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BACKGROUND: Patterns of recurrence after surgery with postoperative chemoradiotherapy (S-CCRT) or surgery alone in patients with oesophageal squamous cell carcinoma (SCC) may differ. This might influence the nature and timing of subsequent management strategies. METHODS: Patients with SCC who had undergone R0 resection were included. Propensity score matching was used to select matched groups. Survival and recurrence were compared by Kaplan-Meier analysis. Univariable and multivariable Cox regression analyses were used to identify prognostic factors for overall and disease-free survival. RESULTS: A total of 1390 patients were included, of whom 1000 had surgery alone and 390 underwent S-CCRT. Propensity score matching yielded 213 well balanced pairs. The 3-year overall survival rate and median survival time in the S-CCRT group were 0·50 and 36·5 (95 per cent c.i. 25·1 to 52·6) months respectively, compared with 0·38 and 22·8 (18·2 to 29·0) months in the surgery-alone group (P = 0·006). The 3-year disease-free survival rate and median disease-free survival time in the S-CCRT group were 0·46 and 30·6 (22·2 to 39·3) months respectively, compared with 0·36 and 17·6 (11·3 to 23·9) months in the surgery-alone group (P = 0·006). The 2-year freedom from locoregional recurrence rate was 0·87 and 0·77 in the S-CCRT and surgery-alone groups respectively (P = 0·003). In multivariable analysis, independent prognostic factors for disease-free survival included age over 56 years, pT3-4 category, pN category, poor differentiation, tumour length exceeding 4·0 cm, and receiving postoperative chemoradiotherapy (hazard ratio 0·62, 95 per cent c.i. 0·47 to 0·81; P < 0·001). CONCLUSION: Oesophagectomy with postoperative chemoradiotherapy was associated with longer survival and lower recurrence rates, especially at a locoregional level, compared with surgery alone.
Assuntos
Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/terapia , Quimiorradioterapia Adjuvante , Neoplasias Esofágicas/mortalidade , Neoplasias Esofágicas/terapia , Esofagectomia , Recidiva Local de Neoplasia/epidemiologia , Fatores Etários , Carcinoma de Células Escamosas/patologia , Intervalo Livre de Doença , Neoplasias Esofágicas/patologia , Feminino , Humanos , Masculino , Análise por Pareamento , Pessoa de Meia-Idade , Análise Multivariada , Prognóstico , Pontuação de Propensão , Taiwan/epidemiologiaRESUMO
In the exposure process of photolithography, a free-form lens is designed and fabricated for UV-LED (Ultraviolet Light-Emitting Diode). Thin film metallic glasses (TFMG) are adopted as UV reflection layers to enhance the irradiance and uniformity. The Polydimethylsiloxane (PDMS) with high transmittance is used as the lens material. The 3-D fast printing is attempted to make the mold of the lens. The results show that the average irradiance can be enhanced by 6.5~6.7%, and high uniformity of 85~86% can be obtained. Exposure on commercial thick photoresist using this UV-LED system shows 3~5% dimensional deviation, lower than the 6~8% deviation for commercial mercury lamp system. This current system shows promising potential to replace the conventional mercury exposure systems.
RESUMO
BACKGROUND: Exposure to environmental endocrine-disrupting chemicals (EDCs) is associated with allergy, chronic inflammation, and immunodeficiency. Phthalates, the common EDCs used in plastic industry, may act as adjuvants to disrupt immune system and enhance allergy. Plasmacytoid DCs (pDCs) are predominant cells secreting type I interferon (IFN) against infection and are professional antigen-presenting cells in regulating adaptive immunity. However, the effects of phthalates on the function of pDCs are unknown. METHODS: Circulating pDCs were isolated from healthy subjects, were pretreated with diethylhexyl phthalate (DEHP) and butyl benzyl phthalate (BBP), and were stimulated with Toll-like receptor (TLR)-9 agonist CpG. IFN-α/IFN-ß levels, surface markers, and T-cell stimulatory function were investigated using ELISA, flow cytometry, and pDC/T-cell coculture assay. Mechanisms were investigated using receptor antagonists, pathway inhibitors, Western blotting, and chromatin immunoprecipitation. RESULTS: Diethylhexyl phthalate and butyl benzyl phthalate suppressed CpG-induced IFN-α/IFN-ß expression in pDCs, and the effect was reversed by aryl hydrocarbon receptor (AHR) antagonist. Diethylhexyl phthalate suppressed CpG-activated mitogen-activated protein kinase (MAPK)-MEK1/2-ERK-ELK1 and NFκB signaling pathways. Diethylhexyl phthalate suppressed CpG-induced interferon regulatory factor (IRF)-7 expression by suppressing histone H3K4 trimethylation at IRF7 gene promoter region through inhibiting translocation of H3K4-specific trimethyltransferase WDR5 from cytoplasm into nucleus. Butyl benzyl phthalate or diethylhexyl phthalate-treated pDCs suppressed IFN-γ but enhanced IL-13 production by CD4+ T cells. CONCLUSION: Phthalates may interfere with immunity against infection and promote the deviation of Th2 response to increase allergy by acting on human pDCs via suppressing IFN-α/IFN-ß expression and modulating the ability to stimulate T-cell responses.
