The objectives of these studies were, first, to determine the effect of elevated luminal viscosity on the gastrointestinal absorption of four model drugs and, second, to identify the key processes influencing drug absorption under elevated viscosity conditions. Studies were conducted in vitro and in healthy female mongrel does under fasting conditions. In the canine model, both the rate and extent of paracetamol and hydrochlorothiazide absorption were significantly decreased by the coadministration of 15 g guar gum dissolved in 500 ml normal saline. In the case of cimetidine, the rate but not extent of absorption was decreased. Owing to the high variability in the data, no statistically based conclusion could be drawn about the effects of coadministered guar gum on the oral absorption of the poorly soluble mefenamic acid. Based on the in vitro data, it appears that substantial reductions in the dissolution rate of paracetamol, hydrochlorothiazide and cimetidine account for the effects observed in vivo. It is concluded that the effect of an elevation in the intraluminal viscosity on drug absorption is greatest for highly soluble drugs, and results from a combination of a decrease in dissolution rate and gastric emptying rate. (C) 1998 Elsevier Science B.V.
The objective of this study was to evaluate the effects which hydroxypropylmethylcellulose (HPMC) may exert on oral drug absorption, in cases where this soluble fiber is administered to regulate blood lipid levels. Studies were conducted in vitro and in healthy female mongrel dogs using two different grades of HPMC, i.e. K8515 HPMC and ultra high molecular weight (UHMW) HPMC. The maximum plasma concentration, C-max, of paracetamol and both the C-max and the area under the concentration-time curve, AUC, of cimetidine were significantly decreased by the coadministration of 10 g of K8515 HPMC or 7.5 g of UHMW HPMC dissolved in 500 mL normal saline under fasting conditions. No statistically significant effects were observed on hydrochlorothiazide or mefenamic acid absorption. Based on in vitro data and previous studies it appears that reductions in gastric emptying and dissolution rate of paracetamol account for the effect observed in vivo. For cimetidine, a drug which can be absorbed from both the small and the large intestine, the indigestibility of HPMC in the colon in addition to the great reduction of dissolution rate led to reductions of both the C-max and AUC values. The long T-max values, even in the absence of HPMCs and the more modest reduction of the dissolution rate of hydrochlorothiazide by the HPMCs are thought to have precluded the observation of any significant alterations in the in vivo absorption profile. Owing to its erratic absorption, no statistically based conclusion could be drawn about the effects of coadministered HPMC on the oral absorption of the poorly soluble mefenamic acid. It is concluded that the effects of HPMCs on drug absorption in dogs are most pronounced for compounds with absorption profiles that are dependent on gastric emptying, i.e. compounds that are highly water soluble and that exhibit short T-max values. Compounds with long absorption profiles appear to be less susceptible to changes in absorption behavior due to coadministration of HPMCs. (C) 1998 John Wiley & Sons, Ltd.
Aberrant expression of apoptosis-related genes including the 'cell death suppressor gene' bcl-2, may play an important pathogenetic role in cancer expression by 2-CdA, and or GST would provide a basis for their efficacy in suppressing arthritis by interfering with the upregulation of bcl-2 mRNA in the synovial lining cells (Muller-Laduer et al., 1995). However, the lack of a direct inhibitory effect on the induction of bcl-2 biosynthesis at the relatively high concentrations tested suggests that both GST and 2-CdA exert their beneficial effects in these patients through a bcl-2 independent mechanism.
