Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial.

BACKGROUND: In 2004, a randomised phase III trial by the European Organisation for Research and Treatment of Cancer (EORTC) and National Cancer Institute of Canada Clinical Trials Group (NCIC) reported improved median and 2-year survival for patients with glioblastoma treated with concomitant and adjuvant temozolomide and radiotherapy. We report the final results with a median follow-up of more than 5 years. METHODS: Adult patients with newly diagnosed glioblastoma were randomly assigned to receive either standard radiotherapy or identical radiotherapy with concomitant temozolomide followed by up to six cycles of adjuvant temozolomide. The methylation status of the methyl-guanine methyl transferase gene, MGMT, was determined retrospectively from the tumour tissue of 206 patients. The primary endpoint was overall survival. Analyses were by intention to treat. This trial is registered with Clinicaltrials.gov, number NCT00006353. FINDINGS: Between Aug 17, 2000, and March 22, 2002, 573 patients were assigned to treatment. 278 (97%) of 286 patients in the radiotherapy alone group and 254 (89%) of 287 in the combined-treatment group died during 5 years of follow-up. Overall survival was 27.2% (95% CI 22.2-32.5) at 2 years, 16.0% (12.0-20.6) at 3 years, 12.1% (8.5-16.4) at 4 years, and 9.8% (6.4-14.0) at 5 years with temozolomide, versus 10.9% (7.6-14.8), 4.4% (2.4-7.2), 3.0% (1.4-5.7), and 1.9% (0.6-4.4) with radiotherapy alone (hazard ratio 0.6, 95% CI 0.5-0.7; p<0.0001). A benefit of combined therapy was recorded in all clinical prognostic subgroups, including patients aged 60-70 years. Methylation of the MGMT promoter was the strongest predictor for outcome and benefit from temozolomide chemotherapy. INTERPRETATION: Benefits of adjuvant temozolomide with radiotherapy lasted throughout 5 years of follow-up. A few patients in favourable prognostic categories survive longer than 5 years. MGMT methylation status identifies patients most likely to benefit from the addition of temozolomide. FUNDING: EORTC, NCIC, Nélia and Amadeo Barletta Foundation, Schering-Plough.

Atributos físicos de um Latossolo Vermelho distroférrico em sistema de integração lavoura-pecuária

O pisoteio dos animais durante o pastejo pode compactar as camadas superficiais e comprometer a qualidade física dos solos em sistema de integração lavoura-pecuária (SILP). A hipótese deste trabalho é de que o pisoteio dos animais decorrente da intensificação do pastejo das culturas de aveia e azevém num Latossolo Vermelho distroférrico com SILP sob plantio direto reduz a qualidade física do solo. Os objetivos deste trabalho foram quantificar a densidade do solo (Ds), a porosidade de aeração (εa), a permeabilidade do solo ao ar (Ka) e a resistência do solo à penetração (RP) e estimar índices de continuidade de poros a partir das relações entre εa e a Ka. A área estudada, localizada no município de Campo Mourão - PR, foi manejada em SILP com semeadura direta de soja/milho no verão e consórcio de aveia com azevém no inverno, utilizados como forragem para o pastejo pelos animais. Os tratamentos consistiram em quatro alturas de pastejo (7, 14, 21 e 28 cm) e um tratamento controle (testemunha). Em cada tratamento foram coletadas 20 amostras com estrutura indeformada, nas profundidades de 0-7,5 e 7,5-15 cm. Não foram constatadas diferenças significativas na Ds, εa e Ka entre a testemunha e os tratamentos pastejados. Após oito anos de SILP, a Ds, a εa e a Ka não confirmaram a hipótese de que a intensificação do pisoteio animal reduz a qualidade física do solo. Contudo, a RP mostrou diferenças entre os tratamentos pastejados e a testemunha, com valores restritivos de RP até 15 cm de profundidade, sugerindo que a maior intensidade de pastejo resulta em redução da qualidade física do solo.

