Objective assessment of WHO/ECOG performance status.

PURPOSE: Performance status is an important factor in determining quality of life, the choice of treatment, and prognostic tool in patients. All scoring systems currently in use measure the patient's performance subjectively. A new method of objective assessment of performance ECOG/WHO grades 2 and 3 was constructed and tested. METHODS: A performance meter-an adapted USB data logger with a mercury tilt switch-was constructed. The device was tested in a feasibility study on 33 residents of a retirement home. Parallel to the objective assessment, each resident gave their own estimate of their performance, and each resident was in turn assessed by the nursing staff. RESULTS: With the performance meter, 4 residents (12%) were assessed as PS ≥ 3 in comparison with 8 (24%) and 7 (21%) residents with an ECOG score ≥ 3 estimated by patients themselves and nursing staff respectively. CONCLUSION: Subjective scoring-estimated by patients themselves and by nursing staff-showed underestimation of patients' performance. In 12% of patients, a better performance score was observed with objective measurement in comparison with subjective assessment. Performance meter could be a useful tool for health care professionals for type of care decisions.

Increased phosphatidylethanolamine N-methyltransferase gene expression in non-small-cell lung cancer tissue predicts shorter patient survival.

Lipid mobilization is of great importance for tumor growth and studies have suggested that cancer cells exhibit abnormal choline phospholipid metabolism. In the present study, we hypothesized that phosphatidylethanolamine N-methyltransferase (PEMT) gene expression is increased in non-small-cell lung cancer (NSCLC) tissues and that increased gene expression acts as a predictor of shorter patient survival. Forty-two consecutive patients with resected NSCLC were enrolled in this study. Paired samples of lung cancer tissues and adjacent non-cancer lung tissues were collected from resected specimens for the estimation of PEMT expression. SYBR Green-based real-time polymerase chain reaction was used for quantification of PEMT mRNA in lung cancer tissues. Lipoprotein lipase (LPL) and fatty acid synthase (FASN) activities had already been measured in the same tissues. During a four-year follow-up, 21 patients succumbed to tumor progression. One patient did not survive due to non-cancer reasons and was not included in the analysis. Cox regression analysis was used to assess the prognostic value of PEMT expression. Our findings show that elevated PEMT expression in the cancer tissue, relative to that in the adjacent non-cancer lung tissue, predicts shorter patient survival independently of standard prognostic factors and also independently of increased LPL or FASN activity, the two other lipid-related predictors of shorter patient survival. These findings suggest that active phosphatidylcholine and/or choline metabolism are essential for tumor growth and progression.

Lipoprotein lipase in non-small cell lung cancer tissue is highly expressed in a subpopulation of tumor-associated macrophages.

High lipoprotein lipase (LPL) activity in non-small cell lung cancer (NSCLC) tissue strongly predicts shorter patient survival. We tested the hypothesis that in NSCLC tissue, macrophages are the major site of LPL expression. LPL expression in the entire NSCLC tissue and in the adjacent non-cancer lung tissue was compared to the expression of genes preferentially expressed in macrophages. LPL expression at the cellular level was analyzed by mRNA fluorescence in situ hybridization. In the whole cancer tissue (but not in the adjacent non-cancer tissue), expression of LPL correlated with expression of genes preferentially expressed in macrophages (MSR1, CD163, FOLR2), but not with expression of genes preferentially expressed in tumor cells. All cells in the cancer and adjacent non-cancer tissue exhibit low LPL expression. However, in cancer tissue only, there were individual highly LPL-expressing cells which were macrophages. These LPL-overexpressing cells were approximately 10 times less abundant than anti-CD163-stained, tumor-associated macrophages. To conclude, in NSCLC tissue, a subpopulation of tumor-associated macrophages highly expresses LPL. Because tumor-associated macrophages are pro-tumorigenic, these cells should be further characterized to better understand the underlying nature of the close relationship between high LPL activity in NSCLC tissue and shorter patient survival.

Monitoring, control and diagnostics using RFID infrastructure.

This work demonstrates the developed application for disinfection control by the sensing of chemical agents. The objective was to develop an Automatic Disinfectant Tracker (ADT) that would verify the disinfection of the hands of nurses, doctors, staff, patients, and visitors in hospitals within a required time frame. We have successfully investigated the development of hand disinfection control mechanisms and demonstrated two approaches, both based on the wireless Ultra-High-Frequency-based Radio-Frequency Identification (UHF-RFID) technology. The 100 % efficacy of detecting propanol and ethanol concentration was achieved by using the static disinfectant control (SDC-ADT) method. The time domain response provides an accurate determination of their performance in practice simply by measuring the applied disinfectant concentration and the duration of application. The present paper resulted from the measurements of a capacitive chemical sensor fabricated in the Laboratory for Microelectronics, (LMFE) and on measurements, based on a commercially available resistive type of sensor. A graphic user interface (IDS-GUI) is designed to successfully set the logger parameters and display the results.

Increased fatty acid synthase activity in non-small cell lung cancer tissue is a weaker predictor of shorter patient survival than increased lipoprotein lipase activity.

