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Feasible Option (feasible + option)
Selected AbstractsUse of a cyanoacrylate ester adhesive for splinting of replanted teethDENTAL TRAUMATOLOGY, Issue 6 2008Márcia Regina Negri The long-term clinical and radiographic success of the case reported in this paper indicates that the splinting technique using a quick-setting cyanoacrylate ester adhesive may be a feasible option for making a rapid, simple and efficient contention of replanted teeth in situations where the routinely used materials are not readily available. [source] Cash-based interventions: lessons from southern SomaliaDISASTERS, Issue 3 2006Hanna Mattinen Abstract Commodity distributions, the predominant relief response, are subject to growing criticism, while donors and humanitarian actors are increasingly viewing cash-based interventions as a viable alternative. This paper aims to contribute to the current debate on cash-based interventions by drawing on the experience of Action Contre la Faim in southern Somalia, where it has implemented cash for work programmes since 2004. The authors conclude that cash-based interventions are a feasible option in complex emergencies as well as in highly insecure environments as long as appropriate modalities are employed and objectives are clearly set in accordance with the needs and the context. Cash as a relief response offers wide-reaching possibilities for the future from both the perspective of the donor/agency and the standpoint of the beneficiary. It enables the beneficiaries to take control of the relief themselves and to adapt it to their individual requirements in a timely manner. [source] Decentralisation and Integration into the Community Administrations: A New Perspective on European AgenciesEUROPEAN LAW JOURNAL, Issue 4 2004Edoardo Chiti The purpose of this paper is to verify whether the various regulations by sector ought not to be regarded as variants of an emergent general model of joint exercise of certain Community functions. It is argued that such general model is still in the making, but it is in the process of becoming consolidated, notwithstanding the variety of approaches adopted by European legislators. Such a pattern is characterised by specific, differentiated organisational and procedural features. This conclusion is relevant in several different ways, the first of which is that it provides new conceptual tools for interpreting and explaining the process of administrative integration between supranational and national public authorities, in particular by specifying the taxonomy of the patterns through which a Community function can be carried out by two different authorities acting jointly. Second, the decentralised integration model should be considered as a sound and feasible option for the administrative evolution of the Community legal system. [source] Non-surgical treatment of hepatocellular carcinomaALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 1 2002A. M. Alsowmely Primary hepatocellular cancer is a disease with a poor prognosis for which there is little consensus on treatment and a paucity of comparative trials. The coexistence of cancer with cirrhosis complicates treatment, and also confers a high risk for the development of further tumours. Surgery, either by hepatic resection or orthotopic liver transplantation, is only a feasible option in a minority of patients. This article surveys the non-surgical approaches to the treatment of hepatocellular cancers,local ablation techniques, arterial embolization with and without chemotherapy, conventional chemotherapy and hormonal modulation, and targeted and external irradiation. [source] Liver Transplantation with Grafts from Controlled Donors after Cardiac Death: A 20-Year Follow-up at a Single CenterAMERICAN JOURNAL OF TRANSPLANTATION, Issue 3 2010S. Yamamoto The first liver transplantation (LTx) in Sweden was performed in 1984, but brain death as a legal death criterion was not accepted until 1988. Between November 1984 and May 1988, we performed 40 consecutive LTxs in 32 patients. Twenty-four grafts were from donors after cardiac death (DCD) and 16 grafts from heart-beating donors (HBD). Significantly, more hepatic artery thrombosis and biliary complications occurred in the DCD group (p < 0.01 and p < 0.05, respectively). Graft and patient survival did not differ between the groups. In the total group, there was a significant difference in graft survival between first-time LTx grafts and grafts used for retransplantation. There was better graft survival in nonmalignant than malignant patients, although this did not reach statistical significance. Multivariate analysis revealed cold ischemia time and post-LTx peak ALT to be independent predictive factors for graft survival in the DCD group. In the 11 livers surviving 20 years or more, follow-up biopsies were performed 18,20 years post-LTx (n = 10) and 6 years post-LTx (n = 1). Signs of chronic rejection were seen in three cases, with no difference between DCD and HBD. Our analysis with a 20-year follow-up suggests that controlled DCD liver grafts might be a feasible option to