Diffuse large B-cell lymphoma (DLBCL) is the most common hematologic malignancy worldwide. Although substantial improvement has been achieved by the frontline rituximab-based chemoimmunotherapy, up ...to 40%-50% of patients will eventually have relapsed or refractory disease, whose prognosis is extremely dismal.
We have carried out two prospective cohort studies that include over 1,500 DLBCL patients treated with rituximab plus CHOP (#NCT01202448 and #NCT02474550). In the current report, we describe the outcomes of refractory DLBCL patients. Patients were defined to have refractory DLBCL if they met one of the followings, not achieving at least partial response after 4 or more cycles of R-CHOP; not achieving at least partial response after 2 or more cycles of salvage therapy; progressive disease within 12 months after autologous stem cell transplantation.
Among 1,581 patients, a total of 260 patients met the criteria for the refractory disease after a median time to progression of 9.1 months. The objective response rate of salvage treatment was 26.4%, and the complete response rate was 9.6%. The median overall survival (OS) was 7.5 months (95% confidence interval, 6.4 to 8.6), and the 2-year survival rate was 22.1%±2.8%. The median OS for each refractory category was not significantly different (p=0.529).
In line with the previous studies, the outcomes of refractory DLBCL patients were extremely poor, which necessitates novel approaches for this population.
A two-dimensional electron gas (2DEG) was formed at the interface of an ultrathin Al2O3/TiO2 heterostructure that was fabricated using atomic layer deposition (ALD) at a low temperature (<300 °C) on ...a thermally oxidized SiO2/Si substrate. A high electron density (∼1014 cm–2) and mobility (∼4 cm2 V–1 s–1) were achieved, which are comparable to those of the epitaxial LaAlO3/SrTiO3 heterostructure. An in situ resistance measurement directly demonstrated that the resistance of the heterostructure interface dropped significantly with the injection of trimethylaluminum (TMA), indicating that oxygen vacancies were formed on the TiO2 surface during the TMA pulse in the ALD of Al2O3 films, such that they provide electron donor states to generate free electrons at the interface of the ultrathin Al2O3/TiO2 heterostructure. The activation energy of the electron donor states to move to the Ti 3d conduction band plays an essential role in the electrical characteristics of the 2DEG. Interestingly, the donor state level can be tailored by the control of TiO2 crystallinity, which eventually adjusts the electron density. The activation energy was decreased to less than 20 meV to generate ultrashallow donor states while improving the TiO2 crystallinity, such that the 2D electrons become readily delocalized, even at room temperature, to create a 2DEG.
The purpose of this study was to identify the characteristics of supernumerary teeth, analyze the associated complications, and to present new clinical knowledge on surgical interventions for ...supernumerary teeth.
This retrospective cohort study was based on the medical records and radiographic records of patients who underwent surgical extraction of supernumerary teeth. The relationships among the patient's age, gender, anatomic features of supernumerary teeth, and presence and type of complications (i.e., spacing, rotation, delayed eruption of the adjacent tooth, cyst formation.) were investigated. The groups were compared by using the Mann-Whitney U test, the Kolmogorov-Smirnov test, and multiple logistic regression analysis (P < .05).
The study population consisted of 705 participants who underwent extraction for 1036 supernumerary teeth. The mean age of the participants was 11.5 years, and 73.5% of the participants were males. The complication rate was 55.6%. Variables associated with an increased risk of complications were the patient's age, dentition, tuberculate shape, and horizontal direction of eruption (P < .05).
An increase in the patient's age or abnormalities in the shape and direction of eruption of supernumerary teeth was associated with complications. These parameters should be considered while formulating the treatment plan.
Many studies have been recently reported that veterinary antibiotics released into the environment have a detrimental effect on humans such as the occurrence of antibiotic-resistant bacteria. ...However, only limited information is available regarding to the release of antibiotics in environmental compartments in Korea. Objectives of this study were to evaluate the concentrations of antibiotics in water, sediment, and soil adjacent to a composting facility in Korea and to determine the dilution effects of antibiotics when released into the environment. Seven antibiotics of chlortetracycline, oxytetracycline, tetracycline, sulfamethazine, sulfamethoxazole, sulfathiazole, and tylosin were evaluated by high-performance liquid chromatography–tandem mass spectrometry following pretreatment using solid-phase extraction to clean the samples. Results showed that the highest concentration of each antibiotic in both aqueous and solid samples was detected from a site adjacent to the composting facility. We also found that the studied water, sediment, and soil samples are contaminated by veterinary antibiotics throughout comparison with studies from other countries. However, relatively lower concentrations of each antibiotic were observed from the rice paddy soil located at the bottom of the water stream. Further research is necessary to continuously monitor the antibiotics release into ecosystems, thereby developing an environmental risk assessment.
