EFFICACY OF AUTOLOGOUS STEM CELL TRANSPLANTATION IN ADULT BURKITT/BURKITT-LIKE LYMPHOMA: A SYSTEMATIC REVIEW.

BACKGROUND: Burkitt and Burkitt like lymphoma (BL/BLL) are highly proliferative germinal or post-germinal B cell tumors. Few studies have evaluated the impact of autologous stem cell transplantation (ASCT) on disease outcomes. AIM: We performed a systematic review to analyze the efficacy of ASCT as frontline consolidation and for treatment of relapsed/refractory cases in adult BL/BLL. MATERIALS AND METHODS: Eligible studies with clear outcome measures on the efficacy of ASCT in adult patients with BL/BLL were identified through systematic search. The overall survival (OS), progression-free survival (PFS), complete response (CR), partial response (PR), and progression/relapse were used to assess the efficacy. RESULTS: For patients who underwent ASCT in first CR, 5-year PFS and OS ranged between 70-78% and 70-83% respectively. For relapsed/refractory disease, 5-year PFS and OS were 27% and 31%, respectively. Patients undergoing ASCT for chemoresistant disease fared poorly with 3-year OS of 7% vs 37% for chemosensitive disease (p ≤ 0.00001). The overall response rate to ASCT for patients transplanted in first CR ranged between 71% and 93% and was 37% for patients who were transplanted in disease status other than first CR. Disease progression/relapse was observed in 16-29% of the patients transplanted in first CR, and 55% to 60% in relapsed disease. CONCLUSION: We found insufficient evidence to support ASCT over chemotherapy alone in the first remission for adult BL/BLL. Evidence supports guidelines recommending ASCT for chemosensitive disease but suggests there is no benefit to ASCT for chemoresistant disease.

Enhanced room temperature ferromagnetism and green photoluminescence in Cu doped ZnO thin film synthesised by neutral beam sputtering.

The Cu (3 to 15 at%) is incorporated into ZnO thin film by atomic beam co-sputtering has been investigated for enhancement in room temperature ferromagnetism and green photo-luminance. These Cu-ZnO thin films examined with Raman spectroscopy, X-Ray Diffraction (XRD), UV-Visible spectroscopy, Hall measurement, magnetic force microscopy (MFM) and magnetic hysteresis. Raman spectroscopy, XRD confirms wurtzite structure and improvement in the crystallinity of ZnO upto 7% Cu. Further increase in Cu concentration results in growth in Cu nanoparticles. On increasing Cu concentration, there is decrement in transparency and increase in band gap with increase in n-type carrier concentration as confirmed from UV-Visible and Hall measurement studies. Magnetic measurement exhibited unique feature of room temperature ferromagnetic ordering in undoped and doped sample upto 3% Cu. The enhancement in magnetic moment as well as green emission in photoluminescence response with increase in Cu doping indicates that generation of large defects in ZnO by Cu doping, which can be attributed to combined effect of the presence of oxygen vacancies and/or structural inhomogeneity as well as formation of bound magnetic polarons. Importantly, synthesised Cu doped ZnO thin films can be used as spin LEDs and switchable spin-laser diodes.

Salicylic acid induces amelioration of chromium toxicity and affects antioxidant enzyme activity in Sorghum bicolor L.

