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1.
BMC Musculoskelet Disord ; 23(1): 449, 2022 May 13.
Artículo en Inglés | MEDLINE | ID: mdl-35562717

RESUMEN

BACKGROUND: Advances in magnetic resonance imaging (MRI) have made it possible to find the vertebral body bruise (VBB), which was not found in computed tomography (CT) after trauma. There has been only one study with adult patients about whether traumatic VBB will cause a collapse of the vertebral body or not. The purpose is to elucidate the progression of VBB in non-osteoporotic adult patients and to identify the possible factors influencing the progression. METHOD: The VBB was defined on MRI as band-like or diffuse zones of high signal intensity on T2-weighted sequences without fracture of the cortex based on CT. The study population with traumatic VBB associated with non-osteoporotic spinal fracture was composed of 15 females and 21 males. The minimal follow-up period was 6 months. The ratio of anterior to posterior heights of the VBB, the ratio of anterior heights of the VBB to the average of those of cranial and caudal adjacent vertebral bodies, the anterior wedge angle of the VBB, and the focal angle around the VBB were compared between the initial and final visits. We evaluated the age of the patients, the C2 plumb line distance, the regional location of VBB, the etiology of VBB, and the treatment methods of the fractures as possible risk factors influencing the progression. RESULTS: There was no difference in the ratios and angles between the initial and final visits. The differences in the ratios and angles between the initial and final visits were not dependent on the possible risk factors. The anterior superior area is the most common in the distribution of VBB. CONCLUSIONS: Unlike compression fractures, the vertebral body with traumatic VBB found in adult patients with non-osteoporotic spinal fractures of AO classification A or B types did not develop collapse. In clinical practice, it is reasonable to diagnose it as a spinal fracture rather than a VBB if the collapse of a possible VBB occurs.


Asunto(s)
Contusiones , Fracturas por Compresión , Fracturas Osteoporóticas , Fracturas de la Columna Vertebral , Adulto , Femenino , Fracturas por Compresión/complicaciones , Humanos , Masculino , Fracturas Osteoporóticas/complicaciones , Estudios Retrospectivos , Fracturas de la Columna Vertebral/complicaciones , Fracturas de la Columna Vertebral/etiología , Vértebras Torácicas/lesiones , Cuerpo Vertebral
2.
Nano Lett ; 21(12): 5186-5194, 2021 Jun 23.
Artículo en Inglés | MEDLINE | ID: mdl-34125558

RESUMEN

Hybrid perovskites are emerging as a promising, high-performance luminescent material; however, the technological challenges associated with generating high-resolution, free-form perovskite structures remain unresolved, limiting innovation in optoelectronic devices. Here, we report nanoscale three-dimensional (3D) printing of colored perovskite pixels with programmed dimensions, placements, and emission characteristics. Notably, a meniscus comprising femtoliters of ink is used to guide a highly confined, out-of-plane crystallization process, which generates 3D red, green, and blue (RGB) perovskite nanopixels with ultrahigh integration density. We show that the 3D form of these nanopixels enhances their emission brightness without sacrificing their lateral resolution, thereby enabling the fabrication of high-resolution displays with improved brightness. Furthermore, 3D pixels can store and encode additional information into their vertical heights, providing multilevel security against counterfeiting. The proof-of-concept experiments demonstrate the potential of 3D printing to become a platform for the manufacture of smart, high-performance photonic devices without design restrictions.

