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[CDDP-ACR treatment in patients with recurrent ovarian cancer with prior chemotherapy containing CDDP--a preliminary study of a 14-day continuous infusion of CDDP with ACR].

Six patients with recurrent ovarian cancer who had prior chemotherapy were studied for the clinical efficacy of CDDP-ACR treatment. Five out of the 6 had received CDDP a total doses of 1,320, 780, 750, 475, and 340 mg. CDDP-ACR therapy consisted of continuous infusion of CDDP at a daily dose of 10 mg/m2 over 14 days (total CDDP doses; 140 mg/m2) and of intermittent infusion of ACR (aclarubicin) at a dose of 20 mg/body every other day (total ACR doses: 140 mg). There were one CR and five PR and a response rate up to 100% was noted. Toxicity was manifested in slight nausea or vomiting, but there was no nephrotoxicity. However bone marrow was severe. Thrombocytopenia less than 50,000/mcl in 4 pts (67%) and leukopenia less than 1,000 mcl in 3 pts (50%). The mean filterable platinum exposure measured by area under the concentration-time curve (AUC) was as high as 19.7 +/- 6/0 mg.hr/ml. In conclusion the bone marrow toxicity in this regimen was severe, but the therapeutic efficacy was promising. Further studies on the appropriate infusion time and the minimum effective dose of CDDP are needed.

Abdominal Neoplasms

The maturation of the central auditory conduction in preterm infants until three months post term. V. The auditory cortical response (ACR).

Auditory cortical evoked responses (ACRs) were recorded in 65 preterm infants, at least on 3 occasions in 48 of them. The infants were divided into 5 groups according to their gestational age (GA). The recording sessions were performed at 8 conceptional age (CA) levels, defined as the gestational age added to the chronological age. The last recordings were obtained at 50-52 weeks CA. The ACRs were analyzed for the primary complex containing middle latency components (MLR) and the secondary complex, containing the slow late components. The ACR records first appear at about 25 weeks CA, initiating the premature stage followed by a transitional stage around term date and the gradual development into the mature stage, achieved at 50-52 weeks CA. The detectability rate of the various components generally increased with increasing conceptional age, for some of the components, especially N2p and N2, this rate achieved a value of about 80%. The degree of prematurity did not influence appreciably the development of the ACR. The waveforms, and to a lesser extent the latency and amplitude values, are strongly age dependent. Remarkable topographic differences between the ACR parameter latency and more importantly amplitude values are found between the derivations from the vertex and the central temporal areas, supporting the theory of different generation sites for the ACR components. The premature and mature ACR appeared relatively insensitive to changes in the states of vigilance. The ACR in premature infants are useful in developmental studies with respect to the central audition in premature infants and might contribute in the clinical assessment on the quality of the premature central auditory system.

Cerebral Cortex

[Extended radical mastectomy using preoperative local injection of activated carbon particle adsorbing aclarubicin (ACR-CH)].

ACR-CH was injected prior to surgery of breast cancer. Incidence of black staining of regional lymph nodes and concentration of ACR in the nodes were examined in order to evaluate the usefulness of preoperative local injection of ACR-CH. 1) In 13 cases of extended radical mastectomy, black staining was seen in nodes of all the regions. Especially, in parasternal, retromanubrial, anterior mediastinal and supraclavicular nodes, 46% or more of the nodes were stained and ACR concentration of 6-7 micrograms/g was obtained. 2) When incidence of black staining of the metastasis-free nodes was compared with that of the nodes with metastasis, it was 79% in the metastasis free nodes and 42% in the nodes with metastasis. The average ACR concentration was 54.16 +/- 123.16 in the stained nodes and 2.58 +/- 3.59 in unstained nodes, the former being significantly higher than the latter. 3) Majority of the stained nodes with metastasis had only very small metastatic foci and nodes with significant metastasis were only very rarely stained. 4) In conclusion, we believe that anticancer effect of ACR-CH can be expected to small metastatic foci in the parasternal lymph nodes and more distal nodes, dissection of which tends to be incomplete at extended radical mastectomy, as well as to free cancer cells in the lymph vessels.

