[Adjuvant contact radiotherapy for conjunctival malignancies: Preliminary results of a series of 14 patients treated with the Papillon 50 machine]. / Radiothérapie de contact adjuvante des tumeurs malignes de la conjonctive : résultats préliminaires d'une série de 14 patients traités avec l'appareil Papillon 50.

PURPOSE: To evaluate the results of an adjuvant contact irradiation using 50kV photons after resection of conjunctival malignancies. MATERIALS AND METHOD: From 2012 to 2014, 14 patients (male: nine; female: five) have been treated by contact irradiation after resection of a malignant tumor of the conjunctiva (melanoma: five patients; malignant fibrous histiocytoma: one patient; carcinoma: eight patients) The treatment was performed using the Papillon 50 machine (Ariane). Three to four sessions were delivered, each giving a dose of 10Gy. The median follow-up in survivors was 33 months. RESULTS: The tolerance was good. A cataract was seen in one patient, and a moderate eye dryness in one. There was no corneal ulcer. One patient died of intercurrent disease. One patient with carcinoma recurred locally. CONCLUSION: Adjuvant contact radiotherapy provides a good local control after resection of conjunctival malignancies (melanoma, malignant histiocytofibroma, carcinoma). Thanks to its precision, this technique is well tolerated with a low rate of complications. Furthermore, it is delivered on an ambulatory basis.

Twin machines validation for VMAT treatments using electronic portal-imaging device: a multicenter study.

PURPOSE: To verify the accuracy of volumetric arc therapy (VMAT) using the RapidArc™ device when switching patients from one single linear accelerator (linac) to a paired energy and mechanics "twin" linac without reoptimization of the original treatment plan. PATIENTS AND METHODS: Four centers using 8 linacs were involved in this study. Seventy-four patients previously treated with the 6MV photon RapidArc™ technique were selected for analysis, using 242 measurements. In each institution, all patients were planned on linac A, and their plans were verified both on linac A and on the twin linac B. Verifications were done using the amorphous silicium electronic portal imager (EPID) of the linacs and were analyzed with the EpiQa software (Epidos, Bratislavia, Slovakia). The gamma index formalism was used for validation with a double threshold of 3 % and 3 mm with a measurement resolution of 0.39 mm/pixel, and a smoothed resolution of approximately 2.5 mm. RESULTS: The number of points passing the gamma criteria between the measured and computed doses was 94.79 ± 2.57 % for linac A and 94.61 ± 2.46 % for linac B. Concerning the smoothed measurement analysis, 98.67 ± 1.26 % and 98.59 ± 1.20 % points passing the threshold were obtained for linacs A and B, respectively. The difference between the 2 dose matrices acquired on the EPID was very small, with 99.92 ± 0.06 % of the points passing the criteria. CONCLUSION: For linacs sharing the same mechanical and energy parameters, this study tends to indicate that patients may be safely switched from treatment with one linac to treatment with its twin linac using the same VMAT plan.

Evaluation of Interventions for Prevention of Back, Neck, and Shoulder Disorders in Three Occupational Groups.

An epidemiologic study was carried out in order to evaluate the effects of prevention programs at the workplace aimed at reducing back, neck, and shoulder morbidity among active workers. The intervention group included 275 workers in three occupational subgroups: hospital workers, warehouse workers, and office workers. The control group included 250 workers as comparable as possible to the intervention group. Comparisons were made, according to one-year changes in morbidity scores, for low back, upper back, neck, and shoulder disorders separately. An overall measure was also used. The one-year change in the overall measure was significantly different between the intervention group and the control group, indicating a positive effect of the prevention programs. Positive effects were stronger for some sites of pain and some occupational groups.

Beta-3 adrenoceptor selectivity of the dioxolane dicarboxylate phenethanolamines.

