Uterine sarcomas are rare and comprise only 3% of all uterine cancers. Within the group of adult soft tissue sarcomas, they account for ∼7% of new cases. They consist of several distinct histological ...subtypes like leiomyosarcoma, endometrial stromal tumors, undifferentiated sarcomas, pure heterologous sarcomas, and mixed epithelial and mesenchymal tumors. Standard treatment in localized disease is abdominal hysterectomy. Bilateral salpingo-oophorectomy and lymphadenectomy have no proven value in leiomyosarcomas and high-grade undifferentiated sarcomas. However, in endometrial stromal tumors, given the hormonal reponsiveness of most tumors, salpingo-oophorectomy is generally recommended. Carcinosarcomas are treated according to current recommendations for epithelial uterine cancers. In leiomyosarcomas, postoperative radiation does not improve both relapse-free and overall survival. adjuvant chemotherapy seems to improve survival in the context of uncontrolled phase II trials. However, it is currently not considered standard of care in the absence of data from randomized trials. In contrast, adjuvant chemotherapy does improve overall survival in carcinosarcomas and is therefore considered standard of care. Systemic therapy for advanced uterine leiomyosarcomas, undifferentiated uterine sarcomas, and heterologous sarcomas is generally following the recommendations for adult soft tissue sarcomas. Endometrial stromal sarcomas are usually hormonal receptor positive, which allows endocrine therapy in most cases.
Plastic particles smaller than 5mm, so called microplastics have the capability to accumulate in rivers, lakes and the marine environment and therefore have begun to be considered in eco-toxicology ...and human health risk assessment. Environmental microplastic contaminants may originate from consumer products like body wash, tooth pastes and cosmetic products, but also from degradation of plastic waste; they represent a potential but unpredictable threat to aquatic organisms and possibly also to humans. We investigated exemplarily for polyethylene (PE), the most abundant constituent of microplastic particles in the environment, whether such fragments could be produced from larger pellets (2mm×6mm). So far only few analytical methods exist to identify microplastic particles smaller than 10μm, especially no imaging mass spectrometry technique. We used at first time-of-flight secondary ion mass spectrometry (ToF-SIMS) for analysis and imaging of small PE-microplastic particles directly in the model system Ottawa sand during exposure to sea surf simulation. As a prerequisite, a method for identification of PE was established by identification of characteristic ions for PE out of an analysis of grinded polymer samples. The method was applied onto Ottawa sand in order to investigate the influence of simulated environmental conditions on particle transformation. A severe degradation of the primary PE pellet surface, associated with the transformation of larger particles into smaller ones already after 14days of sea surf simulation, was observed. Within the subsequent period of 14days to 1month of exposure the number of detected smallest-sized particles increased significantly (50%) while the second smallest fraction increased even further to 350%. Results were verified using artificially degraded PE pellets and Ottawa sand.
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•Pre-production microplastic pellets were used to evaluate the methodology•Secondary microplastic < than 10μm can be detected directly in sea sand•Surface Ions of microplastic particles were used to identify them in sea sand matrix•Chemical images gave size distribution patterns of microplastic particles in matrix•Larger microplastic particles were exposed to a sea surf simulation•Particle number (<10μm) increased from 14 to 31d exposure
Docetaxel/cisplatin/infusional 5-fluorouracil (5-FU; DCF) is a standard chemotherapy regimen for patients with advanced gastric cancer (GC). This phase II study evaluated docetaxel/oxaliplatin (TE), ...docetaxel/oxaliplatin/5-FU (TEF), and docetaxel/oxaliplatin/capecitabine (TEX) in patients with advanced GC.
Patients with metastatic or locally recurrent gastric adenocarcinoma (including carcinoma of the gastro-oesophageal junction) were randomly assigned (1 : 1 : 1) to TE, TEF, or TEX. Each regimen was tested at two doses before full evaluation at optimized dose levels. The primary end point was progression-free survival (PFS). Overall survival (OS), tumour response, and safety were also assessed. A therapeutic index (median PFS relative to the incidence of febrile neutropenia) was calculated for each regimen and compared with DCF (historical data).