Assuntos
Células Dendríticas/efeitos dos fármacos , Epigenômica , Interferon Tipo I/efeitos dos fármacos , Interferon Tipo I/genética , Ácidos Ftálicos/farmacologia , Western Blotting , Sobrevivência Celular , Células Cultivadas , Células Dendríticas/citologia , Células Dendríticas/imunologia , Ensaio de Imunoadsorção Enzimática , Citometria de Fluxo , Humanos , Interferon Tipo I/metabolismo , Interferon-alfa/análise , Interferon-alfa/imunologia , Interferon-alfa/metabolismo , Interferon beta/análise , Interferon beta/metabolismo , Interferon gama/imunologia , Interferon gama/metabolismo , Reação em Cadeia da Polimerase em Tempo Real , Estudos de Amostragem , Sensibilidade e Especificidade , Linfócitos T/efeitos dos fármacos , Linfócitos T/imunologia , Linfócitos T/metabolismo , Receptor Toll-Like 9/genética , Receptor Toll-Like 9/imunologia , Receptor Toll-Like 9/metabolismoRESUMO
BACKGROUND: The size of the breast stem-cell pool could underlie the intrauterine roots of breast cancer. We studied whether breast stem cells exist in umbilical cord blood and if they correlate with hematopoietic stem-cell measurements that have been positively associated with perinatal risk factors for breast cancer. SUBJECTS AND METHODS: We isolated mononuclear cells from umbilical cord blood of 170 singleton full-term pregnancies and determined, by reverse transcription polymerase chain reaction, the presence of genes of putative breast epithelial stem-cell/progenitor markers [including epithelial cell adhesion molecule (EpCAM), CD49f (α6-integrin), CD117 (c-kit receptor), CD24, and CD29 (ß1-integrin)]. By immunocytochemistry, we colocalized protein expressions of EpCAM+CD49f+, CD49f+CD24+, and CD24+CD29+. We correlated concentrations of putative breast stem-cell/progenitor subpopulations, quantified by flow cytometry, with concentrations of hematopoietic stem cells. RESULTS: Mammary stem-cell phenotypes were identified in umbilical cord blood. The measured EpCAM+ subpopulation was positively correlated with concentrations of CD34+ and CD34+CD38- hematopoietic stem cells (both P=0.006). Additionally, EpCAM+CD49f+ and CD49f+CD24+ subpopulations were positively correlated to the CD34+ cells (P=0.03 and 0.008, respectively). CONCLUSION: The positive association between measurable breast and hematopoietic stem cells in human umbilical cord blood suggests plausible mechanisms for a prenatal influence on breast cancer risk.