{The temperature dependence of the EPR spectra of the recently discovered Ag6S3O4 phase in the Ag-O-S system prepared by two methods, the known method of co-precipitation from aqueous solution and a new method depending on the interaction of Ag2S and Ag2SO4 solid reagents, has been investigated. No EPR spectra were observed at room temperature, while at liquid helium temperature a number of EPR spectra have been recorded, which disappeared upon increasing temperature up to liquid nitrogen temperature. The sample obtained by the co-precipitation method revealed an intense, rich EPR spectrum that has been tentatively interpreted assuming the presence of at least two different Ag2+ ion complexes, one monomer resulting in an intense anisotropic, rhombic EPR powder pattern with g1 = 1.93(1)
Likodimos V, Guskos N, Wabia M, Typek J. Exchange interactions of ions. Physical Review B - Condensed Matter and Materials Physics [Internet]. 1998;58:8244-8247. WebsiteAbstract
BACKGROUND/AIMS: Chronic hepatitis C appears to have a highly variable natural course with 20% of patients developing cirrhosis within 20 years, while the majority of them run a relatively mild course. We studied the relationships of epidemiological, biochemical and virological features with histological severity (grade) and liver disease progression (stage). METHODOLOGY: Liver histology, serum HCV RNA level and HCV genotype were determined in a well-defined cohort of 152 consecutive (100 males, 52 females) patients with chronic hepatitis C. RESULTS: Patients with minimal or mild chronic hepatitis were significantly younger than those with moderate or severe chronic hepatitis (mean age: 41.1 vs 49.5 years respectively, p=0.003). On the other hand, patients with no or mild fibrosis compared to those with moderate or severe fibrosis and to those with cirrhosis were significantly more frequently males (73%, 64% and 43%, p=0.01), parenteral drug users (36%, 11% and 11%, p=0.01) and infected with other than 1b genotype (86%, 52% and 33%, p<0.0001), significantly younger (mean age: 37, 48 and 58 years, p<0.0001) and had significantly lower HCV RNA levels (geometric mean: 6.9, 19.2 and 17.5 x 10(5) eq/ml, p=0.007). Multivariate analysis showed that stage was significantly related only to patient age (p<0.0001), HCV genotype (p=0.0025) and HCV RNA level (p=0.044). CONCLUSIONS: In chronic hepatitis C, histological severity seems to be associated only with patient age, while progression of the disease is mainly associated with patient age, HCV genotype and viremia level.
The mechanism of 2-deoxyribonolactone formation from the reaction of photogenerated 2'-deoxyuridin-1'-yl radical with molecular oxygen in water has been investigated.
The mechanism of 2-deoxyribonolactone formation from the reaction of photogenerated 2′-deoxyuridin-1′-yl radical with molecular oxygen in water has been investigated.
Purpose. To evaluate the outcome and the prognosis of patients with ovarian germ cell malignancies who were treated with platinum-based chemotherapy immediately after initial surgery. Methods. We conducted a retrospective review of patients with ovarian germ cell tumors who were referred for consideration of treatment to the Departments of Medical Oncology participating in the Hellenic Cooperative Oncology Group. Results. Over a 14-year period 53 patients were included in our study. There were 13 patients with dysgerminoma and 40 patients with nondysgerminomatous tumors. Forty percent of patients underwent complete resection of their tumors. Platinum-based chemotherapy consisted primarily of cisplatin, vinblastine, and bleomycin (PVB) in 9 patients; bleomycin, etoposide, and cisplatin (BEP) in 15 patients; and bleomycin, etoposide, and carboplatin (BEC) in 25 patients. With a median follow-up of 39 months, 5 patients developed progressive disease and died of their tumor and 1 patient died of bleomycin- induced lung toxicity with no evidence of active tumor. The 5-year overall survival was 100% for patients with dysgerminoma and 85% for patients with nondysgerminomatous tumors. Eighty percent of patients with advanced nondysgerminomatous tumors and residual disease after surgery remain disease free. Conclusion. With this study we confirm that patients with ovarian germ cell malignancies have a favorable outcome when treated with platinum-based chemotherapy.