The beta-1, beta-2 and beta-3 adrenergic properties of several benzodioxole-containing phenethanolamines were determined in vitro in both functional and binding assays. In addition, two of the compounds were evaluated for their effects on radioligand binding and cyclic AMP (cAMP) production in stably transfected Chinese Hamster Ovary (CHO) cells expressing the cloned rat or human beta-3 adrenoceptor or the human beta-2 or beta-1 adrenoceptor. The (+/-)-R*,R*-racemate, CL 314,514, and the pure (-)-R,R enantiomer, CL 316,243, stimulated rat adipocyte lipolysis (beta-3 effect) with EC50 values in the low nanomolar range, while having no effect on the rate of contraction of guinea pig atria (beta-1 effect) and little or no ability to prevent the insulin-stimulated incorporation of [14C]glucose into rat soleus muscle glycogen (beta-2 effect) with concentrations as great as 100 microM. The lack of beta-1 and beta-2 adrenergic activity was confirmed by the low affinity of the compounds for beta-1 or beta-2 adrenoceptors in plasma membranes from rat heart or rat soleus muscle, respectively. In CHO cells expressing each human beta adrenoceptor subtype, CL 314,514 bound to beta-3-CHO cells with a Ki of 2 microM and stimulated cAMP production with an activation constant (Kact) of 1 microM, whereas it did not bind to either beta-1- or beta-2-CHO cells at 100 microM. CL 316,243 bound to membranes from rat beta-3-CHO cells with a Ki of 1 microM and stimulated cAMP production in beta-3-CHO cells with a Kact of 0.7 nM.(ABSTRACT TRUNCATED AT 250 WORDS)

Level of education, lifestyle, and morbidity in two groups of white collar workers.

STUDY OBJECTIVE: The aim was to examine the relationship between level of education, lifestyle, and morbidity in two groups of male white collar workers, and to determine whether any differences found could be related to objective differences in working conditions. DESIGN: The study was a survey of a random sample of commercial travellers and a sample of men with sedentary occupations, representing two different groups of white collar workers. Survey interviews were conducted during the annual compulsory medical examination. Subjects were classified into three levels of education and differences according to level of education were studied in relation to 40 frequent health problems, lifestyle variables, body mass index, height, and working conditions. SUBJECTS: There were 1364 men in the commercial traveller group, mean age 39.5 years, and 525 men in the sedentary group, mean age 36.2 years. There were 22 exclusions because of unclassifiable levels of education and four refused to be interviewed. SETTING: The study took place in 11 towns in France. MAIN RESULTS: When age was taken into account there were only minor differences in the prevalence of health disorders. Lifestyle variables and height were clearly related to the level of education. Observed differences could not be explained by constraints or declared difficulties in working conditions. CONCLUSIONS: Differences in health practices related to level of education are observed even in groups that are relatively homogeneous socially. Lifestyle may be important as an intermediate determinant of health disorders among less educated people.

Low-back pain in commercial travelers.

The role of occupational environment in the occurrence of low-back pain was analyzed for 1719 commercial travelers (1376 men and 343 women). At the beginning of the study (T0) the group was interviewed to determine current lifestyle and occupational factors associated with low-back pain during the previous 12 months. Twelve months later (at T1), a subsample of 1118 persons (893 men, 225 women) was reinterviewed to study the association between the incidence of low-back pain during the year of follow-up and the risk factors at T0. At T0 low-back pain was significantly related with time spent driving a car at work, comfort of the car seat, carrying loads during work, standing for long periods at work, smoking, and psychosomatic factors. At T1 driving 10 h/week or more, seat comfort, and psychosomatic factors were associated with first occurrence of low-back pain.

Occupational exposure and cancer of the pancreas: a review.

Many hypotheses have been proposed about the aetiology of cancer of the pancreas, especially concerning the effects of tobacco, coffee, alcohol, diet, and pancreatic pathology. Results of numerous epidemiological studies are, however, inconsistent. Chemical carcinogens have been implicated as possible risk factors. Animal studies have been carried out to determine the role of these chemical factors but, except for nitrosamines and their derivatives (components of tobacco), chemicals have not been proved carcinogenic for the pancreas. Many studies have also been conducted among occupational groups. Several of them showed an excess risk of cancer of the pancreas, especially in the chemical and petroleum industries. The lack of accuracy about the nature of products used, however, does not permit a definitive conclusion as to their carcinogenic role. This paper is a review of publications about occupational exposures and cancer of the pancreas.

Calcium mediates the interconversion between two states of the liver inositol 1,4,5-trisphosphate receptor.

