Rate Pn Research Articles

Treatment Management of Small Renal Masses in the 21st Century: A Paradigm Shift

Partial (PN) or radical nephrectomy (RN) represents the standard of care for patients with small renal masses. Active surveillance (AS) also may be considered. We examined the rates of PN, RN, and AS within a contemporary population-based cohort. Using the surveillance, epidemiology and end results database, we identified 26,468 patients diagnosed with T1aN0M0 renal cell carcinoma, between years 1988 and 2008. Determinants of PN and AS were assessed using logistic regression analyses within surgically managed patients and within the entire cohort, respectively. Overall, 8,966 (34%), 14,705 (56%), and 2,797 (11%) patients underwent PN, RN, and AS, respectively. The rate of PN increased (4.7% in 1988 to 40.4% in 2008, P<0.001), whereas the rate of RN decreased over time (92.9% in 1988 to 41.4% in 2008, P<0.001). The rate of AS increased over time (2.4% in 1988 to 18.2% in 2008, P<0.001). In multivariable analyses, the determinants for PN consisted of more contemporary year of diagnosis, younger patient age, male gender, Caucasian race, married status, and decreasing tumor size (all P≤0.003). The determinants of AS consisted of more contemporary year of diagnosis, more advanced age, male gender, decreasing tumor size, and unmarried marital status (all P≤0.001). Regional differences for management of localized RCC were detected. It is encouraging that PN rates have increased in an eightfold fashion. Moreover, a fivefold increase was recorded for AS. These figures show a paradigm shift in the management of small renal masses.

1120 Increasing rates of active surveillance relative to surgical management in patients diagnosed with T1aN0M0 renal cell carcinoma

INTRODUCTION AND OBJECTIVES: Partial (PN) or radical nephrectomy (RN) represents the standard of care for patients with small renal masses. Active surveillance (AS) may also be considered. We examined the rates of PN, RN and AS within a contemporary population-based cohort. METHODS: Using the Surveillance, Epidemiology and End Results database, we identified 26468 patients diagnosed with T1aN0M0 renal cell carcinoma, between years 1988 and 2008. Determinants of AS and PN were assessed using logistic regression analyses within surgically managed patients and within the entire cohort, respectively. RESULTS: Overall, 2797 (11%), 8966 (34%), and 14705 (56%) and patients underwent AS, PN, and RN, respectively. The rate of AS increased over time (from 2.4% in 1988 to 18.2% in 2008, P 0.001). Meanwhile, the rate of PN increased (from 4.7% in 1988 to 40.4% in 2008, P 0.001), while the rate of RN decreased over time (from 92.9% in 1988 to 41.4% in 2008, P 0.001). In multivariable analyses, the determinants of AS consisted of more contemporary year of diagnosis, more advanced age, male gender, decreasing tumor size, and unmarried marital status (all P 0.001). In comparison, the determinants for PN consisted of more contemporary year of diagnosis, younger patient age, male gender, Caucasian race, married status, and decreasing tumor size (all P 0.003). Regional differences for management of localized RCC were detected. CONCLUSIONS: AS may be considered in advanced age and infirm patients. It is noteworthy that a 5-fold increase was recorded for AS over the last two decades. Conversely, it is also encouraging that PN rate has increased in an 8-fold fashion, for the same time period.

INFLUENCE OF SALINITY AND AMMONIUM: NITRATE RATIO ON GROWTH, PHOTOSYNTHESIS, FATTY ACID AND THE ACTIVITY OF ANTIOXIDATIVE ENZYMES IN CANOLA