Aclarubicin

[Randomized-controlled study of treatment with UFT-MMC or UFT-ACR in advanced gastric cancer. Tohoku Study Group of Cancer Treatment for the Digestive Organs].

The effect of UFT-MMC- or UFT-ACR-therapy on the unresectable or recurrent gastric cancer was studied by a multicenter, randomized-controlled trial. All the patients who were randomly divided into the two groups were administered orally with 400 or 600 mg/day of UFT everyday. In addition, the UFT-MMC group was intravenously injected weekly for three weeks and then triweekly after six weeks with 6 or 8 mg/body of MMC, while the UFT-ACR group was intravenously injected with 20 mg/body of ACR for 5 serial-days every three weeks. Out of 88 cases registered, 75 (85.2%) were evaluable, consisting of 40 (31 complete cases) in UFT-MMC and 35 (27 complete cases) in UFT-ACR. There was no difference in various background factors between the two groups. PR, NC and PD was 10/31, 15/31 and 6/31 in the UFT-MMC group, whereas 0/27, 22/27 and 5/27 in the UFT-ACR group, respectively. The efficacy in the former group was higher, though not significant (U-test, p = 0.052), than that in the latter group. However, there was no difference in the 50% survival time (4.9 months in UFT-MMC vs. 5.4 months in UFT-ACR) of the either group.

Aclarubicin

Comparative Analysis of Volatile Compounds, Amino Acids, Fatty Acids, and Lipidomic Profiles in Thigh Muscles of Commercial Arbor Acres (AA) Broilers and Indigenous Chengkou and Langshan Chickens.

Flavor-related compounds and nutritional components of chicken meat vary among different breeds, but comprehensive comparisons of these characteristics between commercial and indigenous chickens remain insufficiently characterized. In this study, three chicken breeds (Arbor Acres, Chengkou, and Langshan) were slaughtered at their respective market ages, and the volatile flavor compounds, amino acids, fatty acids, and lipidomic profiles of thigh muscle were analyzed to investigate breed-associated differences in flavor-related and nutritional characteristics. Langshan chickens exhibited the highest total volatile compound content and also had the highest total amino acid levels, with significantly higher contents of umami and sweet amino acids. In addition, both indigenous breeds showed higher levels of arachidonic acid (C20:4n6) than Arbor Acres broilers, while Chengkou chickens had the highest content of docosahexaenoic acid (DHA, C22:6n3). Lipidomic analysis identified 787 lipids, with glycerophospholipids and sphingolipids as the predominant classes. Differential lipid analysis revealed that Langshan chickens had 38 upregulated lipids compared with Arbor Acres chickens, while Chengkou chickens exhibited 258 differential lipids relative to Arbor Acres chickens. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis indicated that these differential lipids were mainly associated with glycerolipid, sphingolipid, and glycerophospholipid metabolism. Correlation analysis further revealed significant associations between specific lipids and flavor-related compounds, amino acids, and fatty acids, suggesting their potential roles in breed-associated differences. Overall, this study demonstrates that indigenous chicken breeds possess distinct flavor-related and nutritional profiles compared with commercial Arbor Acres broilers and provides valuable insights into breed-associated differences in chicken meat characteristics.

amino acids

The maturation of the central auditory conduction in preterm infants until three months post term. IV. Composite group averages of the cortical auditory evoked responses (ACRs).

Composite group averages were constructed from cortical auditory evoked responses (ACRs), which are recorded sequentially at maximally 8 conceptional age levels in 5 groups of 49 preterm infants, with additional inclusion of the records of 16 prematures obtained at different conceptional age levels. The group averages for the 5 gestational age groups showed replicable waveforms at all conceptional age (CA) levels reflecting the intragroup stability of the ACR complex. From the earliest age levels, from 25 weeks CA on, ACR group averages can be obtained, containing relative low voltage fast waves and high voltage slow waves. The most outstanding developmental changes in the ACR complex are the waveform changes. Until about 36 weeks CA a premature waveform is found, followed by a transitional phase with low voltage noisy records. Finally the adult waveform is found in the measurements at three months after term date. The latency values of the group averages are determined by the waveform changes. Persistent amplitude differences are found for the slow late waves between the vertex and the central temporal derivations.