AIM: Chromium (Cr(VI)) would inflict serious morphological, metabolic, and physiological anomalies in plants ranging from chlorosis of shoot to lipid peroxidation and protein degradation. Cr(VI) toxicity is often associated with oxidative stress, caused by the excessive formation of reactive oxygen species (ROS). In response, plants are equipped with a repertoire of mechanisms to counteract heavy metal (HM) toxicity. Salicylic acid (SA) plays a key role in the signal transduction pathways of various stress responses, demonstrating the protective effect of SA against abiotic stress factors. So, the present investigation was carried out to study the amelioration of pernicious effects of different concentration of Cr(VI) (0.0, 2.0, and 4.0 mg Cr(VI) kg-1 soil in the form of potassium dichromate) by treatments of salicylic acid solution viz. pretreatment and foliar spray via antioxidative enzymes and their metabolites. RESULTS: With different treatments of salicylic acid solution, the reinstatement from ill effects of Cr(VI) toxicity was contemplated but the most conspicuous effect was observed when salicylic acid solution was supplied through the foliar spray (0.50 mM). This was accompanied with an increase in ascorbate peroxidase activity and hydrogen peroxide content and decrease in peroxidase activity and ascorbic acid content. SIGNIFICANCE OF THE STUDY: This study suggests that salicylic acid when applied through pre-treatment of seeds or through a foliar spray can be used to ameliorate the toxic effects of chromium (VI). Salicylic acid has the great potential for reducing the toxicity of heavy metals without negatively impacting the growth of the plants.

A national survey of nurse-led and delivered services within sexual health across the United Kingdom.

This was a cross-sectional study using an online survey to evaluate the provision of nurse-led and delivered services within genitourinary medicine in the UK. Results showed that such services are being widely utilised and are generally well supported by medical staff. The delivery of nurse-led and delivered services appears to be quite variable. Clinical guidelines and standards may help to ensure a more uniform approach to these services and help to maintain high standards of care.

Effect of Chromium(VI) Toxicity on Enzymes of Nitrogen Metabolism in Clusterbean (Cyamopsis tetragonoloba L.).

Heavy metals are the intrinsic component of the environment with both essential and nonessential types. Their excessive levels pose a threat to plant growth and yield. Also, some heavy metals are toxic to plants even at very low concentrations. The present investigation (a pot experiment) was conducted to determine the affects of varying chromium(VI) levels (0.0, 0.5, 1.0, 2.0, and 4.0 mg chromium(VI) kg(-1) soil in the form of potassium dichromate) on the key enzymes of nitrogen metabolism in clusterbean. Chromium treatment adversely affect nitrogenase, nitrate reductase, nitrite reductase, glutamine synthetase, and glutamate dehydrogenase in various plant organs at different growth stages as specific enzyme activity of these enzymes decreased with an increase in chromium(VI) levels from 0 to 2.0 mg chromium(VI) kg(-1) soil and 4.0 mg chromium(VI) kg(-1) soil was found to be lethal to clusterbean plants. In general, the enzyme activity increased with advancement of growth to reach maximum at flowering stage and thereafter decreased at grain filling stage.

Reduction of nutrient contaminants into shallow eutrophic waters through vegetated treatment beds.

One of the most effective mitigative approaches to eutrophication is the reduction of nutrient loading into water bodies. Bioremediation presents an economically viable and ecologically sustainable technology to nutrient pollution control taking advantage of the remarkable ability of plants and their associated microbial community to assimilate and remove nutrients from the environment. In this study, four emergent macrophytes (Cyperus haspan, Pandanus amaryllifolius, Pontederia cordata and Thalia geniculata) and two floating plants (Hygroryza aristata and Pistia stratiotes) were deployed in bank-side treatment beds and comparatively assessed for their remediative capabilities for nutrient control. P. stratiotes exhibited the highest removal efficiency for both nitrate and phosphate among the six plant species studied. Emergent macrophytes, P. amaryllifolius, C. haspan and P. cordata, were also found to be highly effective in nutrient uptake exhibiting removal efficiencies up to 100%. With the exception of T. geniculata, depletion of nutrients as a result of plant uptake significantly impeded the natural colonization of algae invariably leading to improvements in water quality in terms of turbidity and pH. Suppression of algae proliferation by T. geniculata was not preceded by a reduction in nutrient concentrations suggesting that T. geniculata may be directly inhibiting algal growth through allelopathy.

Hybrid Sargassum-sand sorbent: a novel adsorbent in packed column to treat metal-bearing wastewaters from inductively coupled plasma-optical emission spectrometry.