3.
J BUON ; 22(4): 1046-1052, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28952226

RESUMEN

PURPOSE: To evaluate the outcomes of chemoradiotherapy (CRT) after neoadjuvant chemotherapy consisting of gemcitabine and erlotinib for unresectable locally advanced pancreatic cancer. METHODS: Between 2010 and 2014, 24 patients with unresectable pancreatic cancer received neoadjuvant gemcitabine/erlotinib followed by CRT. There were 9 men and 15 women, and median age was 61 years (range 48-77). Radiotherapy (RT) was delivered to the tumor and regional lymph nodes with a median dose of 50.4 Gy (range 50.4-56). All patients received concurrent chemotherapy, with 5-fluorouracil (5-FU), capecitabine or gemcitabine and 17 patients received maintenance chemotherapy with gemcitabine plus erlotinib, 5-FU plus leukovorin or capecitabine plus oxaliplatin. The median follow-up period was 17 months (range 7-31). RESULTS: The median overall survival (OS) and post-RT OS (PROS) were 17.8 and 10.7 months, respectively. On multivariate analysis, RT dose (p=0.005) and maintenance chemotherapy (p=0.019) were significant prognostic factors for OS. In addition, RT dose ≥54Gy (p=0.021) and concurrent gemcitabine (p=0.012) were identified as favorable prognostic factors for PROS. Grade 3 hematologic and gastrointestinal toxicities occurred in 3 and 2 patients, respectively. CONCLUSIONS: Intensive treatment with gemcitabine-based CRT, high RT dose, and maintenance chemotherapy may improve survival outcomes in locally advanced pancreatic cancer patients receiving neoadjuvant gemcitabine/erlotinib.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias Pancreáticas/tratamiento farmacológico , Neoplasias Pancreáticas/radioterapia , Anciano , Capecitabina/administración & dosificación , Quimioradioterapia/métodos , Desoxicitidina/administración & dosificación , Desoxicitidina/análogos & derivados , Clorhidrato de Erlotinib/administración & dosificación , Femenino , Fluorouracilo/administración & dosificación , Humanos , Leucovorina/administración & dosificación , Masculino , Persona de Mediana Edad , Terapia Neoadyuvante/métodos , Gemcitabina , Neoplasias Pancreáticas
4.
Am J Ther ; 23(6): e1449-e1455, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-25285672

RESUMEN

Biliary tract cancer is a heterogenous group. Gemcitabine plus cisplatin has been the standard chemotherapy for advanced biliary tract cancer, but there is lack of evidence on treatment in patients with intrahepatic cholangiocarcinoma (IHC). We analyzed 29 patients with only IHC who received gemcitabine plus cisplatin between June 2010 and February 2013. The median age was 63 years (range, 40-78 years), and Eastern Cooperative Oncology Group performance status of all patients was <2. The median progression-free survival and median overall survival (OS) were 4.3 and 7.3 months, respectively. Multivariate analysis showed that platelet count (≤180 × 10 per liter), metastatic site of more than 2, and albumin level (≤3.5 g/dL) were independent prognostic factors for decreased OS. OS was estimated based on the number of adverse prognostic factors: zero or 1 (good prognostic group), 2 (intermediate group), or 3 (poor prognostic group). The median OS for good (n = 15), intermediate (n = 10), and poor (n = 4) prognostic group was 10.5, 6.1, and 1.6 months, respectively (P < 0.005). Relatively better prognosis of the good prognosis group comparing to other prognosis groups can be expected from the prognostic model established in this study by analyzing patients with IHC treated with gemcitabine.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de los Conductos Biliares/tratamiento farmacológico , Colangiocarcinoma/tratamiento farmacológico , Neoplasias Hepáticas/tratamiento farmacológico , Adulto , Anciano , Neoplasias de los Conductos Biliares/patología , Colangiocarcinoma/patología , Cisplatino/administración & dosificación , Desoxicitidina/administración & dosificación , Desoxicitidina/análogos & derivados , Supervivencia sin Enfermedad , Femenino , Humanos , Neoplasias Hepáticas/patología , Masculino , Persona de Mediana Edad , Modelos Teóricos , Análisis Multivariante , Pronóstico , Tasa de Supervivencia , Gemcitabina
5.
Sci Technol Adv Mater ; 15(2): 024801, 2014 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-27877660

RESUMEN

The formation of the icosahedral phase (I-phase) as a secondary solidification phase in Mg-Zn-Y and Mg-Zn-Al base systems provides useful advantages in designing high performance wrought magnesium alloys. The strengthening in two-phase composites (I-phase + α-Mg) can be explained by dispersion hardening due to the presence of I-phase particles and by the strong bonding property at the I-phase/matrix interface. The presence of an additional secondary solidification phase can further enhance formability and mechanical properties. In Mg-Zn-Y alloys, the co-presence of I and Ca2Mg6Zn3 phases by addition of Ca can significantly enhance formability, while in Mg-Zn-Al alloys, the co-presence of the I-phase and Mg2Sn phase leads to the enhancement of mechanical properties. Dynamic and static recrystallization are significantly accelerated by addition of Ca in Mg-Zn-Y alloy, resulting in much smaller grain size and more random texture. The high strength of Mg-Zn-Al-Sn alloys is attributed to the presence of finely distributed Mg2Sn and I-phase particles embedded in the α-Mg matrix.