Soil nitrogen dynamics after Brachiaria desiccation

Brachiaria species, particularly B. humidicola, can synthesize and release compounds from their roots that inhibit nitrification, which can lead to changes in soil nitrogen (N) dynamics, mainly in N-poor soils. This may be important in crop-livestock integration systems, where brachiarias are grown together with or in rotation with grain crops. The objective of the present study was to determine whether this holds true in N-rich environments and if other Brachiaria species have the same effect. The soil N dynamics were evaluated after the desiccation of the species B. brizantha, B. decumbens, B. humidicola, and B. ruziziensis, which are widely cultivated in Brazil. The plants were grown in pots with a dystroferric Red Latosol in a greenhouse. Sixty days after sowing, the plants were desiccated using glyphosate herbicide. The plants and soil were analyzed on the day of desiccation and 7, 14, 21 and 28 days after desiccation. The rhizosphere soil of the grasses contained higher levels of organic matter, total N and ammonium than the non-rhizosphere soil. The pH was lowest in the rhizosphere of B. humidicola, which may indicate that this species inhibits the nitrification process. However, variations in the soil ammonium and nitrate levels were not sufficient to confirm the suppressive effect of B. humidicola. The same was observed for B. brizantha, B. decumbens and B. ruziziensis, thereby demonstrating that, where N is abundant, none of the brachiarias studied has a significant effect on the nitrification process in soil.

In vivo study of an injectable poly(acrylonitrile)-based hydrogel paste as a bulking agent for the treatment of urinary incontinence.

Urinary incontinence can be treated by endoscopic injection of bulking agents, however, no optimal therapeutic effect has been achieved upon this treatment yet. In the present study, the development of a injectable poly(acrylonitrile) hydrogel paste is described, and its efficacy and histological behavior, once injected into the submucosal space of the minipig bladder, are evaluated. A device was developed to mix poly(acrylonitrile) hydrogel powder with glycerin, used as carrier, prior to injection into the submucosal space of the bladder. Several paste deposits, depending on the size of the bladder, were injected per animal. The implants were harvested at days 7, 14, 21, 28, 84 and 168 and analyzed morphologically and by histology. The persistence of the implants was demonstrated. However, at later time points the implants were split up and surrounded by granulomatous tissue, which was gradually replaced by histiocytes and adipocytes. Transitory focal urothelial metaplasia was observed only at day 7 and moderate foreign body reaction was detected predominantly between the second and fifth week. This study demonstrated the feasibility to develop an injectable paste of poly(acrylonitrile) hydrogel thought to provide the expected bulking effect, necessary for the treatment of urinary incontinence.

Confirmation du status spécifique de Sorex samniticus Altobello, 1926 (Mammalia, Insectivora)

A shrew belonging to the genus Sorex and displaying an entirely new karyotype (2N = 52, NF = 52) has been found in Italy, where it coexists with Sorex araneus. the form with 52 chromosomes differs from S. araneus in some cranial and dental characters. On the other hand, it is very similar to the type of Sorex samniticus Altobello, 1926, whose specific status is thus confirmed.

Blood lymphocyte subsets in rats with adjuvant arthritis

To determine the phenotype of peripheral blood lymphocytes during the time-course of adjuvant arthritis (AA) to detect alterations that could be involved in the pathogenesis of the arthritic process. METHODS--Phenotype analysis was performed on days 7, 14, 21, 28, 42, 56 and 70 after arthritis induction using monoclonal antibodies to CD5, CD4 and CD8 subsets, and flow cytometry. The proportion of activated lymphocytes and lymphocytes was also assessed with monoclonal antibodies to IL-2R (CD25), to Ia antigen and by polyclonal antibodies to rat Ig. RESULTS--Adjuvant arthritis produced leukocytosis with neutrophilia. Rats with AA showed a marked increase in the number of both CD4+ and CD8+ cells. The ratio CD4/CD8 decreased because the rise in CD8+ cells was more pronounced than the increase in CD4+ cells. Changes in lymphocyte counts showed two well-defined periods: the first, from day 14 to day 28, during which the inflammation of the joints reached a maximum and changes in lymphocyte subsets were more pronounced, that is, there was a threefold increase in CD8+ lymphocytes over normal counts, and the second, from day 42 to day 70, in which modified parameters improved considerably but remained different from controls. CONCLUSION--Alterations were detected in the phenotype of peripheral blood lymphocytes in AA, which provides an additional marker of disease activity.

Vaikuttava oppiminen on sidoksissa oppijan oppimis- ja kehitysprosesseihin

Artikkeli on tiivistelmä kirjoittajan väitöskirjasta Kontekstuaalinen oppiminen - oppimisen organisoituminen ja vaikuttava koulutus (Tampereen yliopisto 1999)