Purpose: To evaluate the activity and toxicity of the combination of paclitaxel given by three-hour infusion, and carboplatin as first- line chemotherapy in patients with advanced breast cancer (ABC). Background: Paclitaxel is an active agent in ABC. Furthermore, our group has shown that the combination of paclitaxel and carboplatin is effective in anthracycline-resistant ABC. Patients and methods: From January 1996 until March 1997, 66 women with ABC were treated with paclitaxel (175 mg/m2) by three-hour infusion followed by carboplatin at an AUC of 6 mg x min/ml every three weeks. The median age of the patients was 56 years (range 28-75). A total of 39 patients had received adjuvant chemotherapy and 22 of them were treated with an anthracycline or mitoxantrone-containing regimen. Results: A total of 324 cycles (median: six) were administered, 273 (85%) of them at full dose. The median number of delivered cycles was six. The median delivered dose intensity (DI) of paclitaxel was 55.1 mg/m2/week (range 30.5-69.3) and the relative DI was 0.95 (range 0.5-1.2). Eight patients (12%, 95% confidence interval (CI): 5%-22%) achieved complete and 28 (42%, 95% CI: 30%-55%) partial responses. Grade 3-4 toxicities included anemia (5%), granulocytopenia (24%), thrombocytopenia, nausea/vomiting and allergic reaction (3% each), myalgias/arthralgias and neurotoxicity (1,5% each). Febrile neutropenia occurred in eight (12%) patients. Alopecia was universal. After a median follow-up of 17.3 (range 0.07- 24.5) months, 48 (72%) patients have demonstrated tumor progression and 24 (36%) have died. Median time to progression was 8.6 (range 0.07- 23+) months and median survival 20.4 (range 0.07-24.5+) months. Conclusions: The combination of paclitaxel and carboplatin has moderate activity in ABC and can be easily delivered on an outpatient basis with manageable toxicity. This regimen may be useful especially in patients to whom anthracyclines or cisplatin administration is precluded because of other concomitant diseases.
Purpose: To evaluate the efficacy and safety of the docetaxel-cisplatin combination in patients with advanced non-small-cell lung cancer (NSCLC). Patients and methods: Chemotherapy-naive patients with histologically confirmed, measurable stage IIIB or IV NSCLC, a World Health Organization (WHO) performance status of 0-2 and adequate bone marrow, renal, hepatic and cardiac function were eligible for the study. Patients received docetaxel (100 mg/m2) as an one-hour infusion on day 1 and cisplatin (80 mg/m2) as a 30-min infusion with appropriate hydration on day 2. Granulocyte colony- stimulating factor (G-CSF; 150 μg/m2, SC) was given on days 3 to 13. Treatment was repeated every three weeks. Results: Fifty-three patients were enrolled (28 with stage IIIB and 25 with stage IV). One complete and 23 partial responses were observed (overall response rate (OR): 45%; 95% CI: 34,1%-61.8%). The response rate was 57% and 32% in patients with stages IIIB and IV disease (P = NS). The median time to progression was 36 weeks and the median survival 48 weeks; the one-year survival was 48%. Grade 3-4 neutropenia occurred in 23 patients, 15 of whom were hospitalized for neutropenic fever; two patients died of sepsis. Grade 2 neurotoxicity was observed in six patients and grade 3 in five patients; grade 3 fatigue occurred in seven patients, grade 3-4 mucositis in four patients and grade 3- 4 diarrhea in six patients. Mild allergic reactions and oedema were observed in five and four patients, respectively. The median dose intensity was 30 mg/m2/week for docetaxel and 24 mg/m2/week for cisplatin, corresponding to 91% and 89% of the specified protocol doses, respectively. Conclusions: The docetaxel-cisplatin combination is an active regimen in advanced NSCLC, but hematologic toxicity remains high despite the prophylactic use of G-CSF.
The synthesis of protected 1',2'-didehydro-2'-deoxyadenosines has been optimized by incorporating a phosphoranylidene protection of the adenine amino function. These unsaturated adenosines have served as substrates for the electrophilic iodopivaloyloxylation leading to new nucleosides modified at the anomeric position. Reaction of halopivaloates 10, 11 and 12 with tributyltin hydride generates indirectly C-1' radicals through a beta-(acyloxy)alkyl rearrangement. Rate constants for these rearrangements have been measured by using free-radical clock methodology and comparison of these data with previous reported results provides structural information about the nature of this important class of radicals. (C) 1997 Elsevier Science Ltd. All rights reserved.
The synthesis of protected 1',2'-didehydro-2'-deoxyadenosines has been optimized by incorporating a phosphoranylidene protection of the adenine amine function. These unsaturated adenosines have served as substrates for the electrophilic iodopivaloyloxylation leading to new nucleosides modified at the anomeric position. Reaction of halopivaloates 10, 11 and 12 with tributyltin hydride generates indirectly C-1' radicals through a $\beta$- (acyloxy)alkyl rearrangement. Rate constants for these rearrangements have been measured by using free-radical clock methodology and comparison of these data with previous reported results provides structural information about the nature of this important class of radicals.
