Old versus new FIGO staging systems in predicting overall survival in patients with uterine leiomyosarcoma: a study of 86 cases.

OBJECTIVES: Uterine leiomyosarcoma (uLMS) was staged using the FIGO system for endometrial cancers. The new FIGO system takes into consideration tumor size disregarding myometrial and cervical involvement. We aimed to compare the two systems and see which more accurately predicts overall survival (OS). METHODS: 86 patients with uLMS (1984-2010) were retrospectively staged using both FIGO systems. Mean OS rates were estimated using the Kaplan-Meier method. RESULTS: More patients had stage-I disease by the new FIGO system (42 versus 33). Five versus 18 and 27 versus 5 had old and new stage-II and III diseases respectively. Five and 4 patients with old stage II and III uLMS respectively were downstaged to stage I while 18 with old stage III were downstaged to stage II. Median follow-up was 23.5 months with a median OS of 114 (95% CI, 61-166) months. Although patients with stage I tumors had a higher mean OS rate compared to those with higher stage disease by either system, patients with old stage II-IV disease showed similar mean OS rates, with stage III-IV patients having a slightly better mean OS and a similar trend was observed with the new system. Patients with new FIGO stage III had a higher mean OS rate than those with stage II or IV disease (37.6 versus 28.1 and 34.3 months). Nonetheless, no statistical significant differences were seen in OS according to stage using either system (p=0.786 and p=0.400 respectively). CONCLUSION: Neither FIGO staging system is ideal in classifying patients into four clinically significant stages.

Application of metabolic engineering to improve both the production and use of biotech indigo.

A fermentation process was developed for production of indigo from glucose using recombinant Escherichia coli. This was achieved by modifying the tryptophan pathway to cause high-level indole production and adding the Pseudomonas putida genes encoding naphthalene dioxygenase (NDO). In comparison to a tryptophan-over-producing strain, the first indigo-producing strain made less than half of the expected amount of indigo. Severe inactivation of the first enzyme of aromatic biosynthesis, 3-deoxy-D-arabino-heptulosonate 7-phosphate (DAHP) synthase (the aroGfbr gene product), was observed in cells collected from indigo fermentations. Subsequent in vitro experiments revealed that DAHP synthase was inactivated by exposure to the spontaneous chemical conversion of indoxyl to indigo. Indigo production was thereafter improved by increasing the gene dosage of aroGfbr or by increasing substrate availability to DAHP synthase in vivo by either amplifying the tktA (transketolase) gene or inactivating both isozymes of pyruvate kinase. By combining all three strategies for enhancing DAHP formation in the cell, a 60% increase in indigo production was achieved. Metabolic engineering was then further applied to eliminate a byproduct of the spontaneous conversion of indoxyl to indigo, thereby solving a serious problem with the use of bio-indigo in the final denim dyeing application.

Restoration of fertility in young obese (Lep(ob) Lep(ob)) male mice with low dose recombinant mouse leptin treatment.

OBJECTIVE: We investigated the effects of low-dose leptin treatment on restoration of fertility in young adult male leptin deficient obese mice. EXPERIMENTAL DESIGN AND RESULTS: MMTV-TGF-alpha Lep(ob) Lep(ob) mice (8--10 weeks old) were treated with recombinant mouse leptin. In experiment 1, four mice (5 microg/g body weight leptin followed by 2.5 microg/g) lost weight and impregnated females (number of pregnancies/number of females, 3/6, 5/6, 5/10, 4/10). In experiment 2, Leptin-Obese (2.5 microg/g) and Control-Lean mice weighed significantly less than Control-Obese mice. Epididymal pad weights of Control-Obese mice were the heaviest, followed by those of Leptin-Obese mice, and Control-Lean mice were the lightest. Testes weight was greater in Control-Lean vs Control-Obese mice. Leptin-Obese mice had testes weight not significantly different from either control group. Four of five Leptin-Obese mice impregnated females (4/10, 5/10, 2/10, 5/12, 0/10). CONCLUSIONS: These results indicate that low-dosage mouse recombinant leptin treatment restored fertility to young Lep(ob) Lep(ob) male mice. Although body weights of Leptin-Obese mice were similar to those of lean age-matched mice, epididymal fat pad weights were heavier. International Journal of Obesity (2001) 25, 95-97

The commercial production of chemicals using pathway engineering.