6.
J Colloid Interface Sci ; 647: 93-103, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37245273

RESUMEN

Although MoO2-based electrodes have been intensively studied as potential candidate anodes for lithium-ion batteries (LIBs) based on their high theoretical capacity (840 mAh g-1 and 5447 mAh cm-3), common issues such as severe volume variation, electrical conductivity loss, and low ionic conductivity, are prevalent. In this study, we demonstrate enhanced Li-ion kinetics and electrical conductivity of MoO2-based anodes with ternary MoO2-Cu-C composite materials. The MoO2-Cu-C was synthesized via two-step high energy ball milling where Mo and CuO are milled, followed by the secondary milling with C. With the introduction of the Cu-C hybrid matrix in MoO2 nanoparticles via the element transfer method using mechanochemical reactions, the sluggish Li-ion diffusion and unstable cycling behavior were significantly improved. The inactive Cu-C matrix contributes to the increase in electrical and ionic conductivity and mechanical stability of active MoO2 during cycling, as characterized by various electrochemical analyses and ex situ analysis techniques. Hence, the MoO2-Cu-C anode delivered promising cycling performance (674 mAh g-1 (at 0.1 A g-1) and 520 mAh g-1 (at 0.5 A g-1), respectively, after 100 cycles) and high-rate property (73% retention at 5 A g-1 as comparison with the specific capacity at 0.1 A g-1). The MoO2-Cu-C electrode is a propitious next-generation anode for LIBs.

7.
Infect Dis Ther ; 11(2): 887-898, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-35267172

RESUMEN

INTRODUCTION: While guidelines stronglyrecommend dexamethasone in critical COVID-19, the optimal threshold to initiate corticosteroids in non-critically ill patients with COVID-19 remains unclear. Using data from a state-wide COVID-19 registry, we evaluated the effectiveness of early corticosteroids for preventing clinical deterioration among non-critically ill patients hospitalized for COVID-19 and receiving non-invasive oxygen therapy. METHODS: This was a target trial using observational data from patients hospitalized for COVID-19 at 39 hospitals participating in the MI-COVID19 registry between March 16, 2020 and August 24, 2020. We studied the impact of corticosteroids initiated within 2 calendar days of hospitalization ("early steroids") versus no early steroids among non-ICU patients with laboratory-confirmed SARS-CoV2 receiving non-invasive supplemental oxygen therapy. Our primary outcome was a composite of in-hospital mortality, transfer to intensive care, and receipt of invasive mechanical ventilation. We used inverse probability of treatment weighting (IPTW) and propensity score-weighted regression to measure the association of early steroids and outcomes. RESULTS: Among 1002 patients meeting study criteria, 231 (23.1%) received early steroids. After IPTW, to balance potential confounders between the treatment groups, early steroids were not associated with a decrease in the composite outcome (aOR 1.1, 95%CI 0.8-1.6) or in any components of the primary outcome. CONCLUSION: We found no evidence that early corticosteroid therapy prevents clinical deterioration among hospitalized non-critically ill COVID-19 patients receiving non-invasive oxygen therapy. Further studies are needed to determine the optimal threshold for initiating corticosteroids in this population.

8.
Neuro Oncol ; 24(3): 482-491, 2022 03 12.
Artículo en Inglés | MEDLINE | ID: mdl-34611696

RESUMEN

BACKGROUND: We aimed to investigate the detection rate of body CT or PET/CT for sites of extracranial disease in patients with a new pathological diagnosis of CNS DLBCL and to identify factors associated with sites of extracranial disease. METHODS: An international multicenter cohort study of consecutive immunocompetent patients with a new diagnosis of CNS DLBCL confirmed by brain biopsy who underwent CT and/or PET/CT to evaluate for sites of extracranial disease between 1998 and 2019. The primary outcome was the detection rate of extracranial lymphoma by CT or PET/CT. Subgroup analyses according to age and EBV status were also performed. Logistic regression analyses were performed to determine factors related to sites of extracranial disease. Detection rates of CT and PET/CT were compared. RESULTS: One thousand and forty-three patients were included. The overall detection rate of CT or PET/CT was 2.6% (27/1043). The treatment approach was adjusted in 74% of these patients. Multivariable analysis demonstrated that age >61 years (OR, 3.10; P = .016) and EBV positivity (OR, 3.78; P = .045) were associated with greater odds of extracranial lymphoma. There was no statistically significant difference in detection rate between CT and PET/CT (P = .802). In patients ≤61 years old, the false-referral rates were significantly higher than the detection rates (P < .001). CONCLUSION: Our results showed increased odds of extracranial lymphoma in patients with older age or EBV-positive lymphoma. Treatment was adjusted in a majority of patients diagnosed with extracranial lymphoma, thereby supporting the current guidelines for the use of contrast-enhanced body CT or PET/CT in patients with newly diagnosed CNS DLBCL.