D-myo-Inositol 1,4,5-trisphosphate (Ins(1,4,5)P3) regulates intracellular Ca2+ by mobilizing Ca2+ from a non-mitochondrial store. We have investigated the effects of Ca2+ on the binding of [32P]Ins (1,4,5)P3 to permeabilized rat hepatocytes and a liver plasma membrane-enriched fraction. Increasing the free Ca2+ concentration in the medium from 0.1 nM to 0.7 microM increased the capacity of a high affinity binding component (KD = 2-3 nM) in permeabilized cells by a factor of 10. If the membrane fraction was preincubated at 37 degrees C before binding was measured at 4 degrees C, all of the Ins(1,4,5)P3 receptors were transformed to a low affinity state (KD = 65 +/- 12 nM, Bmax = 3.1 +/- 0.1 fmol/mg, n = 4). When 0.7 microM of Ca2+ was added, the receptors were totally transformed to a high affinity state (KD = 2.8 +/- 0.4 nM, Bmax = 2.7 +/- 0.4 fmol/mg, n = 4). The EC50 of the Ca2(+)-induced interconversion of the Ins(1,4,5)P3 receptor was 140 nM. This Ca2(+)-induced transformation of the Ins(1,4,5)P3 receptor from a low affinity to a high affinity state was associated with an inhibition of the Ins(1,4,5)P3-induced Ca2+ release in permeabilized hepatocytes. These data suggest that the Ins(1,4,5)P3-dependent hormones, by increasing the intracellular Ca2+ concentration, induce a reversible transformation of the receptor from its low affinity state, coupled to the Ca2+ release, to a desensitized high affinity state. Transformation of the receptor may play a role in the oscillatory release of Ca2+ observed in single isolated hepatocytes.

Occupational risk factors for cancer of the pancreas: a case-control study.

The role of the occupational environment in the occurrence of cancer of the pancreas was analysed in a case-control study of 171 cases of pancreatic cancer and 317 controls matched for age at interview, sex, hospital, and interviewer. The study was conducted in France between 1982 and 1985 and covered 15 important industries and various other occupations. The results are given for the whole population, a subgroup of manual workers (46 cases and 108 controls), and a subgroup of French nationals (114 cases and 253 controls). After adjustment for cigarette smoking, and coffee and alcohol consumption, workers in the food industry (OR = 1.86) and the leather industry (OR = 1.63) showed higher risks than other industries. In the sub-group of French nationals only the risk associated with the textile industry was significantly higher than unity (OR = 2.30). No significant increase in risk was associated with work in any of the other branches studied; printing showed a moderate increase in risk (OR = 1.54). The subgroup of manual workers showed an increase in risk for cancer of the pancreas among those working in the building materials and building trades classification (OR = 2.16) and transportation (OR = 1.57).

Comparison of antibody, antigen, and metabolite assays for hospitalized patients with disseminated or peripheral candidiasis.

Repeat serum samples from 22 patients with proven disseminated candidiasis and 42 with simple peripheral colonization were assayed for Candida antibodies by coelectrosyneresis, immunoprecipitation, and A and B immunofluorescence, for metabolites by D-arabinitol measurement, and for antigens by the mannan immunoassay and Cand-tec latex agglutination (mean number of samples tested, 2.5 per patient). For the antibody and metabolite assays, the results showed no statistical difference between the two groups. By contrast, the results of both antigen assays were positive for a significantly larger number of patients with disseminated candidiasis than of those with simple peripheral colonization. Results were regardless of whether the patients were neutropenic. They were not predictive of death. We calculated that the mannan antigen assay had 29% sensitivity and 97% specificity for the diagnosis of disseminated candidiasis. Likelihood ratios of a positive and a negative result of this test were 9.2 and 0.7, respectively, for this diagnosis. In the latex agglutination test, likelihood ratios were 2.5, 1.5, 1.6, and 0.3 when the test was positive for dilutions of 1/8, 1/4, and 1/2 and was negative, respectively.

[Characterisation of 2 reversible states of the inositol 1,4,5-trisphosphate receptor in rat hepatocytes]. / Caractérisation de deux états interconvertibles du récepteur de l'inositol 1,4,5-trisphosphate dans les hépatocytes de rat.