increase the donor pool. [source] Sequential Pancreaticoduodenectomy after Living Donor Liver Transplantation for CholagiocacinomaAMERICAN JOURNAL OF TRANSPLANTATION, Issue 10 2008Y. Soejima Liver transplantation (LT) for patients with primary sclerosing cholangitis (PSC) is often contraindicated due to concomitant occurrence of cholangiocarcinoma (CC). Cases of simultaneous pancreaticoduodenectomy (PD) with LT have been sporadically reported; however, the applicability of such an invasive procedure to patients with CC has not been validated. We report here a case of sequential PD performed 44 days after a successful living donor liver transplantation (LDLT) using a left lobe graft. Although a clear pancreatic juice leakage through the drain persisted for days after surgery, the patient recovered from the complication and was discharged 32 days after the procedure. Currently, 1 year after LDLT, the patient is doing well with no evidence of recurrence. In conclusion, a sequential PD following LDLT is a safe and feasible option to treat CC complicating PSC. Long-term follow-up and accumulation of cases are necessary to evaluate the effectiveness of this procedure for this complicated disease. [source] Feasibility of Left Lobe Living Donor Liver Transplantation Between Adults: An 8-Year, Single-Center Experience of 107 CasesAMERICAN JOURNAL OF TRANSPLANTATION, Issue 5p1 2006Y. Soejima Operative mortality for a right lobe (RL) donor in adult living donor liver transplantation (LDLT) is estimated to be as high as 0.5,1%. To minimize the risk to the donor, left lobe (LL)-LDLT might be an ideal option in adult LDLT. The aim of the study was to assess the feasibility of LL-LDLT between adults based on a single-center experience of 107 LL-LDLTs performed over 8 years. The mean graft weight of LL grafts was 452 g, which amounted to 40.5% of the estimated standard liver volume of the recipients. The overall 1-, 3- and 5-year patient survival rates in LL-LDLT were 81.4, 76.9 and 74.7%, respectively, which were comparable to those of RL-LDLT. Twenty-six grafts (24.3%) were lost for various reasons with three losses directly attributable to small-for-size graft syndrome. Post-operative liver function and hospital stay in LL donors were significantly better and shorter than that in RL donors, while the incidence of donor morbidity was comparable between LL and RL donors. In conclusion, LL-LDLT was found to be a feasible option in adult-to-adult LDLT. Further utilization of LL grafts should be undertaken to keep the chance of donor morbidity and mortality minimal. [source] MANAGEMENT OF POPLITEAL ARTERY ANEURYSMSANZ JOURNAL OF SURGERY, Issue 10 2006Maher Hamish Background: Popliteal artery aneurysms (PAA) are the most common peripheral aneurysm and are recognized as ,the silent killer of the leg circulation'. The timing and type of interventions used in their treatment is still controversial. This review examines the published data on the natural history, epidemiology, clinical presentation and management options available. The aim of this study is to try and reach a consensus with regards to the best management of PAA. Method: A systematic review of data in the English published works since 1980. Results: The authors include 53 studies containing 2854 patients with 4291 PAA. Most published data involves retrospective studies and personal experience, with one multicentre study. No randomized controlled studies exist regarding the management of PAA. Conclusions: 1. Although most PAA are of atherosclerotic origin in old patients, trauma, infection and family history are the main causes in young patients. 2. Great vigilance is needed for diagnosis as only approximately five patients are seen each year by a major vascular centre. There is no place for screening programmes to detect PAA. 3. Approximately 45% of patients are asymptomatic at the time of initial diagnosis. Aortic aneurysms are found in 40% and bilateral PAA in 50% of patients. More than 95% of patients are men with a mean age of 65 years and 45% have hypertension. 4. Surgical reconstruction is recommended for all symptomatic and asymptomatic aneurysms larger than 2 cm. Five-year graft patency rates after surgical repair range from 30 to 97%, with 5-year limb salvage ranging from 70 to 98%. Patient survival rates at 5 and 10 years are 75 and 46%, respectively. 5. If carried out carefully, intra-arterial thrombolysis can safely prepare patients presenting with acute ischaemia from occluded PAA, for surgical revascularization to restore distal run-off. 6. Endovascular repair of a PAA is a feasible option, although little evidence is yet available. 