Search

Background: While immune-cell infiltrated tumors, such as human papillomavirus positive (HPV+) ororpharyngeal squamous cell carcinomas (OPSCC) have been associated with an improved clinical prognosis, there is evidence to suggest that OPSCCs are also subjected to increased immunoregulatory influence. The objective of this study was to assess whether patients with clinically aggressive OPSCC have a distinct immunosuppressive immune signature in the primary tumor. Methods: This retrospective case-control study analyzed 37 pre-treatment tissue samples from HPV+ and HPV-negative OPSCC patients treated at a single institution. The cases were patients with known disease recurrence and the controls were patients without disease recurrence. An mRNA-expression immune-pathway profiling was performed, and correlated to clinical outcomes. The TCGA head and neck cancer database was utilized to make comparisons with the institutional cohort. Results: In our cohort, HPV-negative and HPV+ patients with known disease recurrence both had significantly increased suppressive monoctyte/macrophage and granulocyte cell-expression-profile enrichment. Similar findings were found in the TCGA cohort when comparing HPV-negative to positive patients. Conclusions: our study demonstrates that patients with recurrent HPV+ OPSCC had suppressive monocyte/macrophage and granulocyte immune-cell enrichment, similar to those seen in the more aggressive HPV-negative OPSCC.

The nanomaterials are materials of dimensions 1-100 nm. Advanced materials and Nanosystems; synthesis and characterization is an emerging field of research. The day by day modification in synthesis approaches may generate a new synthetic approach. The gradual development in the synthesis techniques from the bulk to nanoparticles synthesis has been reported in this chapter. We are focused on all types of synthesis methods for advanced nanomaterials and the techniques used for nanomaterials characterization. For the Commercial production of nanomaterials, various bottom-up and top-down approaches have been developed during the last two decades. Here, we are trying to summarize the basic principle of solid phase, vapour phase and liquid phase synthetic techniques in detail with a schematic setup.

In the present work ZnSe nanorods (NRs) have been synthesised using simple Co-precipitation method and as-synthesised sample annealed at 300 0 C in air atmosphere. The structural, morphological and optical properties of prepared samples have been investigated using x-rays diffraction (XRD), transmission electron microscope (TEM), UV-Visible and Photoluminescence (PL) spectroscopy techniques. The XRD results revealed the formation of hexagonal structure of as-synthesized ZnSe NRs which were elongated to the reflection (101). TEM micrographs confirmed the formation of nanorods. Air annealing quenched the hexagonal ZnSe NRs to the hexagonal ZnSe/ZnO nanoparticles. UV–visible absorption spectroscopy predicted the blue shift in band gap of NRs and NPs to the bulk band gap of ZnSe. The PL spectra and corresponding CIE diagram predicted the as-synthesized NRs and quenched NPs emitted bluish colour and found suitable for Blue LEDs and Lasers which are useful in medical, health, pharmaceutical and food industry.

Over the last two decades cardiovascular calcification (CVC) evolved from a poorly understood process and largely underestimated issue to one due to complex pathophysiologic mechanisms and posing significant health threats. Many clinical conditions are associated with the development of CVC and in several cases the events leading to its growth have been elucidated. Vascular calcification is not uniformly a marker of atherosclerosis, as extensive medial calcification can occur in patients with chronic kidney disease for example. Research efforts have focused on developing therapies tailored at slowing the progression of CVC in the hope to improve the health of affected subjects. Patients with chronic kidney disease are at particularly high risk of suffering from the consequences of CVC and have therefore been targeted with various inhibitors of calcification. Other rarer disorders associated with CVC also have been the focus of research leading to novel therapeutic advances. In this chapter we review some of the most common conditions associated with CVC and some of the most recent therapeutic advances in each area.

