Survival of Patients with Primary Brain Tumors: Comparison of Two Statistical Approaches

Purpose

We reviewed the survival time for patients with primary brain tumors undergoing treatment with stereotactic radiation methods at the Masaryk Memorial Cancer Institute Brno. We also identified risk factors and characteristics, and described their influence on survival time.

Methods

In summarizing survival data, there are two functions of principal interest, namely, the survival function and the hazard function. In practice, both of them can depend on some characteristics. We focused on nonparametric methods, propose a method based on kernel smoothing, and compared our estimates with the results of the Cox regression model. The hazard function is conditional to age and gross tumor volume and visualized as a color-coded surface. A multivariate Cox model was also designed.

Results

There were 88 patients with primary brain cancer, treated with stereotactic radiation. The median survival of our patient cohort was 47.8 months. The estimate of the hazard function has two peaks (about 10 months and about 40 months). The survival time of patients was significantly different for various diagnoses (p≪0.001), KI (p = 0.047) and stereotactic methods (p = 0.033). Patients with a greater GTV had higher risk of death. The suitable threshold for GTV is 20 cm³. Younger patients with a survival time of about 50 months had a higher risk of death. In the multivariate Cox regression model, the selected variables were age, GTV, sex, diagnosis, KI, location, and some of their interactions.

Conclusion

Kernel methods give us the possibility to evaluate continuous risk variables and based on the results offer risk-prone patients a different treatment, and can be useful for verifying assumptions of the Cox model or for finding thresholds of continuous variables.     

The use of immunological tolerance to investigate B lymphocyte replacement kinetics in chickens

A simple mathematical model has been derived, describing the irreversible inactivation of immature B cells by high doses of antigen during induction of tolerance, and the antigen-independent replacement of B cells by differentiation of their precursors. The latter leads to recovery from tolerance, the rate of which can be used to assess the rate of B cell replacement in experiments. The model has been compared with experimental tolerance to human albumin in newly hatched chickens.(1) It has been shown that this tolerance cannot be explained only by elimination of B cells but (2) the computed rate of B cell replacement agreed with the experimental rate assessed by immunization of tolerant chickens with a cross-reacting antigen. (3) In order to further verify the model, additional experiments to test the rate of B cell replacement were suggested by the model.     

Why does a sucrose choice reduce the consumption of alcohol in C57BL/6J mice?

To determine why animals reject alcohol when offered palatable solutions of sucrose, male C57BL/6J mice were challenged first with 5% sucrose then with 10% sucrose, while given continuous free-access to alcohol and water. The 5% sucrose dramatically reduced the intake of alcohol and increased the intake of total fluid by an average of 7.3 ml/day. The suppression of alcohol intake could not be attributed to a volumetric ceiling since access to 10% sucrose produced a further large increase in total intake (8.8 ml/day). The results support the interpretation that animals consume alcohol for characteristics it shares with sucrose.     

Contribution to the biosynthesis of erythromycin in the presence of propionic acid-1-14C

Опыты деградации с активным эритромицином, полученным путем прибавле ния пропионовой-1-¹⁴Cкислоты в ферментационную среду, показали, что активность наблудается только в эритронолиде, лактоне молекулы эритромицина. Caxapa, дезозамин и кладиноза не были мечены. Активность пропиональдегида VI, которая представляет активность терминальной единицы C₃ эритронолида, в общем отвечала двукратной величине активности единицы C₃, вычисленной на основании активности насыщенного лактона V. Активность метиллевулиновой кислоты VII соответствует теоретической величине, вычисленной для двух активных атомов углерода, что свидетельствует о равноценности единиц C₃ насыщенного лактона. Указанные результаты соответствуют представлению, что в присутствии пропионовой 1-¹⁴C кислоты лактон молекулы эритромицина синтезируется из 1 молекулы пропионила CoA и 6 молекул метилмалонила CoA, с последующим декарбоксилированием.     