Asunto(s)
Linfoma de Células B Grandes Difuso , Linfoma , Sistema Nervioso Central/patología , Estudios de Cohortes , Fluorodesoxiglucosa F18 , Humanos , Linfoma/diagnóstico por imagen , Linfoma/patología , Linfoma de Células B Grandes Difuso/diagnóstico por imagen , Linfoma de Células B Grandes Difuso/patología , Persona de Mediana Edad , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Tomografía Computarizada por Rayos X/métodos
9.
Eur J Obstet Gynecol Reprod Biol ; 265: 90-95, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34474227

RESUMEN

OBJECTIVES: Women with a previous trachelectomy have an increased risk of premature delivery and second trimester miscarriage. In this study we aim to evaluate factors and regimes possibly affecting the risk for prematurity following fertility sparing robotic radical trachelectomy (RRT) in cervical cancer. METHODS: A retrospective study of the reproductive outcome following RRT with a cervical cerclage performed at one of four academic centers between 2007 and 2019. Factors possibly related to premature delivery, such as postoperative non-pregnant cervical length, previous vaginal deliveries, preservation of the uterine arteries, and the use of a second trimester oral metronidazole/no sexual intercourse regime, were assessed. RESULTS: 109 women remained for analyses after excluding recurrences before pregnancy (n = 8), secondary hysterectomy (n = 2), and women with less than six months follow up (n = 10). 74 pregnancies occurred in 52/71 women attempting to conceive, 56 of which developed past the first trimester. Two of 22 women (9%) who were prescribed an oral metronidazole regime (400 mg × 2 from gestational week 15 + 0 to 21 + 6 and abstaining from sexual intercourse for the duration of the pregnancy) had a premature delivery, compared with 13/31 (42%) where the regime was not applied (p = 0.009). The association remained after regression analyses including possible contributing factors as of above, none of which associated with prematurity at regression analyses (p = 0.001). CONCLUSIONS: The observed four-fold reduction in premature delivery indicates that an oral metronidazole/no sexual intercourse regime may reduce second trimester miscarriage and premature deliveries following an RRT. No association was observed for other investigated factors.


Asunto(s)
Aborto Espontáneo , Preservación de la Fertilidad , Traquelectomía , Neoplasias del Cuello Uterino , Coito , Femenino , Humanos , Metronidazol/uso terapéutico , Recurrencia Local de Neoplasia , Embarazo , Segundo Trimestre del Embarazo , Tercer Trimestre del Embarazo , Estudios Retrospectivos , Neoplasias del Cuello Uterino/cirugía
10.
Pediatrics ; 147(1)2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33386332