The effects of sodium chloride (NaCl) salinity (0 and 200 mM) and ammonium (NH4):nitrate (NO3) ratios (100:0, 25:75, 50:50, and 75:25) on growth, photosynthesis, fatty acids and the activity of antioxidative enzymes were investigated in canola plants. Leaf area and fresh and dry weights of leaves were significantly reduced by the salinity. The reduction in vegetative characteristics varied in both salinized and unsalinized plants according to the NH4:NO3 ratios so that the lowest reduction was observed with the 50:50 (NH4:NO3) ratio. Increased NH4 up to 50 percent (50:50) of total N, promotes the yield at both salinized and unsalinized plants. In both salinized and unsalinized plants, the increased NH4 and NO3 ratio in the nutrient solution reduced the photosynthetic (Pn) rate and stomatal conductance; however, the reduction in Pn rate was severely impaired at a higher ratio of NH4 in the nutrient solution. In both salinized and unsalinized plants, the 75:25 ratio had the lowest potassium (K) and sodium (Na) content; however, the K/Na ratio was the highest in 50:50 ratio. An increase of NH4 in the solution led to a significant increase in NH4 content in both salinized and unsalinized plants. Salinity increased NH4 content so that the salinized plant had nearly twice as high NH4 content in the leaves. The activity of nitrate reductase was increased by increasing NH4 from 0 to 50% and then reduced at a higher ratio of NH4 in the solution. The activities of antioxidative enzymes increased in salinized plants regardless of the NH4:NO3 ratios. In salinized plants, the activities of superoxide dismutase and catalase enzymes were increased by 44.4 % and 97.5%, respectively. Within salinized and unsalinized treatments, the highest activities of all antioxidant were observed in 75:25 ratio, while they remained unchanged for all NH4:NO3 ratios. The increased NH4 content in the solution increased the oil content and the maximum oil content in both salinized and unsalinized plant was obtained in both 50:50 and 75:25 ratios. The percentage of oleic acid was affected by both salinity and NH4:NO3 ratios. The ratios of NH4:NO3 had no effect on the protein content; however, salinity reduced the protein content by 20%.

Impact of baseline characteristics on efficacy and safety after bortezomib-based induction and maintenance in newly diagnosed multiple myeloma (MM) patients ineligible for transplant in the phase IIIb UPFRONT study.

8072 Background: The multicenter, phase IIIb UPFRONT study compares the efficacy and safety of 3 bortezomib (Vc)-based induction regimens, VcD (Vc–dexamethasone), VcTD (Vc–thalidomide–dexamethasone) and VcMP (Vc–melphalan–prednisone), followed by weekly Vc maintenance, in newly diagnosed MM patients ineligible for HDT–SCT. Methods: Patients were randomized (1:1:1) to receive 8 three-week cycles of induction followed by 5 five-week cycles of maintenance. Efficacy and safety data were analyzed by patient and disease baseline characteristics including age, gender, Charlson comorbidity index (CCI) and ISS stage after 300 patients (100 patients per arm) had the opportunity to complete all 13 cycles. Data were pooled across all three treatment arms. Response was assessed using IMWG criteria. AEs were graded by NCI-CTCAE v3.0. Results: Rates of ≥VGPR were higher in patients age <75 years (p=0.034). Patients with a CCI of 0 showed a trend to better ≥VGPR (p=0.078). A multivariate analysis showed similar results. There was no significant difference in ≥VGPR by gender, race, or ISS stage. Grade ≥3 AE rates appeared lower in patients <75 years, and PN rates (all grade) tended to be lower in males and in white patients. There were no apparent trends in the rates of grade ≥3 AEs or PN (all grade) by CCI or ISS stage. Previous reports from this study have shown that ≥VGPR rates were similar by treatment arm, but that rates of grade ≥3 AEs and PN were higher in the VcTD arm (Niesvizky, ASH 2010). Conclusions: The results of this subgroup analysis show that patients <75 years had higher rates of ≥VGPR and lower rates of grade ≥3 AEs in the UPFRONT study. These results suggest that Vc-containing regimens are active across various patient subgroups including gender, race, co-morbidity status, and ISS stage. Baseline characteristic N ≥VGPR (%) P value* <75 years 157 48 0.034 ≥75 years 100 35 Male 137 40 0.292 Female 120 47 White 192 43 0.789 Nonwhite 65 45 CCI 0 146 48 0.078 CCI ≥1 111 37 ISS 1 62 45 0.238 ISS 2 111 40 ISS 3 72 51 * Univariate chi-square p value.

Photosynthesis and chlorophyll fluorescence response to low sink demand of tubers and roots in Dahlia pinnata source leaves

Photosynthetic rate (PN) and chlorophyll (Chl) fluorescence induction of source leaves in response to a low sink demand created by girdling the branch (GB) between the root-tuber-system and the leaves were studied in Dahlia pinnata L. cv. Rigolet during the stage of rapid tuber growth in the greenhouse. GB resulted in significantly lower values of PN, stomatal conductance (gs), and transpiration rate (E), but in higher leaf temperature (Tl) compared with those of controls. With exception of maximum quantum yield of photosystem 2 (PS 2) photochemistry (Fv/Fm) and maximum ratio of quantum yields of photochemical and concurrent non-photochemical processes in PS 2 (Fv/F0), no significant differences were observed in Chl fluorescence parameters between girdled and control leaves on days 1 and 2 after GB, indicating no apparent damage in the photosynthetic apparatus. However, longer girdling duration resulted in higher non-photochemical Chl fluorescence quenching (NPQ), but lower Fv/F0, actual efficiency of energy conversion in PS 2 under steady-state conditions (ΦPS2), and photochemical quenching coefficient (qP) in comparison with controls from 10:00 to 16:00 or 15:00 on days 4 and 5, respectively, indicating reversible injury in the photosynthetic apparatus.