Laboratory batch and column experiments were carried out to examine the efficiency of algal-based treatment technique to clean-up wastewaters emanating from inductively coupled plasma-optical emission spectrometry (ICP-OES). Chemical characterization revealed the extreme complexity of the wastewater, with the presence of 14 different metals under very low pH (pH = 1.1), high conductivity (6.98 mS/cm), total dissolved solid (4.46 g/L) and salinity (3.77). Batch experiments using Sargassum biomass indicated that it was possible to attain high removal efficiencies at optimum pH of 4.0. Efforts were also made to continuously treat ICP-OES wastewater using up-flow packed column. However, swelling of Sargassum biomass leads to stoppage of column. To address the problem, Sargassum was mixed with sand at a ratio of 40: 60 on volume basis. Remarkably, the hybrid Sargassum-sand sorbent showed very high removal efficiency towards multiple metal ions with the column able to operate for 11 h at a flow rate of 10 mL/min. Metal ions such as Cu, Cd, and Pb were only under trace levels in the treated water until 11 h. The results of the treatment process were compared with trade effluent discharge standards. Further the process evaluation and cost analysis were presented.

A field study to evaluate runoff quality from green roofs.

Green (vegetated) roofs are emerging as practical strategies to improve the environmental quality of cities. However, the impact of green roofs on the storm water quality remains a topic of concern to city planners and environmental policy makers. This study investigated whether green roofs act as a source or a sink of various metals (Na, K, Ca, Mg, Al, Fe, Cu, Cd, Pb, Zn, Mn, Cr, Ni, Li and Co), inorganic anions (NO3-, NO2-, PO4(3-), SO4(2-), Cl-, F- and Br-) and cation (NH4+). A series of green roof assemblies were constructed. Four different real rain events and several artificial rain events were considered for the study. Results showed that concentrations of most of the chemical components in runoff were highest during the beginning of rain events and subsided in the subsequent rain events. Some of the important components present in the runoff include Na, K, Ca, Mg, Li, Fe, Al, Cu, NO3-, PO4(3-) and SO4(2-). However, the concentration of these chemical components in the roof runoff strongly depends on the nature of substrates used in the green roof and the volume of rain. Based on the USEPA standards for freshwater quality, we conclude that the green roof used in this study is reasonably effective except that the runoff contains significant amounts of NO3- and PO4(3-).

Characteristics and environmental mobility of trace elements in urban runoff.

The spatial and temporal distribution of various trace elements in water and suspended solids in urban runoff from residential and industrial sites was studied. 240 sequential urban runoff samples from 39 rain/storm events were collected, processed and analyzed for 13 elements (12 metals - Al, Co, Cd, Cr, Cu, Fe, Mn, Pb, Ni, Ti, V, and Zn, and one metalloid--As). The experimental protocol used in this study was validated using standard reference material (NIST 1648, urban particulate matter) and certified rain water samples. Good agreement was obtained between the certified and measured values. Al, Fe and Zn were found to be abundant in both residential and industrial runoffs. Some of the metals demonstrated first flush phenomena. Investigation of dissolved fraction, environmentally mobile fraction and total concentration for the 13 elements revealed that trace elements in industrial runoff were highly enriched as compared to those in the residential runoff. The environmentally mobile fraction was quite significant for most of the trace elements. Statistical correlations among the metals were studied, and principal component analysis (PCA) was used for identification of the major sources of the metals/metalloid in both residential and industrial runoffs. Crustal leaching, paints from building walls, and atmospheric deposition were found to be the main sources of metals/metalloid in runoff from the residential site while emissions from petrochemical and semiconductor industries, metal corrosion and vehicular emissions were the main sources of metals/metalloid in runoff from the industrial site. These results are presented and discussed in this paper.

Biosorption of lead(ll) and copper(ll) from stormwater by brown seaweed Sargassum sp.: batch and column studies.