Assuntos
Biomarcadores Tumorais/análise , Mama/citologia , Sangue Fetal/citologia , Células-Tronco/citologia , Antígenos de Neoplasias/análise , Antígenos de Neoplasias/biossíntese , Mama/metabolismo , Neoplasias da Mama/metabolismo , Antígeno CD24/análise , Antígeno CD24/biossíntese , Moléculas de Adesão Celular/análise , Moléculas de Adesão Celular/biossíntese , Separação Celular , Suscetibilidade a Doenças , Molécula de Adesão da Célula Epitelial , Feminino , Citometria de Fluxo , Células-Tronco Hematopoéticas/citologia , Humanos , Imuno-Histoquímica , Integrina alfa6/análise , Integrina alfa6/biossíntese , Integrina beta1/análise , Integrina beta1/biossíntese , Leucócitos Mononucleares/citologia , Microscopia Confocal , Proteínas Proto-Oncogênicas c-kit/análise , Proteínas Proto-Oncogênicas c-kit/biossíntese , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Células-Tronco/metabolismoRESUMO
BACKGROUND: The molecular chaperone heat shock protein-90 (Hsp90) is a promising cancer drug target, but current Hsp90-based therapy has so far shown limited activity in the clinic. METHODS: We tested the efficacy of a novel mitochondrial-targeted, small-molecule Hsp90 inhibitor, Gamitrinib (GA mitochondrial matrix inhibitor), in the Transgenic Adenocarcinoma of the Mouse Prostate (TRAMP) model. The TRAMP mice receiving 3-week or 5-week systemic treatment with Gamitrinib were evaluated for localised or metastatic prostate cancer, prostatic intraepithelial neoplasia (PIN) or localised inflammation using magnetic resonance imaging, histology and immunohistochemistry. Treatment safety was assessed histologically in organs collected at the end of treatment. The effect of Gamitrinib on mitochondrial dysfunction was studied in RM1 cells isolated from TRAMP tumours. RESULTS: Systemic administration of Gamitrinib to TRAMP mice inhibited the formation of localised prostate tumours of neuroendocrine or adenocarcinoma origin, as well as metastatic prostate cancer to abdominal lymph nodes and liver. The Gamitrinib treatment had no effect on PIN or prostatic inflammation, and caused no significant animal weight loss or organ toxicity. Mechanistically, Gamitrinib triggered acute mitochondrial dysfunction in RM1 cells, with loss of organelle inner membrane potential and release of cytochrome-c in the cytosol. CONCLUSIONS: The Gamitrinib has pre-clinical activity and favourable tolerability in a genetic model of localised and metastatic prostate cancer in immunocompetent mice. Selective targeting of mitochondrial Hsp90 could provide novel molecular therapy for patients with advanced prostate cancer.
Assuntos
Adenocarcinoma/prevenção & controle , Antineoplásicos/uso terapêutico , Proliferação de Células/efeitos dos fármacos , Guanidinas/uso terapêutico , Proteínas de Choque Térmico HSP90/antagonistas & inibidores , Lactamas Macrocíclicas/uso terapêutico , Neoplasias da Próstata/prevenção & controle , Adenocarcinoma/genética , Adenocarcinoma/patologia , Animais , Antineoplásicos/farmacologia , Células Cultivadas , Modelos Animais de Doenças , Progressão da Doença , Avaliação Pré-Clínica de Medicamentos , Feminino , Predisposição Genética para Doença , Guanidinas/farmacologia , Proteínas de Choque Térmico HSP90/metabolismo , Lactamas Macrocíclicas/farmacologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/metabolismo , Terapia de Alvo Molecular/métodos , Metástase Neoplásica , Neoplasia Prostática Intraepitelial/genética , Neoplasia Prostática Intraepitelial/patologia , Neoplasia Prostática Intraepitelial/prevenção & controle , Neoplasias da Próstata/genética , Neoplasias da Próstata/patologiaRESUMO
BACKGROUND: Breast cancer is less common in China than in the United States and perinatal characteristics predict breast cancer risk in the offspring. We determined levels of pregnancy hormones in Boston and Shanghai to identify those possibly involved in the intrauterine origin of breast cancer. PARTICIPANTS AND METHODS: We compared maternal and cord blood levels of estradiol, estriol, testosterone, progesterone, prolactin, insulin-like growth factors (IGF) 1 and 2, insulin-like growth factor-binding protein 3, adiponectin and sex hormone-binding globulin (SHBG) in 241 Caucasian and 295 Chinese women. RESULTS: In both centers, hormone levels at the 16th were predictive of those at the 27th gestational week, but there was little correlation between maternal and cord blood levels. In cord blood, we found significantly (P < 0.01) higher levels of estradiol (44.2%), testosterone (54.5%), IGF-2 (22.7%) and strikingly SHBG (104.6%) in Shanghai women, whereas the opposite was true for IGF-1 (-36.8%). CONCLUSIONS: Taking into account the current understanding of the plausible biological role of the examined endocrine factors, those likely to be involved in the intrauterine origin of breast cancer are SHBG and IGF-2, with higher cord blood levels among Chinese, and IGF-1, with higher cord blood levels among Caucasian women.
