The present study aimed to identify genes associated with patient survival to improve our understanding of the underlying biology of gliomas. We investigated whether the expression of genes selected ...using random survival forests models could be used to define glioma subgroups more objectively than standard pathology. The RNA from 32 non‐treated grade 4 gliomas were analyzed using the GeneChip Human Genome U133 Plus 2.0 Expression array (which contains approximately 47 000 genes). Twenty‐five genes whose expressions were strongly and consistently related to patient survival were identified. The prognosis prediction score of these genes was most significant among several variables and survival analyses. The prognosis prediction score of three genes and age classifiers also revealed a strong prognostic value among grade 4 gliomas. These results were validated in an independent samples set (n = 488). Our method was effective for objectively classifying grade 4 gliomas and was a more accurate prognosis predictor than histological grading.
To investigate the safety and the immunologic and clinical responses of dendritic cell therapy for patients with recurrent malignant glioma.
Twenty-four patients with recurrent malignant glioma (6 ...grade 3 and 18 grade 4 patients) were evaluated in a phase I/II clinical study of dendritic cell therapy. All patients were resistant to the standard maximum therapy. The patient's peripheral blood dendritic cells were generated with granulocyte macrophage colony-stimulating factor, plus interleukin 4 with or without OK-432, and pulsed with an autologous tumor lysate. Dendritic cells were injected intradermally, or both intratumorally and intradermally every 3 weeks.
The protocols were well tolerated with only local redness and swelling at the injection site in several cases. Clinical responses were as follows: 1 patient with partial response, 3 patients with minor response, 10 patients with stable disease, and 10 patients with progressive disease. The patients whose dendritic cells were matured with OK-432 had longer survival times than the dendritic cells from patients without OK-432 maturation. The patients with both intratumoral and intradermal administrations had a longer survival time than the patients with intradermal administration only. Increased ELISPOT and delayed-type hypersensitivity responses after vaccination could provide good laboratory markers to predict the clinical outcome of patients receiving dendritic cell vaccination. The overall survival of patients with grade 4 glioma was 480 days, which was significantly better than that in the control group.
This study showed the safety and clinical response of autologous tumor lysate-pulsed dendritic cell therapy for patients with malignant glioma. Dendritic cell therapy is recommended for further clinical studies in malignant glioma patients.
Objective
Management of cervicomedullary compression due to foramen magnum stenosis in achondroplasia remains controversial, especially for patients with no symptoms or mild symptoms. We examined the ...effectiveness of polysomnography (PSG) as an indicator for cervicomedullary decompression treatment.
Methods
We retrospectively reviewed nine achondroplasia cases (mean age 1 year and 9 months) treated from 2008 to 2015. All patients were examined by PSG, magnetic resonance imaging (MRI), and otolaryngeal fibroscopy. We analyzed demographic data, clinical presentation, degree and type of respiratory impairment, severity of foramen magnum stenosis and concomitant cervicomedullary compression, treatment (conservative or surgical), and clinical outcome.
Results
Eight of nine patients presented with no severe symptoms in the daytime. However, MRI revealed four severe, four moderate, and one mild case of cervicomedullary compression, and PSG demonstrated severe sleep apnea in four cases and moderate sleep apnea in five cases. All sleep apnea cases were obstructive or obstructive-dominant. Fibroscopy revealed no upper airway stenosis in six cases and mild stenosis in three cases. Four patients who had severe sleep-related respiratory disturbance on PSG and severe or moderate cervicomedullary compression were treated by cervicomedullary decompression. Three of these patients demonstrated improved sleep respiration soon after surgery, while one required temporary tracheostomy due to bilateral vocal cord paralysis caused by compression during intratracheal intubation.
Conclusion
Polysomnography can be a useful indicator for cervicomedullary decompression surgery, especially in cases of seemingly asymptomatic achondroplasia with severe foramen magnum stenosis.
