Background:
The incidence of DLBCL increases with age, with over 40% of patients being 70 years old or older.
DLBCL has often treated with R‐CHOP (‐like) regimen of 6–8 course, but many elderly ...patients are exhausted during the treatment.
According to the CTCAE (ver5.0), weight change 10% from baseline was defined as grade 2.
However, in elderly DLBCL patients, the change effect on their survival.
Aims:
We conducted a retrospective cohort study examining the influence of change body weight after the first chemotherapy on their outcome and survival.
Methods:
Clinical records of 236 patients who had received R‐CHOP (‐like) regimen were retrospectively analyzed.
They were newly diagnosed DLBCLby WHO 2008 criteria.
They were treated at Japanese Red Cross Kyoto Daiichi Hospital between January 1st, 2008 and October 31st, 2018.
Data on clinical characteristics and treatment modalities were obtained by review of medical charts.
Body weight was taken as the average over 3 days before chemotherapy started.
We grouped as follows; old‐plus(≧ 70 years and weight change more than 10% over from baseline 10% over from baseline), old‐minus(≧ 70 years and not weight change 10% over from baseline), young‐plus(<70 years and weight change 10% over from baseline), young‐minus(<70 years and not weight change 10% over from baseline).
Progression‐free survival (PFS) and overall survival (OS) were estimated using the Kaplan‐Meier method.
We set the primary endpoint as the 5‐year overall survival (5yOS) which was evaluated by using a log‐rank test.
We defined 5yOS as the time from first chemotherapy to any cause of death.
Results:
We analyzed 236 patients (142 males, 94 females) and 131(55.6%) was 70 years and over.
65 patients were ECOG PS>1.
Old‐plus were 18 patients, and old‐minus were 113, young‐plus were 9, young‐minus were 96.
The 5‐year OS rate of all was 67.2% (95%Cl: 59.3–73.9%), PFS rate was 64.9% (95%Cl: 57.2–71.5%) in all patients. The average of change weight after the first therapy was 5.05%. In elderly patients changing in body weight more than 10% over from baseline after the first therapy had worse clinical outcomes with shorter 5yOS (63.3% vs. 18.7%, P <0.001 HR 3.469, 95% CI 1.708 to 7.048, see figure 1). However, there is no significant difference in young people
(5yOS 77.9% vs. 46.7%, P = 0.221 HR 2.113, 95% CI 0.62 to 7.202, see figure 2).
Summary/Conclusion:
Weight change 10% from baseline after the first therapy was associated with poor outcomes in elderly people with Newly Diagnosed DLBCL (see figure 3).
This could suggests that adjusting drug dosage in the second therapy in those patients will improve their survival.
Spontaneous hemopneumothorax is a rare clinical entity sometimes requiring an operation in the early stage. Two patients who underwent successful video-assisted thoracic surgery (VATS) for ...spontaneous hemopneumothorax are presented. In both cases, the bleeding point was clearly identified, and hemostasis was easily obtained by clipping the point and placing three access ports in the usual fashion. Furthermore, the evacuation of clotted blood and resection of bulla were performed with no difficulties. The postoperative courses were smooth, and no complications occurred, although the preoperative general condition in the second case was hemodynamically unstable. The advantages of VATS over conventional thoracotomy include less time required to access the pleural cavity, a better view, and more facilitated manipulation during surgery. Because spontaneous hemopneumothorax is a benign disease, VATS should be considered an initial treatment option in all patients with this condition, even those with active bleeding.
「Abstract」: Background and Objective: To find clinical factors associated with prognosis of implant, periodontal tissue of implants and the adjacent teeth was evaluated in long-term follow-up cases. ...Materials and Methods: Cases: 10 female patients (age of 40-70 years old) who had posterior implant placement and periodontal treatment on the adjacent teeth and 40 POI system implants were used; 1-10 year follow-up. Evaluation: 1. If there is marginal bone loss and periimplantitis 2. If there is attachment loss of the adjacent teeth and mobility 3. If there are any changes in interproximal contact point and occlusion 4. If occlusal guards are used Results: There were a few cases which had slight marginal bone loss. Periimplantitis was observed in a case which might be caused by occlusal trauma related with a most distally positioned implant. There was a case which had modest mobility related with occlusal interference. Use of occlusal guardwas not certain. Conclusion: No evidence of risk for implant placement adjacent to the periodontal treated teeth was found. However, control of periodontal tissue and occlusal force is important in patients who had implants and periodontal treated teeth. In addition, it is necessary for patients and dentists to understand importance of maintenance/follow-up phase.
We describe quantum monte carlo simulations of the static and dynamic properties of the one dimensional boson Hubbard model, emphasizing the extent to which an external confining potential modifies ...the behavior. While the superfluid-Mott insulator quantum phase transition no longer exists when the system is confined, Mott and superfluid regions persist locally in the system. We construct a 'state diagram' based on the local density and compressibility profiles. Solitons present in the dynamics of the unconfined system survive the addition of a trapping potential.
The phase diagram of a Hamiltonian which describes a particle moving in a periodic potential and coupled to an external heat bath has been analyzed in detail. By renormalization-group methods, it is ...proved that this system exhibits an unusual transition between diffusive behavior and a self-trapped phase. The dynamics along the transition line is shown to be integrable and the order parameter, the mobility, is computed exactly.
On the basis of quantum Monte Carlo (QMC) simulations we study the formation of Mott domains in the one-dimensional Hubbard model with an additional confining potential. We find evidences of quantum ...critical behavior at the boundaries of the Mott-insulating regions. A local compressibility defined to characterize the local phases exhibits a non-trivial critical exponent on entering the Mott-insulating domains. Both the local compressibility and the variance of the local density show universality with respect to the confining potential. We also study the momentum distribution function of the trapped system, and determine its phase diagram.
The limit of infinitely strong interaction is the relevant one for understanding the low energy sector of strongly correlated electronic systems like high-temperature superconductors and new related ...compounds like the so-called ladder materials. The
t-
J model is the generic one, where strong correlation is taken into account by projecting out doubly occupied sites. We present simulations for both the single-hole and finite doping cases of the
t-
J model performed with newly developed quantum Monte Carlo algorithms, in chains, ladders, and planes, where the spectral function and the quasiparticle weight are obtained.
This paper gives a guideline for preparation of anatase TiO
2 films by pulsed laser deposition (PLD) technique, and the mechanism of preferential formation of anatase is described. The TiO
2 films ...with different thicknesses, 50, 100 and 300 nm, were prepared on quartz-glass substrates by Nd:YAG pulsed laser deposition, and subsequently annealed in air at 500 and 1000 °C. Their structures and optical properties have been investigated. The as-deposited film with a thickness of 50 nm was a mixture of amorphous, anatase and rutile. Anatase still existed after annealing for 1 h at 1000 °C. In contrast, the anatase phase was not present in the 300 nm thick film and only the rutile phase was observed. In the film with a thickness of 100 nm, anatase was found only in the as-deposited state. It has been revealed experimentally that the anatase phase is formed when the as-deposited films have an amorphous structure. This is strongly supported by an additional experiment using a sapphire single-crystal substrate. A micromechanical calculation substantiates that the anatase formation from the amorphous phase is preferred in terms of the strain energy and Gibbs free energy.
PDF