Assuntos
Neoplasias da Mama/etiologia , Sangue Fetal/metabolismo , Hormônios/sangue , Adiponectina/sangue , Adulto , Neoplasias da Mama/sangue , Neoplasias da Mama/epidemiologia , China , Feminino , Hormônios Esteroides Gonadais/sangue , Humanos , Proteína 3 de Ligação a Fator de Crescimento Semelhante à Insulina , Proteínas de Ligação a Fator de Crescimento Semelhante a Insulina/sangue , Fator de Crescimento Insulin-Like I/análise , Gravidez , Prolactina/sangue , Globulina de Ligação a Hormônio Sexual/análise , Estatísticas não Paramétricas , Estados Unidos , Adulto JovemRESUMO
Asthma is a chronic airway inflammatory disease. Chronic aspiration by gastric fluid in gastroesophageal reflux disease (GERD) is considered a primary inflammatory factor exacerbating or predisposing patients to asthma. Airway smooth muscle cells (SMCs) are considered an important component in airway remodeling. To investigate the role of gastric fluid in airway SMC inflammation and airway remodeling, we examined gastric fluid-induced cytokine and chemokine profiles, airway SMC migration and matrix metalloproteinase expression in rat primary rat airway SMCs. The T helper cell type 2 (Th2) cytokines interleukin 4, interleukin 6 and tumor necrosis factor 2 (TNF-α) and the chemokines, lipopolysaccharide-induced CXC chemokine (LIX/CXCL5), cytokine-induced neutrophil chemoattractant 2 (CINC-2), CINC-3, fractalkine, ciliary neurotrophic factor (CNTF), and vascular endothelial growth factor were induced by gastric fluid in primary cultured rat airway SMCs. Migration of rat airway SMCs was enhanced by gastric fluid and conditioned medium. The migration of rat airway SMCs enhanced by gastric fluid was associated with actin polymerization and activation of focal adhesion kinase. Matrix metalloproteinase 2 expressions in airway SMCs was enhanced by gastric fluid and conditioned medium. The results suggest potential mechanisms by which gastric fluid aspiration might influence SMC-mediated airway remodeling.
Assuntos
Remodelação das Vias Aéreas , Líquidos Corporais/metabolismo , Quimiocinas/metabolismo , Miócitos de Músculo Liso/metabolismo , Estômago/fisiologia , Traqueia/citologia , Actinas/metabolismo , Animais , Linhagem Celular , Movimento Celular , Técnicas de Cocultura , Ativação Enzimática , Proteína-Tirosina Quinases de Adesão Focal/metabolismo , Macrófagos/citologia , Masculino , Metaloproteinase 2 da Matriz/metabolismo , Camundongos , Miócitos de Músculo Liso/citologia , Miócitos de Músculo Liso/enzimologia , Polimerização , Ratos , Ratos WistarRESUMO
BACKGROUND: Impetigo herpetiformis (IH) is a rare skin disorder that occurs during pregnancy. It was previously associated with high maternal and fetal mortality and morbidity, but now has a better prognosis. CASE REPORT: We report a case of a pregnant woman with IH who presented with generalized erythematous pustular eruptions in the 32nd week of gestation. The IH progressed rapidly, and gestational hypertension was observed in the 36th week. The lesions did not subside, despite treatment with corticosteroids and phototherapy. She delivered a healthy male baby via cesarean section in the 37th week. One month after her delivery, her skin returned to normal, except for residual pigmentation, with complete recovery 3 months postpartum. CONCLUSION: An experienced medical team comprising obstetricians, dermatologists, perinatologists and neonatologists is critical to aggressively treat this life-threatening specific dermatosis of pregnancy and to prevent ensuing complications, such as fluid and electrolyte imbalance, secondary infection and placental insufficiency.