We present new Middle Miocene paleomagnetic data for the central Japan Arc, and discuss their implications for Miocene rotation. To obtain a refined paleodirection, we made magnetic measurements on ...basaltic to andesitic lavas and intrusive rocks from 12 sites in the Tsugu volcanic rocks (ca 15 Ma) in the northern part of the Shitara area, Japan. Significant secondary magnetizations in samples with strong magnetic intensities are interpreted as lightning‐induced components. Mean directions carried by magnetite and/or titanomagnetite were determined for all sites. An overall mean direction with a northerly declination was obtained from dual‐polarity site means for nine sites. This direction is indistinguishable from the mean direction for coeval parallel dikes in the northern part of the Shitara area, and also indistinguishable from the Miocene reference direction derived from the paleopole for the North China Block in the Asian continent. These comparisons suggest little or no rotation or latitudinal motion in the study area with respect to the North China Block since 15 Ma. We obtained a refined early Middle Miocene paleodirection (D = 9.7°, I = 52.5°, α95 = 4.8°; 30 sites) and paleopole (82.0°N, 230.8°E, A95 = 5.6°) for Shitara by combining data from the Tsugu volcanic rocks and a coeval dike swarm. An anomalous direction found at three sites could be a record of an extraordinary field during a geomagnetic polarity transition or excursion. Paleomagnetic data from Shitara suggest that: (i) the western wing of the Kanto Syntaxis, a prominent cuspate geologic structure in central Honshu, underwent a counterclockwise rotation with respect to the main part of the southwestern Japan Arc between ca 17.5 Ma and 15 Ma; (ii) collision between the Japan and Izu–Bonin (Ogasawara) Arcs began prior to 15 Ma; and (iii) clockwise rotation of the entire southwestern part of the Japan Arc had ceased by 15 Ma.
Molecular analysis of the growing teratoma syndrome has not been extensively studied. Here, we report a 14-year-old boy with a growing mass during treatment for a mixed germ cell tumor of the pineal ...region. Tumor markers were negative; thus, growing teratoma syndrome was suspected. A radical resection via the occipital transtentorial approach was performed, and histopathological examination revealed a teratoma with malignant features. Methylation classifier analysis confirmed the diagnosis of teratoma, and
loss and 12p gain were identified by copy number variation analysis, potentially elucidating the cause of growth and malignant transformation of the teratoma. The patient remains in remission after intense chemoradiation treatment as a high-risk germ cell tumor.
In this study, we provide long-term outcome data of patients with primary central nervous system lymphoma.
The long-term outcomes of PCNSL patients diagnosed between 1982 and 2006 were reviewed. ...Neurological late neurotoxicity symptoms, neuroradiological brain atrophy and leukoencephalopathy were evaluated. Surviving patients completed the Quality of Life Questionnaire-30 and Brain Cancer Module-20. The differences in overall survival were assessed using the Kaplan-Meier method and log-rank test. The differences between groups in terms of each investigated parameter were analyzed using the Wilcoxon signed-rank test.
Among 112 PCNSL patients, there were 33 (29.4%) long-term (> 5 years) survivors. The median survival of all long-term survivors was 105.7 months; of these, 8 (7.1%) were alive at the latest follow-up, with a mean survival time of 170.2 months (range, 121.8–286.4). Clinical assessment revealed severe neurotoxicity in 14 patients (42.4%), moderate neurotoxicity in 5 (15.1%), and normal status in 14 (42.4%). Correlations were seen between the neuroradiological imaging score changes and neurocognitive condition (P=0.0001), neurocognitive condition and the whole brain irradiation dose (P=0.0004), and atrophy and the whole brain irradiation dose (P=0.0035).
A more severe clinical condition was found to be associated with increasing age and whole brain irradiation dose in long-term survivors with PCNSL.
The primary goal of this phase I study was to assess the safety and immunologic responses of personalized peptide vaccination for patients with advanced malignant glioma.