Background and objectives In the CaLIPSO study, intravenous administration of SNF472 (300 or 600 mg) during hemodialysis significantly attenuated progression of coronary artery and aortic valve calcification. SNF472 selectively inhibits formation of hydroxyapatite, the final step in cardiovascular calcification. Because bone mineral is predominantly hydroxyapatite, we assessed changes in bone mineral density in CaLIPSO. Design, setting, participants, & measurements Patients with coronary artery calcification at screening (Agatston score of 100–3500 U) were randomized 1:1:1 to receive placebo, 300 mg SNF472, or 600 mg SNF472 as an intravenous infusion during hemodialysis three times weekly for 52 weeks. Dual-energy x-ray absorptiometry (DXA) scans were obtained at baseline (screening) and end of treatment, and between-group changes from baseline were compared using analysis of covariance. Results Among 274 randomized patients, 202 had evaluable DXA scans at baseline and postrandomization (the DXA-modified intention-to-treat population). Mean (95% confidence interval) changes in total-hip bone mineral density from baseline to week 52 were −1.5% (−2.7% to −0.3%), −1.5% (−2.7% to −0.4%), and −2.5% (−3.8% to −1.2%) in the placebo, 300 mg SNF472, and 600 mg SNF472 groups, respectively. Mean (95% confidence interval) changes in femoral-neck bone mineral density from baseline to week 52 were −0.3% (−1.6% to 1.0%), −1.0% (−2.3% to 0.2%), and −2.6% (−4.0% to −1.3%), respectively. Regression analyses showed no correlation between change in coronary artery calcium volume and change in bone mineral density at either location. Changes in serum alkaline phosphatase, calcium, magnesium, phosphate, and intact parathyroid hormone levels were similar across treatment groups. Clinical fracture events were reported for four of 90, three of 92, and six of 91 patients in the placebo, 300 mg SNF472, and 600 mg SNF472 groups, respectively. Conclusions Bone mineral density decreased modestly in all groups over 1 year. In the 600 mg SNF472 group, the reduction appeared more pronounced. Reported fractures were infrequent in all groups. Clinical Trial registry name and registration number: Effect of SNF472 on Progression of Cardiovascular Calcification in End-Stage-Renal-Disease (ESRD) Patients on Hemodialysis (HD), NCT02966028

Cardiovascular calcification (CVC) contributes to morbidity and mortality in patients undergoing dialysis. We examined the pharmacodynamic effects of SNF472, a calcification inhibitor, on plasma calcium phosphate crystallization using spectrometric measurements, and its correlations with effects on CVC in rats or humans. Rats (N = 38) injected with vitamin D (days 1–3) to induce CVC were infused with saline or SNF472 (days 1–12). Inhibition of CVC was 50–65% with SNF472 3 mg/kg and ~ 80% with SNF472 10 or 30 mg/kg. SNF472 dose-dependently inhibited calcium phosphate crystallization, which correlated with inhibition of CVC (r = 0.628, P = 0.005). In patients with calciphylaxis (N = 14), infusion of SNF472 (~ 7 mg/kg) during hemodialysis for 12 weeks inhibited calcium phosphate crystallization by nearly 70%. In patients with CVC (N = 274), infusion of SNF472 during hemodialysis for 52 weeks inhibited calcium phosphate crystallization (placebo: 15%; 300 mg: 61%; 600 mg: 75%), which correlated with inhibition of CVC (r = 0.401, P = 0.003). These findings show a direct correlation between inhibition of calcium phosphate crystallization in plasma and inhibition of CVC both in a rat model and in humans, supporting the use of the pharmacodynamic assay in clinical trials as a potentially predictive tool to evaluate the activity of calcification inhibitors.

Background and Aims In the CaLIPSO study, SNF472 significantly attenuated progression of coronary artery calcium (CAC) volume score compared with placebo. This pre-specified analysis examined the effect of SNF472 on CAC progression in key subgroups of patients in CaLIPSO. Method Patients with a CAC Agatston score of 100 to 3500 at baseline were randomized to SNF472 300 mg (n=92), SNF472 600 mg (n=91), or placebo (n=91), infused during hemodialysis (HD) thrice weekly for 52 weeks. Patients received standard of care therapy, including phosphate binders and calcimimetics as determined by investigator. The primary endpoint (change in log CAC volume score from baseline to week 52 in the combined dose groups vs placebo) was analyzed for patients who received SNF472 or placebo and had an evaluable CT scan post-randomization (modified ITT population). Sensitivity analysis was also performed for the per protocol population of patients that met entry criteria, received 80% of scheduled treatment, completed the study procedures, and had both a baseline and week 52 evaluable CT scan. The analysis plan pre-specified key subgroups: age, sex, diabetes, dialysis vintage, and arteriosclerotic cardiovascular disease (ASCVD), as well as baseline use of non-calcium phosphate binders, calcium-based phosphate binders, calcimimetics, activated vitamin D, warfarin, or statins. Results Demographics and disease characteristics were similar across the treatment groups. Age (mean±SD) at baseline was 63.6±8.9 years and 39% of the patients were female; 62% had diabetes and 41% had prior ASCVD. Median dialysis vintage was 42.4 months; 33% had received hemodialysis for ≥5 years. Concomitant medications at baseline were: non-calcium phosphate binders, 62%; calcium-based phosphate binders, 28%; calcimimetics, 31%; activated vitamin D, 51%; warfarin, 8%; and statins, 64%. CAC volume progression was 11% for the combined dose groups and 20% for placebo (p=0.016). Treatment differences for CAC volume score progression from baseline to week 52 were similar across the subgroups (FIGURE). All interaction p-values were non-significant, and comparisons favored SNF472 vs placebo in each subgroup for both the modified ITT and per protocol population. Conclusion SNF472 treatment for 52 weeks attenuated CAC progression compared with placebo in all subgroups of the CaLIPSO study. These results support the potential benefit of SNF472 across a broad population of patients with cardiovascular calcification. Future studies are needed to determine the effects of SNF472 on cardiovascular events in patients receiving HD.