RESUMEN

BACKGROUND AND OBJECTIVES: Human papillomavirus (HPV) antibody responses to the 9-valent human papillomavirus (9vHPV) vaccine among girls and boys (aged 9-14 years) receiving 2-dose regimens (months 0, 6 or 0, 12) were noninferior to a 3-dose regimen (months 0, 2, 6) in young women (aged 16-26 years) 4 weeks after last vaccination in an international, randomized, open-label trial (NCT01984697). We assessed response durability through month 36. METHODS: Girls received 2 (months 0 and 6 [0, 6]: n = 301; months 0 and 12 [0, 12]: n = 151) or 3 doses (months 0,2, and 6 [0, 2, 6]: n = 301); boys received 2 doses ([0, 6]: n = 301; [0, 12]: n = 150); and young women received 3 doses ([0, 2, 6]: n = 314) of 9vHPV vaccine. Anti-HPV geometric mean titers (GMTs) were assessed by competitive Luminex immunoassay (cLIA) and immunoglobulin G-Luminex immunoassay (IgG-LIA) through month 36. RESULTS: Anti-HPV GMTs were highest 1 month after the last 9vHPV vaccine regimen dose, decreased sharply during the subsequent 12 months, and then decreased more slowly. GMTs 2 to 2.5 years after the last regimen dose in girls and boys given 2 doses were generally similar to or greater than GMTs in young women given 3 doses. Across HPV types, most boys and girls who received 2 doses (cLIA: 81%-100%; IgG-LIA: 91%-100%) and young women who received 3 doses (cLIA: 78%-98%; IgG-LIA: 91%-100%) remained seropositive 2 to 2.5 years after the last regimen dose. CONCLUSIONS: Antibody responses persisted through 2 to 2.5 years after the last dose of a 2-dose 9vHPV vaccine regimen in girls and boys. In girls and boys, antibody responses generated by 2 doses administered 6 to 12 months apart may be sufficient to induce high-level protective efficacy through at least 2 years after the second dose.


Asunto(s)
Alphapapillomavirus/inmunología , Anticuerpos Antivirales/sangre , Vacunas contra Papillomavirus/administración & dosificación , Adolescente , Adulto , Biomarcadores/sangre , Niño , Relación Dosis-Respuesta Inmunológica , Femenino , Estudios de Seguimiento , Humanos , Masculino , Vacunas contra Papillomavirus/inmunología , Adulto Joven
11.
Nat Commun ; 11(1): 23, 2020 01 07.
Artículo en Inglés | MEDLINE | ID: mdl-31911620

RESUMEN

Assembly of infectious influenza A viruses (IAV) is a complex process involving transport from the nucleus to the plasma membrane. Rab11A-containing recycling endosomes have been identified as a platform for intracellular transport of viral RNA (vRNA). Here, using high spatiotemporal resolution light-sheet microscopy (~1.4 volumes/second, 330 nm isotropic resolution), we quantify Rab11A and vRNA movement in live cells during IAV infection and report that IAV infection decreases speed and increases arrest of Rab11A. Unexpectedly, infection with respiratory syncytial virus alters Rab11A motion in a manner opposite to IAV, suggesting that Rab11A is a common host component that is differentially manipulated by respiratory RNA viruses. Using two-color imaging we demonstrate co-transport of Rab11A and IAV vRNA in infected cells and provide direct evidence that vRNA-associated Rab11A have altered transport. The mechanism of altered Rab11A movement is likely related to a decrease in dynein motors bound to Rab11A vesicles during IAV infection.


Asunto(s)
Dineínas/metabolismo , Virus de la Influenza A/fisiología , Gripe Humana/metabolismo , Proteínas de Unión al GTP rab/metabolismo , Transporte Biológico , Dineínas/genética , Interacciones Huésped-Patógeno , Humanos , Virus de la Influenza A/genética , Gripe Humana/genética , Gripe Humana/virología , ARN Viral/genética , ARN Viral/metabolismo , Proteínas de Unión al GTP rab/genética
12.
Neuroreport ; 30(11): 765-770, 2019 08 07.
Artículo en Inglés | MEDLINE | ID: mdl-31233447

RESUMEN

Oncostatin M is a muscle-secreted myokine that has various effects on neuronal function, however, the underlying molecular mechanism has been poorly defined. In this study, we showed that Oncostatin M increased the phosphorylation of Akt and ERK, proteins crucial for neuron cell survival and proliferation. Furthermore, Oncostatin M increased the expression of c-Fos, a protein with significant involvement in neuronal cell proliferation and survival, through both Akt and ERK. Oncostatin M also increased intracellular calcium concentrations that act upstream of Akt and ERK. Treatment with Oncostatin M led to the recovery of high-glucose-induced impairment of Akt phosphorylation. Thus, Oncostatin M can protect neuronal cell damage related to high-glucose conditions, showing potential as a therapeutic agent.