This study evaluated the potential use of brown seaweed Sargassum sp to sequester lead and copper (Pb(II) and Cu(ll)) from urban runoff based on batch as well as column experiments. The equilibrium data exhibited Langmuir isotherms. The adsorption capacity of this seaweed was found to be 196.1 mgg(-1) and 84.0 mg g(-1) for Pb(ll) and Cu(ll), respectively, which are in good agreement with those values obtained for the aqueous solution (188.6 mg g(-1) for Pb(ll) and 86.9 mg g(-1) for Cu(II)). The functional group analysis of the seaweed using FTIR demonstrated that the carboxyl functional groups are mainly responsible for biosorption. The cation exchange capacity of the biosorbent was 2.25 meq/g. This observation suggested that ion exchange mechanism is predominantly responsible for the metal ion uptake. The column study showed that the highest bed height and the lowest flow rate result in a substantial enhancement of the metals uptake with the biosorption uptake capacities being 264.3 mg Pb(ll) g(-1) and 86.0 mg Cu(ll) g(-1). In the binary system, the biosorption capacity was observed to be 208.7 mg Pb(ll) g(-1) and 61.0 mg Cu(II) g(-1). The predicted breakthrough curves by the Thomas adsorption model gave a good fit of the experimental data with r2 ranging from 0.92 to 0.99.

Proteus syndrome: a rare cause of hemihypertrophy and macrodactyly on bone scanning.

Proteus syndrome is a rare, sporadic genetic disorder characterized by overgrowth of multiple different tissues in a mosaic pattern. It is associated with connective tissue nevi, epidermal nevi, disproportionate overgrowth of multiple tissues, vascular malformations, characteristic tumors, and specific facial anomalies. Joseph Merrick, popularly known as the Elephant Man, is now believed to have suffered from Proteus syndrome. A case of Proteus syndrome and associated findings on bone scintigraphy are presented.

Evaluation of pulmonary nodules: comparison of a prototype dual crystal (LSO/NAI) dual head coincidence camera and full ring positron emission tomography (PET).

PURPOSE: To determine the concordance of a prototype dual head coincidence camera (LSO-PS) and full ring PET (BGO-PET) using (18)F-fluorodeoxyglucose (FDG) in the evaluation of pulmonary nodules (PNs). MATERIALS AND METHODS: Patients referred for evaluation of < or =3 PNs (< or =3 cm diameter) were prospectively studied on the same day with both BGO-PET and LSO-PS. Imaging was performed at 60 and 120 min after injection of 370MBq FDG, respectively. Images were independently interpreted by four observers with each observer blinded to the other modality for the same patient. Lesions were scored in terms of relative intensity versus background. Non-attenuation corrected (nonAC) BGO-PET was used as the reference test. RESULTS: Forty-seven patients with 54 PNs (mean diameter 1.7 cm, S.D. 0.7) were included. Twelve nodules were in the < or =1.0 cm - 27 in the 1.1-2.0 cm - and 15 in the 2.1-3.0 cm range. Interobserver agreement was similar for both FDG imaging modalities. Using a sensitive assessment strategy with LSO-PS (> or = faint intensity deemed positive), there was a 97% (38/39, 95%CI 87-100%) concordance with BGO-PET and one false positive case with LSO-PS. Conservative reading (moderate or intense intensity deemed positive) resulted in a 92% (36/39, 95%CI 80-97%) concordance with BGO-PET, without false positives. The only lesion missed by LSO-PS using both assessment strategies involved a nodule 1.5 cm diameter that demonstrated moderate increased FDG uptake on BGO-PET. CONCLUSION: Depending on the test positivity criteria, LSO-PS demonstrates a high concordance (92-97%) with nonAC BGO-PET for the characterization of pulmonary nodules.

In search of an unknown primary tumour presenting with extracervical metastases: the diagnostic performance of FDG-PET.