7. Lifelong, careful patient surveillance is essential to detect and treat new aneurysms at other sites. [source] Investigating the Feasibility of Stem Cell Enrichment Mediated by Immobilized SelectinsBIOTECHNOLOGY PROGRESS, Issue 6 2007Nichola Charles Hematopoietic stem cell therapy is used to treat both malignant and non-malignant diseases, and enrichment of the hematopoietic stem and progenitor cells (HSPCs) has the potential to reduce the likelihood of graft vs host disease or relapse, potentially fatal complications associated with the therapy. Current commercial HSPC isolation technologies rely solely on the CD34 surface marker, and while they have proven to be invaluable, they can be time-consuming with variable recoveries reported. We propose that selectin-mediated enrichment could prove to be a quick and effective method for recovering HSPCs from adult bone marrow (ABM) on the basis of differences in rolling velocities and independently of CD34 expression. Purified CD34+ ABM cells and the unselected CD34, ABM cells were perfused over immobilized P-, E-, and L-selectin-IgG at physiologic wall shear stresses, and rolling velocities and cell retention data were collected. CD34+ ABM cells generally exhibited lower rolling velocities and higher retention than the unselected CD34, ABM cells on all three selectins. For initial CD34+ ABM cell concentrations ranging from 1% to 5%, we predict an increase in purity ranging from 5.2% to 36.1%, depending on the selectin used. Additionally, selectin-mediated cell enrichment is not limited to subsets of cells with inherent differences in rolling velocities. CD34+ KG1a cells and CD34, HL60 cells exhibited nearly identical rolling velocities on immobilized P-selectin-IgG over the entire range of shear stresses studied. However, when anti-CD34 antibody was co-immobilized with the P-selectin-IgG, the rolling velocity of the CD34+ KG1a cells was significantly reduced, making selectin-mediated cell enrichment a feasible option. Optimal cell enrichment in immobilized selectin surfaces can be achieved within 10 min, much faster than most current commercially available systems. [source] Phase 2 study of intraperitoneal topotecan as consolidation chemotherapy in ovarian and primary peritoneal carcinoma,CANCER, Issue 3 2008Howard G. Muntz MD Abstract BACKGROUND. Intravenous topotecan is approved for the treatment of ovarian cancer (OC). In intraperitoneal (i.p.) topotecan studies, 20 mg/m2 dosing was tolerable. This study evaluated the feasibility, safety, and preliminary efficacy of i.p. topotecan as consolidation chemotherapy in patients with OC or primary peritoneal cancers (PPCs). METHODS. Patients with stage III/IV ovarian or PPC in clinical complete response after surgical cytoreduction and intravenous carboplatin/paclitaxel chemotherapy who had benign findings or minimal persistent disease (,1 cm diameter) at second-look surgery were eligible. Intraperitoneal topotecan 20 mg/m2 was infused once every 21 days for 4 to 6 cycles. Kaplan-Meier estimates were used to calculate progression-free survival (PFS) and overall survival (OS). RESULTS. Twenty patients were enrolled (18 [90%] patients had OC). Sixteen patients received 4 cycles, 3 patients received 6 cycles, and 1 patient withdrew after 1 cycle. The mean delivered dose was 18 mg/m2. Grade 3/4 toxicities included neutropenia and thrombocytopenia (45% for both). Grade 1/2 abdominal distension and nausea were reported in 60% and 40% of patients, respectively. Median PFS was 24 months from second-look surgery (95% confidence intervals [CI]: ±10 months). Sixteen patients were alive and median OS was not reached at the time of data analysis. OS estimated at either 30 months from second-look surgery, or 3 years from initial diagnosis, was 84% (95% CI, 68%-100%). CONCLUSIONS. Consolidation i.p. topotecan is a feasible option for women withadvanced ovarian and primary peritoneal cancers. Further investigation of i.p. topotecan is warranted in this patient population. Cancer 2008. © 2008 American Cancer Society. [source] Radioimmunotherapy of small-volume disease of metastatic colorectal cancerCANCER, Issue S4 2002Results of a phase II trial with the iodine-13, carcinoembryonic antigen antibody hMN-1, labeled humanized anti Abstract BACKGROUND Whereas radioimmunotherapy (RIT) has shown disappointing results in bulky, solid tumors, preclinical results in small-volume disease and in an adjuvant setting are promising. In a previous Phase I study, the authors had encouraging results with the iodine-131 (131I),labeled humanized anti,carcinoembryonic antigen (anti-CEA) antibody (MAb) hMN-14 in small-volume disease of colorectal cancer. The aim of this study was to evaluate, in a subsequent Phase II trial, the therapeutic efficacy of this 131I-labeled humanized anti-CEA antibody in colorectal cancer patients with small-volume disease or in an adjuvant setting. METHODS Thirty colorectal cancer patients, with small-volume metastatic disease (n = 21; all lesions , 3.0 cm, and chemorefractory to 5-fluorouracil and folinic acid) or in an adjuvant setting (n = 9), 4,6 weeks after surgical resection of liver metastases with curative intention, were studied. The patients were given a single injection of 131I-hMN-14 immunoglobulin G at a 60 mCi/m2 dose level, which was shown to be the maximum tolerated dose in the previous Phase I study. Follow-up was obtained at 3-month intervals for as long as 36 months. RESULTS At a mean blood-based red marrow dose of 1.8 ± 0.8 Gy, myelotoxicity was the only toxicity observed, but only 1 of 28 assessable patients developed transient Grade 4 