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Selected AbstractsHigh-Risk Cutaneous Squamous Cell Carcinoma without Palpable Lymphadenopathy: Is There a Therapeutic Role for Elective Neck Dissection?DERMATOLOGIC SURGERY, Issue 4 2007JUAN-CARLOS MARTINEZ MD PURPOSE The beneficial role of elective neck dissection (END) in the management of high-risk cutaneous squamous cell carcinoma (CSCC) of the head and neck remains unproven. Some surgical specialists suggest that END may be beneficial for patients with clinically node-negative (N0) high-risk CSCC, but there are few data to support this claim. We reviewed the available literature regarding the use of END in the management of both CSCC and head and neck SCC (HNSCC). METHODOLOGY The available medical literature pertaining to END in both CSCC and HNSCC was reviewed using PubMed and Ovid Medline searches. RESULTS Many surgical specialists recommend that END be routinely performed in patients with N0 HNSCC when the risk of occult metastases is estimated to exceed 20%; however, patients who undergo END have no proven survival benefit over those who are initially staged as N0 and undergo therapeutic neck dissection (TND) after the development of apparent regional disease. There is a lack of data regarding the proper management of regional nodal basins in patients with N0 CSCC. In the absence of evidence-based data, the cutaneous surgeon must rely on clinical judgment to guide the management of patients with N0 high-risk CSCC of the head and neck. CONCLUSIONS Appropriate work-up for occult nodal disease may occasionally be warranted in patients with high-risk CSCC. END may play a role in only a very limited number of patients with high-risk CSCC. [source] Cell-type-specific limitation on in vivo serotonin storage following ectopic expression of the Drosophila serotonin transporter, dSERTDEVELOPMENTAL NEUROBIOLOGY, Issue 5 2006Sang Ki Park Abstract The synaptic machinery for neurotransmitter storage is cell-type specific. Although most elements of biosynthesis and transport have been identified, it remains unclear whether additional factors may be required to maintain this specificity. The Drosophila serotonin transporter (dSERT) is normally expressed exclusively in serotonin (5-HT) neurons in the CNS. Here we examine the effects of ectopic transcriptional expression of dSERT in the Drosophila larval CNS. We find a surprising limitation on 5-HT storage following ectopic expression of dSERT and green fluorescence protein-tagged dSERT (GFP-dSERT). When dSERT transcription is driven ectopically in the CNS, 5-HT is detectable only in 5-HT, dopamine (DA), and a very limited number of additional neurons. Addition of exogenous 5-HT does not dramatically broaden neuronal storage sites, so this limitation is only partly due to restricted intercellular diffusion of 5-HT. Furthermore, this limitation is not due to gross mislocalization of dSERT, because cells lacking or containing 5-HT show similar levels and subcellular distribution of GFP-dSERT protein, nor is it due to lack of the vesicular transporter, dVMAT. These data suggest that a small number of neurons selectively express factor(s) required for 5-HT storage, and potentially for function of dSERT. © 2006 Wiley Periodicals, Inc. J Neurobiol, 2006 [source] An Atomic and Mesoscopic Study of Precipitation Kinetics in Al-Zr-Sc Alloys,ADVANCED ENGINEERING MATERIALS, Issue 12 2006E. Clouet This study illustrates how a quantitative multiscale modelling of the precipitation kinetics can be performed. Using a very limited number of experimental data and ab-initio calculations, we built for the Al-Zr-Sc alloy an atomic model from which mesoscopic quantities like the interface free energy or the nucleation free energy could be deduced. For the two binary Al-Zr and Al-Sc alloys, it was shown that a good agreement can be obtained between the KMC simulations, different mesoscopic models (CD and CNT) and experimental data. For the ternary alloy, CNT could be extended leading to predictions of an increase of the nucleation rate in agreement with atomic simulations and with experimental data. [source] Strong seasonal disequilibrium measured between the oxygen isotope signals of leaf and soil CO2 exchangeGLOBAL CHANGE BIOLOGY, Issue 11 2010LISA WINGATE Abstract The oxygen isotope composition (,18O) of atmospheric CO2 is among a very limited number of tools available to constrain estimates of the biospheric gross CO2 fluxes, photosynthesis and respiration at large scales. However, the accuracy of the partitioning strongly depends on the extent of isotopic disequilibrium between the signals carried by these two gross fluxes. Chamber-based field measurements of total CO2 and CO18O fluxes from foliage and soil can help evaluate and refine our models of isotopic fractionation by plants and soils and validate the extent and pattern of isotopic disequilibrium within terrestrial ecosystems. Owing to sampling limitations in the past, such measurements have been very rare and covered only a few days. In this study, we coupled automated branch and soil chambers with tuneable diode laser absorption spectroscopy techniques to continuously capture the ,18O signals of foliage and soil CO2 