A Decade of Surgically Removed Small Renal Masses in The Netherlands: Characteristics and Trends in Type of Surgery and Pathologic Reporting

To assess nationwide the pathologic characteristics and trends in type of surgery and pathologic reporting in surgically managed renal tumors ≤ 4 cm. A review of all pathologic reports of primary small renal masses operated on in the Netherlands during the period 1995 to 2005 was performed. The data source was a nationwide central archive of histocytopathology (Patologisch Anatomisch Landelijk Geautomatiseerde Archief). Tumors were stratified into three groups: ≤ 2, 2.1 to 3.0, and 3.1 to 4.0 cm. Age, sex, type of operation, and tumor pathology were analyzed. For renal-cell carcinomas, grade (3-tiers Fuhrman) and stage (2002 Tumor, Node, Metastasis) were assessed. Trends in type of surgery (radical or partial nephrectomy [PN]) and pathologic reporting during the study period were analyzed. Of all operated primary kidney tumors, 25.3% were ≤ 4.0 cm. The mean age of the patients was 63.1 years (standard deviation 11.7), and the male/female ratio was 3:2. Only 7.5% were benign tumors, and 9.8% were locally advanced (≥ T₃). Tumors ≤ 3.0 cm were more likely to be benign (P = 0.006) and of lower stage (P ≤ 0.001) than tumors of 3.1 to 4 cm. PN was performed in 16.5% of the cases. Grade and subtype were reported in 55% of the cases. The rate of PNs performed increased during the decade. There was a trend in increased reporting of grade and subtype. A quarter of all the operated primary kidney tumors were ≤ 4 cm. Smaller tumors were more likely to be benign and of lower stage. A cutoff size regarding biologic aggressiveness can be settled at the 3 cm size. The PN rate increased along the decade. Grade and subtype reporting rates remained suboptimal, although a positive trend was noted.

The influence of environmental factors and nutrient concentrations in tissues of the seaweed Ahnfeltia tobuchiensis (Rhodophyta: Ahnfeltiales) on the primary production and dark respiration of its population

Complex investigations of the influence of environmental factors, viz., the temperature, photosynthetically active radiation (PAR), ambient seawater concentrations of ammonium (NH4), and orthophosphate (PO4), as well as the contents of organic carbon (C), nitrogen, phosphorus, and a-chlorophyll (Ch) on the rate of photosynthesis (Pn) and dark respiration (Rd) in the tissues of the unattached red seaweed Ahnfeltia tobuchiensis (Rhodophyta: Ahnfeltiales) population, were performed in the summers of 2000 and 2008 in Izmeny Bay (Kunashir Island) under in situ conditions. The dependence of photosynthesis on PAR intensity (P-I dependence) is described by the equation of a hyperbolic tangent. The population of A. tobuchiensis forms a layer up to 50 cm thick with an area of 23.3 km2 and a biomass of 125 000 tons. The Pn rate of seaweed population during daylight hours varies within a wide range, with an average of 1.04 mg O2 O2/(gdry weight h) and largely depends on PAR intensity and availability (r = 0.70–0.98). The maximum photosynthesis rate (Pmax) is substantially defined by the ambient concentration of NH4 (r2 = 0.91, p < 0.01). The rate of Rd during the night is on average 0.1 mg O2/(gdry weight h) and mainly depends on the content of Ch in seaweed tissues (r2 = 0.83, p < 0.01), which, in its turn, is regulated by the ambient concentration of PO4 (r2 = 0.86, p < 0.01). With average biomass values of 5.4 kg/m2 or 1.8 kgdry weight/m2, the net primary production (Pn) of seaweed population is estimated to be on average 22.5 g O2/(m2 day) or 8.4 g C/(m2 day). Based on these indices, the investigated population is one of the most productive ecosystems of the World Ocean. It is supposed that such indices of the A. tobuchiensis population are attained due to the highly efficient use of weak light and a low light-saturation level of photosynthesis, compared to other seaweeds.