Asunto(s)
Glucosa/administración & dosificación , Hipocampo/metabolismo , Neuronas/metabolismo , Oncostatina M/metabolismo , Proteínas Proto-Oncogénicas c-akt/metabolismo , Proteínas Proto-Oncogénicas c-fos/metabolismo , Animales , Células Cultivadas , Hipocampo/efectos de los fármacos , Sistema de Señalización de MAP Quinasas/efectos de los fármacos , Ratones , Neuronas/efectos de los fármacos , Oncostatina M/administración & dosificación , Fosforilación
13.
J Gastrointest Surg ; 23(6): 1206-1217, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-30421120

RESUMEN

BACKGROUND: Guidelines recommend neoadjuvant therapy (NT) for clinical stage II-III (locally advanced) rectal adenocarcinoma, but utilization remains suboptimal. The causes of NT omission remain poorly understood. METHODS: The main outcomes in this study of patients with resected clinically non-metastatic rectal adenocarcinoma in the 2010-2015 National Cancer Database were local staging utilization in patients with non-metastatic tumors (i.e., undocumented clinical stage/pathologic stage I-III) and NT utilization for locally advanced tumors. Multivariable regression was used to examine predictors of these outcomes. Facility-specific risk- and reliability-adjusted local staging and NT rates were calculated. Positive margins and overall survival (OS) were examined as secondary outcomes. RESULTS: Local staging was omitted in 7737/43,819 (17.7%) patients with clinically non-metastatic tumors and NT was omitted in 5199/31,632 (16.4%) patients with locally advanced tumors. NT was utilized in 24,826 (91.1%) locally advanced patients who had local staging vs. 1607 (36.6%) patients who did not; 2785 (53.6%) locally advanced patients with NT omitted also had local staging omitted. Treatment at facilities with lowest quintile local staging rates was associated with NT omission (relative risk 2.41, 95% confidence interval 2.11, 2.75). Adjusted facility local staging rates varied sixfold (16.1-98.0%), facility NT rates varied twofold (43.9-95.9%), and they were correlated (r = 0.58; P < 0.001). Local staging omission and NT omission were independently associated with positive margins and decreased OS. CONCLUSIONS: Local staging omission is a common care process in over half of cases of omitted NT. These data emphasize the need for quality improvement efforts directed at providing facilities feedback about their local staging rates.


Asunto(s)
Adenocarcinoma/patología , Estadificación de Neoplasias , Neoplasias del Recto/patología , Recto/patología , Adenocarcinoma/terapia , Adolescente , Adulto , Anciano , Colectomía/métodos , Femenino , Humanos , Masculino , Márgenes de Escisión , Persona de Mediana Edad , Terapia Neoadyuvante/estadística & datos numéricos , Neoplasias del Recto/terapia , Reproducibilidad de los Resultados , Estudios Retrospectivos , Resultado del Tratamiento , Adulto Joven
14.
J Gastrointest Surg ; 23(4): 659-669, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30706375

RESUMEN

INTRODUCTION: Neoadjuvant therapy (NT) is the standard of care for clinical stage II-III rectal adenocarcinoma, but utilization remains suboptimal. We aimed to determine the underlying reasons for omission of local staging and NT. METHODS: We conducted a retrospective study of patients with clinical stage II-III or undocumented clinical stage/pathologic stage II-III rectal adenocarcinoma who were treated in 2010-2016 in one of nine Intermountain Healthcare hospitals. The outcomes of omission of local staging and NT were examined with multivariable models. Risk- and reliability-adjusted rates of local staging and NT were calculated for surgeons who treated ≥ 3 patients. Pathologic and long-term outcomes were examined after excluding patients who were not resected or who underwent local excision (N = 11). RESULTS: Local staging was omitted in 43/240 (17.9%) patients and NT was omitted in 41/240 (17.1%). The strongest risk factors for local staging and NT omission were upper rectal tumors and surgeons who treated ≤ 3 cases/year. Thirty-six of 41 (87.8%) cases of omitted NT had local staging omitted. Adjusted surgeon-specific local staging rates varied 1.6-fold (56.3-92.4%) and NT rates varied 2.8-fold (34.1-97.1%). Surgeon local staging and NT rates were strongly correlated (r = 0.92). NT was associated with lower rates of positive circumferential radial margins (7.9 vs. 20.0%; P = 0.02), node positivity (33.3 vs. 55.0%; P = 0.01), and local recurrences (7.6 vs. 14.9% at 5 years; P = 0.0176). CONCLUSIONS: NT omission should be understood as a consequence of surgeon failure to perform local staging in most cases. Quality improvement efforts should focus on improving utilization of local staging.


