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Improved Control (improved + control)
Selected AbstractsEffectiveness of selective neck dissection in the treatment of the clinically positive neckHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 9 2008FRCS ORL-HNS, Rajan S. Patel MBChB Abstract Background. The aim of this work was to determine whether or not patients treated with therapeutic selective neck dissection for head and neck squamous cell carcinoma were oncologically disadvantaged compared with those having comprehensive procedures. Methods. The study involves a retrospective review of 232 therapeutic neck dissections with a minimum of 2 years follow-up. Results. Patients having selective neck dissection had fewer adverse prognostic factors compared with patients having comprehensive dissection (pN2/3, p = .001; and extracapsular spread, p = .001). There were trends toward improved control in the dissected neck (96% vs 86%, p = .06), and disease-specific survival (59% vs 43%, p = .06) following selective neck dissection. Disease-specific survival for all patients was adversely affected by pN classification (p <.001) and extracapsular spread (p <.001). Conclusions. Patients undergoing aggressive neck surgery had more extensive disease. Selective neck dissection can be used to effectively treat clinically positive nodal disease in selected patients. © 2008 Wiley Periodicals, Inc. Head Neck 2008 [source] Matrix vapor deposition/recrystallization and dedicated spray preparation for high-resolution scanning microprobe matrix-assisted laser desorption/ionization imaging mass spectrometry (SMALDI-MS) of tissue and single cellsRAPID COMMUNICATIONS IN MASS SPECTROMETRY, Issue 3 2010Werner Bouschen Matrix preparation techniques such as air spraying or vapor deposition were investigated with respect to lateral migration, integration of analyte into matrix crystals and achievable lateral resolution for the purpose of high-resolution biological imaging. The accessible mass range was found to be beyond 5000 u with sufficient analytical sensitivity. Gas-assisted spraying methods (using oxygen-free gases) provide a good compromise between crystal integration of analyte and analyte migration within the sample. Controlling preparational parameters with this method, however, is difficult. Separation of the preparation procedure into two steps, instead, leads to an improved control of migration and incorporation. The first step is a dry vapor deposition of matrix onto the investigated sample. In a second step, incorporation of analyte into the matrix crystal is enhanced by a controlled recrystallization of matrix in a saturated water atmosphere. With this latter method an effective analytical resolution of 2,µm in the x and y direction was achieved for scanning microprobe matrix-assisted laser desorption/ionization imaging mass spectrometry (SMALDI-MS). Cultured A-498 cells of human renal carcinoma were successfully investigated by high-resolution MALDI imaging using the new preparation techniques. Copyright © 2010 John Wiley & Sons, Ltd. [source] Reduction of bias in static closed chamber measurement of ,13C in soil CO2 effluxRAPID COMMUNICATIONS IN MASS SPECTROMETRY, Issue 2 2010K. E. Anders Ohlsson The 13C/12C ratio of soil CO2 efflux (,e) is an important parameter in studies of ecosystem C dynamics, where the accuracy of estimated C flux rates depends on the measurement uncertainty of ,e. The static closed chamber method is frequently used in the determination of ,e, where the soil CO2 efflux is accumulated in the headspace of a chamber placed on top of the soil surface. However, it has recently been shown that the estimate of ,e obtained by using this method could be significantly biased, which potentially diminish the usefulness of ,e for field applications. Here, analytical and numerical models were used to express the bias in ,e as mathematical functions of three system parameters: chamber height (H), chamber radius (Rc), and soil air-filled porosity (,). These expressions allow optimization of chamber size to yield a bias, which is at a level suitable for each particular application of the method. The numerical model was further used to quantify the effects on the ,e bias from (i) various designs for sealing of the chamber to ground, and (ii) inclusion of the commonly used purging step for reduction of the initial headspace CO2 concentration. The present modeling work provided insights into the effects on the ,e bias from retardation and partial chamber bypass of the soil CO2 efflux. The results presented here supported the continued use of the static closed chamber method for the determination of ,e, with improved control of the bias component of its measurement uncertainty. Copyright © 2009 John Wiley & Sons, Ltd. [source] Combined Pancreatic Islet,Lung Transplantation: A Novel Approach to the Treatment of End-Stage Cystic FibrosisAMERICAN JOURNAL OF TRANSPLANTATION, Issue 7 2010L. Kessler Patients with end-stage cystic fibrosis (CF) and severe CF-related diabetes (CFRD) may benefit from combined lung-pancreatic islet transplantation. In the present study, we report the long-term follow-up of four end-stage CF patients treated with combined bilateral lung and pancreatic islet transplantation from the same donor. All patients were C-peptide negative (<0.5 ,g/L) and inadequately controlled despite intensive insulin treatment. One patient was transplanted with 4 019 ± 490 islet equivalent/kg injected into the transverse colic vein using a surgical approach. In the remaining three patients, islets were cultured for 3,6 days and transplanted by percutaneous transhepatic catheterization of the portal vein. In all patients, islet allograft recovery was recognized by elevation in the plasma level of C-peptide (>0.5 ,g/L). At 6 months after transplantation, one patient showed multiple episodes of acute lung transplant rejection and a progressive decline in pancreatic islet cell function. Three out of four patients experienced an improved control of glucose levels with a HbA1c of 5.2%, 7% and 6% respectively at 1.5, 2 and 15 years follow-up. Compared with the pretransplant period, there was a 50% reduction in mean daily insulin needs. Pulmonary function remained satisfactory in all patients. In