Binary Response Models for Panel Data: Identification and Information

This paper considers a panel data model for predicting a binary outcome. The conditional probability of a positive response is obtained by evaluating a given distribution function (F) at a linear combination of the predictor variables. One of the predictor variables is unobserved. It is a random effect that varies across individuals but is constant over time. The semiparametric aspect is that the conditional distribution of the random effect, given the predictor variables, is unrestricted. This paper has two results. If the support of the observed predictor variables is bounded, then identification is possible only in the logistic case. Even if the support is unbounded, so that (from Manski (1987)) identification holds quite generally, the information bound is zero unless F is logistic. Hence consistent estimation at the standard pn rate is possible only in the logistic case.

The Weekly Infusion of Bortezomib Reduces Peripheral Neuropathy.

Abstract 3887Poster Board III-823 BackgroundPeripheral neuropathy (PN) is a non-hematologic side effect frequently reported in elderly patients treated with bortezomib-melphalan-prednisone (VMP). To address this issue, both bortezomib-melphalan-prednisone-thalidomide (VMPT) and VMP dosing regimens were changed; and bortezomib schedule was modified from twice weekly to weekly administration. AimsTo determine incidence and risk factors of bortezomib-associated PN in twice weekly or weekly bortezomib infusion schedules. MethodsPatients (N=511) older than 65 years were randomly assigned to receive VMPT followed by maintenance with bortezomib and thalidomide or VMP. Initially, patients were treated with nine 6-week cycles of VMPT (induction: bortezomib 1.3 mg/m2 days 1,4,8,11,22,25,29,32 in cycles 1-4 and days 1,8,22,29 in cycles 5-9; melphalan 9 mg/m2 days 1-4; prednisone 60 mg/m2 days 1-4 and thalidomide 50 mg days 1-42; maintenance: bortezomib 1.3 mg/m2 every 15 days and thalidomide 50 mg/day as maintenance) or VMP (bortezomib, melphalan and prednisone at the same doses and schedules previously described without maintenance). In March 2007, the protocol was amended: both VMPT and VMP induction schedules were changed to nine 5-week cycles and bortezomib schedule was modified to weekly administration (1.3 mg/m2 days 1,8,15,22 in cycles 1-9). Baseline grade ≥ 2 PN was an exclusion criteria. Results254 VMPT patients and 257 VMP patients were evaluated in intention-to-treat: 141 patients received twice weekly infusion of bortezomib and 370 once weekly. The overall incidence of PN was 37% in the VMPT patients and 27% in the VMP patients (p=0.01) while the grade ≥ 3 was quite similar (8% and 5%. p=0.19). When VMPT and VMP groups were combined, the incidence of PN was significantly higher in patients who received twice weekly infusion of bortezomib: the incidence of all grade PN was 45% in the twice weekly group and 27% in the once weekly group (p=0.0002), including a grade ≥ 3 PN incidence of 16% and 3% (p<0.0001), respectively (table 1). In multivariate analysis, the weekly infusion of bortezomib was the only predictive factor of lower incidence of PN (p<0.0001) whereas low-dose thalidomide did not affect PN rate (p=0.16). The weekly infusion of bortezomib significantly reduced discontinuation rate and bortezomib dose reduction (table 1). The weekly infusion of bortezomib slightly reduced the CR rate (p=0.07), but did not affect progression-free survival (p=0.31) and overall survival (p=0.44) (table 1). ConclusionThe weekly infusion of bortezomib significantly decreased incidence of PN, discontinuation rate and dose-reduction rate without significant reduction of PFS. The addition of low-dose thalidomide to VMP did not increase the incidence of grade 3-4 PN. An update of these data and correlation between PN and clinical outcome will be presented at the meeting.Table 1Safety and efficacy for the twice weekly or weekly Bortezomib schedule. The VMPT and VMP groups are togetherBortezomib Twice weekly (N = 135)Bortezomib Once weekly (N = 315)p-valueAll grade PN (%)45270.0002Grade 3-4 PN (%)163<0.0001Drug discontinuation (%)1330.001Dose reduction (%)3912<0.001CR rate (%)33250.072-years PFS (%)68600.312-years OS (%)91890.44 Disclosures:Bringhen:Celgene: Honoraria; Janssen-Cilag: Honoraria. Boccadoro:Janssen-Cilag: Research Funding, consultancy and advisory committees; Celgene: Research Funding, consultancy and advisory committees; Pharmion: Research Funding, consultancy and advisory committees. Palumbo:Janssen-Cilag: Honoraria; Celgene: Honoraria.

