We conducted a multicenter, randomized trial to compare preoperative chemoradiotherapy followed by surgery with surgery alone in patients with stage I and II squamous-cell cancer of the esophagus.
...The preoperative combined therapy consisted of two one-week courses; each involved radiotherapy, in a dose of 18.5 Gy delivered in five fractions of 3.7 Gy each, and 80 mg of cisplatin per square meter of body-surface area, administered 0 to 2 days before the first day of radiotherapy. The surgical plan included one-stage en bloc esophagectomy and proximal gastrectomy by the abdominal and right thoracic routes, to be performed immediately after randomization in the group assigned to surgery alone and two to four weeks after the completion of preoperative chemoradiotherapy in the group assigned to combined therapy.
A total of 297 patients entered the study; 11 were found to be ineligible, and 4 were lost to follow-up. Of the remaining 282, 139 were assigned to surgery alone and 143 to combined therapy. After a median follow-up of 55.2 months, no significant difference in overall survival was observed; the median survival was 18.6 months for both groups. As compared with the group treated with surgery alone, the group treated preoperatively had longer disease-free survival (P=0.003), a longer interval free of local disease (P=0.01), a lower rate of cancer-related deaths (P=0.002), and a higher frequency of curative resection (P=0.017). However, there were more postoperative deaths (P=0.012) in the group treated preoperatively with chemoradiotherapy. Three prognostic factors were found to influence survival in a multivariate analysis: the disease stage, based on computed tomography; the location of the tumor; and whether the surgical resection was curative.
In patients with squamous-cell esophageal cancer, preoperative chemoradiotherapy did not improve overall survival, but it did prolong disease-free survival and survival free of local disease.
A new method of sequential extraction of proteins followed by quantitative and qualitative determination by reverse-phased high-performance liquid chromatography (RP-HPLC) was used to analyse the ...effect of environmental conditions (3N fertilisation rates, two varieties, two sites and two growing seasons) on quantitative and qualitative variation of wheat storage proteins. The results showed that
N supply (fertilisation and site) was the most important environmental factor affecting protein content and composition. The most important effect was quantitative: the total protein, protein unit and subunit contents increased with the supply of nitrogen to the grain. As grain protein increased, the gliadin and glutenin contents and the gliadin to glutenin ratio increased. Gliadin showed a higher correlation with total protein content than glutenin. In the variety Rinconada, glutenin content was higher than that in Bancal. As total glutenin increased, both high and low-molecular weight (HMW and LMW) fractions increased and their ratio (HMW/LMW) did not change significantly, despite a slope of LMW subunits two times greater (0.69) than that of HMW fractions (0.31). The quantity of each HMW subunit (RP-HPLC peak) increased with total HMW-glutenin, but their relative percentage increased for some peaks and decreased for others. The composition of the HMW subunit was more stable in Bancal than in Rinconada. This general pattern of variation was also characteristic of the LMW subunit. Concerning gliadin composition we noted that the content of different gliadin monomers (RP-HPLC peaks) or pools of monomers (α-, β-, γ-, ω-gliadin) increased with total gliadin content. The proportion of certain peaks was stable whereas the contribution of other peaks was related to the variation in gliadin content and depended on the variety.
The transition quadrupole moments, Qt, of four weakly populated collective bands up to spin ∼65ℏ in 157,158Er have been measured to be ∼11 eb demonstrating that these sequences are associated with ...large deformations. However, the data are inconsistent with calculated values from cranked Nilsson–Strutinsky calculations that predict the lowest energy triaxial shape to be associated with rotation about the short principal axis. The data appear to favor either a stable triaxial shape rotating about the intermediate axis or, alternatively, a triaxial shape with larger deformation rotating about the short axis. These new results challenge the present understanding of triaxiality in nuclei.
.
