BACKGROUND: In a multidisciplinary conference patients with advanced non-resectable hepatocellular carcinoma (HCC) were stratified according to their clinical status and tumor extent to different regional modalities o...BACKGROUND: In a multidisciplinary conference patients with advanced non-resectable hepatocellular carcinoma (HCC) were stratified according to their clinical status and tumor extent to different regional modalities or to best supportive care. The present study evaluated all patients who were stratified to repeated transarterial chemoembolization (TACE) from 1999 until 2003 in terms of tumor response, toxicity, and survival. A moderate embolizing approach was chosen using a combination of degradable starch microspheres (DSM) and iodized oil (Lipiodol) in order to combine anti-tumoral efficiency and low toxicity. METHODS: Fourty-seven patients were followed up prospectively. TACE treatment consisted of cisplatin (50 mg/m2), doxorubicin (50 mg/m2), 450-900 mg DSM, and 5-30 ml Lipiodol. DSM and Lipiodol were administered according to tumor vascularization. Patient characteristics,toxicity, and complications were outlined. In multivariate regression analyses of pre-treatment variables from a prospective database, predictors for tumor response and survival after TACE were determined. RESULTS: 112 TACE courses were performed (2.4±1.5 courses per patient). Mean maximum tumor size was 75 (± 43) mm, in 68% there was bilobar disease. Best response to TACE treatment was: progressive disease (PD) 9%, stable disease (SD) 55%, partial remission (PR) 36%, and complete remission (CR) 0%. Multivariate regression analyses identified tumor size ≤75 mm, tumor number ≤5, and tumor hypervascularization as predictors for PR. The overall 1-, 2-, and 3-year-survival rates were 75%, 59%, and 41%, respectively, and the median survival was 26 months. Low α-fetoprotein levels (<400 ng/ml) (Odds ratio=3.3) and PR as best response to TACE (Odds ratio=6.7) were significantly associated with long term survival (>30 months, R2=36%). Grade 3 toxicity occurred in 7.1% (n=8), and grade 4 toxicity in 3.6% (n=4) of all courses in terms of reversible leukopenia and thrombocytopenia. The incidence of major complications was 5.4% (n=6). All compli展开更多
AIM： To evaluate the treatment effect of percutaneous ethanol injection （PEI） for patients with advanced, non-resectable HCC compared with combination of transarterial chemoembolisation （TACE） and repeated single...AIM： To evaluate the treatment effect of percutaneous ethanol injection （PEI） for patients with advanced, non-resectable HCC compared with combination of transarterial chemoembolisation （TACE） and repeated single-session PEI, repeated single-session PEI alone, repeated TACE alone, or best supportive care. METHODS： All patients who received PEI treatment during the study period were included and stratified to one of the following treatment modalities according to physical status and tumor extent： combination of TACE and repeated single-session PEI, repeated single-session PEI alone, repeated TACE alone, or best supportive care. Prognostic value of clinical parameters including Okuda-classification, presence of portal vein thrombosis, presence of ascites, number of tumors, maximum tumor diameter, and serum cholinesterase （CHE）, as well as Child-Pugh stage, α-fetoprotein （AFP）, fever, incidence of complications were assessed and compared between the groups. Survival was determined using Kaplan-Meier and multivariate regression analyses.展开更多
AIM: In nonresectable cholangiocellular carcinoma (CCC)therapeutic options are limited. Recently, systemic chemotherapy has shown response rates of up to 30%.Additional regional therapy of the arterially hyper vascula...AIM: In nonresectable cholangiocellular carcinoma (CCC)therapeutic options are limited. Recently, systemic chemotherapy has shown response rates of up to 30%.Additional regional therapy of the arterially hyper vascularized hepatic tumors might represent a rational approach in an attempt to further improve response and palliation. Hence, a protocol combining transarterial chemoembolization and systemic chemotherapy was applied in patients with CCC limited to the liver.METHODS: Eight patients (6 women, 2 men, mean age 62 years) with nonresectable CCC received systemic chemotherapy (gemcitabine 1 000 mg/m2) and additional transarterial chemoembolization