Integration of metabolic pathway engineering and fermentation production technologies is necessary for the successful commercial production of chemicals. The 'toolbox' to do pathway engineering is ever expanding to enable mining of biodiversity, to maximize productivity, enhance carbon efficiency, improve product purity, expand product lines, and broaden markets. Functional genomics, proteomics, fluxomics, and physiomics are complementary to pathway engineering, and their successful applications are bound to multiply product turnover per cell, channel carbon efficiently, shrink the size of factories (i.e., reduce steel in the ground), and minimize product development cycle times to bring products to market.

Effect of warning on feigned malingering on the WAIS-R in college samples.

Research indicates claimant malingering of cognitive deficits to be common in personal injury litigation. Efforts have been made to either detect such tendencies or deter efforts at malingering. The present study examined whether warning people that feigned malingering efforts would be detected results in more valid profiles on the Wechsler Adult Intelligence Scale-Revised. Undergraduates (N = 48) were randomly assigned to one of three conditions: feigned malingerers without warning, feigned malingerers with warning, and controls. Analysis indicated both feigned malingerer groups performed significantly worse than the control group; however, feigned malingerers with warning did not perform significantly better than those without warning. Unlike previous research using the Wechsler Memory Scale-Revised, results did not support effectiveness of warning in reducing feigned malingering scores.

Improved potency of hyperactive and actin-resistant human DNase I variants for treatment of cystic fibrosis and systemic lupus erythematosus.

The ability of recombinant human DNase I (DNase I) to degrade DNA to lower molecular weight fragments is the basis for its therapeutic use in cystic fibrosis (CF) patients and its potential use as a treatment for systemic lupus erythematosus (SLE). To increase the potency of human DNase I, we have generated and characterized three classes of mutants: (a) hyperactive variants, which have from one to six additional positively charged residues (+1 to +6) and digest DNA much more efficiently relative to wild type, (b) actin-resistant variants, which are no longer inhibited by G-actin, a potent inhibitor of DNase I, and (c) combination variants that are both hyperactive and actin-resistant. For DNA scission in CF sputum where the DNA concentration and length are large, we measured a approximately 20-fold increase in potency relative to wild type for the +3 hyperactive variant Q9R/E13R/N74K or the actin-resistant variant A114F; the hyperactive and actin-resistant combination variant was approximately 100-fold more potent than wild type DNase I. For digesting lower concentrations of DNA complexed to anti-DNA antibodies in human serum, we found a maximal enhancement of approximately 400-fold over wild type for the +2 variant E13R/N74K. The +3 enzymes have approximately 4000-fold enhancement for degrading moderate levels of exogenous DNA spiked into human serum, whereas the +6 enzyme has approximately 30,000-fold increased activity for digesting the extremely low levels of endogenous DNA found in serum. The actin resistance property of the combination mutants further enhances the degree of potency in human serum. Thus, the human DNase I variants we have engineered for improved biochemical and pharmacodynamic properties have greater therapeutic potential for treatment of both CF and SLE.

Effect of glucose on the cultivation of mammalian cells.

Most of the glucose consumed by mammalian cells cultivated in vitro is converted to lactate. The glucose consumption rate appears to be affected by glucose concentration. In a batch cultivation of cells the glucose concentration can be manipulated at a low level by programmed feeding of glucose. In such a culture the specific consumption rate of glucose and the fraction of glucose converted to lactate can be reduced. This reduced conversion rate of glucose to lactate appears to coincide with an increased oxygen uptake rate. A possible consequence of such programmed feeding of glucose is the increased oxidation of glutamine and the concurrent increased production of ammonium. For the cultivation of hybridoma cells high concentrations of ammonium and lactate can be growth inhibitory. It is suggested that the identification of the optimum cultivation conditions is necessary if such a programmed feeding is to be used to increase cell concentration and medium utilization efficiency.

The anesthetic management of a patient with an obstructing intratracheal mass: a case report.

A patient with a large mass in his lower trachea presents a real challenge to the anesthesiologist. The anticipated management and alternatives must be discussed with the surgeons beforehand. This report describes a procedure that successfully managed such a case involving a neurofibroma without evidence of neurofibromatosis.