Background: hemorrhagic transformation (HT) is a frequent complication of ischemic stroke, and parenchymal hematoma (PH)-type HT has been shown to correlate with symptomatic deterioration. Because ...both bone and vascular smooth muscle cells are composed of type 1 collagen, we hypothesized that the integrity of blood vessels around the infarction area might be more damaged in osteoporotic conditions after a cardioembolic stroke. Methods: we measured frontal skull Hounsfield unit (HU) values on brain CT images from cardioembolic stroke patients. We conducted a receiver operating characteristic curve analysis in a large sample registry to identify the optimal HU threshold for predicting osteopenia and osteoporosis. Hazard ratios were estimated using a Cox regression analysis to identify whether osteoporotic conditions were an independent predictor of PH-type HT in patients with cardioembolic stroke. Results: altogether, 600 consecutive patients (>18 years old) with cardioembolic stroke were enrolled over a 12-year period at our hospital. The infarction volume and hypothetical osteoporosis were independent predictive factors for PH-type HT development in patients with cardioembolic stroke. In the male group, hypothetical osteoporosis was an independent predictor for PH-type HT development after cardioembolic stroke (hazard ratio, 4.12; 95% confidence interval, 1.40–12.10; p = 0.010). Conclusions: our study suggests an association between possible osteoporosis and the development of PH-type HT in patients with cardioembolic stroke. Our findings could help to predict PH-type HT by providing a convenient method for measuring the HU value using brain CT images.
Background and purpose
This study aimed to evaluate the efficacy of intra-arterial thrombectomy (IAT) and prognosis for acute ischaemic stroke patients with active cancer.
Methods
We retrospectively ...reviewed 253 patients who underwent IAT within 24 h after stroke onset between January 2012 and August 2017. We classified the patients into active cancer (
n
= 26) and control groups (
n
= 227) and compared clinical data. Primary outcome was a modified Rankin scale score at 3 months with ordinal logistic regression (shift analysis).
Results
Initial National Institutes of Health Stroke Scale (NIHSS) and rate of successful recanalisation did not differ between groups, but the active cancer group showed poor outcomes at 3 months on shift analysis (
P
= 0.001). The independent predictors of poor prognosis were age adjusted common odds ratio (aOR) 1.03, 95% confidence interval (CI) 1.01–1.05, baseline NIHSS (aOR 1.14, 95% CI 1.09–1.19), baseline C-reactive protein level (aOR 1.14, 95% CI 1.03–1.25), any cerebral haemorrhage (aOR 1.92, 95% CI 1.21–3.06), and active cancer (aOR 2.35, 95% CI 1.05–5.25). Mortality at 90 days was 30.8% in the cancer group and 8.8% in the control group (
P
= 0.003).
Conclusions
Although baseline characteristics and recanalisation rate after IAT up to 24 h after stroke onset were similar between acute ischaemic stroke patients with active cancer and without any cancer, stroke-related death and short-term outcome were significantly poorer in patients with active cancer than the controls. Post-procedural haemorrhage and active cancer itself were independent predictors of a decrease in functional independence at 3 months.
An organic catalyst “(R, R)-1,2-diphenylethylenediamine(DPEN) derivative’’ was devel-oped as a chiral bifunctional organocatalyst and applied for asymmetric Michael additions of aromatic ketones to ...trans-β-nitroalkene compounds under neutral conditions. The isopropyl-subs-tituted thiourea catalyst in neutral condition provides high chemical yield and enantioselectivities (ee) (up to 96% yield, 98% ee).
Aim
To evaluate the effectiveness of adjuvant treatment for morcellated, uterus‐confined leiomyosarcoma in a multicenter setting.
Methods
We identified patients with International Federation of ...Gynecology and Obstetrics stage I uterine leiomyosarcoma primarily treated with surgery between 2003 and 2016. Among them, patients who underwent one of the following morcellation methods were included: (i) power morcellation; (ii) intracorporeal morcellation using scalpels or electrocautery; and (iii) vaginal morcellation. Patients' survival outcomes were compared according to the implementation of adjuvant treatment.