exchange in a Pinus pinaster Aït forest in France. Over the growing season, we observed a seasonally persistent isotopic disequilibrium between the ,18O signatures of net CO2 fluxes from leaves and soils, except during rain events when the isotopic imbalance became temporarily weaker. Variations in the ,18O of CO2 exchanged between leaves, soil and the atmosphere were well explained by theory describing changes in the oxygen isotope composition of ecosystem water pools in response to changes in leaf transpiration and soil evaporation. [source] A time-parallel implicit method for accelerating the solution of non-linear structural dynamics problemsINTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN ENGINEERING, Issue 4 2009Julien Cortial Abstract The parallel implicit time-integration algorithm (PITA) is among a very limited number of time-integrators that have been successfully applied to the time-parallel solution of linear second-order hyperbolic problems such as those encountered in structural dynamics. Time-parallelism can be of paramount importance to fast computations, for example, when space-parallelism is unfeasible as in problems with a relatively small number of degrees of freedom in general, and reduced-order model applications in particular, or when reaching the fastest possible CPU time is desired and requires the exploitation of both space- and time-parallelisms. This paper extends the previously developed PITA to the non-linear case. It also demonstrates its application to the reduction of the time-to-solution on a Linux cluster of sample non-linear structural dynamics problems. Copyright © 2008 John Wiley & Sons, Ltd. [source] Necessity of re-evaluation of estramustine phosphate sodium (EMP) as a treatment option for first-line monotherapy in advanced prostate cancerINTERNATIONAL JOURNAL OF UROLOGY, Issue 2 2001Tadaichi Kitamura Abstract Estramustine phosphate sodium (EMP) was first introduced in the early 1970s for the treatment of prostate cancer, when EMP was supposed to have the dual effect of estrogenic activity and cytotoxicity. For the following decades, it was used mainly in hormone-refractory cases, with a conventional dosage of 4,9 capsules/day, which showed a 30,35% objective response rate. However, a very limited number of cases have been reported that used EMP as a first-line monotherapy in the conventional dosage. One study showed a response rate of 82%, which is at least as effective as conventional estrogen (diethylstilbestrol; DES) monotherapy. Nevertheless, EMP was almost abandoned for the treatment of prostate cancer because of severe adverse side-effects, especially in the cardiovascular system and gastrointestinal tract. Recently, two facts have become evident. First, EMP interferes with cellular microtubule dynamics but does not show alkylating effects. Second, EMP is able to produce a complex with calcium when dairy products are taken concomitantly with EMP, resulting in a decrease in the absorption rate of EMP from the gut. Many clinical trials have been undertaken without warning against concomitant dairy product intake since the introduction of EMP. This fact will jeopardize almost all the clinical trials performed before 1990. It is considered that response rates have been underestimated and better results could have been obtained because side-effects decrease dose-dependently. Low-dose EMP monotherapy (2 capsules/day) has been performed infrequently in previously untreated advanced prostate cancer. The only large trial by the European Organization for Research and Treatment of Cancer in 1984 was biased in selecting patients. Nevertheless, the response rate of EMP is comparable to that of DES. In this study, the adverse side-effects of EMP were less than that of DES. Recently, a study was conducted at the University of Tokyo of 11 patients with advanced prostate cancer on low-dose EMP as first-line monotherapy. The study found that the mean serum prostate-specific antigen level decreased to within the normal range by day 50; mean serum testosterone, leutinizing hormone and follicle-stimulating hormone reduced to undetectable levels by day 20; and mean serum estradiol increased to a very high level within 1 week. These data implicate that low-dose EMP can suppress quickly and adequately the pituitary,gonadal axis, although the antitumor effect has not as yet been elucidated. For these reasons, it is necessary to re-evaluate low-dose EMP monotherapy in previously untreated advanced prostate cancer. [source] The flora of the South Sandwich Islands, with particular reference to the influence of geothermal heatingJOURNAL OF BIOGEOGRAPHY, Issue 6 2000P. Convey Abstract Aim, To carry out as comprehensive a survey as practicable of the flora (higher plants, mosses, liverworts, lichens, basidiomycete fungi and diatoms) of the isolated, volcanically active, South Sandwich Islands archipelago in the southern South Atlantic. To relate the components of this flora to (1) the influence of local geothermal heating and (2) wider regional floras. Location, South Sandwich Islands, southern South Atlantic Ocean, maritime Antarctic (56,60° S, 26,28° W). Methods, Ice-free accessible sites on all 11 of the major islands in the