procedures (50 mg/m2cisplatin, 50 mg/m2 doxorubicin, up to 600 mg degradable starch microspheres). Clinical follow-up of patients, tumor markers, CT and ultrasound were performed to evaluate maximum response and toxicity.RESULTS: Both systemic and regional therapies were tolerated well; no severe toxicity (WHO Ⅲ/Ⅳ) was encountered. Nausea and fever were the most commonly observed side effects. A progressive rarefication of the intrahepatic arteries limited the maximum number of chemoembolization procedures in 4 patients. A median of 2 chemoembolization cycles (range, 1-3) and a median of 6.5 gemcitabine cycles (range, 4-11) were administered.Complete responses were not achieved. As maximum response, partial responses were achieved in 3 cases,stable diseases in 5 cases. Two patients died from progressive disease after 9 and 10 mo. Six patients are still alive. The current median survival is 12 mo (range, 9-18); the median time to tumor progression is 7 mo (range, 3-18). Seven patients suffered from tumor-related symptoms prior to therapy, 3 of these experienced a treatment-related clinical relief. In one patient the tumor became resectable under therapy and was successfully removed after 10 mo.CONCLUSION: The present results indicate that a combination of systemic gemcitabine therapy and repeated regional chemoembolizations is well tolerated and may enhance the ef展开更多
Mechanical alloying and annealing at 1150 °C for 2 h under an argon atmosphere were used to prepare Ti-45S5 bioglass nanocomposites. Ti-45S5 bioglass material was chemically modified by silver. The antibacterial ...Mechanical alloying and annealing at 1150 °C for 2 h under an argon atmosphere were used to prepare Ti-45S5 bioglass nanocomposites. Ti-45S5 bioglass material was chemically modified by silver. The antibacterial activity of Ti-10% 45S5 bioglass nanocomposite containing silver against Streptococcus mutans and Staphylococcus aureus was studied. Nanocomposites were characterized by X-ray diffraction, scanning electron microscopy equipped with an electron energy dispersive spectrometer and transmission electron microscopy to evaluate phase composition, crystal structure and grain size. In vitro bacterial adhesion study indicated a significantly reduced number of Streptococcus mutans and Staphylococcus aureus on the bulk nanostructured Ti-45S5 bioglass-Ag plate surface in comparison to that on microcrystalline Ti plate surface. Nanostructured Ti-based biomaterials can be considered to be the future generation of dental implants.展开更多
A new kind of biomedical Ti-45S5 Bioglass-Ag nanocomposites and their scaffolds with antibacterial function was developed by the introduction of 1.5 wt% Ag into the Ti-10 wt% 45S5 Bioglass matrix. The microstructure, ...A new kind of biomedical Ti-45S5 Bioglass-Ag nanocomposites and their scaffolds with antibacterial function was developed by the introduction of 1.5 wt% Ag into the Ti-10 wt% 45S5 Bioglass matrix. The microstructure, hardness and corrosion resistance in Ringer solution of the Ag-doped Ti-45S5 glass were investigated. The Vickers hardness of the bulk Ti-10 wt% 45S5 Bioglass-1.5 wt% Ag nanocomposites reached 480 HVo.3. Contact angles of water on the micro- crystalline Ti and nanostructured Ti-10 wt% 45S5 Bioglass-1.5 wt% Ag sample were determined and show visible decrease from 55.2° to 49.6°. In vitro tests culture of normal human osteoblast cells showed very good cells proliferation, colonization and multilayering. In vitro bacterial adhesion study indicated a significantly reduced number of bacteria （Staphylococcus aureus） on the bulk nanostructured Ti-10 wt% 45S5 Bioglass-1.5 wt% Ag plate surface in comparison with that on microcrystalline Ti plate surface. Development of porous Ti-10 wt% 45S5 Bioglass-1.5 wt% Ag scaffolds aims in enhancing bone ingrowth and prosthesis fixation.展开更多