In Europe, coordinated activities in healthcare informatics education started in the late 1980's with the establishment of European Courses in Health Telematics. At the same time the European Commission foresaw the need for spreading the knowledge of IT in the Healthcare Sector. Therefore the EC, since then, have supported the initiatives that aim to create awareness, stimulate diffusion, educate and train the users (healthcare professionals) in the application of Information Technology to the Healthcare Sector. Such initiatives are the NIGHTINGALE project, which is an essential project in the planning and implementation of strategy in training the Nursing profession in using and applying healthcare information systems, the IT EDUCTRA project, which is a very practical project in the field of the education and training of the Healthcare Professionals in Information Technologies, and the ERASMUS Master's Course, which is aiming at giving those working, or intending to work in the health service and related activities a broad, advanced postgraduate education in Health Informatics.
In Europe, coordinated activities in healthcare informatics education started in the late 1980s with the establishment of European courses in health telematics. At the same time the European Commission foresaw the need for spreading the knowledge of Information Technology (IT) in the healthcare sector. Therefore the EC, since then, has supported the initiatives that aim to create awareness, stimulate diffusion, and educated and train the users (healthcare professionals) in the application of IT in health care [I]. Initiatives, such as the NIGHTINGALE project, are essential for the planning and implementation of strategies for training the nursing profession in using and applying healthcare information systems. Other projects are the IT EDUCTRA project, which is a practical project in the field of education and training of healthcare professionals in information technologies, and the ERASMUS Master's Course, which aims at giving those working (or intending to work) in the health service and related activities, a broad, advanced postgraduate education in health informatics.
We present a program for the calculation of the frequency band structure of an infinite photonic crystal, and of the transmission, reflection and absorption coefficients of light by a slab of this crystal. The crystal consists of a stack of identical slices parallel to a given surface; a slice may consist of a number of different components, each of which can be either a homogeneous plate or a multilayer of spherical particles of given periodicity parallel to the surface.
We present first-principles calculations of the electronic structure and hyperfine fields of 3d and 4sp impurities on the (001) surface of Ni. The calculations are based on the local-spin-density-functional theory and employ a Korringa-Kohn-Rostoker Green's function method for impurities at surfaces. The systematic behaviour obtained for the hyperfine fields of the 4sp adatoms or impurities in the first surface layer is completely different from that found in the bulk. Instead of a single maximum with a very large hyperfine-field value at about the end of an sp series, the adatoms exhibit two maxima with a pronounced minimum in between. This behaviour can be traced back to the reduced coordination number of the adatoms which leads to a much smaller relative splitting of the bonding and antibonding peaks, and to the lower symmetry at the surface which results in an on-site s-p: hybridization. The hyperfine fields found for the 3d impurities at the surface are determined basically by the ferromagnetic or antiferromagnetic coupling of the local impurity moment to the substrate magnetization and are therefore in more or less similar to those for bulk impurities.
We present first-principles calculations of the electronic structure and hyperfine fields of 3d and 4sp impurities on the (001) surface of Ni. The calculations are based on the local-spin-density-functional theory and employ a Korringa-Kohn-Rostoker Green's function method for impurities at surfaces. The systematic behaviour obtained for the hyperfine fields of the 4sp adatoms or impurities in the first surface layer is completely different from that found in the bulk. Instead of a single maximum with a very large hyperfine-field value at about the end of an sp series, the adatoms exhibit two maxima with a pronounced minimum in between. This behaviour can be traced back to the reduced coordination number of the adatoms which leads to a much smaller relative splitting of the bonding and antibonding peaks, and to the lower symmetry at the surface which results in an on-site s-p(z) hybridization. The hyperfine fields found for the 3d impurities at the surface are determined basically by the ferromagnetic or antiferromagnetic coupling of the local impurity moment to the substrate magnetization and are therefore more or less similar to those for bulk impurities.
