Radiation therapy for vaginal and perirectal lesions in recurrent ovarian cancer.

The role for localized radiation to treat ovarian cancer (OC) patients with locally recurrent vaginal/perirectal lesions remains unclear, though we hypothesize these patients may be salvaged locally and gain long-term survival benefit. We describe our institutional outcomes using intensity modulated radiation therapy (IMRT) +/- high-dose rate (HDR) brachytherapy to treat this population. Our primary objectives were to evaluate complete response rates of targeted lesions after radiation and calculate our 5-year in-field control (IFC) rate. Secondary objectives were to assess radiation-related toxicities, chemotherapy free-interval (CFI), as well as post-radiation progression-free (PFS) and overall survival (OS). PFS and OS were defined from radiation start to either progression or death/last follow-up, respectively. This was a heavily pre-treated cohort of 17 recurrent OC patients with a median follow-up of 28.4 months (range 4.5-166.4) after radiation completion. 52.9% had high-grade serous histology and 4 (23.5%) had isolated vaginal/perirectal disease. Four (23.5%) patients had in-field failures at 3.7, 11.2, 24.5, and 27.5 months after start of radiation, all treated with definitive dosing of radiation therapy. Patients who were platinum-sensitive prior to radiation had similar median PFS (6.5 vs. 13.4 months, log-rank p = 0.75), but longer OS (71.1 vs 18.8 months, log-rank p = 0.05) than their platinum-resistant counterparts. Excluding patients with low-grade histology or who were treated with palliative radiation, median CFI was 14.2 months (range 4.7 - 33.0). Radiation was well tolerated with 2 (12.0%) experiencing grade 3/4 gastrointestinal/genitourinary toxicities. In conclusion, radiation to treat locally recurrent vaginal/perirectal lesions in heavily pre-treated OC patients is safe and may effectively provide IFC.

Tapping an Amazônian plethora: four medicinal plants of Marajó Island, Pará (Brazil).

This study focused its attention on four medicinal plants (Carapa guianensis, Elephantopus scaber, Piper umbellatum, Stachytarpheta cayenensis) used by Caboclo communities on Marajó, the main island of the Amazon delta. In the field, interviews were conducted with Caboclos and the medicinal usages and preparation procedures of the four plants were recorded. In the laboratory, the plant extracts were subjected to bioassays and their crude chemical composition was established. All four plants showed significant bioactivity and the chemical tests confirmed the presence of bioactive compounds. In addition, the results of both the field and laboratory studies corresponded well with those of a literature search. The ethnopharmacological significance of the four plants is discussed.

Isoelectric points of urinary light chains in myelomatosis: analysis in relation to nephrotoxicity.

Measurements of the isoelectric point (pI), sialic acid content, and polymerisation were made of 43 light chains isolated from the urine of patients with myelomatosis excreting large amounts of light chains. The pIs ranged from 3.5-9.5, and 23 were greater than 7.0. Sialylation was detected in 62% of light chains, and 69% showed microheterogeneity of charge. There was no clear association between the pI, sialylation, or polymerisation and the presence of renal failure, as assessed by serum creatinine concentrations. Light chains with pI spectrotype in the basic range, however, were found to produce more proximal tubular dysfunction than acidic light chains.

Chromatographic study of the interrelationships of immunoglobulin A and alpha 1-microglobulin in myelomatosis.

The binding of alpha 1-microglobulin (alpha 1-m) to serum immunoglobulin A (IgA) myeloma proteins have been examined by analytical and preparative Superose high-performance gel chromatography. Enzyme immunoassays showed that in the serum alpha 1-m was bound to monomeric IgA, but not to the polymeric IgA, and was also present in a free form. The IgA-alpha 1-m complexes involved covalent and non-covalent bonds. Considerable variation in the ratio of bound to unbound forms of alpha 1-m was observed that appears to be a result of variation of the IgA alpha heavy chains. Reduction of monomeric IgA produced alpha 1-m-heavy chain complexes, free alpha 1-m, light and alpha heavy chains, and traces of alpha 1-m attached to IgA that was resistant to reduction.

Identification and measurement of paraprotein polymers by high performance gel filtration chromatography.

An evaluation of Superose 6, a new high performance gel filtration medium, has been made for the rapid separation and quantitation of paraprotein polymers. There is a significant correlation between relative serum viscosity and the concentration of polymeric IgA as demonstrated by FPLC using the Superose 6 columns. The retention times of the columns are highly reproducible and allow good resolution of polymers and provide a simple way of separating IgG3 from albumin. Scaling up to the preparative Superose 6B could be achieved with little loss of resolution.

Applications of fast protein liquid chromatography TM in the separation of plasma proteins in urine and cerebrospinal fluid.

Fast Protein Liquid Chromatography TM (FPLC), in which an anion-exchange column is used, provides rapid separation and reproducible profiling of the plasma proteins in urine and cerebrospinal fluid (CSF). Chromatographic separation of the proteins takes 1 h for urine specimens and 45 min for CSF. The elution sequence from the anion-exchange column is similar to the electrophoretic mobility. Individual proteins have the same retention times independently of which type of specimen is used. The elution characteristics of 21 plasma proteins have been identified. We illustrated some applications of this system, including the profiling of tubular protein-uria, the isolation of Bence Jones proteins from urine, and the investigation of hemoglobin-derived products in the CSF.