A retrospective study was carried out to determine the performance of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in patients with unknown primary tumours presenting with metastases external to the neck. All patients referred to an academic PET centre (July, 1997 to December, 2000) presenting with an extracervical metastasis and no prior systemic therapy were eligible. The minimum follow-up period was 11 months. From 63 eligible cases, known metastases were FDG avid in all but one neuroendocrine process. PET scans were retrospectively classified as positive for a primary tumour (n=29), i.e. revealing at least one anatomical site suspected to be the primary tumour. This was confirmed in 16, either by histology (n=10) or radiological and clinical follow-up (n=6). There were four false positive cases. In nine patients, the primary tumour was never confirmed. Of the remaining 33 negative PET scans the primary tumour was clinically not found in 18. Follow-up and additional pathology investigations demonstrated the primary tumour in 15. A survey on clinical usefulness of PET (response rate 83%) suggested that PET positively contributed to diagnostic understanding in 29 of 52 evaluable cases. Applied late in the diagnostic trajectory, approximately four patients need to be scanned by PET in order to find one primary tumour. However, in addition to direct demonstration of unknown primaries, there appears to be a positive effect on the diagnostic work-up of these patients of a similar magnitude.

Prospective use of serial questionnaires to evaluate the therapeutic efficacy of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in suspected lung cancer.

BACKGROUND: A study was undertaken to study the effect of (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) on the diagnosis and management of clinically problematic patients with suspected non-small cell lung cancer (NSCLC). METHODS: A prospective before-after study was performed in a cohort of all 164 patients (university/community settings) referred for PET between August 1997 and July 1999. PET was restricted to cases where non-invasive tests had failed to solve clinical problems. The impact on diagnostic understanding and management was assessed using questionnaires (intended treatment without PET, actual treatment choice after PET, post hoc clinical assessment). RESULTS: Diagnostic problems especially pertained to unclear radiological findings (n=112; 63%), mediastinal staging (n=36; 20%), and distant staging issues (n=16; 9%). PET findings were validated by reviewing medical records. PET had a positive influence on diagnostic understanding in 84%. Improved diagnostic understanding solely based on PET was reported in 26%. According to referring physicians, PET resulted in beneficial change of treatment in 50%. Cancelled surgery was the most frequent change in treatment after PET (35%). CONCLUSION: FDG PET applied as "add on" technology in patients with these clinical problems appears to be a clinically useful tool, directly improving treatment choice in 25% of patients. The value of increased confidence induced by PET scanning requires further evaluation.

An evaluation of the applicability of quantitative clinical standards for the management of genital chlamydial infection using an electronic database.

A prototype electronic database was designed for use as a retrospective audit tool to provide data that allowed comparison of genital chlamydial infection management performance with a series of quantitative operational consensus standards. However, some of the terms used by the standards require further definition for translation into database fields to improve accuracy and general application as an audit tool. Construction of the database involved differentiation between prior and clinic diagnostic points, as well as a forward contact trail of specific quantitative indicators of contact tracing. More definition is needed of the meaning of diagnosis and contact in the standards. For clinic-diagnosed patients, the time to treatment was mainly dependent on clinical factors, not on the availability of a chlamydial test result. For about one-third of patients (with prior management), several standards cannot be applied because data are not available, and this raises the issue of data sharing between various agencies involved in chlamydial testing. More data from other clinics may help both to test the appropriateness of, and inform, some of the operational standards. The database could be developed as a real-time audit tool for use with electronic patient records.

Prophylactic efficacy of amifostine and its analogues against sulphur mustard toxicity.