BACKGROUND AND AIMS: Cumulative evidence suggests the involvement of fatty acid synthase (FAS) in tumor growth. We tested the hypothesis that increased FAS activity and gene expression in non-small cell lung cancer (NSCLC) tissue have a prognostic significance that is independent of that of increased lipoprotein lipase (LPL) activity in the same tissue. METHODS: Forty two consecutive patients with resected NSCLC were enrolled in the study. Paired samples of lung cancer tissue and adjacent non-cancer lung tissue were collected from resected specimens for estimation of FAS activity and expression of its gene. LPL activity had previously been measured in the same tissues. During a 4-year follow-up, 21 patients died due to tumor progression. One patient died due to a non-cancer reason and was not included in the analysis. RESULTS: High FAS activity in cancerous tissue relative to that in the adjacent non-cancer lung tissue was associated with weight loss in the 3 months immediately before tumor excision and patient death during the follow-up. Higher FAS activity in the cancer tissue was associated with higher LPL activity in the same tissue, which also predicted shorter patient survival, but LPL was the stronger predictor. FAS gene expression was higher in the adjacent non-cancer tissue than in the cancer tissue but had no predictive value. CONCLUSION: Our study further underlines the involvement of cancer tissue FAS activity in tumor growth but also indicates its weaker importance compared to LPL activity.

Increased lipoprotein lipase activity in non-small cell lung cancer tissue predicts shorter patient survival.

BACKGROUND AND AIMS: Cumulative evidence suggests the involvement of lipoprotein lipase (LPL) in tumor progression. We tested the hypothesis that increased LPL activity in resectable non-small cell lung cancer (NSCLC) tissue and the increased LPL gene expression in the surrounding non-cancer lung tissue found in our previous study are predictors of patient survival. METHODS: Forty two consecutive patients with resected NSCLC were enrolled in the study. Paired samples of lung cancer tissue and adjacent non-cancer lung tissue were collected from resected specimens for baseline LPL activity and gene expression estimation. During a 4-year follow-up, 21 patients died due to tumor progression. One patient died due to a non-cancer reason and was not included in Cox regression analysis. RESULTS: High LPL activity in cancer tissue (relative to the adjacent non-cancer lung tissue) predicted shorter survival, independently of standard prognostic factors (p=0.003). High gene expression in the non-cancer lung tissue surrounding the tumor had no predictive value. CONCLUSIONS: Our study further underlines the involvement of cancer tissue LPL activity in tumor progression.

Increased apolipoprotein E gene expression and protein concentration in lung cancer tissue do not contribute to the clinical assessment of non-small cell lung cancer patients.

BACKGROUND: We tested the hypothesis that apolipoprotein E (apo E) gene expression and protein concentration are increased in resectable non-small cell lung cancer tissue and that these apo E tissue estimations may be beneficially used in clinical assessment of non-small cell lung cancer patients. METHODS: Paired samples of lung cancer and adjacent, apparently healthy, non-cancer lung tissue were collected from 42 patients with resectable non-small cell lung cancer. Apo E gene expression in tissue was measured by quantitative PCR. Apo E protein in tissue and serum was quantified by a nephelometric method. Patients were followed for 3 years. RESULTS: Apo E gene expression and protein concentration were 1.6 and 4.1-fold higher in the cancer tissue than in the adjacent non-cancer tissue (p<0.0001 in both cases). Increase of apo E protein concentration in the cancer tissue (relative to the non-cancer tissue) correlated with the decrease of apo E protein concentration in the serum (p=0.021). However, none of these apo E estimations related to stage of cancer or histological type of tumor and do not predict patient survival. CONCLUSIONS: Our preliminary study shows that despite the distinct increase of apo E gene expression and protein concentration in the cancer tissue and the concurrent decrease of apo E protein concentration in the serum, the measured apo E values have limited usefulness in clinical assessment of patients with resectable non-small cell lung cancer.

Lipoprotein lipase activity and gene expression in lung cancer and in adjacent noncancer lung tissue.

The authors tested the hypothesis that lipoprotein lipase (LPL) gene expression and enzyme activity are increased in lung cancer tissue, as compared to adjacent, apparently healthy, lung tissue. Paired samples of lung cancer tissue and adjacent noncancer lung tissue were collected from 42 patients with resectable non-small cell lung cancer. LPL activity was higher in cancer tissue (1.9-fold median difference, P < .0001); however, LPL gene expression was higher in noncancer tissue (3.8-fold median difference, P < .0001). The higher LPL activity in lung cancer tissue provides a possible mechanism for increasing the supply of lipid nutrients to the tumor, necessary for tumor growth.

Cell membrane fluidity and prognosis of lung cancer.

BACKGROUND: Membranes of tumor cells have been found to posses higher fluidity than membranes of non-tumor cells. Plasma membrane fluidity is significantly correlated with malignant potential of these cells. METHODS: Seventy-five patients operated on for lung cancer were studied prospectively. During the operation, lung tumor samples were taken from the resected lung for evaluation by electron paramagnetic resonance. The fluidity variable H13, which is proportional to the plasma membrane fluidity, was determined from the electron paramagnetic resonance spectra. The association between H13 and survival was determined by survival analysis using Kaplan-Meier curves and Cox regression. RESULTS: Pathologic TNM stage and the fluidity variable H13 were the only prognostic variables significantly associated with survival time in multivariate proportional hazards regression model. Thus, H13 was shown to be an independent prognostic variable for survival, which was also confirmed by a separate analysis relating the TNM stage and H13. Dividing the patients into two groups, one with an H13 value higher than the median and another with H13 below the median, resulted in significantly different survival curves (p = 0.01). CONCLUSIONS: Patients with high plasma membrane fluidity, indicated by high H13 of the resected lung tumor tissue, seem to have poorer prognosis than those with less fluid membranes. We suggest that the fluidity variable could be used as an independent additional prognostic factor and a tool to identify patients who may be helped by adjuvant postoperative therapy.