archipelago were visited by helicopter in January 1997. During each visit, voucher specimens of each floral group were collected. The comprehensiveness of collections obtained at each site varied with the duration of each visit (a function of tight logistic constraints) and extent of site. Visit duration varied from 1 to 9 h at most sites, with longer periods spent on Bellingshausen Island (2 days) and Leskov Island (1 day). Candlemas Island was examined in greater detail over a 4-week period in February 1997. At all sites, particular attention was given to areas influenced by geothermal heating. Results, Data obtained in 1997 are combined with updated records from the only previous survey (in 1964) to provide a baseline description of the flora of the archipelago, which currently includes 1 phanerogam, 38 mosses, 11 liverworts, 5 basidiomycete fungi, 41 lichenised fungi and 16 diatoms with, additionally, several taxa identified only to genus. Major elements of the moss and liverwort floras are composed of South American taxa (32% and 73%, respectively), with a further 45% of mosses having bipolar or cosmopolitan distributions. These two groups show low levels of Antarctic endemicity (11% and 18%, respectively). In contrast, 52% of lichens and 80% of basidiomycete fungi are endemic to the Antarctic. A further 36% of lichens are bipolar/cosmopolitan, with only 5% of South American origin. Main Conclusions, The flora of the South Sandwich Islands is clearly derived from those of other Antarctic zones. The flora of unheated ground is closely related to that of the maritime Antarctic, although with a very limited number of species represented. That of heated ground contains both maritime and sub-Antarctic elements, confirming the importance of geothermal heating for successful colonisation of the latter group. The occurrence of several maritime Antarctic species only on heated ground confirms the extreme severity of the archipelago's climate in comparison with well-studied sites much further south in this biogeographical zone. [source] Paramedical treatment in primary dystonia: A systematic review,MOVEMENT DISORDERS, Issue 15 2009Cathérine C.S. Delnooz MD Abstract Dystonia is a disabling movement disorder with a significant impact on quality of life. The current therapeutic armamentarium includes various drugs, botulinum toxin injections, and occasionally (neuro)surgery. In addition, many patients are referred for paramedical (including allied health care) interventions. An enormous variation in the paramedical treatment is provided, largely because evidence-based, accepted treatment regimes are not available. We have conducted a systematic review of studies that explored the effect of various paramedical interventions in primary dystonia. Only studies that have used clinical outcome measures were included. There were no class A1 or A2 studies and therefore, level 1 or 2 practice recommendations for a specific intervention could not be deducted. Many papers were case reports, mostly with a very limited number of patients and a clear publication bias for beneficial effects of a particular paramedical intervention. Some potentially interesting interventions come from class B studies, which include physical therapy in addition to botulinum toxin injections (BoNT-A) in cervical dystonia; sensorimotor training and transcutaneous electrical nerve stimulation (TENS) in writer's cramp; and speech therapy added to BoNT-A injections in laryngeal dystonia. Good quality clinical studies are therefore warranted, which should have the aim to be generally applicable. A design in which the paramedical intervention is added to a current gold standard, for example, BoNT-A injections in cervical dystonia, is recommended. © 2009 Movement Disorder Society [source] Practitioner Review: Cognitive rehabilitation for children with acquired brain injuryTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 4 2005Jenny Limond Background:, The need to address acquired cognitive impairments is increasing in child populations seen across a range of settings. However, current clinical practice following brain injury in children does not necessarily incorporate the use of cognitive rehabilitation models or techniques. The aim of this paper is to review the literature in this area. Methods:, All published interventions targeting the cognitive domains of attention, memory and/or executive function that could be identified were reviewed. Different cognitive rehabilitation techniques are briefly described and the clinical and research implications of the findings are discussed. Results:, Eleven papers, involving 54 children and adolescents receiving intervention, were identified. This literature describes generalised cognitive rehabilitation programmes as well as more specific strategies targeting focal deficits. Conclusions:, There is an absence of randomised controlled trials and a very limited number of studies using other methodological approaches, providing at this time no conclusive evidence for the efficacy of cognitive rehabilitation for children with acquired brain injury, but a clear need to address a range of methodological difficulties in this field of enquiry. [source] | |||||||||||||