Overall, 248 patients were randomly assigned to receive optimized dose treatment. Median PFS was longer with TEF (7.66 95% confidence interval (CI): 6.97–9.40 months) versus TE (4.50 3.68–5.32 months) and TEX (5.55 4.30–6.37 months). Median OS was 14.59 (95% CI: 11.70–21.78) months for TEF versus 8.97 (7.79–10.87) months for TE and 11.30 (8.08–14.03) months for TEX. The rate of tumour response (complete or partial) was 46.6% (95% CI 35.9–57.5) for TEF versus 23.1% (14.3–34.0) for TE and 25.6% (16.6–36.4) for TEX. The frequency and type of adverse events (AEs) were similar across the three arms. Common grade 3/4 AEs were fatigue (21%), sensory neuropathy (14%), and diarrhoea (13%). Febrile neutropenia was reported in 2% (TEF), 14% (TE), and 9% (TEX) of patients. The therapeutic index was improved with TEF versus TEX, TE, or DCF.
These results suggest that TEF is worthy of evaluation as an arm in a phase III trial or as a backbone regimen for new targeted agents in advanced GC.
Trial registration number: NCT00382720.
Abstract Background Patients with gastrointestinal stromal tumour (GIST) are often followed up after surgery with longitudinally repeated imaging examinations to detect recurrence early. Studies on ...follow-up of GIST patients are few, the optimal follow-up methods are unknown and the recommendations for follow-up vary in guidelines. Methods We reviewed the current evidence for follow-up of patients treated with surgery alone and of patients who were treated with adjuvant or neoadjuvant imatinib. Results Imaging of the abdomen and the pelvis with computerised tomography (CT) or magnetic resonance imaging (MRI) usually suffices, since metastases are uncommon at other sites. The frequency of imaging may be adjusted with the risk of recurrence with time. Very low risk GISTs are very frequently cured with surgery and usually require no regular follow-up after complete surgery, and annual CT of the abdomen and the pelvis for 5 years suffices for most patients with a low to intermediate risk for recurrence. Most high-risk patients are treated with imatinib for at least 3 years after surgery. CT or MRI may be carried out 6-monthly during adjuvant imatinib, 3 to 4-monthly during the 2 years that follow discontinuation of imatinib when the risk of recurrence is high, and then at 6–12 month intervals to complete 10 years of follow-up. Recurrence after the first 10 years of follow-up is infrequent. Conclusions The follow-up schedules are best tailored with the risk of recurrence. The risk of recurrence should be estimated with the prognostic tools that consider the most relevant prognostic factors.
Local recurrence (LR) in osteosarcoma is associated with very poor prognosis. We sought to evaluate which factors correlate with LR in patients who achieved complete surgical remission with adequate ...margins.
We analyzed 1355 patients with previously untreated high-grade central osteosarcoma of the extremities, the shoulder and the pelvis registered in neoadjuvant Cooperative Osteosarcoma Study Group trials between 1986 and 2005. Seventy-six patients developed LR.
Median follow-up was 5.56 years. No participation in a study, pelvic tumor site, limb-sparing surgery, soft tissue infiltration beyond the periosteum, poor response to neoadjuvant chemotherapy, failure to complete the planned chemotherapy protocol and biopsy at a center other than the one performing the tumor resection were significantly associated with a higher LR rate. No differences were found for varying surgical margin widths. Surgical treatment at centers with small patient volume and additional surgery in the primary tumor area, other than biopsy and tumor resection, were significantly associated with a higher rate of ablative surgery.
Patient enrollment in clinical trials and performing the biopsy at experienced institutions capable of undertaking the tumor resection without compromising the oncological and functional outcome should be pursued in the future.
Solid-State Qubits with Current-Controlled Coupling Hime, T; Reichardt, P.A; Plourde, B.L.T ...
Science (American Association for the Advancement of Science),
12/2006, Letnik:
314, Številka:
5804
Journal Article
Recenzirano
The ability to switch the coupling between quantum bits (qubits) on and off is essential for implementing many quantum-computing algorithms. We demonstrated such control with two flux qubits coupled ...together through their mutual inductances and through the dc superconducting quantum interference device (SQUID) that reads out their magnetic flux states. A bias current applied to the SQUID in the zero-voltage state induced a change in the dynamic inductance, reducing the coupling energy controllably to zero and reversing its sign.
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