Cerebral Cortex

Segmentation of human chromosomes induced by 5-ACR (5-azacytidine).

The 5-ACR (5-azacytidine) introduced in human lymphocyte cultures induces a lack or a delay of condensation of some chromosome segments corresponding to the G-bands. The resulting R-banding is very similar to that obtained with a 7-h treatment by BrdU, although the segmentation may be much stronger (pulverization) with high doses. However, the 5-ACR does not induce chromatid asymmetry, as BrdU does. This constitutes a new argument for considering that the segmentation and the asymmetry of chromatids depend, at least partly, on two different mechanisms, where proteins are probably involved. Another effect of 5-ACR is to increase chromosome associations by satellites, secondary constrictions, and telomeric regions.

Azacitidine

The ACR-NEMA Digital Imaging and communications Standard: a nontechnical description.

The purpose of this report is to present, in nontechnical terms, the purpose and history of the American College of Radiology and National Electrical Manufacturers Association (ACR-NEMA) Digital Imaging and Communications Standard (ACR-NEMA Standards Publication no. 300-1985), an explanation of what the standard is, the characteristics of the standard, possible applications of the standard, and ongoing standardization efforts. It is assumed that the reader has at least a basic understanding of the concepts and technologies described collectively as picture archiving and communication systems (PACS). For information on PACS, please refer to the NEMA PACS Primer and the list of suggested reading contained therein (for copies, write or call NEMA, 2101 L St, Suite 300, Washington, DC 20037, ATTN: Ms Cindy Fuscoe; telephone 202-457-1965).

Computer Communication Networks

A bidirectional ACR-NEMA interface between the VA's DHCP Integrated Imaging System and the Siemens-Loral PACS.

There is a wide range of requirements for digital hospital imaging systems. Radiology needs very high resolution black and white images. Other diagnostic disciplines need high resolution color imaging capabilities. Images need to be displayed in many locations throughout the hospital. Different imaging systems within a hospital need to cooperate in order to show the whole picture. At the Baltimore VA Medical Center, the DHCP Integrated Imaging System and a commercial Picture Archiving and Communication System (PACS) work in concert to provide a wide-range of departmental and hospital-wide imaging capabilities. An interface between the DHCP and the Siemens-Loral PACS systems enables patient text and image data to be passed between the two systems. The interface uses ACR-NEMA 2.0 Standard messages extended with shadow groups based on draft ACR-NEMA 3.0 prototypes. A Novell file server, accessible to both systems via Ethernet, is used to communicate all the messages. Patient identification information, orders, ADT, procedure status, changes, patient reports, and images are sent between the two systems across the interface. The systems together provide an extensive set of imaging capabilities for both the specialist and the general practitioner.

Data Display

PACS mini refresher course. Network and ACR-NEMA protocols.

The backbone of the picture archiving and communication system (PACS) is the electronic network used to move information. Communications networks require electronic rules of operation or protocols so that a set of data being transmitted reaches the intended destination and does not collide with another set of transmitted data. The most efficient protocol is flexible and can respond to the fluctuations in volume of data transmitted via the network. Successful network connection of PACS devices requires standardized interfaces so that equipment from multiple vendors can use the network protocol. The American College of Radiology (ACR) and the National Electrical Manufacturers Association (NEMA) have developed a standard for imaging equipment interfaces: DICOM (Digital Imaging and Communications in Medicine). The DICOM standard allows interoperability among different computers and operating systems. It is flexible and will allow modification and expansions as new imaging techniques evolve. The authors and the ACR-NEMA committee believe that the DICOM standard represents an important choice for radiologists, since it was developed with their interests in mind.

Computer Communication Networks

ACR-NEMA digital imaging and communications standards: minimum requirements.

The purposes, implications, and history of development of the American College of Radiology-National Electrical Manufacturers Association (ACR-NEMA) Digital Imaging and Communication Standard and its contents are briefly described, and the minimum requirements of the ACR-NEMA Digital Imaging and Communication Standard are described with a concise introduction of each layer. The usefulness, validity, current status, and future development of the standard are also discussed.