Asunto(s)
Adenocarcinoma/patología , Adenocarcinoma/terapia , Quimioradioterapia Adyuvante/estadística & datos numéricos , Terapia Neoadyuvante/estadística & datos numéricos , Pautas de la Práctica en Medicina/estadística & datos numéricos , Neoplasias del Recto/patología , Neoplasias del Recto/terapia , Adenocarcinoma/mortalidad , Adulto , Anciano , Anciano de 80 o más Años , Quimioradioterapia Adyuvante/normas , Femenino , Estudios de Seguimiento , Disparidades en Atención de Salud/estadística & datos numéricos , Humanos , Masculino , Márgenes de Escisión , Persona de Mediana Edad , Terapia Neoadyuvante/normas , Recurrencia Local de Neoplasia/epidemiología , Recurrencia Local de Neoplasia/etiología , Recurrencia Local de Neoplasia/prevención & control , Estadificación de Neoplasias , Pautas de la Práctica en Medicina/normas , Utilización de Procedimientos y Técnicas/normas , Utilización de Procedimientos y Técnicas/estadística & datos numéricos , Proctectomía , Garantía de la Calidad de Atención de Salud , Indicadores de Calidad de la Atención de Salud/estadística & datos numéricos , Neoplasias del Recto/mortalidad , Reproducibilidad de los Resultados , Estudios Retrospectivos , Cirujanos/normas , Cirujanos/estadística & datos numéricos , Resultado del Tratamiento , Estados Unidos/epidemiología
15.
Sci Technol Adv Mater ; 9(4): 045004, 2008 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27878032

RESUMEN

The plastic deformation of Ti45Zr16Be20Cu10Ni9 bulk metallic glass has been investigated by nanoindentation performed with loads ranging from 10 to 200 mN in a wide range of loading rates. The plastic flow in the alloy exhibited conspicuous serrations at low loading rates. The serrations, however, became less prominent as the rate of indentation increased. Atomic force microscopy showed a significant pile-up of materials around the indents, indicating that a highly localized plastic deformation occurred under nanoindentation. The possible mechanism governing the plastic deformation in bulk metallic glass specimens is tentatively discussed in terms of strain-induced free volume.

16.
Integr Med Res ; 7(3): 287-295, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-30271718

RESUMEN

BACKGROUND: Currently, there is no clearly established therapy to treat mild cognitive impairment (MCI); consequently, alternative therapies, such as acupuncture, have been attempted. In many clinical studies, the potential benefits of acupuncture for cognitive improvement have been identified in clinical outcomes; however, the mechanism remains unclear. Accordingly, this study aims to investigate the therapeutic mechanism of acupuncture therapy using functional near-infrared spectroscopy and its feasibility in treating individuals with impaired cognitive function. METHODS: This study is designed to be a prospective, two-arm, parallel clinical trial involving 24 participants. The patient group will be treated with acupuncture twice per week for 12 weeks; meanwhile, the healthy control group will not undergo acupuncture treatment. Functional near-infrared spectroscopy assessment and a working memory test will be performed at baseline and every 6 weeks to investigate the therapeutic mechanism of acupuncture. The primary outcome will be measured using the Korean version of the Montreal Cognitive Assessment. The secondary outcomes will be the Alzheimer's Disease Assessment Scale-cognitive subscale score, working memory task accuracy, response rate, response time, and hemodynamic response of the prefrontal lobe. The outcomes will be evaluated at baseline, and at 6 and 12 weeks after subject allocation. DISCUSSION: This clinical pilot trial is designed to determine the feasibility of acupuncture as an effective and safe treatment for improving cognitive function in patients with MCI. Results of this study may provide guidance for future larger-scale clinical trials. TRIAL REGISTRATION: Clinical Research Information Service (CRIS), Republic of Korea: KCT0002451. Registered September 5, 2017.