Background: Asymmetry in the wild is a controversial, and to date, unresolved subject.Fluctuating asymmetry(FA) is the developmental instability(intra-individual variation) while, directional asymmetry(DA) expresses t...Background: Asymmetry in the wild is a controversial, and to date, unresolved subject.Fluctuating asymmetry(FA) is the developmental instability(intra-individual variation) while, directional asymmetry(DA) expresses the asymmetry of the population mean.Methods: We analysed 63 Great Grey Shrike(Lanius excubitor) skins at the Naturalis Biodiversity Center, Leiden, the Netherlands.The black markings on the tails were digitized in order to evaluate the symmetry of the two sides of each shrike.Ptilochronology helped understand if nutritional condition affected symmetry.Results: ANOVA revealed no significant differences in size of the tail between sexes(F = 1.67, p > 0.05).However, there was significant difference in the shape of the black area in feathers between the sexes(F = 2.14, p < 0.05), and males had more elongated and slender black areas.Further, DA was observed only in males, but FA was noted in both sexes.Spearman correlation showed no significant association between FA score and tail features in both the sexes.However, in females, we observed a negative significant correlation between the number of fault and growth bars.The shape of the black area in the tail displayed no statistically significant association with the tail features in both sexes although growth bars influenced tail shape more than the number of fault bars.Conclusions: We concluded that the characteristics discovered by us need to also be checked in the field and if they can be used to sex individuals.Also, chromatic manipulative studies are require to verify if DA influences sexual selection in the Great Grey Shrike.展开更多
文摘BACKGROUND: In a multidisciplinary conference patients with advanced non-resectable hepatocellular carcinoma (HCC) were stratified according to their clinical status and tumor extent to different regional modalities or to best supportive care. The present study evaluated all patients who were stratified to repeated transarterial chemoembolization (TACE) from 1999 until 2003 in terms of tumor response, toxicity, and survival. A moderate embolizing approach was chosen using a combination of degradable starch microspheres (DSM) and iodized oil (Lipiodol) in order to combine anti-tumoral efficiency and low toxicity. METHODS: Fourty-seven patients were followed up prospectively. TACE treatment consisted of cisplatin (50 mg/m2), doxorubicin (50 mg/m2), 450-900 mg DSM, and 5-30 ml Lipiodol. DSM and Lipiodol were administered according to tumor vascularization. Patient characteristics,toxicity, and complications were outlined. In multivariate regression analyses of pre-treatment variables from a prospective database, predictors for tumor response and survival after TACE were determined. RESULTS: 112 TACE courses were performed (2.4±1.5 courses per patient). Mean maximum tumor size was 75 (± 43) mm, in 68% there was bilobar disease. Best response to TACE treatment was: progressive disease (PD) 9%, stable disease (SD) 55%, partial remission (PR) 36%, and complete remission (CR) 0%. Multivariate regression analyses identified tumor size ≤75 mm, tumor number ≤5, and tumor hypervascularization as predictors for PR. The overall 1-, 2-, and 3-year-survival rates were 75%, 59%, and 41%, respectively, and the median survival was 26 months. Low α-fetoprotein levels (<400 ng/ml) (Odds ratio=3.3) and PR as best response to TACE (Odds ratio=6.7) were significantly associated with long term survival (>30 months, R2=36%). Grade 3 toxicity occurred in 7.1% (n=8), and grade 4 toxicity in 3.6% (n=4) of all courses in terms of reversible leukopenia and thrombocytopenia. The incidence of major complications was 5.4% (n=6). All compli
文摘AIM： To evaluate the treatment effect of percutaneous ethanol injection （PEI） for patients with advanced, non-resectable HCC compared with combination of transarterial chemoembolisation （TACE） and repeated single-session PEI, repeated single-session PEI alone, repeated TACE alone, or best supportive care. METHODS： All patients who received PEI treatment during the study period were included and stratified to one of the following treatment modalities according to physical status and tumor extent： combination of TACE and repeated single-session PEI, repeated single-session PEI alone, repeated TACE alone, or best supportive care. Prognostic value of clinical parameters including Okuda-classification, presence of portal vein thrombosis, presence of ascites, number of tumors, maximum tumor diameter, and serum cholinesterase （CHE）, as well as Child-Pugh stage, α-fetoprotein （AFP）, fever, incidence of complications were assessed and compared between the groups. Survival was determined using Kaplan-Meier and multivariate regression analyses.