We present first-principles calculations of the electronic structure and hyperfine fields of 4sp impurities on the (001) surfaces of Ni and Fe. The calculations are based on the local-spin-density-functional theory and employ a Green's function method for impurities at surfaces. The systematic behavior obtained for the hyperfine fields of adatoms or impurities in the first surface layer is completely different from that found in the bulk, mainly due to the reduction of the symmetry and the coordination number at the surface. Our results explain the surprisingly small hyperfine-field values measured for Se adatoms and provide challenging predictions to be confirmed by future experiments.
We present first-principles calculations of the electronic structure and hyperfine fields of 4sp impurities un the (001) surfaces of Ni and Fe. The calculations are based on the local-spin-density functional theory and employ a Green's function method for impurities at surfaces. The systematic behavior obtained for the hyperfine fields of adatoms or impurities in the first surface layer is completely different from that found in the bulk, mainly due to the reduction of the symmetry and the coordination number at the surface. Our results explain the surprisingly small hyperfine-field values measured for Se adatoms and provide challenging predictions to be confirmed by future experiments.
The Evolution of Information Technology is rapid. Electronic circuits substitute mental activities and new Technology invades to all aspects of life. Nursing, which is like all the other Health related professions information-intensive, could use the new Technology to be facilitated. The implementation of Informatics to Nursing was supported by the growing information that Nursing has to manage. The definition of Nursing Informatics was put on 1980 and since then a lot attempts to define Nursing Informatics have followed. The applications of Nursing Informatics are focused on four fields of Nursing: Administration of Nursing, Clinical Practice, Education, and Research. The first applications of Nursing Informatics made visible the need for the development of a Unified Language System. The efforts, today, are focused on two fields: to establish a standard definition of the terms of or related to Nursing Informatics, to establish standard definitions and Classification Schemes for the Nursing Phenomena and Practice so that they can be processed by Nursing Informatics. In solving these problems important role plays the study of Linguistics. Another important factor that should be taken into account is the Development of International Standards of general acceptance that enhances communication aspects. Apart from the International Standardisation Organisations, other non-profit organisations have constituted Special Groups that are dealing with the promotion of Nursing Informatics. Final Nursing Informatics should follow the previous attempts of Nursing to establish a Unified Language System. All the steps of the development of the application are described. In particular subjects that are covered are: the scope of the application, the collection of the material, the designing and building up of the Database, the development of a User Interface and the characteristics of the Application.
The analysis of force systems from an ideal arch has shown that the ratio of the moments produced by a straight wire connecting two malaligned brackets depends on the ratio of the angulations of the brackets to the interbracket axis. Although this result permits assessment of the relative forces and moments, prediction of future tooth movement requires knowledge of the position of center of resistance as well. In this study, the forces and moments produced by a straight portion of an arch wire were transferred from the brackets to the center of resistance. The purpose was to compare the force system at the brackets to the force system at the center of resistance and to assess whether bracket geometry can be applied to predict initial tooth movement. A computer model was used to simulate two teeth connected by a straight portion of wire. Forces and moments were calculated with the use of equations derived from elementary beam theory. The results show that the force system at the center of resistance may be of an entirely different "geometry" type than that at the bracket. Factors that influence the force system include the interbracket distance, the angulation of the teeth, the length of the tooth root, and the width of the bracket.
A chain of impurity cells in a photonic insulator introduces impurity modes of the electromagnetic field over a narrow band of frequencies. We introduce a model of this band in the manner of a tight-binding description of impurity bands in semiconductors, and use it to describe waveguiding along the chain, and, in particular, across a corner of 90° . We also point out the possibility of using impurity bands in photonic insulators to study wave propagation along an effectively one-dimensional disordered chain.