Changes in leaf organisation, photosynthetic performance and wood formation duringex vitroacclimatisation of black mulberry (Morus nigraL.)

Changes in anatomical organisation of the leaf, photosynthetic performance and wood formation were examined to evaluate the temporal and spatial patterns of acclimatisation of micropropagated slow-growing black mulberry (Morus nigra L.) plantlets to the ex vitro environment. Leaf structure differentiation, the rates of net photosynthesis (P(n)), transpiration (E) and stomatal conductance (g(s)), and secondary xylem growth were determined in the course of a 56-day acclimatisation. Differentiation of palisade parenchyma was observed 7 days after transfer. At this stage, the rates of P(n), E and g(s) reached maximum values, after which the rates of all three gas exchange parameters gradually decreased. The highest proportion of woody area occupied by vessels was also observed 7 days after transfer. An important feature of developing woody tissue is the difference in patterns of vessel distribution from the characteristic differentiation patterns of earlywood and latewood vessels in mature wood of ring-porous trees. Vessels with lumen areas over 3000 microm(2) were only differentiated in acclimatised plantlets, whereas vessels in stems sampled on days 0 and 7 had very small lumen areas of up to 560 microm(2). Full acclimatisation, observed 56 days after transfer to the ex vitro environment, was associated with the rapid growth of new in vivo formed leaves, very low rates of E and g(s), and much increased secondary xylem tissue within the stem area.

The use of partial nephrectomy in European tertiary care centers

Purpose The objective was to define the trends of PN use over time at six tertiary care European centers. Methods Data were retrieved from institutional databases for patients treated with either PN or radical nephrectomy (RN) for stages T 1–2N 0M 0 renal cell carcinoma (RCC) between 1987 and 2007. For purpose of temporal trend analyses patients were divided into five equally sized groups according to the date of surgery. Categorical and multivariable logistic regression analyses assessed predictors of PN use. Results Overall 597 (31.7%) patients were treated with PN. Overall, a 4.5-fold increase of PN was recorded. The absolute increases were 41.7–86.3%, 14.9–69.3% and 8.1–35.3% for lesions ≤2 cm, 2.1–4 cm and 4.1–7 cm (chi-square trend test p < 0.001), respectively. In multivariable logistic regression models, decreasing tumor size, younger age, more contemporary date of surgery, male gender and institutional PN rate represented independent predictors of the individual probability of treatment with PN. Lack of data from community hospitals limits the generalizability of our findings. Conclusion Based on data from six tertiary care centers, the contemporary rate of PN ranges from 86 to 35% for renal masses ≤2 cm to 4.1–7 cm and is indicative of excellent quality of care.

Yield, Leaf Senescence, and Cry1Ac Expression in Response to Removal of Early Fruiting Branches in Transgenic Bt Cotton

Two-year field experiments were conducted at Linqing, Yellow River valley of China, to study the plant response to the removal of early fruiting branches in transgenic Bt ( Bacillus thuringiensis) cotton ( Gossypium hirsutum L.) from 2003 to 2004. Plants were undamaged and treated by removing two basal fruiting branches (FB) at squaring to form the control and the removal treatment, respectively. The plant height, leaf area (LA), dry weight of fruiting forms (DWFF), the number of fruiting nodes (NFN), photosynthetic (Pn) rate, and levels of leaf chlorophyll (Chl), N, P, K, and Cry1Ac protein in main-stem leaves were measured at a 10- or 20-d interval after FB removal, and the sink/source ratio as indicated by NFN/LA and DWFF/LA was determined. FB removal significantly increased the plant height, LA, and plant biomass in both years. Lint yields were increased 7.5 and 5.2% by removal compared with their controls in 2003 and 2004, respectively. Significant increases in boll size (5.7 and 5.1%) were also observed in removal than in control for both years. Either NFN/LA or DWFF/LA was significantly reduced by removal before 40 d after removal; however, both NFN/LA and DWFF/LA were significantly enhanced by FB removal at 80 d after removal compared to the untreated control. There was no significant difference in fiber quality in the first two harvests between removal and control, but fiber strength and micronarie in the third harvest were significantly improved by FB removal. In terms of leaf Chl, Pn rate, levels of total N, P, and K in late season, leaf senescence was considerably delayed by FB removal. Levels of Cry1Ac protein in the fully expanded young leaves were considerably higher in FB-excised plants than in control, indicating FB removal enhanced Cry1Ac expression. It is suggested that the yield and quality improvement with FB removal may be attributed to the increased NFN/LA or DWFF/LA in late season and delayed leaf senescence, respectively. FB removal can be a potential practice incorporated into the intensive cultivation system for enhancing transgenic Bt cotton production.