Myo-inositol-1,4,5-trisphosphate or (I(1,4,5)P3) is generated in liver cells after hormonal stimulation. It bind to specific receptors and induces the release of Ca2+ from an intracellular store. This receptor has been found in permeabilized hepatocytes and showed two states of low- and high-affinity with KD of 1-2 and 40-50 nmol/l, respectively. Measurements of 45Ca2+ release, mediated by different analogues, revealed that the low-affinity site was coupled to the Ca2+ channel open state. The pretreatment of cells with vasopressin, an I(1,4,5)P3-dependent agonist, induced an 60 percent increase of the binding capacity of the high-affinity sites. Incubation with 1 mumol/l Ca2+ increased the number of high-affinity sites from 5 to 65 fmol/10(6) cells. This effect was associated with a decrease in the number of low-affinity sites from 130 to 80 fmol/10(6) cells. Our results suggest that the intracellular Ca2+ concentration rise mediated by I(1,4,5)P3-dependent agonists, induced a conversion of the low-affinity form of the I(1,4,5)P3 receptor, coupled to Ca2+ release, to a desensitized high-affinity one. This process could explain the oscillations of the intracellular Ca2+ concentration observed in hormone-treated single cells.

Characterization of two forms of inositol 1,4,5-trisphosphate receptor in rat liver.

Two binding sites for [32P]myo-inositol 1,4,5-trisphosphate (Ins(1,4,5)P3) were detected in a crude particulate fraction prepared from rat liver homogenate and in permeabilized hepatocytes. The same high- and low-affinity sites with KDs of 1.8-2.6 nM and 35-71 nM, respectively, were detected in subcellular fractions enriched in plasma membranes, mitochondria and microsomes, with relative proportions close to those found in the crude membrane fraction. The order of potency of three inositol phosphates in inhibiting [32P]Ins(1,4,5)P3 binding to the two sites, i.e. Ins(1,4,5)P3 greater than Ins(2,4,5)P3] greater than Ins(1,3,4,5)P4, and the inhibition by heparin, strongly suggest that neither of the binding sites reflected components due to the 3-kinase or the 5-phosphatase. A close correlation was observed between the dose-response curves for Ca2+ release by Ins(1,4,5)P3 and Ins(2,4,5)P3 and the occupancy of the low-affinity binding site by these agonists. These results support the view that the two [32P]Ins(1,4,5)P3 binding sites are two forms of the same receptor.

Hormonal regulation of inositol 1,4,5-trisphosphate receptor in rat liver.

Inositol 1,4,5-trisphosphate (IP3) is a second messenger which induces Ca2+ release from an intracellular store. We have investigated the properties of the [32P]IP3 binding sites in rat liver. Two specific [32P]IP3 receptors with KD of 2.3 and 88 nM and respective capacities of 33 fmol/mg protein and 195 fmol/mg protein have been detected in a crude membrane fraction prepared from rat liver homogenate. The pretreatment of the liver with IP3-dependent hormones increased two-fold the capacity of the high affinity site. This effect was partly reversed by dibutyryl cyclic AMP. Permeabilized hepatocytes also displayed two [32P]IP3 binding sites with KD of 1.5 and 84 nM and respective capacities of 8 and 300 fmol/10(6) cells. We have measured the [32P]IP3 binding and the IP3-induced 45Ca2+ release in the same batch of permeabilized hepatocytes. In a low Mg2+ medium, the EC50 for 45Ca2+ release was in close correlation with the KD for the low affinity site. These data suggest that an equilibrium between two states of the IP3 receptor is regulated by hormone action and the low affinity state is responsible for the intracellular Ca2+ release.

[A phase III trial comparing the antiemetic activity of tetracosactide with dexamethasone in combination with metoclopramide, diphenhydramine and clorazepate during chemotherapy including cisplatin]. / Essai phase III comparant l'activité anti-émétique du tétracosactide à la dexaméthasone employés en association avec le metoclopramide, la diphénhydramine et le clorazépate au cours de chimiothérapies comportant du cisplatine.

In order to compare the safety and the antiemetic effectiveness of tetracosactide (TCS) or beta 1,24 ACTH with those of dexamethasone (DXM) as an adjunct to high-dose metoclopramide, diphenhydramine and clorazepate, 33 patients receiving cisplatin based cancer chemotherapy were enrolled in a double-blind cross-over clinical trial. TCS and DXM were given intravenously, respectively at a dose of 2 mg and 20 mg, and concurrently to the cisplatin infusion. No statistically significant difference was noted between the two drugs with regard to efficacy or side effects. We conclude that TCS can serve as a substitute for DXM in combination antiemetic regimens for management of cisplatin-induced nausea and vomiting.