. We assigned 143 student smokers from 6 vocational high schools to intervention (n=78) and comparison groups (n=65). Data were collected at the baseline, the end of the program, and 1- and 4-month follow-up time points. For the intervention group, the smoking-abstinence rates confirmed using the urine cotinine test were 22.73% at the end of the program and 20.75% at the 4-month follow-up point. Days smoked in the past month, number of cigarettes smoked per day, and the Fagerström Test for Nicotine Dependence score of the intervention group decreased at all of the time points. The group differences in these variables were statistically significant; the magnitude of effect sizes ranged from 0.44 to 0.95. Multicomponent programs addressing smoking-cessation barriers that students encounter can help adolescents quit smoking.

Acne vaccines targeting Propionibacterium acnes.

Acne vulgaris is one of the most common skin diseases and can affect a large number of individuals at some point in their lives. Though the disease is multi-factorial, the Gram-positive, anaerobic bacterium Propionibacterium acnes (P. acnes), a member of resident skin microflora, is implicated in acne inflammation and associated with acne lesions. Common treatments such as antibiotic or benzoyl peroxide nonspecifically reduce bacteria population on the skin, which may disrupt homeostasis and cause further complications such as promoting growth of antibiotic-resistant bacteria strains. A component vaccine and an inactivated whole bacteria vaccine are made to target specifically P. acnes. The component vaccine targeting P. acnes surface sialidase and heat-inactivated P. acnes vaccine have both been shown to reduce P. acnes- induced inflammation in vivo and neutralize P. acnes in vitro, suggesting their potentials as new treatment for acne vulgaris. To facilitate acne studies, a bioengineering approach was utilized to design a new human acne model using tissue chamber. The tissue chamber of human sebocytes is shown to produce in mice a microenvironment similar to human acne inflammation. This approach can also be utilized in future studies in developing therapeutic acne vaccines and designing possible combined treatment of acne vaccine with alternative acne treatments.

Synthesis of aza bicyclic enones via anionic cyclization: application to the total synthesis of (-)-brunsvigine.

[reaction: see text] A general approach to the synthesis of aza bicyclic enones was developed via a simple two-step annulation involving a Mitsunobu protocol and anionic cyclization. According to this strategy the total synthesis of (-)-brunsvigine was accomplished with 12% overall yield.

Unilateral sacroiliitis as an unusual complication of acupuncture.

Septic sacroiliitis is an uncommon disease and is rarely reported as a complication of acupuncture. We present a case of unilateral septic sarcoiliitis, which developed as a complication of acupuncture because of failure to sterilise the skin properly before treatment. Bone scan and computed tomography were positive for sacroiliitis. After a course of antibiotics with oxacillin for 6 weeks, the condition was completely improved. This case report stresses the importance of sterilisation procedures before acupuncture therapy.

[Studies on longevity tea].

This paper reports the preparation, physical and chemical identification and content determination of Longevity Tea. The preparation process is advanced, the content determination is simple and accurate and thus can be taken as standards for the quality control of Longevity Tea.

Electrophysiology of nitrous oxide on cerebellar granule cells: a single-cell study.

We recorded 18 single cells in the granule cell layer of the cat. Each single cell was screened and identified as a granule cell based on a set of criteria derived from known electrophysiological properties of granule cells. We then monitored the effects of nitrous oxide on the spontaneous activities and the auditory responses of these cells. Nitrous oxide consistently caused a severe inhibition of spontaneous activities as well as responses to sound in these cells. Furthermore, the amplitudes of their action potentials decreased during the inhibition. Three of the 18 cells were subsequently injected intracellularly with HRP. All three were verified to be granule cells. In those granule cells we recorded intracellularly, nitrous oxide did not change the resting membrane potentials. The gradual decrease in the amplitudes of action potentials suggested that some of the mechanisms leading to the genesis of action potentials were being altered by nitrous oxide. It is also possible that nitrous oxide may act on synaptic transmission at a site located postsynaptically on the granule cells.

Auditory responses in the posterior vermis of the cat: the buried cerebellar cortex.

Although an auditory area has been found over the exposed area of lobules VI-VIII in the posterior cerebellar vermis of the cat, there has been little information on its buried portion. This point should be of some concern, since very little of the brain tissue in lobules VI-VIII of the cerebellar cortex is exposed. We have systematically explored the posterior vermis with long electrode tracks and compared auditory responses recorded from neurons within the granule cell layer in the folial crown with those in the buried cortex. There was a similarity between neural activities recorded from the exposed surface area and those from the buried portion both in the temporal discharge pattern of neurons to sound and in the spatial distribution pattern of auditory responses.

Changes in brainstem and cortical auditory potentials during Qi-Gong meditation.