Results
From 13 institutions, 55 patients were included; 31 for adjuvant treatment group and 24 for surgery only group. The clinicopathological characteristics including the mass size, morcellation methods, extent of surgery, and mitotic count were similar between the groups. In the adjuvant treatment group, 67.7%, 19.4% and 12.9% of patients received chemotherapy, chemoradiation and radiation, respectively. After a median follow‐up of 50.5 months, the adjuvant treatment and surgery only groups showed similar overall survival (5‐year rate, 92.0% vs 90.4%; P = 0.959). No significant difference in progression‐free survival was observed between the two groups (3‐year rate, 46.1% vs 78.2%; P = 0.069). On multivariate analyses, adjuvant treatment did not affect progression‐free survival (adjusted HR, 2.138; 95% CI, 0.550–8.305; P = 0.273). The adjuvant treatment group showed a trend towards more common distant metastasis, compared to the surgery only group (25.8% vs 4.2%; P = 0.062). The incidences of pelvic, retroperitoneal, and abdominal recurrences were not different between the groups.
Conclusion
Despite its frequent use in clinical practice, adjuvant treatment did not improve the survival outcomes of patients with morcellated, International Federation of Gynecology and Obstetrics stage I uterine leiomyosarcoma.
Aim
The present cross‐sectional study was carried out among community‐dwelling Koreans to determine the validity of various muscle mass indices and to propose more clinically relevant diagnostic ...criteria.
Methods
This study measured the anthropometrics, body composition and physical capability of 415 older Koreans. Skeletal muscle indices were calculated by dividing appendicular lean mass by height or weight. Apart from this, we adjusted appendicular lean mass for body mass index, body surface area or waist‐to‐height ratio, which we then named the qualitative muscle mass index. Skeletal muscle function deficit was defined as a combination of weakness and slowness.
Results
Qualitative muscle indices were closely associated with physical capabilities. Receiver operating characteristic and logistic analyses showed that qualitative muscle indices had significantly greater discriminatory powers regarding low muscle function than did the height‐adjusted index in both men and women, and even showed higher discriminatory potentials than the weight‐adjusted index in men (all P < 0.05). The cut‐off values of qualitative muscle indices of body mass index‐, body surface area‐, and waist‐to‐height ratio‐adjusted indices for identifying functional deficits were 0.760, 11.40 and 34.18 for men, and 0.530, 8.91 and 23.07 for women, respectively.
Conclusions
The present study suggests that qualitative muscle indices are more accurate in predicting low muscle function than are height‐ and weight‐adjusted indices, because they consider anthropometric characteristics as part of the definition. The results might provide new avenues for conceptualizations of sarcopenia accompanied by obesity, and can be used as ethnic‐specific reference values of muscle mass indices based on functional outcome in an elderly Korean/Asian population. Geriatr Gerontol Int 2017; 17: 99–107.
Summary Background Vascularized bone grafts for the treatment of Kienböck’s disease may facilitate revascularization and remodeling of the avascular lunate. The aim of this study was to evaluate the ...radiological and clinical results obtained when a fourth extensor compartmental artery (ECA) bone graft was used to treat Kienböck’s disease. Methods Between May 2009 and June 2012, 13 patients (6 men, 7 women) with Kienböck’s disease were treated with placement of fourth ECA vascularized bone grafts. The mean patient age was 39.2 (20–58) years, and the mean follow-up period was 32.5 (12–72) months. At the time of surgery, One patient had Lichtman’s stage II Kienböck’s disease, 11 stage IIIA disease, and one stage IIIB disease. We measured the pre- and post-operative ranges of motion, pain, grip strength, and radiological parameters, including the carpal height ratio and the radioscaphoid angle. Results At the last follow-up, pain was significantly reduced, and grip strength had improved from 60.5% to 87.8% relative to that of the contralateral side. The mean range of motion for flexion had improved from 39° to 53° while that of wrist joint extension improved from 41° to 56°. There were little or no changes in either the carpal height ratio or the radioscaphoid angle (both p values > 0.05). Conclusions Placing of a fourth ECA vascularized bone graft is a reliable alternative to other revascularization procedures for treatment of Kienböck’s disease. Such grafting is effective, minimally invasive, and associated with a low risk of pedicle kinking.
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