thrombocytopenia. Of the 21 patients with radiologically documented lesions, 19 were assessable. Three experienced partial remission and eight showed minor responses up to 15 months in duration (corresponding to an objective response rate of 16% and an overall response rate of 58%; the mean duration of response was 9 months). At the time this article was written, seven of nine patients in the adjuvant setting had remained free of disease for up to 36 months (one patient relapsed after 6 months and another after 30 months), whereas the relapse rate in a historical control group receiving chemotherapy was 67% over the same time period. Five patients with radiologically documented lesions, having experienced at least disease stabilization as a consequence of RIT, were retreated at the same 60-mCi/m2 dose level at 8,16 months after the first therapy. No evidence of increased toxicity was observed (no hematologic toxicity was higher than Grade 3). Two of four assessable retreated patients experienced partial remissions; one of these four again experienced disease stabilization as a consequence of the second radioantibody therapy injection. CONCLUSIONS These data suggest that RIT is a safe and effective form of therapy for small-volume colorectal cancer and has potential as treatment for colorectal cancer in an adjuvant setting. Toxicity is restricted to mild and transient leuko- and thrombocytopenia. Retreatment seems to be a feasible option. A prospective randomized comparison with standard chemotherapy is indicated. Cancer 2002;94:1373,81. © 2002 American Cancer Society. DOI 10.1002/cncr.10308 [source] The climate learning ladder.ENVIRONMENTAL POLICY AND GOVERNANCE, Issue 1 2010A pragmatic procedure to support climate adaptation Abstract We introduce a new pragmatic procedure called the ,climate learning ladder' to structure policy analysis, support reflection and identify critical decisions to support climate adaptation. This tool is the result of the reflexive learning process that occurred while developing innovative appraisal methods in the Alxa League of Inner Mongolia, China, and in the Guadiana river basin in the European Union. Building capacities to cope with climate change requires going beyond simply providing ,more knowledge' on climate impacts to policy makers. Instead, climate adaptation can be understood as a multi-step social process in which individuals and organizations need to learn how to (1) manage different framings of the issues at stake while raising awareness of climate risks and opportunities, (2) understand different motives for, and generate adequate incentives or sanctions to ensure, action, (3) develop feasible options and resources for individual and collective transformation and collaboration and (4) institutionalize new rights, responsibilities and feedback learning processes for climate adaptation in the long term. Copyright © 2010 John Wiley & Sons, Ltd and ERP Environment. [source] Alternative Scenarios for Managing the Environmental Performance of a Service Sector CompanyJOURNAL OF INDUSTRIAL ECOLOGY, Issue 4 2006Seppo Junnila Summary This article presents a scenario analysis for a life-cycle model of service sector companies. The model is based on six case companies and it is applied to test the influence of 32 management scenarios. The scenarios simulate feasible options for environmental management measures in companies, and the life-cycle assessment method is used to model their relevance in terms of the total environmental impact of the company. The study found that the bulk of tested scenarios had only a minor influence on the total environmental impact of the company. Some individual management scenarios, though, turned out to have a major influence on the organization's environmental performance. The scenarios with greatest influence were those related to the procurement of electricity, building energy consumption, commuting vehicle mix, space usage efficiency, and refurbishment periods of the building. All of these management scenarios had an influence of more than 10% on the environmental impact of the model organization. [source] WATER SUPPLY EVALUATION OF TAIWAN'S SILICON VALLEY,JOURNAL OF THE AMERICAN WATER RESOURCES ASSOCIATION, Issue 5 2001Wen-Cheng Huang ABSTRACT: The objective of this paper is to examine a deficit in water for the Hsinchu area, the location of Taiwan's "Silicon Valley." The methods suggested in this paper to diagnose water shortage problems are simple and practical. The results show that Hsinchu is in an area without sufficient water to meet demand for domestic and industrial uses. Until the completion of the Baoshan II Reservoir in 2006, the most feasible options for the Taiwan Water Supply Corporation to offset the water deficiency in Hsinchu City over the next five years are: (a) to obtain water gratuitously from the southern Yungheshan Reservoir; (b) to import additional water at an extra charge from other sources such as the northern Shihmen Reservoir and the agricultural sector; and (c) to conduct a comprehensive water conservation program at the Hsinchu Science-based Industrial Park. [source] | |||||||||||||