The purpose of this prospective study was to determine the incidence of any form of 21α-hydroxylase deficiency among Greek women with hyperandrogenic symptoms, and to test the predictive value of basal serum 17-hydroxyprogesterone (17-OHP) in the early follicular phase as a screening index for patient preselection to adrenocorticotropic hormone (ACTH) testing. Eighty-eight unselected women with hyperandrogenic symptoms were examined in the Gynecological Endocrinology Unit of the Second Department of Obstetrics and Gynecology of Athens University. Using the ACTH-stimulated 17-OHP values at 60 minutes (17-OHP60) the study population was divided into four groups (A, B, C and D). Clinical and basal hormonal parameters as well as serum 17-OHP60 values and human leukocyte antigens were studied. Both clinical and basal hormonal parameters could be used to distinguish only patients with severe 21α-hydroxylase deficiency (group A). In contrast, patients with moderate non-classical congenital adrenal hyperplasia (NC-CAH; group B), heterozygotes for NC-CAH (group C), and unaffected females (group D) can be diagnosed and classified only by serum 17-OHP60 values. In conclusion, the incidence of NC-CAH in Greek females with hyperandrogenic symptoms is 3.4%. The positive predictive value of basal 17-OHP is only 13% for this disease. Only 17-OHP60 helps to diagnose and classify moderate and mild forms of NC-CAH. Thus, it seems that ACTH testing is imperative in every subject suspected of this enzymatic disorder.
SERUM levels of IL-1β, IL-6 and TNF-α were measured in 48 healthy, termed neonates on the 1st (N1), 5th (N5) and 40th (N40) day after birth, compared with those in maternal serum (MS), umbilical cord (UC) and adult controls. Cytokine Values in N1 and N5 were significantly elevated, than those in UC and in controls (P<0.0001). IL-1β and IL-6 declined significantly from N1 to N40 (P<0.0001), while TNF-α increased significantly from N1 to N5 and declined thereafter. MS∞IL-1β and IL-6, but not MS∞TNF- α, were significantly higher than those of controls (P<0.0001). IL-1β values depended on the mode of delivery. In conclusion, the increased concentrations of IL-1β, IL-6 and TNF-α during the perinatal period might suggest their involvement in an inflammation-like process during normal parturition, and reflect also a newborn immune response to the stress of delivery and environmental changes.
Interferon-gamma (IFN-gamma) is considered an important determinant of the balance between T-helper type 1 and 2 cytokines and has been used experimentally for the treatment of atopic dermatitis. However, contrasting results have been reported relative to the Th-1/Th-2 cytokine profile in atopic patients. In this study, we examined cytokine production by polyclonally activated peripheral blood mononuclear cells (PBMC) from children with atopic dermatitis, and assessed the influence of in vitro IFN-gamma pretreatment on these cells. A fraction of PBMC isolated from children with severe atopic dermatitis, as well as from age-matched controls, was initially exposed to IFN-gamma. After washing, both treated and untreated cells were then put into culture either alone or with the addition of phytohemagglutinin (PHA) or phorbol myristate acetate (PMA) plus ionomycin. IL-4, IL-5, IL-10 and IFN-gamma production were measured in the supernatants using commercially available ELISAs. PBMC from atopic patients produced more IL-4 (P = 0.04) and IL-10 (P = 0.03) and less IFN-gamma (P = 0.01) than controls, when stimulated with PHA. Interestingly, in PMA + ionomycin stimulated cultures, the atopic cytokine profile was different with more IL-5 (P = 0.0068) and less IFN-gamma production (P = 0.00046) than the control group. When cells were pretreated with IFN-gamma, there were no significant differences between patients and controls. PBMC from children with atopic dermatitis show alterations in cytokine production, compatible in general terms with the Th-1/Th-2 model. Exposure of PBMC to IFN-gamma before activation results in a reduction of these differences, so that cytokine production becomes similar in the atopic and normal groups.
Purpose. To develop a simple approach for investigating absorption kinetics, which does not require modeling assumptions or intravenous data. Methods. The concentration (C) -time (t) data are plotted as a phase plane plot (dC/dt versus C). Errorless C,t data were generated from one and two compartment models employing first-order, zero-order and Michaelis-Menten input kinetics, and the phase plane plots were constructed. A simple test based on the ratio of slopes of the separate linear regression analyses of absorption and elimination data of the phase plane plot is proposed to justify or not the presence of zero-order input kinetics. Errant data were used to assess the performance of the test developed. Literature data of theophylline and nitroglycerin formulations were analyzed using the phase plane plot. Input rate-time profiles were constructed for one compartment model drugs utilizing the data of the phase plane plot. Results. The geometric forms of the phase plane plots derived from the errorless data of the various pharmacokinetic models were found to be indicative of the absorption kinetics. Very good results were obtained when the test for the discernment of absorption kinetics was applied to errant data. Zero-order absorption kinetics were justified (i) for the transdermal absorption of nitroglycerin and (ii) only for a certain period of time, for the gastrointestinal absorption of theophylline. Conclusions. Investigation of absorption kinetics can be accomplished with the phase plane method. The cumulative character of the classical percent absorbed versus time plots can be misleading in justifying the presence of zero-order input kinetics.