Assuntos
Hipertensão Induzida pela Gravidez/diagnóstico , Impetigo/diagnóstico , Complicações Infecciosas na Gravidez/diagnóstico , Corticosteroides/uso terapêutico , Adulto , Antibacterianos/uso terapêutico , Cálcio/uso terapêutico , Cesárea , Ciclosporina/uso terapêutico , Dermatite Herpetiforme/diagnóstico , Dermatite Herpetiforme/tratamento farmacológico , Dermatite Herpetiforme/terapia , Fármacos Dermatológicos/uso terapêutico , Feminino , Humanos , Hipertensão Induzida pela Gravidez/tratamento farmacológico , Impetigo/complicações , Impetigo/tratamento farmacológico , Recém-Nascido , Nascido Vivo , Masculino , Fototerapia , Gravidez , Complicações Infecciosas na Gravidez/terapia , Resultado do TratamentoRESUMO
Magnetic properties, phase evolution, and microstructure of melt spun Hf-substituted Sm(Co0.97Hf0.03)(x)Cy (x = 5-9; y = 0-0.1) ribbons quenched at the wheel speed of 40 m/s are investigated. X-ray diffraction analysis shows that the main phases existed in Sm(Co0.97Hf0.03)(x) ribbons are 1:5 phase for x = 5-5.5; 1:5 and 1:7 phases for x = 6; 1:7 phase for x = 6.5-7.5; 1:7 and 2:17 phases for x = 8; and only 2:17 phase for x = 8.5-9, respectively. For Sm(Co0.97Hf0.03)(x) (x = 5-9) ribbons, the optimum magnetic properties of B(r) = 5.6 kG, (i)H(c)= 15.6 kOe and (BH)(max) = 7.1 MGOe are obtained for Sm(Co0.97Hf0.03)6.5 ribbons. Furthermore, a slight amount of C addition in Sm(Co0.97Hf0.03)(x) ribbons slightly modify phase constitution and effectively refine the grain size from 200-700 nm for C free ribbons to 10-70 nm, strengthening the exchange coupling effect between magnetic grains of the ribbons. As a result, magnetic properties are further improved. The magnetic properties of B(r) = 6.9 kG, (i)H(c) = 9.2 kOe and (BH)(max) = 10.0 MGOe can be achieved for Sm(Co0.97Hf0.03)7.5C0.1 nanocomposites.
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Cristalização/métodos , Magnetismo , Nanoestruturas/química , Nanoestruturas/ultraestrutura , Samário/química , Temperatura Alta , Substâncias Macromoleculares/química , Teste de Materiais , Conformação Molecular , Tamanho da Partícula , Transição de Fase , Rotação , Propriedades de SuperfícieRESUMO
Magnetic properties and phase evolution of melt spun R9.5Fe(bal.)Ti2B10 (R = MM(A), MM(B), MM(C), Pr, Nd, Ce, and La) nanocomposites have been investigated. Based on the results for the X-ray diffraction and thermal magnetic analysis, only 2:14:1 and alpha-Fe phases appear for R = MM(A) and Pr, and an additional Fe3B phase is present for R = MM(B), MM(C), Nd, and Ce. Besides, the uniform fine grain size of 20-40 nm is almost unchanged for the ribbons with various rare earth elements. Accordingly, magnetic properties of MM9.5Fe(bal.)Ti2B10 nanocomposites are mainly dominated by the composition of Mischmetals or the rare earth elements adopted, and are consistent with the outcome for the combinations of magnetic properties of their corresponding R9.5Fe(bal.)Ti2B10 nanocomposites. In this study, the optimum magnetic properties of B(r) = 9.3 kG, (i)H(c) = 12.1 kOe and (BH)(max) = 18.0 MGOe can be achieved for MM(B)9.5Fe(bal.)Ti2B10 nanocomposites. They not only exhibit comparable magnetic properties to the commercial available powders but also reduce the original material cost effectively.
Assuntos
Bismuto/química , Cristalização/métodos , Ferro/química , Magnetismo , Nanoestruturas/química , Nanoestruturas/ultraestrutura , Titânio/química , Temperatura Alta , Substâncias Macromoleculares/química , Teste de Materiais , Conformação Molecular , Nanotecnologia/métodos , Tamanho da Partícula , Rotação , Propriedades de SuperfícieRESUMO
Effect of dopants on the soft magnetic properties and high frequency characteristics of FeCoBM thin films (M = Ti, Nb, Hf, and Ta) have been studied. For (Fe0.55Co0.45)(100-x)B(x) (x = 5-15) thin films, with the increase of B content, the resistivity was increased because B could decrease the crystallinity of the films. The (Fe0.55Co0.45)90B10 thin film showed the optimum properties, where 4piM(s) = 16.1 kG, H(ce) = 64.2 Oe, H(ch) = 13.5 Oe, H(k) = 310 Oe and p = 338 microomega-cm. To reduce the coercivity of the film, the elements M, including Ti, Nb, Hf, and Ta, were selected to substitute for B in the FeCoB films. It was found that (Fe0.55Co0.45)90B6Ti2Nb2 thin film after annealing at a temperature of 200 degrees C for 30 min showed the optimal properties, where 4piM(s) = 15.8 kG, H(ce) = 4.8 Oe, H(ch) = 3.6 Oe, H(k) = 224 Oe and p = 290 microomega-cm. The theoretically calculated ferromagnetic resonance frequency of the developed films can be higher than 5 GHz.