Computer Systems

Hypercard coding system for the ACR Index for Radiological Diagnoses.

We describe a computer version of the Index for Radiological Diagnoses of the American College of Radiology (ACR). This system combines a graphics interface with a search mechanism while preserving the hierarchical structure of the Index. The graphics interface allows easy selection of an anatomic part, while the search mechanism provides the code numbers associated with an entered term. The computer system and the paperback version of the ACR Index were compared by having 52 volunteers (21 radiology faculty members, 21 radiology residents, and 10 medical students) each code 30 cases with the book and a matched set of 30 cases with the computer. The average time to code cases was shorter when the computer was used (52.2 vs 64.5 sec; p less than .0001). Accuracy was higher when the computer was used (96.4% vs 90.4%; p less than .0001). The average confidence in the computer diagnosis was also higher (9.73 vs 9.51, on a scale of 1-10; p = .0016). This system demonstrates the ability of a computer program to outperform an analogous noncomputerized system.

Disease

The gene encoding the human preproacrosin (ACR) maps to the q13-qter region on chromosome 22.

Human proproacrosin is specified by a single gene (ACR). Using a series of human-rodent somatic cell hybrids containing variant complements of human chromosomes, the preproacrosin gene was found to cosegregate with human chromosome 22. Somatic cell hybrids containing translocation chromosomes carrying parts of chromosome 22 were used to locate the preproacrosin gene to the region 22q13-22qter. By probing the DNA of 82 individuals, a restriction fragment length polymorphism was found with SstI in 14 cases.

Acrosin

Prevalence and level of antibodies to the circumsporozoite proteins of human malaria parasites, including a variant of Plasmodium vivax, in the population of two epidemiologically distinct areas in the state of Acre, Brazil.

A seroepidemiological study of the prevalence of antibodies against the repeating epitopes of circumsporozoite (CS) proteins of human malaria parasites was conducted in 2 different areas in the state of Acre, Brazil in 1987 and 1990. In 1987 antibodies against the CS protein of the VK 247 variant Plasmodium vivax as well as antibodies against the CS proteins of P. falciparum and the classic P. vivax were found at relatively high rates in the 2 areas, but significant microepidemiological differences were observed. In 1990, when large scale migration in Amazonia had ceased and control measures were applied in the study areas, the malaria endemicity decreased, as determined by the declining prevalence of anti-sporozoite antibodies against all Plasmodium species, and the small number of individuals with positive blood smears. Antibodies against sporozoites of the variant P. vivax did not cross-react with the CS proteins of the classic P. vivax, nor with antibodies against sporozoites of P. falciparum and P. malariae. Sera containing antibodies against the CS protein of P. malariae were found at a very low frequency, and only in 1987. The anti-CS protein antibody response to all Plasmodium species was age-related.

Adolescent

New cisplatin schedule in combination with aclarubicin (ACR) with high response rate in recurrent gynecological adenocarcinomas.

Fourteen patients with recurrent gynecological adenocarcinomas (nine with endometrial cancer and six with ovarian cancer) were treated with cisplatin given by 14-day continuous infusion at a daily dose of 10 mg/m2 in combination with aclarubicin (ACR) at a dose of 20 mg/body on alternate days during each 14-day course. The daily dose of cisplatin was given with 1 liter of fluids; no diuretics were administered. The overall response rate was 71.4% (50% in endometrial cancer and 100% in ovarian cancer). It was especially interesting that a 100% response rate was obtained in five patients previously treated with cisplatin; i.e., the present cisplatin dosing schedule was highly effective as second-line therapy in these patients. No renal or gastrointestinal toxicity was observed. These results were pharmacokinetically explained by the plasma concentration of filterable platinum. A low-level, plateau-like curve with a great area under filterable [Pt]-time curve (AUC) seemed to ensure exposure of cancer cells to filterable platinum for sufficiently long periods and freedom from gastrointestinal and renal side effects.

Aclarubicin