Summary The present study aimed to analyse the treatment outcome of four cycles of CHOP (cyclophosphamide—vincristine—doxorubicin—prednisolone) followed by involved field radiation therapy (IF RT) ...for the treatment of stage I–II nasal natural killer (NK)/T-cell lymphoma. From March 1995 to December 1999, 17 patients (median age 41 years; range 30–66) with localized nasal NK/T-cell lymphoma were enrolled. B symptoms were noted in five patients (31%). Sixteen of seventeen patients (94%) were of low risk when classified according to the International Prognostic Index (IPI). The treatment plan consisted of four cycles of CHOP/ chemotherapy followed by IF RT of 45 Gy. Two patients received radiation during the first or second cycle of CHOP because of bleeding from the primary tumour site. Both patients achieved complete responses (CRs). In the remaining 15 patients, after 4 cycles of CHOP, 6 CRs and 3 partial responses (PRs) were achieved (53% of response rate). IF RT was given to six patients (four in CR, one in PR and one in PD), and all six patients achieved CR. Overall, CR was achieved in 10 of 17 patients (58%). The planned sequential chemoradiotherapy was completed in only 6 of 17 patients (35%) because of the progression during chemotherapy. None of the patients who achieved CR experienced relapse of lymphoma during follow-up. The estimated overall three-year survival rate was 59%. In univariate analysis, B symptoms and stage were significant prognostic factors for response and overall survival (P < 0.05). The present study suggests that four cycles of CHOP followed by IF RT is not satisfactory for treating patients with localized nasal NK/T-cell lymphoma, and that further exploration for improved therapy is needed.
Given the more comorbidities with a decline in physiologic reserve, it can be challenging to make appropriate treatment decisions in the elderly.
Here, we prospectively evaluated and compared the ...health-related quality of life (HRQOL) of patients aged ≥65 with aged <65 who were treated with a postoperative chemotherapy for completely resected stage Ib, II or IIIa non-small-cell lung cancer (NSCLC). Either four cycles of paclitaxel (Taxol)–carboplatin (PC) or vinorelbine–cisplatin (NP) was used. The HRQOL was assessed with EORTC QLQ-C30 and EORTC QLQ-LC13.
Between October 2008 and October 2011, a total of 139 patients (aged <65, n = 73; ≥65, n = 66) were enrolled, and 127 (91.4%) completed the questionnaire. Overall, the quality of life (QOL) in elderly patients did not significantly deteriorate with adjuvant chemotherapy and the time trend of QOL in elderly patients was similar to that of younger patients. Although the elderly suffered from increased treatment-related adverse events involving sore mouth, peripheral neuropathy and alopecia compared with the baseline, the same time trends were also observed in younger group. The mean dose intensities (MDIs) for PC and NP regimen were not significantly different between the two age groups.
Postoperative chemotherapy did not substantially reduce HRQOL in elderly NSCLC patients, and HRQOL during and after adjuvant chemotherapy did not significantly differ by age.
Natural polymer-based drug carriers have been developed for antimicrobial applications but several problems remain with their poor controllability of drug loading and degradation. We introduce a ...novel method to produce improved antibiotic alginate fiber with high drug entrapment properties and a delayed degradation profile. A microfluidic spinning system with a low-polarity isopropyl alcohol (IPA) sheath flow was used to dehydrate an alginate/ampicillin aqueous solution and to form densely packed fiber with enhanced drug loading efficiency. The amounts of ampicillin initially loaded in the IPA-fiber were much higher than in the conventional water-based fiber and they released a more prolonged profile. The fibers were characterized by analyzing the morphology, mass loss and structural properties. The fibers were also used for an
in vivo
infected wound healing study. The results showed that the IPA-based fibrous alginate drug carrier possesses superior properties for loading drugs and potentials for wound healing applications with easy management.
Natural polymer-based drug carriers have been developed for antimicrobial applications but several problems remain with their poor controllability of drug loading and degradation.
ICA-ophthalmic artery aneurysms have unique configurations corresponding to relative risks of ophthalmologic morbidities. Presented herein are clinical and radiologic outcomes of coil embolization in ...ophthalmic artery aneurysms.
From January 2003 to September 2013, endovascular coiling was performed in 43 consecutive patients with ophthalmic artery aneurysms, each classified by the degree to which the ophthalmic artery was incorporated by the aneurysm and the contiguity between the ophthalmic artery entry and parent ICA. Clinical and radiologic outcomes of this approach were investigated, including the technical aspects of treatment and the efficacy of balloon test occlusion.