Excited states of the rubidium isotopes
37
87, 89, 91
Rb have been studied at the INFN Legnaro National Laboratory. Measurements of the
γ
-ray decay of fragments produced in binary grazing ...reactions resulting from the interaction of a beam of 530 MeV
96
Zr ions with a
124
Sn target have been complemented by studies of the
γ
-ray decay of fission fragments produced in the interaction of a beam of 230 MeV
36
S ions with a thick
176
Yb target. The structure of the yrast states of
37
87, 89, 91
Rb has been discussed within the context of spherical shell-model and cranked Nilsson-Strutinsky calculations.
Atmospheric Gravity Waves (AGWs) frequently occur around near coastal offshore wind farms. Yet our understanding of how they interact with individual turbines and whole farm energy output is limited. ...This research uses computational fluid dynamics modelling to investigate the impact of near coastal, topographically forced AGWs on offshore wind farm power output in a theoretical wind farm. Preliminary results show the farm contained within one wavelength (4.9km) of the topographically forced AGW. The AGW causes a substantial variation in wind speed across the farm with a subsequent 76% variation in power output compared to 29% in the control case.
L’année 2015 a de nouveau été marquée par l’absence de moniteur de débit Transonic® au sein de notre centre lourd. Nous souhaitions confirmer notre hypothèse comme quoi les fistules natives ...représentent une fréquence relativement plus élevée de thrombose. Le rôle central du diabète dans l’altération vasculaire et la dysfonction endothéliale semble intervenir dans notre cohorte.
Étude rétrospective sur 24 mois (du 01/01/2014 au 31/12/2015). Des données complémentaires ont été intégrées : néphropathie initiale, tabagisme, index de Charlson, mobilité, IMC, décès, intervalle entre deux thromboses.
Trente-six patients ont été inclus (âge moyen 74,3ans±10,5 – 69,4 % d’hommes). Cinquante pour cent des patients ont 75ans et plus. Quarante et un pour cent ont une néphropathie d’origine diabétique et 16 % vasculaire. Soixante-quatre pour cent ont un IMC>25 et 38 %>30 (max 48). Soixante-quatre pour cent des patients sont diabétiques.
Quatre-vingt-quatorze épisodes de thromboses soit 2,61 t/p±2,06. Cinquante-cinq pour cent ont thrombosé au moins 2 fois. L’intervalle moyen entre deux thromboses est de 3,76 mois (min 3 j–max 18 mois). Quarante-quatre pour cent des thromboses concernent les fistules natives et 56 % les prothèses. Quatre-vingt pour cent de l’ensemble des abords ont des antécédents de sténose veineuse. La récidive de thrombose est associée au diabète et au tabagisme ancien (p<0,05 Chi2). Les fistules natives avec récidive de thrombose sont associée au diabète et à l’AOMI (p<0,05 Chi2).
Cette étude confirme la nécessité d’un protocole de surveillance des débits afin de prévenir les thromboses de fistule. Le pourcentage élevé d’épisodes thrombotiques nous permet d’identifier deux éléments cliniques pertinents : les fistules natives ont une fréquence élevée de thrombose ; les récidives de thrombose d’un abord sont fréquentes, elles concernent plutôt les prothèses (70 %). L’épidémiologie actuelle semble jouer un rôle clé dans le caractère récidivant des thromboses. L’hyperplasie endothéliale est liée au syndrome urémique, aux contraintes de cisaillement, à l’hypoxie et à l’inflammation.
Diabète, tabagisme ancien et lésions d’artériopathie périphériques sont des facteurs de risque vasculaire bien identifiés. Leur déterminisme dans la récidive des thromboses interfère certainement avec ces mécanismes d’altération endothéliale.
Pelvic malignancies frequently require post-operative radiation therapy that may induce small bowel damage at an incidence of 5–25%. Various surgical techniques have been reported to prevent acute ...and chronic radiation enteritis. This article describes the technical aspects of pelvic exclusion by an intrapelvic silicone breast prosthesis.
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