Twenty-five patients with ...advanced malignant glioma (8 grade 3 and 17 grade 4 gliomas) were evaluated in a phase I clinical study of a personalized peptide vaccination. For personalized peptide vaccination, prevaccination peripheral blood mononuclear cells and plasma were provided to examine cellular and humoral responses to 25 or 23 peptides in HLA-A24+ or HLA-A2+ patients, respectively; then, only the reactive peptides (maximum of four) were used for in vivo administration.
The protocols were well tolerated with local redness and swelling at the injection site in most cases. Twenty-one patients received more than six vaccinations and were evaluated for both immunologic and clinical responses. Increases in cellular or humoral responses specific to at least one of the vaccinated peptides were observed in the postvaccination (sixth) samples from 14 or 11 of 21 patients, respectively. More importantly, significant levels of peptide-specific IgG were detected in the postvaccination tumor cavity or spinal fluid of all of the tested patients who showed favorable clinical responses. Clinical responses were 5 partial responses, 8 cases of stable disease, and 8 cases of progressive disease. The median overall survival for patients with recurrent glioblastoma multiforme in this study (n = 17) was 622 days.
Personalized peptide vaccinations were recommended for the further clinical study to malignant glioma patients.
Aphids of the tribe Eriosomatini are typically associated with the tree genera Ulmus and Zelkova as the primary host, on which they induce several types of leaf gall. To elucidate evolutionary ...changes in the aphid–host associations and gall morphology, phylogenetic relationships were inferred using 36 species (28 in the ingroup) and based on 52 morphological characters. Phylogenetic analysis with equal character weighting led to hundreds of most‐parsimonious trees, and the strict consensus of these was poorly resolved. However, the successive weighting of characters yielded three most‐parsimonious trees. The strict consensus of these supported the monophyly of the Eriosomatini and the monophyly of most genera. Reconstruction of the aphid–host associations on the consensus tree indicated that the ancestral Eriosomatini were associated with Zelkova and that the association with Ulmus evolved twice independently. Ancestral reconstruction suggests that galls of the leaf‐roll type are ancestral to those of the completely and incompletely closed pouch type, and that each type of pouch galls evolved independently. It is suggested that despite early diversification of the Eriosomatini on Zelkova species, Zelkova‐associated eriosomatines had become extinct or survived as relict parthenogens on the secondary host due to the elimination of Zelkova in most regions since the late Tertiary. In contrast, two large genera in the Eriosomatini, Eriosoma and Tetraneura, are associated with the largest elm section Ulmus whose elements are distributed widely in Eurasia, including boreal regions. Therefore, the available evidence suggests that the present species diversity and distribution patterns of the eriosomatines have been largely affected by the diversification and extinction of their host plants during the late Tertiary and Quaternary.
The family Adelgidae is a small group of insects within Aphidoidea (Hemiptera). Adelgids are typically holocyclic with host‐alternation between the primary and secondary hosts, but some anholocyclic ...species persist either on the primary or secondary host. Like Aphididae, complexities and variation of adelgid life cycles are good models for understanding the evolution of complex life cycles. In this review, we outline the complex life cycles of adelgids, and current status and recent advances in adelgid life cycle studies. We also discuss the evolution of adelgid life cycles by comparing them to closely related aphid life cycles. A switch from holocycly to anholocycly on the primary host needs evolutionary innovations in gallicola behavior and reproduction. This radical evolution can be explained by mutations in a regulatory system that controls the sequence of gene sets producing phenotypes of one morph. In contrast, anholocycly on the secondary host consists of a series of exulis generations already existing in the holocycle. Thus, it may evolve by loss of primary‐host generations through extinction of the primary host, expansion beyond the geographical range of the primary host, or loss of male‐producing sexuparae that return to the primary host. Although the holocycle and its anholocyclic derivatives have been regarded as different species, morphological, ecological and genetic differences are too subtle to separate them into different species. The holocycle and its anholocyclic derivatives should not be split into different species without clearly identifiable morphological differences.
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