Among 14 patients (32.6%, all ophthalmic artery types) undergoing balloon test occlusion before endovascular coiling, patent collaterals between the external carotid artery and ophthalmic artery were demonstrated in 12 (85.7%) and complete compromise of the ophthalmic artery (without affecting vision) occurred in 4 patients during coiling. Steam-shaped S-configured (67.9%) or straight microcatheters (17.8%) facilitated aneurysm selection in most of the superiorly directed ophthalmic artery aneurysms (n = 28), and steam-shaped pigtail microcatheters (85.7%) were useful in medially directed aneurysms (n = 14). Balloon protection (n = 22) was generally used to facilitate coiling, or a stent (n = 9) was alternatively deployed. Satisfactory aneurysmal occlusion was achieved through coil embolization in 37 lesions (86.1%). During follow-up of 35 patients (mean interval, 12.9 ± 9.4 months), only 1 instance (2.9%) of major recanalization was observed.
If one tailors technical strategies, ophthalmic artery aneurysms are amenable to safe and effective endovascular coil embolization, which tends to be stable in follow-up. Balloon test occlusion may be helpful in devising treatment strategies to preserve vision when coiling ophthalmic artery aneurysms (especially those incorporating an ophthalmic artery origin) is done.
Background
The development of dermatitis on face and neck, which was not described in phase 3 clinical trials, has been reported in the literature in patients treated with dupilumab. Little is known ...regarding the causes or defining features of the facial dermatitis.
Objectives
We conducted surveys of consecutive patients with AD on dupilumab to describe its clinical features, morphology and aetiology.
Methods
A multi‐centre prospective cohort study was conducted from 1 January 2020, to 31 December 31 2020. A total of 162 patients under dupilumab treatment were asked to complete a questionnaire and patients were evaluated by dermatologists.
Results
Of all 162 patients, 137 (84.6%) patients reported pre‐existing facial dermatitis prior to dupilumab therapy. One hundred and twenty‐one (88.3%) patients with pre‐existing facial dermatitis reported improvement of their facial dermatitis with dupilumab therapy, nine (6.6%) patients reported no change after the treatment and seven (4.3%) patients of them got worse after the treatment (exacerbation group). Of 25 patients who reported no pre‐existing active facial dermatitis, six (24%) patients reported new‐onset facial erythema after the starting dupilumab therapy (new‐onset group). A large proportion of the patients in both the exacerbation (86%) and new‐onset groups (67%) had a history of facial TCS use. Both groups showed similar clinical manifestations and distribution with few differences.
Conclusions
The vast majority of patients treated with dupilumab in academic institutions from Korea and the United States experienced improvement in their facial dermatitis with dupilumab therapy. A small proportion of patients had new onset and exacerbation. Although the mechanisms of this adverse event remain unclear, steroid withdrawal should be considered as a diagnosis of the erythema in some patients.
Aim To identify the most effective manual aspiration thrombectomy (MAT) method for the initial endovascular management of acute deep-vein thrombosis (DVT) in the lower extremity using a phantom ...model. Materials and methods An acute DVT phantom model was created by infusing a bovine acute thrombus in a 20-mm diameter, 120-cm long plastic tube with banding of the distal portion. A total of 32 types of aspiration methods using combinations of two aspiration catheters (8 and 10 Fr), four syringes (10, 20, 40, and 50 ml), and four different aspiration methods (I, II, III, and IV) were performed. Each method was performed 10 times. The total weight of the aspirated thrombus was measured and compared among the 32 aspiration methods. The aspiration methods were classified based on the length of the dynamic catheter withdrawal (0 cm method I, 15 cm II, 30 cm III, or >45 cm IV) while maintaining continuous negative pressure using a syringe. Analysis of variance and Student's t -test were used for statistical analysis. Results There were no statistically significant differences in the total amount of aspirated thrombus among the various types of aspiration catheters and syringes; however, different aspiration methods showed significantly different results. Acute thrombus was most effectively aspirated by method IV irrespective of the catheter and syringe used. The longer the length of dynamic catheter withdrawal, the greater the amount of total thrombi that could be aspirated, irrespective of the type of aspiration catheter and syringe used (IV > III > II > I; p <0.05). Conclusion MAT can be performed most effectively using method IV. Effective MAT relies on the length of the dynamic catheter withdrawal while maintaining continuous negative pressure using a syringe in the initial endovascular management of acute DVT in the lower extremity.
Silicon Microelectromechanical Systems (MEMS) resonators have broad commercial applications for timing and inertial sensing. However, the performance of MEMS resonators is constrained by dissipation ...mechanisms, some of which are easily detected and well-understood, but some of which have never been directly observed. In this work, we present measurements of the quality factor, Q, for a family of single crystal silicon Lamé-mode resonators as a function of temperature, from 80-300 K. By comparing these Q measurements on resonators with variations in design, dimensions, and anchors, we have been able to show that gas damping, thermoelastic dissipation, and anchor damping are not significant dissipation mechanisms for these resonators. The measured f · Q product for these devices approaches 2 × 10
, which is consistent with the expected range for Akhiezer damping, and the dependence of Q on temperature and geometry is consistent with expectations for Akhiezer damping. These results thus provide the first clear, direct detection of Akhiezer dissipation in a MEMS resonator, which is widely considered to be the ultimate limit to Q in silicon MEMS devices.
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