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Cobalto/química , Cristalização/métodos , Ferro/química , Magnetismo , Membranas Artificiais , Nanoestruturas/química , Nanoestruturas/ultraestrutura , Dureza , Teste de Materiais , Tamanho da PartículaRESUMO
The most primitive engrafting hematopoietic stem cell has been assumed to have a fixed phenotype, with changes in engraftment and renewal potential occurring in a stepwise irreversible fashion linked with differentiation. Recent work shows that in vitro cytokine stimulation of murine marrow cells induces cell cycle transit of primitive stem cells, taking 40 h for progression from G0 to mitosis and 12 h for subsequent doublings. At 48 h of culture, progenitors are expanded, but stem cell engraftment is markedly diminished. We have investigated whether this effect on engraftment was an irreversible step or a reversible plastic feature correlated with cell cycle progression. Long-term engraftment (2 and 6 mo) of male BALB/c marrow cells exposed in vitro to interleukin (IL)-3, IL-6, IL-11, and steel factor was assessed at 2-4-h intervals of culture over 24-48 h using irradiated female hosts; the engraftment phenotype showed marked fluctuations over 2-4-h intervals, with engraftment nadirs occurring in late S and early G2. These data show that early stem cell regulation is cell cycle based, and have critical implications for strategies for stem cell expansion and engraftment or gene therapy, since position in cell cycle will determine whether effective engraftment occurs in either setting.
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Ciclo Celular/fisiologia , Transplante de Células-Tronco Hematopoéticas , Células-Tronco Hematopoéticas/citologia , Células-Tronco Hematopoéticas/fisiologia , Animais , Ciclo Celular/efeitos dos fármacos , Células Cultivadas , Citocinas/farmacologia , Feminino , Masculino , Camundongos , Camundongos Endogâmicos BALB CRESUMO
Significant heterogenity of stage IB (sixth edition of the TNM staging system) nonsmall cell lung cancer (NSCLC) has been identified, and further subclassification according to tumour size has been proposed. The aim of this study is to evaluate the prognostic factors in patients with resected stage IB NSCLC > 3 cm. From January 1980 to December 2000, 525 patients underwent surgical resection for stage IB NSCLC > 3 cm at Taipei Veterans General Hospital, Taipei, Taiwan. The clinicopathological characteristics of these patients were retrospectively reviewed. The 5- and 10-yr overall survival rates were 44.9% and 27.3%, respectively. Age (p < 0.001), tumour size (p = 0.002), extent of pulmonary resection (p = 0.002), histological type (p = 0.005) and number of mediastinal lymph nodes dissected/sampled (p = 0.004) were significant predictors for overall survival in multivariate analysis. Patients with tumour size >7 cm, or > 5 to ≤ 7 cm, had a worse survival than those with tumour size > 3 to ≤ 5 cm. However, visceral pleural invasion did not influence overall survival. Stage IB NSCLC with a diameter > 3 cm may be subclassified according to tumour size regardless of visceral pleural invasion.
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Carcinoma Pulmonar de Células não Pequenas/patologia , Neoplasias Pulmonares/patologia , Idoso , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Feminino , Humanos , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/cirurgia , Linfonodos/patologia , Linfonodos/cirurgia , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Estadiamento de Neoplasias , Pleura/patologia , Pleura/cirurgia , Prognóstico , Estudos Retrospectivos , Fumar/efeitos adversos , Taxa de SobrevidaRESUMO
Breast cancer incidence and birth weight are higher among Caucasian than Asian women, and birth size has been positively associated with breast cancer risk. Pregnancy hormone levels, however, have been generally lower in Caucasian than Asian women. We studied components of the insulin-like growth factor (IGF) system in cord blood from 92 singleton babies born in Boston, USA, and 110 born in Shanghai, China, in 1994-1995. Cord blood IGF-1 was significantly higher among Caucasian compared with Chinese babies (P<10(-6)). The opposite was noted for IGF-2 (P approximately 10(-4)). IGF-1 was significantly positively associated with birth weight and birth length in Boston, but not Shanghai. In contrast, stronger positive, though statistically non-significant, associations of IGF-2 with birth size were only evident in Shanghai. The associations of birth weight and birth length were positive and significant in taller women (for IGF-1 in Boston P approximately 0.003 and 0.03, respectively; for IGF-2 in Shanghai P approximately 0.05 and approximately 0.04, respectively), among whom maternal anthropometry does not exercise strong constraints in foetal growth. The documentation of higher cord blood levels of IGF-1, a principal growth hormone that does not cross the placenta, among Caucasian than in Asian newborns is concordant with breast cancer incidence in these populations.