17.
IEEE Trans Image Process ; 26(10): 5043-5056, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28727550

RESUMEN

In the case of a stepped-frequency waveform (SFW) inverse synthetic aperture radar (ISAR) system, the translational motion (TM) of a target can be usually divided into two parts: 1) target motion within a pulse repetition interval, called the inter-pulse translational motion (IPTM) and 2) target motion between bursts, called the inter-burst translational motion (IBTM). The former induces severe blurring in the ISAR images as well as range-compressed data (i.e., range profile), and the latter also causes dramatic degradation of the ISAR image quality. In this paper, a novel framework for high-resolution gapped SFW (GSFW) ISAR imaging of high-speed maneuvering target is proposed. The main novelty of the proposed method is twofold: 1) accurate TM parameter estimation in conjunction with a compressive sensing theory using a newly devised cost function and particle swarm optimization and 2) compensation for both the IPTM and IBTM phase errors simultaneously even with the GSFW data set. Simulation results using ideal point scatterers show that the proposed method is capable of precise reconstruction of ISAR image and accurate TM parameter estimation. Experimental results using real measured data verify the robustness and the effectiveness of the proposed method.

18.
Tumori ; 103(4): 345-352, 2017 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-28708225

RESUMEN

PURPOSE: The purpose of this study was to investigate the clinical outcomes and prognostic factors of concurrent chemoradiotherapy (CCRT) for locally recurrent biliary tract cancer (BTC) after curative surgical resection. METHODS: We performed a retrospective cohort study of patients with locally recurrent BTC treated with CCRT between October 2004 and December 2013. The study included and analyzed 42 patients with a history of curative-intent surgical resection of confirmed adenocarcinoma originating from the biliary tract. RESULTS: The median time to recurrence after surgery was 16.1 months (range, 4.5-77.8 months). Median follow-up after CCRT was 26.9 months (range, 5.2-81.9) with no grade 3 or higher gastrointestinal toxicities. Analysis of the first site of failure showed local progression (LP) developed in 20 patients (47.6%); among these, 16 (38.1%) had isolated LP. The median values were 15.8 months (range, 1.7-81.7) for LP-free survival (LPFS), 10.6 months (range, 1.7 - 81.7) for progression-free survival (PFS) and 41.2 months (range, 5.2-81.9) for overall survival (OS). Multivariate analysis showed that the level of pre-CCRT carbohydrate antigen (CA) 19-9 and the chemotherapy regimen were significant prognostic factors for LPFS and PFS; pT stage was the only significant prognostic factor for OS. CONCLUSIONS: CCRT for locally recurrent BTC showed promising outcomes as a salvage modality, but LP was still frequent. The pre-CCRT CA 19-9 level and the chemotherapy regimen were prognostic factors for LPFS and PFS.


Asunto(s)
Neoplasias del Sistema Biliar/tratamiento farmacológico , Neoplasias del Sistema Biliar/radioterapia , Recurrencia Local de Neoplasia/tratamiento farmacológico , Recurrencia Local de Neoplasia/radioterapia , Adulto , Anciano , Neoplasias del Sistema Biliar/patología , Quimioradioterapia/métodos , Estudios de Cohortes , Supervivencia sin Enfermedad , Femenino , Fluorouracilo/administración & dosificación , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/patología , Estudios Retrospectivos , Terapia Recuperativa/métodos
19.
J Biomed Res ; 31(3): 226-231, 2017 Jan 19.
Artículo en Inglés | MEDLINE | ID: mdl-28808221

RESUMEN

Prostate stem cell antigen (PSCA) is a cell-membrane glycoprotein consisting of 123 amino acids and highly expressed in the prostate, but there have been few reports on the relationship between rs2294008 ofPSCA and prostate cancer in the literature. Therefore, we evaluated the association between rs2294008 and the risk of prostate cancer. A total of 240 prostate cancer patients and 306 controls (patients with benign prostatic hyperplasia) were enrolled. Genotype analysis of rs2294008 ofPSCA was performed using PCR. Logistic regression analysis was performed according to the genotype ofPSCA rs2294008. We found that CT and TT genotypes were associated with an insignificant risk of prostate cancer compared with the CC genotype (P= 0.627 and 0.397, respectively). In addition, there was no significant difference in rs2294008 according to clinicopathological parameters, such as age, Gleason score, prostate-specific antigen (PSA), stage, and metastasis in prostate cancer (P>0.05 for each). Age, Gleason score, PSA, pathologic stage, and metastasis did not modify the association between PSCA and the risk of prostate cancer (each P>0.05 for each). Taken together, the genetic polymorphism of PSCA rs2294008 was not associated with the risk of prostate cancer. Our results suggest that rs2294008 may not play a role in prostate carcinogenesis.

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