文摘AIM: In nonresectable cholangiocellular carcinoma (CCC)therapeutic options are limited. Recently, systemic chemotherapy has shown response rates of up to 30%.Additional regional therapy of the arterially hyper vascularized hepatic tumors might represent a rational approach in an attempt to further improve response and palliation. Hence, a protocol combining transarterial chemoembolization and systemic chemotherapy was applied in patients with CCC limited to the liver.METHODS: Eight patients (6 women, 2 men, mean age 62 years) with nonresectable CCC received systemic chemotherapy (gemcitabine 1 000 mg/m2) and additional transarterial chemoembolization procedures (50 mg/m2cisplatin, 50 mg/m2 doxorubicin, up to 600 mg degradable starch microspheres). Clinical follow-up of patients, tumor markers, CT and ultrasound were performed to evaluate maximum response and toxicity.RESULTS: Both systemic and regional therapies were tolerated well; no severe toxicity (WHO Ⅲ/Ⅳ) was encountered. Nausea and fever were the most commonly observed side effects. A progressive rarefication of the intrahepatic arteries limited the maximum number of chemoembolization procedures in 4 patients. A median of 2 chemoembolization cycles (range, 1-3) and a median of 6.5 gemcitabine cycles (range, 4-11) were administered.Complete responses were not achieved. As maximum response, partial responses were achieved in 3 cases,stable diseases in 5 cases. Two patients died from progressive disease after 9 and 10 mo. Six patients are still alive. The current median survival is 12 mo (range, 9-18); the median time to tumor progression is 7 mo (range, 3-18). Seven patients suffered from tumor-related symptoms prior to therapy, 3 of these experienced a treatment-related clinical relief. In one patient the tumor became resectable under therapy and was successfully removed after 10 mo.CONCLUSION: The present results indicate that a combination of systemic gemcitabine therapy and repeated regional chemoembolizations is well tolerated and may enhance the ef
文摘Mechanical alloying and annealing at 1150 °C for 2 h under an argon atmosphere were used to prepare Ti-45S5 bioglass nanocomposites. Ti-45S5 bioglass material was chemically modified by silver. The antibacterial activity of Ti-10% 45S5 bioglass nanocomposite containing silver against Streptococcus mutans and Staphylococcus aureus was studied. Nanocomposites were characterized by X-ray diffraction, scanning electron microscopy equipped with an electron energy dispersive spectrometer and transmission electron microscopy to evaluate phase composition, crystal structure and grain size. In vitro bacterial adhesion study indicated a significantly reduced number of Streptococcus mutans and Staphylococcus aureus on the bulk nanostructured Ti-45S5 bioglass-Ag plate surface in comparison to that on microcrystalline Ti plate surface. Nanostructured Ti-based biomaterials can be considered to be the future generation of dental implants.
文摘A new kind of biomedical Ti-45S5 Bioglass-Ag nanocomposites and their scaffolds with antibacterial function was developed by the introduction of 1.5 wt% Ag into the Ti-10 wt% 45S5 Bioglass matrix. The microstructure, hardness and corrosion resistance in Ringer solution of the Ag-doped Ti-45S5 glass were investigated. The Vickers hardness of the bulk Ti-10 wt% 45S5 Bioglass-1.5 wt% Ag nanocomposites reached 480 HVo.3. Contact angles of water on the micro- crystalline Ti and nanostructured Ti-10 wt% 45S5 Bioglass-1.5 wt% Ag sample were determined and show visible decrease from 55.2° to 49.6°. In vitro tests culture of normal human osteoblast cells showed very good cells proliferation, colonization and multilayering. In vitro bacterial adhesion study indicated a significantly reduced number of bacteria （Staphylococcus aureus） on the bulk nanostructured Ti-10 wt% 45S5 Bioglass-1.5 wt% Ag plate surface in comparison with that on microcrystalline Ti plate surface. Development of porous Ti-10 wt% 45S5 Bioglass-1.5 wt% Ag scaffolds aims in enhancing bone ingrowth and prosthesis fixation.
基金partially sponsored by a grant of the Polish Ministry of Sciences and Higher Education(Number NN 304375238)
文摘Background: Asymmetry in the wild is a controversial, and to date, unresolved subject.Fluctuating asymmetry(FA) is the developmental instability(intra-individual variation) while, directional asymmetry(DA) expresses the asymmetry of the population mean.Methods: We analysed 63 Great Grey Shrike(Lanius excubitor) skins at the Naturalis Biodiversity Center, Leiden, the Netherlands.The black markings on the tails were digitized in order to evaluate the symmetry of the two sides of each shrike.Ptilochronology helped understand if nutritional condition affected symmetry.Results: ANOVA revealed no significant differences in size of the tail between sexes(F = 1.67, p > 0.05).However, there was significant difference in the shape of the black area in feathers between the sexes(F = 2.14, p < 0.05), and males had more elongated and slender black areas.Further, DA was observed only in males, but FA was noted in both sexes.Spearman correlation showed no significant association between FA score and tail features in both the sexes.However, in females, we observed a negative significant correlation between the number of fault and growth bars.The shape of the black area in the tail displayed no statistically significant association with the tail features in both sexes although growth bars influenced tail shape more than the number of fault bars.Conclusions: We concluded that the characteristics discovered by us need to also be checked in the field and if they can be used to sex individuals.Also, chromatic manipulative studies are require to verify if DA influences sexual selection in the Great Grey Shrike.