Background and Purpose No therapy is approved for vascular calcification or calcific uraemic arteriolopathy (calciphylaxis), which increases mortality and morbidity in patients undergoing dialysis. Deposition of hydroxyapatite (HAP) crystals in arterial walls is the common pathophysiologic mechanism. The mechanism of action of SNF472 to reduce HAP deposition in arterial walls was investigated. Experimental Approach We examined SNF472 binding features (affinity, release kinetics and antagonism type) for HAP crystalsin vitro, inhibition of calcification in excised vascular smooth muscle cells from rats and bone parameters in osteoblasts from dogs and rats. Key Results SNF472 bound to HAP with affinity (K-D) of 1-10 mu M and saturated HAP at 7.6 mu M. SNF472 binding was fast (80% within 5 min) and insurmountable. SNF472 inhibited HAP crystal formation from 3.8 mu M, with complete inhibition at 30.4 mu M. SNF472 chelated free calcium with an EC(50)of 539 mu M. Chelation of free calcium was imperceptible for SNF472 1-10 mu M in physiological calcium concentrations. The lowest concentration tested in vascular smooth muscle cells, 1 mu M inhibited calcification by 67%. SNF472 showed no deleterious effects on bone mineralization in dogs or in rat osteoblasts. Conclusion and Implications These experiments show that SNF472 binds to HAP and inhibits further HAP crystallization. The EC(50)for chelation of free calcium is 50-fold greater than a maximally effective SNF472 dose, supporting the selectivity of SNF472 for HAP. These findings indicate that SNF472 may have a future role in the treatment of vascular calcification and calcific uraemic arteriolopathy in patients undergoing dialysis.

Background: The high cardiovascular morbidity and mortality in patients with end-stage kidney disease could be partially caused by extensive cardiovascular calcification. SNF472, intravenous myo-inositol hexaphosphate, selectively inhibits the formation and growth of hydroxyapatite. Methods: This double-blind, placebo-controlled phase 2b trial compared progression of coronary artery calcium volume score and other measurements of cardiovascular calcification by computed tomography scan during 52 weeks of treatment with SNF472 or placebo, in addition to standard therapy, in adult patients with end-stage kidney disease receiving hemodialysis. Patients were randomized 1:1:1 to SNF472 300 mg (n=92), SNF472 600 mg (n=91), or placebo (n=91) by infusion in the hemodialysis lines thrice weekly during hemodialysis sessions. The primary end point was change in log coronary artery calcium volume score from baseline to week 52. The primary efficacy analysis combined the SNF472 treatment groups and included all patients who received at least 1 dose of SNF472 or placebo and had an evaluable computed tomography scan after randomization. Results: The mean change in coronary artery calcium volume score was 11% (95% CI, 7–15) for the combined SNF472 dose group and 20% (95% CI, 14–26) for the placebo group ( P =0.016). SNF472 compared with placebo attenuated progression of calcium volume score in the aortic valve (14% [95% CI, 5–24] versus 98% [95% CI, 77–123]; P P =0.40). Death occurred in 7 patients (4%) who received SNF472 and 5 patients (6%) who received placebo. At least 1 treatment-emergent adverse event occurred in 86%, 92%, and 87% of patients treated with SNF472 300 mg, SNF472 600 mg, and placebo, respectively. Most adverse events were mild. Adverse events resulted in discontinuation of SNF472 300 mg, SNF472 600 mg, and placebo for 14%, 29%, and 20% of patients, respectively. Conclusions: Compared with placebo, SNF472 significantly attenuated the progression of coronary artery calcium and aortic valve calcification in patients with end-stage kidney disease receiving hemodialysis in addition to standard care. Future studies are needed to determine the effects of SNF472 on cardiovascular events. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02966028.