ADVANCED MATURITY OF ‘PERLETTE’ TABLE GRAPES BY TRAINING SYSTEMS WHICH INCREASE FOLIAGE EXPOSURE TO SUNLIGHT

Although extensive work has been reported on winegrapes (Vitis vinifera L.) regarding canopy structure, management and microclimate on berry ripening and composition, scarce information has been devoted to this issue in tablegrapes. Canopy microclimate, photosynthesis and other physiological traits were determined in three year old ‘Perlette’ vines trained on a T-trellis, in Sonora, México. In the undivided commercial T-trellis UTT) vine canopy, the photosynthetic photon flux densities (PPFD) reaching external, middle and internal leaf layers were 1922, 53 and 34 μmol m-2 s-1, respectively. In the same order, net photosynthesis (Pn) rates were 19.0, 1.7 and 1.0 μmol CO2 m-2 s-1, while chlorophyll contents were 1.9, 1.7 and 1.0 mg mL-1. No differences in total protein content were found between leaf layers, but significant differences in rubisco specific activity were found among external, middle and internal leaves, reaching 1.07, 0.65 and 0.25 μmol min-1 mg-1, respectively. Four training systems were compared against a commercial undivided T-trellis (UTT): Slanted pergola (Pergola), a specifically designed system (CIAD), Lyre (Lyre) and a divided T-trellis (Divided). Significant differences in PPFD on Lyre, Pergola, CIAD, Divided and UTT yielded 2192, 2076, 1900, 885 and 711 μmol m-2 s-1. At véraison, Pn in Pergola, CIAD, Lyre, Divided and UTT was 12.7, 11, 12.5, 10.5 and 5.1 μmol CO2 m-2 s-1, respectively. Five days after harvest, Pn showed a decrease in all training systems, particularly in UTT which showed only 3.7 μmol CO2 m-2 s-1. Stomatal resistance at véraison and postharvest was highest in UTT with 4.2 and 6.8 s cm-1 for both periods. Total soluble solids by 27 April were 15.7 °Brix for CIAD, while for UTT was only 12.1 °Brix. A week later, CIAD, Lyre, Pergola and Divided reported 16.3, 15.9, 15.5 and 15.2 °Brix, while UTT reached only 13.1 °Brix. Thus by dividing canopies and applying canopy management techniques the harvest date in the early season seedless grapes can be advanced, by increasing light harvest, photosynthetic rate and berry sugar accumulation.

Photosynthetic responses of pea plants (Pisum sativum L. cv. Little marvel) exposed to climate change in Riyadh city, KSA

Pots study was conducted to determine interactive effects of climate change (NO2, SO2 and O3) on photosynthetic responses in pea. The seeds of pea plants (Pisum sativum L. cv. Little marvel) were grown full-season in three pots arranged at four localities in Riyadh city, KSA. Photosynthetic rates (Pn) were measured three times during vegetative and reproductive stages with portable gas exchange system (LI-COR 6400). In general, Pn rates were highly stimulated at Elsefarat area and highly reduced at the 2 nd Industrial city but variable at other localities in Riyadh city. The data showed continuous increases in Pn rates during pre-flowering and early seed formation and drops during late seed formation stage. This study supports that the agricultural areas could have a protective role against adverse impacts of gases exposure in highly polluted areas.

Lenalidomide, Bortezomib, and Dexamethasone (Rev/Vel/Dex) in Patients with Relapsed or Relapsed/Refractory Multiple Myeloma (MM): Preliminary Results of a Phase II Study.