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Peso ao Nascer , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/metabolismo , Sangue Fetal/metabolismo , Fator de Crescimento Insulin-Like II/metabolismo , Fator de Crescimento Insulin-Like I/metabolismo , Adulto , Boston/epidemiologia , China/epidemiologia , Feminino , Humanos , Recém-Nascido , Proteína 3 de Ligação a Fator de Crescimento Semelhante à Insulina , Proteínas de Ligação a Fator de Crescimento Semelhante a Insulina/metabolismo , Masculino , Fatores de RiscoRESUMO
OBJECTIVE: Resection is the best treatment for patients with stage I non-small cell lung cancer (NSCLC). Patterns of disease recurrence after complete resection in stage I NSCLC have not been well demonstrated. The aim of this study was to evaluate the prognostic predictors of post-recurrence survival in patients with resected stage I NSCLC with local recurrence. METHODS: The clinicopathological characteristics of 123 patients with local recurrence after complete resection of stage I NSCLC in Taipei Veterans General Hospital between 1980 and 2000 were retrospectively reviewed. Post-recurrence survival and their predictors were analysed. RESULTS: The patterns of local recurrence included local only in 74 (60.2%) and both local and distant in 49 (39.8%) patients. The 1 and 2 year post-recurrence survival rates for the 74 patients with local only recurrence were 48.7% and 17.6%, respectively. Tumour size (p = 0.033) and treatment for initial recurrence (p<0.001) were significant predictors for post-recurrence survival in 74 patients with local only recurrence in univariate analyses. The hazard of death was greater in patients with larger tumour size. Treatment for initial recurrence (p = 0.001) was still a significant prognostic indicator in multivariate analyses. Patients who underwent reoperation after local recurrence survived longer than those who received chemotherapy and/or radiotherapy and those that received no treatment. CONCLUSIONS: Treatment for initial recurrence is a prognostic predictor for post-recurrence survival in resected stage I NSCLC with local recurrence. Complete surgical resection should be considered in selected candidates with resectable local recurrent disease.
Assuntos
Carcinoma Pulmonar de Células não Pequenas/mortalidade , Neoplasias Pulmonares/mortalidade , Recidiva Local de Neoplasia/mortalidade , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/cirurgia , Prognóstico , Carga TumoralRESUMO
Human immunodeficiency virus type-2 (HIV-2) is a close relative of the prototype acquired immunodeficiency syndrome (AIDS) virus, HIV-1. HIV-2 is biologically similar to HIV-1, but information is lacking concerning clinical outcomes of HIV-2-infected individuals. From 1985 to 1993, a prospective clinical study was conducted in women with HIV-2 and HIV-1 infection to determine and compare rates of disease development. HIV-1-infected women had a 67% probability of AIDS-free survival 5 years after seroconversion in contrast with 100% for HIV-2-infected women. In addition to having significantly less HIV-related disease outcome in HIV-2 enrollees compared to HIV-1 enrollees, the rate of developing abnormal CD4+ lymphocyte counts with HIV-2 infection was also significantly reduced. This natural history study demonstrates that HIV-2 has a reduced virulence compared to HIV-1.
Assuntos
Síndrome da Imunodeficiência Adquirida/microbiologia , Infecções por HIV/microbiologia , HIV-1/patogenicidade , HIV-2/patogenicidade , Síndrome da Imunodeficiência Adquirida/epidemiologia , Síndrome da Imunodeficiência Adquirida/imunologia , Adulto , Linfócitos T CD4-Positivos , Estudos de Coortes , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/imunologia , Humanos , Tolerância Imunológica , Incidência , Contagem de Leucócitos , Estudos Prospectivos , Senegal/epidemiologia , VirulênciaRESUMO
We investigated the magnetic and ferroelectric properties of c-axis oriented orthorhombic phase HoMnO(3) (o-HMO in Pbnm symmetry setting) thin films grown on Nb-doped SrTiO(3)(001) substrates. The o-HMO films exhibit an antiferromagnetic ordering near 42 K, irrespective of the orientation of the applied field. However, an additional magnetic ordering occurring around 35 K was observed when the field was applied along the c-axis of o-HMO, which was absent when the field was applied in the ab-plane. The magnetocapacitance measured along the c-axis showed that although there is evidence of dielectric constant enhancement when the temperature is below 35 K the expected abrupt change in dielectric constant appears at a much lower temperature and reaches maximum around 13.5 K, indicating that the low-temperature c-axis polarization might be related to the ordering of the Ho(3+) moment. The lattice constant analyses using x-ray diffraction and the observation of a slight magnetization hysteresis suggest that the weak second magnetic transition along the c-axis at 35 K might be more relevant to the strain-induced effect on antiferromagnetism.