spectral studies. The magnetic moment values of the manganese(II) complexes are in the range of 5.80-6.15 B.M. suggesting a high spin state of manganese in these complexes. The spectral data are consistent with a tetrahedral geometry around Mn(II) and an octahedral geometry for Mo(VI), in which the ligands act as bidentate chelating agents, coordinated through the nitrogen and sulfur/oxygen atoms. The ligands and their metal complexes have been tested against a number of pathogenic fungi and bacteria at different concentrations and were found to possess sufficient fungicidal and bactericidal properties. Further, the complexes were also tested for their antifertility activity in male albino rats and the results were indeed positive.

Soil physical environment as affected by long-term fertilizer experiment application in a maize-wheat system on sandy loam soils of India was characterized and quantified using a unified soil physical quality index (S). Treatments were 100% and 150% of recommended nitrogen, phosphorus, and p

Heterocyclic ketimines, 5-nitro-3-(indolin-2-one)hydrazinecarbothioamide (L1H), 5-nitro-3-(indolin-2-one)hydrazinecarboxamide (L2H), 6-nitro-3-(indolin-2-one)hydrazinecarbo-thioamide (L3H), and 6-nitro-3-(indolin-2-one) hydrazinecarboxamide (L4H), were prepared by the condensation of thiosemicarbazide and semicarbazide hydrochloride (in the presence of sodium acetate) in ethanol with the respective ketones. The dioxomolybdenum(VI) complexes and oxovanadium(V) complexes have been prepared by mixing dioxobis(2,4-pentanedinato)molybdenum(VI) in 1: 2 molar ratios and vanadium oxytrichloride in 1: 1 and 1: 2 molar ratios with monobasic bidentate ketimines. The resulting complexes have been characterized by elemental analysis, conductance measurements, and spectral studies, including IR, 1H NMR, and UV spectra. The ketimines and their corresponding metal complexes have been tested on a number of pathogenic bacteria and fungi in order to assess their growth inhibition potency at different concentrations.

The Schiff bases, 3-(indolin-2-one)hydrazinecarbothioamide (L1H), 3-(indolin-2-one)hydrazinecarboxamide (L2H), 5,6-dimethyl-3-(indolin-2-one)hydrazinecarbothioamide (L3H), and 5,6-dimethyl-3-(indolin-2-one)hydrazinecarboxamide (L4H), have been synthesized by the condensation of 1 H-indol-2,3-dione and 5,6-dimethyl-1H-indol-2,3-dione with the corresponding hydrazinecarbothioamide and hydrazinecarboxamide, respectively. The complexes of oxovanadium and ligands have been characterized by elemental analyses, melting points, conductance measurements, molecular weight determinations, and IR, 1H NMR and UV spectral studies. These studies showed that the ligands coordinated to the oxovanadium in a monobasic bidentate fashion through oxygen or sulfur and the nitrogen donor system. Thus, penta-and hexacoordinated environment around the vanadium atom has been proposed. All the complexes and their parent organic moieties have been screened for their biological activity on several pathogenic fungi and bacteria and were found to possess appreciable fungicidal and bactericidal properties.

The synthesis of some new manganese(II), oxovanadium(V) and dioxomolybdenum(VI) complexes with 5-chloro-1,3-dihydro-3-[2-(phenyl)-ethylidene]-2H-indol-2-one-hydrazinecarbothioamide (L1H) and 5-chloro-1,3-dihydro-3-[2-(phenyl)-ethylidene]-2H-indol-2-one-hydrazinecarboxamide (L2H) were carried out in unimolar and bimolar ratios. All the new derivatives have been characterized by elemental analyses, molecular weight determinations, molar conductance, magnetic measurements, i.r., 1H-n.m.r. and e.s.r. studies. The i.r. and n.m.r. spectral data suggest the involvement of sulphur/oxygen and azomethine nitrogen in coordination to the central metal ion. The magnetic moment values of the manganese(II) complexes are in the 5.85–6.13 B.M. range, suggesting a high spin state in these complexes. Based on these spectral studies tetrahedral geometry for the manganese(II) complexes and octahedral geometry for the molybdenum complexes has been proposed. In the case of the oxovanadium complexes vanadium is in the penta and hexa coordinated environments. Compounds have been synthesized in an open vessel under microwave irradiation (MWI) using a domestic microwave oven. The reaction time decreases from hours to minutes with improved yield as compared to conventional heating. The free ligands and their metal complexes have been tested in vitro against a number of microorganisms in order to assess their antimicrobial properties. The results indicate that the ligands and their respective metal derivatives possess antimicrobial properties.