The successful implication of the chemical weapons convention stimulated research with a new vigour on the destruction of the stockpiled sulphur mustard (SM). A prophylactic agent for SM will be very useful for personnel engaged in the destruction of SM and during inspections by the Organisation for the Prohibition of Chemical Weapons. Due to simple method of preparation, SM can be used clandestinely during war or by terrorist groups. Inspite of research over several decades no satisfactory prophylactic or treatment regimen has evolved for SM. Amifostine an organophosphorothioate, originally developed as a radioprotector, and its analogues were evaluated as a prophylactic agent for SM. Three analogues by varying the chain length and substitution at the sulphur atom were synthesised and coded as DRDE-06, DRDE-07 and DRDE-08. LD(50) of amifostine and its analogues were estimated through intraperitoneal (i.p.) route. For the protection studies, amifostine and its analogues were administered i.p. in mice, 30 min before dermal (percutaneous) application of SM. The dose of the prophylactic agent was 0.2 LD(50) (i.p.) and that of SM was 152 mg/kg (undiluted) equal to 19-fold LD(50) of SM. Amifostine and one of its analogues, DRDE-07 gave significant protection. Further studies were carried out using amifostine and DRDE-07, and both of them significantly protected mice against SM (155 mg/kg, in PEG 300, equal to 19 LD(50)) when they were administered i.p. either 30 min before or simultaneously. LD(50) of amifostine and DRDE-07 were also estimated through the oral route (1049 or 1248 mg/kg, respectively). Prophylactically administered amifostine and DRDE-07 (0.2 LD(50), p.o.) significantly protected the mice against dermally applied SM (155 mg/kg, in PEG 300, equal to 19 LD(50)). The protection offered by DRDE-07 was better than that of amifostine by the oral route. DRDE-07 (0.2 LD(50), p.o.) also protected significantly with respect to the decrease in body weight and the depletion of GSH induced by SM. DNA damage induced by SM was also significantly reduced by amifostine and DRDE-07 (0.2 LD(50), p.o.). Further studies are in progress on the various pharmacological and toxicological properties of DRDE-07.

Adsorption Behavior of N(2), Water, C(6) Hydrocarbons, and Bulkier Benzene Derivative (TMB) on Na-X Zeolite and Its K(+)-, Rb(+)-, and Cs(+)-Exchanged Analogues.

The hydrothermal crystallization of X-type zeolite with a Si/Al ratio of 1.15 was achieved from the Na(2)O-Al(2)O(3)-SiO(2)-H(2)O system at 368 K under static conditions. The post-synthesis modification was carried out by a conventional ion-exchange technique to obtain K(+)-, Rb(+)-, and Cs(+)-exchanged samples with different degrees of exchange. All the samples were characterized using chemical analysis, IR, SEM, powder XRD, low-temperature nitrogen adsorption, and equilibrium sorption uptakes of different probe molecules. The relative intensities of the XRD peaks of cation-exchanged zeolite were found to be affected to different extents, depending on the nature and the concentration of nonframework cationic size, without any shift in the positions of reflection. The sorptive properties of the K-, Rb-, and Cs-exchanged samples were studied using nitrogen, water, and different C(6) hydrocarbons including bulkier benzene derivative 1,3,5-trimethylbenzene (TMB) as probe molecules. The trend observed in chemical potential estimated as a function of nitrogen coverage indicates different sorption selectivity because of differences in the cationic size and population. Sorption uptake kinetics for probe molecules such as water, n-hexane, cyclohexane, benzene, and TMB were also studied. The samples with higher degrees of exchange and/or cationic size have shown a decrease in hydrophilic character due to the formation of irregular networks of water molecules connected with preadsorbed water molecules, framework oxygen ions, and nonframework cations. Among C(6) hydrocarbons including TMB, the benzene molecule is found to be the most promising probe for the estimation of openness of structure and surface heterogeneity as well. Copyright 2001 Academic Press.

General practitioners' views on the screening for genital Chlamydia trachomatis infection and partner notification.

A postal survey of general practitioners (GPs) in the East Riding of Yorkshire was undertaken to find out their views about screening for Chlamydia trachomatis infection, the reasons for their inability to screen the high-risk population, facilities available for screening in the primary care setting, treatment regimen and the views about partner notification. Although all GPs had the facilities for chlamydial testing, their views on chlamydial screening differed widely and very few offered opportunistic screening. Most of the GPs would prefer the sexual health clinics (genitourinary medicine [GUM] clinics) to undertake partner notification. Less than half of the GPs surveyed offered the ideal antimicrobial therapy against chlamydial infection, as recommended by the Central Audit Group in Genito-urinary Medicine. This survey shows the necessity to disseminate proper guidelines for the management of uncomplicated C. trachomatis infection in the community. Sexual health clinics should make adequate provision to deal with additional workload resulting from the increased referrals of partners to the clinics when the opportunistic screening is widely provided by the GPs.