conclusion, our cases series shows that combined bilateral lung and pancreatic islet transplantation may be a viable therapeutic option for patients with end-stage CF and CFRD. [source] Transcatheter closure of coronary artery fistulae using the Amplatzer duct occluderCATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 2 2006Sarina K. Behera MD Abstract Objective: The aim of this study is to report our experience using the Amplatzer Duct Occluder (ADO) for occlusion of significant coronary artery fistulae (CAF). Background: Transcatheter closure of CAF with coils is well described. Use of newer devices may offer advantages such as improved control of device placement, use of a single instead of multiple devices, and high rates of occlusion. Methods: A retrospective review of all patients catheterized for CAF from July 2002 through August 2005 was performed. Results: Thirteen patients with CAF underwent cardiac catheterization, of which a total of 6 patients had ADO placement in CAF (age, 21 days to 56 years; median age, 4.3 years and weight, 3.8 kg to 74.6 kg; median weight, 13.3 kg). An arteriovenous wire loop was used to advance a long sheath antegrade to deploy the ADO in the CAF. Immediate and short-term outcomes (follow-up, 3 months to 14 months; median follow-up, 8.5 months) demonstrated complete CAF occlusion in 5 patients and minimal residual shunt in 1 patient (who had resolution of right atrial and right ventricular enlargement). On follow-up clinical evaluation, all 6 patients had absence of fistula-related murmurs, and 2 previously symptomatic patients had resolution of congestive heart failure symptoms. Early complications included transient palpitations and atrial arrhythmia in the 2 oldest patients (52 and 56 years old). Conclusions: Use of the ADO is applicable for transcatheter closure of significant CAF. Advantages of using the ADO include the antegrade approach, use of a single device, and effective CAF occlusion. © 2006 Wiley-Liss, Inc. [source] Microfluidic-Assisted Synthesis of Polymer ParticlesCHEMICAL ENGINEERING & TECHNOLOGY (CET), Issue 8 2008A. Serra Abstract Microfluidic devices have recently emerged as promising tools for the synthesis of polymer particles. Over conventional processes, microfluidic-assisted processes allow the production of polymer particles with an improved control over their sizes, size distributions, morphologies, and compositions. In this paper, the most common microfluidic devices are reviewed. Both projection photolithography and emulsification processes are reported for the continuous flow synthesis of polymer particles from a stream of polymerizable liquids. For the latter process, two distinct categories of microfluidic devices have been identified: microchannel-based and capillary-based microsystems. For each category, the existing geometries are described and the different emulsification methods including the co-flowing, cross-flowing, or flow-focusing of the continuous and dispersed phases are commented upon. Finally, for each microsystem the various polymer particles achieved in such devices including, but not restricted to, janus, core,shell, or porous particles and capsules are reported. [source] One-year follow-up of patients with acromegaly treated with fixed or titrated doses of lanreotide Autogel®CLINICAL ENDOCRINOLOGY, Issue 6 2004Ph. Caron Summary objective, Somatostatin analogue treatment is first-line medical therapy for acromegaly. This study compared the efficacy and tolerability of titrated doses of the long-acting somatostatin analogue preparation lanreotide Autogel® with fixed doses and with lanreotide prolonged release (PR) 30 mg microparticles. patients, Patients entering the initial study had received a diagnosis of active acromegaly within the previous 5 years. design, This open, comparative, multicentre study was a 1-year extension of a previous trial during which patients with acromegaly had switched from lanreotide PR 30 mg microparticles injected intramuscularly every 7, 10 or 14 days, for at least 3 months, to one of three fixed doses of lanreotide Autogel® (120, 90, or 60 mg every 28 days, respectively). In this extension study, patients continued to receive 60, 90, or 120 mg of lanreotide Autogel® by deep subcutaneous injection every 28 days for 1 year. Doses could be titrated at entry or after four or eight injections, according to the GH/IGF-I response (dose increased if GH > 2·5 µg/l, or decreased if GH < 1 µg/l with normal IGF-I). measurements, Mean ± SEM GH and IGF-I concentrations were analysed and gallbladder echography performed at weeks 0, 16, 32, and 48. Acromegaly symptoms were recorded monthly and tolerance and side-effects were monitored throughout the study. results, In total, 130 patients entered this extension phase. After 1 year of treatment with titrated doses of lanreotide Autogel®, mean GH (2·4 ± 0·2 µg/l) and IGF-I (287 ± 12 µg/l) concentrations were significantly lower than with lanreotide microparticles (GH, 2·8 ± 0·2 µg/l, P < 0·001; IGF-I, 332 ± 15 µg/l, P < 0·01) or with fixed-dose lanreotide Autogel® (GH, 3·0 ± 0·2 µg/l, P < 0·001; IGF-I, 310 ± 14 µg/l, P = 0·02). GH hypersecretion was reduced to , 2·5 µg/l in 68% of patients with titrated-dose lanreotide Autogel® compared with 49% with microparticles (P < 0·001) and 56% with fixed-dose lanreotide Autogel® (P , 0·005). In the 65 patients who did not require any dose titration, there was no substantial change in serum lanreotide concentration, GH or IGF-I levels over the 12-month study duration. Acromegaly was effectively controlled (GH , 2·5 µg/l and normalized IGF-I) in significantly more patients (43%) compared with microparticles (32%; P < 0·05). There was a trend for improved control of acromegalic symptoms with dose titration, whereas the incidence of gastrointestinal symptoms and local tolerance was similar with lanreotide Autogel® and lanreotide microparticles. Gallbladder echographies showed new lithiasis in 8% of lanreotide Autogel® patients. conclusion, Dose titration of lanreotide Autogel® improved GH and IGF-I control in patients with acromegaly beyond that achieved using fixed doses of lanreotide Autogel® or lanreotide microparticles. Titrated long-term lanreotide Autogel® treatment is well tolerated. [source] | |||||||||||||