In November 2001, the Food and Drug Administration (FDA) approved drotrecogin alfa (activated) (DrotAA) for adults who had severe sepsis and a high risk of death. The FDA required a study to evaluate the efficacy of DrotAA for adults who had severe sepsis and a low risk of death.We randomly assigned adult patients with severe sepsis and a low risk of death (defined by an Acute Physiology and Chronic Health Evaluation [APACHE II] score25 or single-organ failure) to receive an intravenous infusion of placebo or DrotAA (24 microg per kilogram of body weight per hour) for 96 hours in a double-blind, placebo-controlled, multicenter trial. The prospectively defined primary end point was death from any cause and was assessed 28 days after the start of the infusion. In-hospital mortality within 90 days after the start of the infusion was measured, and safety information was collected.Enrollment in the trial was terminated early because of a low likelihood of meeting the prospectively defined objective of demonstrating a significant reduction in the 28-day mortality rate with the use of DrotAA. The study enrolled 2640 patients and collected data on 2613 (1297 in the placebo group and 1316 in the DrotAA group) at the 28-day follow-up. There were no statistically significant differences between the placebo group and the DrotAA group in 28-day mortality (17.0 percent in the placebo group vs. 18.5 percent in the DrotAA group; P=0.34; relative risk, 1.08; 95 percent confidence interval, 0.92 to 1.28) or in in-hospital mortality (20.5 percent vs. 20.6 percent; P=0.98; relative risk, 1.00; 95 percent confidence interval, 0.86 to 1.16). The rate of serious bleeding was greater in the DrotAA group than in the placebo group during both the infusion (2.4 percent vs. 1.2 percent, P=0.02) and the 28-day study period (3.9 percent vs. 2.2 percent, P=0.01).The absence of a beneficial treatment effect, coupled with an increased incidence of serious bleeding complications, indicates that DrotAA should not be used in patients with severe sepsis who are at low risk for death, such as those with single-organ failure or an APACHE II score less than 25.

OBJECTIVE: To compare differences in hospital mortality and resource use in adult severe sepsis subjects randomized to receive drotrecogin alfa (activated) (DrotAA) or placebo in the PROWESS trial. DESIGN: Retrospective, cross-sectional, blinded follow-up of subjects enrolled in a previous randomized, controlled trial. SETTING: One hundred sixty-four tertiary care institutions in 11 countries. PARTICIPANTS: The 1,690 subjects with severe sepsis enrolled and treated with study drug in PROWESS, of whom 1,220 were alive at 28 days (the end of the original PROWESS follow-up). INTERVENTIONS: DrotAA (n = 850), 24 microg/kg/hr for 96 hrs, or placebo (n = 840). MEASUREMENTS AND MAIN RESULTS: New follow-up data through hospital discharge were merged with existing 28-day follow-up data. Hospital mortality was calculated for designated subgroups. Intensive care unit and hospital length of stay and Simplified Therapeutic Intervention Scoring System-28 (TISS-28) scores were calculated overall and in designated subgroups. Hospital discharge location was recorded. The 95% confidence interval of most subgroups contained the relative risk estimate for overall 28-day and hospital mortality. Median hospital length of stay and intensive care unit length of stay were similar in both treatment groups: 16 vs. 17 days (p = .22) and 9 vs. 9 days (p = .7) for placebo vs. DrotAA. No significant difference in TISS-28 scores was observed between treatment groups overall or in subgroups of disease severity. In subjects for whom discharge destination was reported, 42.8% of placebo subjects and 46.8% of DrotAA subjects (two thirds of survivors in each group) were discharged directly to home. CONCLUSIONS: Reduction in hospital mortality with DrotAA in most of the subgroups of PROWESS is consistent with the reduction in 28-day and hospital mortality observed in the overall PROWESS population. Additional survivors created with DrotAA treatment did not increase per-patient resource use or intensive care unit or hospital length of stay.