Background: Single-agent bortezomib (VELCADE®, Vel) and lenalidomide (Revlimid®, Rev) plus dexamethasone (Dex) are approved for relapsed MM patients (pts) following ≥1 prior therapy. Preclinical studies show Rev sensitizes MM cells to Vel and Dex, suggesting combination therapy may enhance clinical activity. In a phase 1 study, Rev/Vel (MTD 1.0mg/m2/15mg) ± Dex (20–40mg) was well tolerated and resulted in a response rate (CR+PR+MR) of 58% in relapsed and/or refractory MM pts. The aim of this multicenter phase 2 study was to evaluate the efficacy and safety of Rev/Vel/Dex (RVD) at the phase-1 MTD in up to 64 relapsed and/or refractory MM pts.Methods: Pts with relapsed/refractory MM and 1–3 prior lines of therapy received up to eight 21-d cycles of Vel 1.0mg/m2, d 1, 4, 8, 11, Rev 15mg, d 1–14 of a 21-d cycle, and Dex 40mg (cycles 1–4)/20mg (cycles 5–8), days of/after Vel dosing. After cycle 8, pts with stable or responding disease were allowed to continue on a maintenance schedule with Vel (d 1 and 8) and Rev (d 1–14) at the dose levels tolerated at the end of cycle 8, with Dex at 10mg (d 1, 2, 8, 9). Pts received concomitant antithrombotic and antiviral prophylaxis. Response was assessed according to modified EBMT and Uniform criteria with toxicities assessed using NCI CTCAE v3.0.Results: 27 pts (19 men, 8 women) have been enrolled to date, including 16 with relapsed and 11 with relapsed and refractory MM. Median age was 71 yrs (range 51–83) and median no. of prior therapies was 2 (range 1–3), including prior SCT in 7, prior Vel in 18, prior Rev in 1, prior thalidomide in 21 and prior Dex in 22 pts. Pts received a median of 7 cycles (range 1–15); 10 pts completed 8 cycles and 5 pts continued on maintenance. Dose reductions were required for Rev in 4, Vel in 4 and Dex in 11 pts. Toxicities were manageable and consisted primarily of G1-2 myelosuppression. Attributable non-hematologic toxicities included 1 DVT in the context of air travel in a pt who had been receiving aspirin 81mg as thromboprophylaxis. Enoxaparin and Coumadin were administered and the pt continued on therapy. Two episodes of atrial fibrillation (G3) were reported, reversed with cardiac medication, attributed to Rev/Dex, prompted Dex dose reduction and have not recurred. G3 PN was reported in only 1 pt despite Vel dose reduction, resulting in treatment discontinuation. In 24 evaluable pts, ORR (CR/nCR+VGPR+PR+MR) is currently 79%, including 33% CR/nCR/VGPR.Conclusions: RVD is very active in pts with relapsed and/or refractory MM, including pts with prior Rev, Vel, thalidomide, and SCT. Dex dose reduction was required in 11 pts and the protocol has been amended to use lower dose Dex at 20 mg, but the combination has been otherwise well tolerated, with low rates of DVT and PN. Accrual is ongoing.

Selective Targeting of a Head and Neck Squamous Cell Carcinoma Cell Line by a Translationally-Controlled Herpes Simplex Virus Thymidine Kinase Suicide Gene

5/41 (12.2%, local 2, neck 1, both 2). 8/10 cases of local recurrences of Stage II are salvaged, 6/11 cases of late lymph node metastasis are salvaged with neck dissection. All pN( ) rate are StageI 20.7% (12/58) and Stage II 21.2% (19/90). Conclusion: Cases of Stage II ( 3cm) and or endophytic type (deep tumor thickness) must be treated with pull-through operation with neck dissection and it is necessary to accomplish prophyractive neck dissection for level I, II, III.

Effect of Ammonium: Nitrate Ratio on Yield, Calcium Concentration, and Photosynthesis Rate in Strawberry

ABSTRACT The effect of ammonium:nitrate (NH4:NO3) ratio in nutrient solution on growth, photosynthesis (Pn), yield, and fruit quality attributes in hydroponically grown strawberry (Fragaria × ananassa Duch) cvs. ‘Camarosa’ and ‘Selva’ was evaluated. There were four nutrient solutions of differing NH4:NO3 ratios as follows: 0:100, 25:75, 50:50, and 75:25. Plants grown in solution with 75% NH4 had lower leaf fresh and dry weights and leaf area than those with 25% NH4 in both cultivars. High ratios of NH4 and NO3 in the solution always reduced the yield. The yield was increased by 38% and 84% in ‘Camarosa’ and ‘Selva,’ respectively, when the plants were grown in the 25NH4:75NO3 solution compared with plants grown in a higher NH4 ratio solution. The increased yield at the 25 NH4:75NO3 ratio was the result of the increase in fruit size, i.e., length and fresh weight of fruits. Plants grown in the 25NH4:75NO3 solution had the highest rate of Pn, while those grown in 75NH4:25NO3 solution had the lowest Pn rates in both cultivars. Increasing the NH4 ratio in the solution from 0 to 75% significantly reduced the calcium (Ca) concentration and postharvest life of the fruits in both cultivars. Both higher leaf area and Pn rate appeared to be the reason for the increased yield and plant growth in the 25:75 ratios of nitrogen (N). The results indicate the preference of strawberry plant growth toward a greater nitrate N form in a hydroponic solution. Therefore, a combination of two forms of N in an appropriate ratio (25NH4:75NO3) appears to be beneficial to plant growth, yield, and quality of strawberry fruits.