"Qi Gong" (QG) is a meditation exercise known for thousands of years in China and has always been widely practiced. It has been claimed to have a variety of healing and other health benefits. To provide an understanding of the effect of QG on brain structures along the whole neural axis from the periphery to the cerebral cortex, we have monitored short-latency auditory brainstem evoked response, middle-latency response, and long-latency cortical auditory evoked potentials, before, during, and after QG. Our results showed that QG caused an enhancement of brainstem auditory evoked response with a concomitant depression of cortical responses. These observations may be related to the healing and other health benefits of QG.

Tonotopic organization in the inferior colliculus of the rat demonstrated with the 2-deoxyglucose method.

We studied the tonotopic organization in the inferior colliculus of the rat with the 2-deoxyglucose method. Isofrequency bands were observed in the central nucleus of the inferior colliculus. In coronal sections, higher sound frequencies elicited bands that were located more ventrally. At caudal levels of the inferior colliculus, isofrequency bands were relatively short and tilted slightly downward toward the midsagittal plane. As the plane of section moved more rostrally, isofrequency bands gradually lengthened, their orientation first turned horizontally and continued with a downward tilt toward the lateral aspect of the brainstem. At rostral levels, high-frequency (greater than 8000 Hz) bands showed more significant increases in length than low-frequency (less than 4000 Hz) bands. Thus, the amount of tissue in the inferior colliculus devoted to higher frequencies was significantly more than that for lower frequencies. In sagittal sections, the isofrequency band moved from a dorsoposterior position to a ventroanterior one as the plane of section moved more laterally. A three-dimensional model of isofrequency planes was reconstructed from the above data.

The renin-angiotensin-aldosterone system in primary and secondary hypertension.

Important advances have been made in understanding the role of the renin-angiotensin-aldosterone system in the pathogenesis and diagnosis of hypertensive disorders. Measurement of plasma renin activity (PRA) and aldosterone is very important in the assessment of secondary hypertension. Hypertensions with increased PRA include renovascular hypertension, some cases of unilateral and bilateral renal parenchymal disease, malignant hypertension, hypertension associated with oral contraceptive agents, and renin-secreting tumors. Hypertension with decreased PRA is observed in four recognized types of primary aldosteronism: adenoma, bilateral hyperplasia, indeterminate aldosteronism, and glucocorticoid-responsive aldosteronism. Other conditions with hypertension and depressed PRA include ACTH and DOC secreting tumors, primary hyperpituitarism, syndromes of 17-hydroxylase and 11-beta-hydroxylase deficiency. Liddle's syndrome, licorice abuse, exogenous administration of mineralocorticoids, and preeclampsia.

Changes of acoustic nerve and cochlear nucleus evoked potentials due to repetitive stimulation.

Evoked potential recordings were studied in the acoustic nerve and cochlear nucleus of adult decerebrate cats as a function of the tone duration (1-1500 msec) and the tone repetition rate (0.5/sec-200/sec). Response decrements due to repetitive tonal stimulation were primarily a function of the inter-tone interval. At inter-tone intervals longer than 100 msec, no response decrements were observed in the acoustic nerve or the cochlear nucleus. With shorter inter-tone intervals, reversible response decrements of identical magnitudes ocurred in both the acoustic nerve and the cochlear nucleus evoked potentials. The mechanism of response decrement may be due to depression at the hair cell-acoustic nerve junction.

Factors that affect the amplitudes and latencies of the vertex short latency acoustic responses in the cat.

The latencies and amplitude of the short latency (less than 10 msec) acoustic evoked responses recorded from the vertex of the cat have been studied as a function of acoustic stimulus parameters. A change in the stimulus intensity, duration, or rate of repetition resulted in parallel changes in the first 5 evoked responses, i.e., the latencies shifted the same amount and the amplitudes were modified in the same proportion. Comparison of responses to monaural versus binaural stimuli indicated an occlusive effect of binaural stimulation only in potential 4.

Sudden fatal pulmonary calcification following renal transplantation.

A 42-year-old male was hemodialyzed for 2 years with excellent control of calcium-phosphate metabolism. He received a cadaveric renal transplant but experienced a prolonged episode of acute tubular necrosis during which he could not tolerate phosphate-binding antacids. His calcium X phosphate product became markedly elevated for 20 days. Following a brief period of function, the homograft was removed on the 45th post-transplant day after severe rejection and subsequent infection. Chest X-ray was normal. Six days after graft nephrectomy, he became acutely dyspneic and markedly hypoxemic. Diffuse, flocculent pulmonary infiltrates appeared on the chest film. The patient expired 1 day later. At postmortem examination, there was severe, diffuse pulmonary alveolar calcification demonstrated by chemical and histologic examination. Although unlikely, the prolonged post-transplant period characterized by elevated calcium X phosphate product may have played a pathogenetic role. Calciphylaxis may have occurred, with hyperparathyroidism as the sensitizing agent and any of several drugs acting as challenger.