Regulation of acetylcholine synthesis in presynaptic endings of cholinergic CNS neurons

Data on acetylcholine (ACh) synthesis in nerve cells are summarized and the mechanism of regulation of this process is described. Under conditions of relative rest on moderate synaptic activity the ACh concentration in the compartment of its synthesis in cholinergic nerve endings is probably maintained at a level corresponding to equilibrium of the reaction catalyzed by the enzyme choline-acetyltransferase (CAT). ACh release is followed by its transport from the compartment of synthesis into the compartment of secretion and automatic resynthesis of new ACh, until equilibrium is restored in the compartment of synthesis. At the same time synaptic activity and ACh release promote synthesis of new ACh by the following pathways. First, a fall in the ACh concentration in the nerve endings disinhibits carriers for choline, and facilitates choline transfer from the extracellular fluid into the cell in accordance with the electrochemical gradient. Second, hydrolysis of liberated ACh increases the choline concentration in the extracellular fluid in the neighborhood of the nerve endings. Third, postactivation hyperpolarization of the nerve endings facilitates transport of choline and an increase in its concentration in the nerve endings. Fourth, there are grounds for considering that stimulation of muscarine receptors promotes a further increase in the choline concentration in the region of the nerve endings by intensification of phosphatidylcholine hydrolysis in postsynaptic cells. Fifth, a decrease in the acetyl-CoA content on account of ACh resynthesis increases pyruvate dehydrogenase activity and acetyl-CoA production. Sixth, it is possible that an increase in the Ca⁺⁺ concentration in nerve endings promotes direct transport of acetyl-CoA from the mitochondria into the cytosol of nerve endings, where ACh is synthesized. It is postulated that under conditions of intensive synaptic activity the rate of supply of acetyl-CoA and choline and also CAT activity in the nerve endings may be factors limiting the velocity of ACh resynthesis.Institute of Physiology, Czechoslovak Academy of Sciences, Prague. Translated from Neirofiziologiya, Vol. 16, No. 5, pp. 603–611, September–October, 1984.     

Ethanol-induced death and lipid composition ofSaccharomyces cerevisiae: A comparative study of the role of sterols

Ethanol tolerance of fourSaccharomyces cerevisiae strains characterized by different amounts of Δ^5,7-sterols was tested. The individual tolerances did not correlate with the strains sterol levels. The highly and medium-accumulating strains exhibited the highest and lowest ethanol tolerances, respectively.     

The effect of Tookad-mediated photodynamic ablation of the prostate gland on adjacent tissues--in vivo study in a canine model.

Photodynamic therapy (PDT) mediated with vascular acting photosensitizer Tookad (Pd-bacteriopheophorbide) was investigated as an alternative modality for treating prostate cancer. Photodynamic effects on the prostate gland and its adjacent tissues were evaluated in a canine model. Interstitial prostate PDT was performed by irradiating individual lobes with a cylindrical diffuser fiber at various drug/light doses. The sensitivity of the adjacent tissues to Tookad PDT was determined by directly irradiating the surface of the bladder, colon, abdominal muscle and pelvic plexus with a microlens fiber at various drug/light doses. The prostate and adjacent tissues were harvested one-week after the treatment and subjected to histopathological examination. PDT-induced prostate lesions were characterized by marked hemorrhagic necrosis. The bladder, colon, abdominal muscle and pelvic plexus appeared to be sensitive to PDT although the Tookad PDT-induced responses in these tissues were minimal compared to that of the prostate gland at the same dose levels. Nevertheless, the protection of the adjacent tissues should be taken into consideration during the total prostate ablation process due to their sensitivity to PDT. The sensitivity of the prostatic urethra is worth further investigation. Direct intraurethral irradiation might provide an ideal means to determine the sensitivity of the prostatic urethra and might lead to transurethral PDT protocols for the management of benign prostatic hyperplasia (BHP).     

Synthesis and antimycobacterial evaluation of N-substituted 3-aminopyrazine-2,5-dicarbonitriles

A series of 14 new compounds related to pyrazinamide were synthesized, characterized with analytical data and screened for in vitro antimycobacterial activity against Mycobacterium tuberculosis, Mycobacterium kansasii and two types of Mycobacterium avium. The series comprised of N-substituted 3-aminopyrazine-2,5-dicarbonitriles derived from 3-chloropyrazine-2,5-dicarbonitrile by nucleophilic substitution of chlorine by various non-aromatic amines (alkylamines, cycloalkylamines and heterocyclic amines). Noteworthy antimycobacterial activity against M. tuberculosis was found among the alkylamino derivatives, for example, 3-(heptylamino)pyrazine-2,5-dicarbonitrile inhibited M. tuberculosis at MIC=51 μmol/L. 3-(Hexylamino)pyrazine-2,5-dicarbonitrile inhibited M. kansasii at MIC=218 μmol/L. Basic structure-activity relationships are discussed. A comparison between calculated and experimentally determined lipophilicity parameters within the series is included.