RESUMO
OBJECTIVE: Acute type A aortic dissection (ATAAD) is a severe, rapidly progressing disease which typically requires patients to undergo emergency surgical intervention. Despite advancements in surgical procedures, still, ATAAD remains a surgical emergency associated with high mortality. The aim of this systematic review and meta-analysis was to compare whether either ascending aorta replacement (AR) or total aortic arch replacement (TR) leads to improved short- and long-term clinical outcomes. MATERIALS AND METHODS: A search of PubMed, Embase, Science Direct, Web of Science, SciELO, BIOSIS, and China National Knowledge Infrastructure (CNKI) databases were supplemented by searching through bibliographies of key articles. Thereafter, data on early and late prognostic factors were extracted. A systematic review and meta-analysis of 15 studies were performed to compare whether either AR or TR leads to a reduction in the risk of in-hospital and short-term mortality, postoperative complications, re-operation rate, and long-term mortality. RESULTS: A total of 15 cohort studies (n = 2822 patients with ATAAD; AR with HA, partial arch = 1911, TR = 911) were deemed eligible and included in the meta-analysis. Compared with TR, AR led to a significantly lower risk of in-hospital mortality (RR = 0.77; 95% CI: 0.61-0.96), shorter cardiopulmonary bypass time (CPB, mean difference = -53.09; 95% CI: -56.68--49.50), circulatory arrest time (CA, mean difference = -8.09; 95% CI: -9.04-7.15), and antegrade cerebral perfusion (ACP, mean difference = -28.62; 95% CI: -30.23--27.00). Differences in the incidence rates of neurological dysfunctions and renal dialysis were not significant. The pooled rate of aortic re-operation was lower in TR group (AR 7.6% vs. TR 5.3%), albeit not significantly (risk ratio = 1.39; 95% CI: 0.94-2.07; p = 0.10). CONCLUSIONS: These findings demonstrate that AR is associated with a lower early mortality rate and shorter operative times overall. Nevertheless, the incidence of postoperative complications in patients undergoing AR is comparable to that of patients undergoing TR. Further prospective follow-up data needs to be collected and analyzed to discern whether there are statistically significant differences in the risks of re-operation and long-term mortality between AR and TR procedures.
Assuntos
Aorta/cirurgia , Aneurisma da Aorta Torácica/cirurgia , Dissecção Aórtica/cirurgia , Prótese Vascular , Doença Aguda , HumanosRESUMO
In uncomplicated pregnancies, first trimester androgen, oestrogen and prolactin concentrations were higher in nulliparous (n=160) than parous (n=260) mothers. Androgens and estrogens were higher in younger than older mothers. These data are consistent with elevated hormone concentrations mediating the breast cancer protection from a first pregnancy and pregnancies occurring at younger ages.
Assuntos
Hormônios Esteroides Gonadais/sangue , Primeiro Trimestre da Gravidez , Feminino , Humanos , GravidezRESUMO
Birth size of a woman has been positively associated with her breast cancer risk, particularly before menopause, but no study has investigated neonatal growth in relation to this risk. We conducted a case-control study nested within a population-based cohort of women, born in Sweden between 1901 and 1961, covering all 405 breast cancer patients and 1081 age- and hospital-matched controls, who were born after newborn charts became available. Compared to neonates who lost <200 g after birth and grew at a rate <25 g day(-1) after reaching postnatal weight nadir (ie, the minimum, before starting to regain weight), those who either lost >/=200 g after birth or grew >/=25 g day(-1) after nadir, or both, were at an approximately 50% increased breast cancer risk. The excess risk was striking and statistically significant among women below 50 years of age, but was not evident among older women. Immediate postnatal weight loss (an indicator of water loss, likely to reflect water retention associated with pregnancy hormones) as well as neonatal weight gain rate after the nadir (known to reflect growth hormone levels) was significantly positively associated with premenopausal breast cancer risk.