Influence of Watermelon Mosaic Virus on Net Photosynthesis, Yields, and Farm-Gate Revenues of Yellow Squash

Abstract Watermelon mosaic virus (WMV) often suppresses yield and shortens the harvest season of yellow summer squash (Cucurbita pepo L.) in the Midwestern United States. Two WMV-susceptible cultivars, ‘Multipik’ and ‘Cougar’, and two cultivars with transgenic resistance to WMV, ‘Patriot II’ and ‘Liberator III’, were evaluated for net photosynthesis (Pn), marketable yield, and farm-gate revenues under high WMV disease incidence during fall 2000 and 2001. Foliage samples were collected from the experiment and tested by enzyme-linked immunosorbent assay (ELISA) for five common cucurbit viruses, and only WMV was found. Pn rates were much lower for ‘Multipik’ and ‘Cougar’ compared to the WMV-resistant cultivars after the initial sampling date (early September) in both years. Fruits and foliage of the resistant cultivars never displayed symptoms of WMV. For the susceptible cultivars, the cumulative marketable yields of ‘Multipik’ were substantially lower than ‘Cougar’. The marketable yield of the best WMV-resi...

Assessing the UV-B Tolerance of Sun and Shade Samples of Two Aquatic Bryophytes Using Short-term Tests

Abstract Sun and shade samples of two aquatic bryophytes, the moss Fontinalis antipyretica and the liverwort Jungermannia exsertifolia subsp. cordifolia, were collected from a mountain stream and cultivated in the laboratory under two artificially imposed radiation regimes: control (only photosynthetically active radiation, PAR) and UV-B (PAR + UV-B). Samples were cultured at 2°C for 78 hr under continuous radiation to determine whether the physiological responses of the two bryophytes to UV-B radiation depended on their previous field acclimation to sun or shade conditions. We also aimed to study whether the short-term effects of UV-B were similar to those caused by longer exposure. Fontinalis antipyretica was more sensitive to UV-B treatment than Jungermannia exsertifolia subsp. cordifolia, showing significant decreases in several physiological variables indicative of vitality: PN rates, OD430/OD410, OD665/OD665a and especially Fv/ Fm. This higher sensitivity occurred in both sun and shade samples of th...

Spatial and temporal variations in diurnal CO2fluxes of different Mediterranean ecosystems in Turkey

Diurnal rates of net CO2 assimilation (PN) and soil respiration (Rh) in the summer were measured in six Mediterranean ecosystems through an automatic continuous monitoring system. The six sites include a typical evergreen Pinus pinea L. forest with two co-occurring sclerophyllous shrubs (Pistacia terebinthus L. and Phillyrea latifolia L.), citrus (Citrus limon L.), corn (Zea mays L.), cotton (Gossypium hirsutum L.), soybean (Glycine max L.) and vineyard (Vitis vinifera L.). All six sites exhibited similar behaviour in that low soil water availability and high evaporative demand not only depressed PN and Rh rates, but also changed the diurnal time course of their peak rates. Except for P. terebinthus and corn, PN rates of all the species peaked in the morning (7:30–9:30), and Rh rates in all the sites were higher during the night than during the day (p < 0.05). Mean rates of net ecosystem emission (NEE) of CO2 to the atmosphere were highest (−23.9 μmol CO2 m−2 s−1) in the corn site and lowest (−0.6 μmol CO2 m−2 s−1) in the vineyard site. On average, all six ecosystems were a net source of CO2 to the atmosphere, due to Rh effluxes exceeding PN rates. Net CO2 assimilation and Rh explained 25% (for corn) to 87% (for citrus) of the diurnal fluctuations of the atmospheric CO2 concentration. Multiple linear regression (MLR) models accounted for 42% (P. pinea) to 95% (cotton) of diurnal variations in PN rates and 30% (forest) to 92% (citrus) of diurnal variations in Rh rates (p ⩽ 0.001). The dependence of diurnal PN and Rh rates on water vapour pressure deficit and soil water deficit for dry and hot summer days appeared to be major and needs to be re-examined for biogeochemical models of climate change effects on CO2 dynamics of Mediterranean ecosystems.