Glycolytic enzyme binding during entrance to daily torpor in deer mice (Peromyscus maniculatus).

Associations of glycolytic enzymes with the subcellular particulate fraction of skeletal muscle and heart were examined during entrance to daily torpor in deer mice (Peromyscus maniculatus). In skeletal muscle a significant decrease in enzyme binding occurred during torpor entrance for phosphofructokinase, glyceraldehyde-3-phosphate dehydrogenase, and pyruvate kinase, with an additional significant decrease for phosphofructokinase and pyruvate kinase during the deepest state of torpor. Reductions in enzyme binding during torpor entrance also occurred in heart; significant changes were observed in hexokinase, glyceraldehyde-3-phosphate dehydrogenase, and pyruvate kinase binding. Contrary to the finding of additional reductions in enzyme binding seen in skeletal muscle, significant increases in enzyme binding during the deepest torpor state were observed for hexokinase, phosphofructokinase, glyceraldehyde-3-phosphate dehydrogenase, pyruvate kinase, and lactate dehydrogenase in heart. These results suggest that a decrease in the binding of glycolytic enzymes to subcellular structures in skeletal muscle and heart may be at least partially responsible for initiating the reduction in metabolic rate during torpor entrance. This decreased binding may continue to mediate the metabolic reduction in skeletal muscle throughout torpor; heart, however, may require the use of different molecular mechanisms. The increased binding in heart during the deepest state of torpor may represent an anticipatory response in preparation for increased activity during arousal.

Good outcome associated with a standardized treatment protocol using selective postoperative radiation in patients with clinical stage I adenocarcinoma of the endometrium.

In 1982, a treatment protocol was instituted for the management of patients with clinical stage I adenocarcinoma of the endometrium. All pertinent historical, operative, and pathologic findings were reviewed by a multidisciplinary committee and 384 patients were prospectively assigned to either high- or low-risk categories. Patients were excluded from the study if they had clinically apparent extrauterine disease, clear cell or serous histologies, or microscopic ovarian metastasis. Patients were considered high-risk if they had one or more of the following factors: grade 3 tumor differentiation, myometrial invasion > 50% of the total wall thickness, pathologic cervical involvement, or adenosquamous histology. Two-hundred twenty-seven (59%) low-risk patients were followed without further treatment after surgery, while pelvic radiation was recommended for 157 (41%) high-risk patients. The 5-year relapse-free survival rates in the low- and high-risk groups were 95 and 81%, respectively. There were no treatment-related deaths. Severe or life threatening chronic radiotherapy complications occurred in 6 (5%) patients. Multivariate Cox analysis identified the following significant prognostic factors: grade, myometrial invasion, cervix involvement, and age. This treatment protocol represents a safe and effective method of managing patients with carcinoma of the endometrium and spares the need for radiation therapy in the low-risk patient.

0-7-21 radiotherapy in nodular melanoma.

Fifty-four patients from August 1975 to March 1980 were treated with high dose per fraction (0-7-21) radiotherapy for malignant melanoma. The patients were subdivided into three clinical subtypes of disease: microscopic residual melanoma following surgery (22 patients), gross residual melanoma following surgery (nine patients), and recurrent melanoma (23 patients). Eighteen of 22 (82%) of patients treated for microscopic residual disease have been free of local recurrence to date. Ten of the 18 are alive and free of disease for up to 44 months following irradiation. Seven of nine (78%) patients treated for gross residual tumor have had no recurrence or progression of tumor in the irradiated volume, five of the nine achieved a complete remission and three are alive and free of disease at ten, 13, and 42 months, respectively. Twenty-three patients with recurrent melanoma were irradiated. Nine achieved a complete remission (39%) of tumor in the irradiated volume and three are alive and free of disease at up to 56 months following irradiation treatment. Three major complications of irradiation have been seen in the 54 patients treated. It is concluded that nodular melanoma is not a radioresistant tumor, large dose per fraction radiotherapy produces a high response rate of patients with measurable disease which is prolonged in some patients. The indications for radiotherapy in nodular melanoma are discussed and prospective studies of irradiation in melanoma are proposed.