Faculty Bibliography

BACKGROUND:Removal of rings is recommended before surgeons aseptically prepare for surgical procedures. OBJECTIVES/OBJECTIVE:This study was undertaken to determine whether there is a difference between bacterial counts under surgical gloves of ring wearers compared with nonring wearers after proper aseptic hand preparation and 3 hours of wear. METHODS:Twenty volunteer veterinary medical students were divided into 2 groups: One group wore a smooth ring band (without projections or mounted stones) on their ring finger, and the other group did not wear a ring. A modified glove juice method was used to obtain bacterial counts (colony-forming units/mL) inside surgically gloved hands prior to a proper aseptic hand preparation and 3 hours after hand preparation and wear. Each of the pre- and postsurgical glove juice samples were inoculated onto Letheen agar plates, which were incubated aerobically under atmospheric conditions for 48 hours at 35 degrees C. Gloves were tested for perforations using a water pressure test. RESULTS:No differences, or significant change, in bacterial counts were found before or after surgery between all ring hands and nonring hands or between ring and nonring hands for ringed participants. No differences in bacterial counts were found within perforated versus nonperforated gloves. CONCLUSION/CONCLUSIONS:There is no compelling evidence to suggest that surgeons wearing rings possess higher bacterial counts under their gloves during surgery.

Interferon-alpha (IFN-alpha) is used as an adjuvant therapy in patients with malignant melanoma and who have undergone surgical resection of high-risk lesions. Defective expression or activation of STAT1 or STAT2 has been shown to correlate with IFN-alpha or resistance in vitro; however, recent data from our laboratory suggest that the anti-tumor effects of IFN-alpha are dependent on STAT1 signaling within host immune cells. We measured STAT1 and STAT2 expression in 28 melanoma biopsies (8 cutaneous lesions; 1 lung metastasis; 19 nodal metastases) obtained from patients prior to the initiation of adjuvant IFN-alpha therapy. Disease recurrence following IFN-alpha treatment did not correlate with the staining intensity of either STAT1 (P = 0.61) or STAT2 (P = 0.52). Tumors with minimal STAT1 or STAT2 expression (< 20% positive) were present in four patients with tumor-positive lymph nodes, who exhibited prolonged relapse-free survival (> 44 months) following adjuvant therapy. Conversely, high levels of STAT1 were present in a patient who recurred during the course of IFN-alpha therapy. A case study of one patient who experienced recurrent disease during IFN-alpha treatment revealed that STAT1 levels were greater in the recurrent tumor when compared to the original lesion. These studies provide direct evidence to suggest that levels of STAT1 and STAT2 within the tumor do not influence a patient's response to adjuvant IFN-alpha.

Resistance to the Ableson protein tyrosine (Abl) kinase inhibitor imatinib mesylate has become a critical issue for patients in advanced phases of chronic myelogenous leukemia. Imatinib-resistant tumor cells develop, in part, as a result of point mutations within the Abl kinase domain. As protein kinase B (Akt) plays a pivotal role in Abl oncogene-mediated cell survival, we hypothesize that concurrent inhibition of Akt will sensitize resistant cells to the residual apoptotic activity of imatinib mesylate, thereby overcoming the resistance. Here, we examined the effect of OSU-03012, a celecoxib-derived phosphoinositide-dependent kinase-1 (PDK-1) inhibitor, on imatinib mesylate-induced apoptosis in 2 clinically relevant breakpoint cluster region (Bcr)-Abl mutant cell lines, Ba/F3p210(E255K) and Ba/F3p210(T315I). The 50% inhibitory concentration (IC50) values of imatinib mesylate to inhibit the proliferation of Ba/F3p210(E255K) and Ba/F3p210(T315I) were 14 +/- 4 and 30 +/- 2 microM, respectively. There was no cross-resistance to OSU-03012 in these mutant cells with an IC50 of 5 microM irrespective of mutations. Nevertheless, in the presence of OSU-03012 the susceptibility of these mutant cells to imatinib-induced apoptosis was significantly enhanced. This synergistic action was, at least in part, mediated through the concerted effect on phospho-Akt. Together these data provide a novel therapeutic strategy to overcome imatinib mesylate resistance, especially with the Abl mutant T315I.

CONTEXT/BACKGROUND:Articles in the medical literature and lay press have supported a belief that individuals, including those dying of cancer, can temporarily postpone their death to survive a major holiday or other significant event, but results and effects have been variable. OBJECTIVE:To determine whether, for the patient dying of cancer, a "death takes a holiday" effect showing a reduction in deaths in the week before a significant event was associated with Christmas, the US holiday of Thanksgiving, or the date of the individual's birthday. DESIGN, SETTING, AND SUBJECTS/METHODS:Analysis of death certificate data for all 1,269,474 persons dying in Ohio from 1989-2000, including 309,221 persons dying with cancer noted as the leading cause of death. MAIN OUTCOME MEASURE/METHODS:We measured the total number of cancer deaths in the 2 weeks centered on the event of interest and the proportion of these deaths that occurred in the week before the event to determine whether this proportion was significantly different from 0.5 by using an exact binomial test. RESULTS:The proportion of persons dying of cancer in the week before Christmas, Thanksgiving, and the individual's birthday was not significantly different from the proportion dying in the week after the event (P = .52, .26, and .06, respectively). However, among black individuals there was an increase in cancer deaths in the week before Thanksgiving (P = .01), whereas women showed an increase in cancer deaths in the week before their birthday (P = .05). There was no statistically significant excess of deaths in the postevent week in any subgroup. CONCLUSION/CONCLUSIONS:We found no evidence, in contrast to previous studies, that cancer patients are able to postpone their deaths to survive significant religious, social, or personal events.