Purpose: To determine the efficacy and safety of 21 monthly cycles of pamidronate therapy in patients with advanced multiple myeloma. Patients and Methods: Patients with stage III myeloma and at least one lyric lesion received either placebo or pamidronate 90 mg intravenously administered as a 4-hour infusion monthly for 21 cycles. At study entry, the patients were stratified according to whether they were to receive first-line (stratum 1) or second-line (stratum 2) antimyeloma chemotherapy. Skeletal events (pathologic fracture, radiation or surgery to bone, and spinal cord compression) and hypercalcemia were assessed monthly. Results: The results of the first nine previously reported cycles are extended to 21 cycles. Of the 392 randomized patients, efficacy could be evaluated in 198 who received pamidronate and 179 who received placebo. After 21 cycles, the proportion of patients who developed any skeletal event was lower in the pamidronate-group (P= .015). The mean number of skeletal events per year was less in the pamidronate-group (1.3) than in placebo-treated patients (2.2; P = .008). Although survival was not different between the pamidronate-treated group and placebo patients overall, stratum 2 patients who received pamidronate lived longer than those who received placebo (14 v 21 months, P = .041). Pamidronate was safe and well tolerated during the 21 cycles of therapy. Conclusion: Long-term monthly infusions of pamidronate as an adjunct to chemotherapy are superior to chemotherapy alone in reducing skeletal events in stage III multiple myeloma patients, and may improve the survival of patients on salvage therapy.
The role of the anisotropic impurity scattering in the determination of the low-field Hall coefficient of Al-4d dilute alloys is investigated by means of systematic theoretical calculations, as well as experimental measurements for AlZr and AlMo. The theoretical results, obtained without using any adjustable parameter, are in excellent agreement with the experimental data and a consistent interpretation of the systematic variation of the low-field Hall coefficient for aluminium-based dilute alloys with transition-metal impurities is given.
The role of the anisotropic impurity scattering in the determination of the low-field Hall coefficient of Al-4d dilute alloys is investigated by means of systematic theoretical calculations, as well as experimental measurements for Al-Zr and AI-Mo. The theoretical results, obtained without using any adjustable parameter, are in excellent agreement with the experimental data and a consistent interpretation of the systematic variation of the low-field Hall coefficient for aluminium-based dilute alloys with transition-metal impurities is given. (C) 1998 Elsevier Science Ltd. All rights reserved.
We report a systematic study of the spin-polarization energy of 3d impurities in monovalent simple-metal hosts, by means of self-consistent, local-spin-density-functional, impurity-in-jellium calculations, and propose a phenomenological model for the interpretation of our results. {[}S0163-1829(98)03424-9].
We report a systematic study of the spin-polarization energy of 3d impurities in monovalent simple-metal hosts, by means of self-consistent, local-spin-density-functional, impurity-in-jellium calculations, and propose a phenomenological model for the interpretation of our results.
The age and dynamics of the young LMC clusters SL 666 and NGC 2098 were investigated using CCD observations obtained with the 3.9m Anglo-Australian Telescope. SL 666 was found to have an age of 1 - 1.25 x 10(8) yr, while NGC 2098 is somewhat younger, with an age of 6.3 - 7.9*E(7) yr. In the case of SL 666 the good quality of the acquired data allowed the construction of the main sequence luminosity function as a function of radius, which revealed mass segregation, also confirmed from star counts. Since the age of SL 666 is significantly lower than the mean relaxation time of at least 5 x 10(8) yr calculated for this cluster and since the mass range of the cluster members does not permit us to assume faster energy equipartition, the observed mass segregation seems to be due to the way stars form in the cluster. Indications on a star formation scenario are examined. Disruption time is also discussed and there is strong evidence that the cluster is bound. NGC 2098 shows strong evidence of mass segregation, but further observations are needed in this case.
Maternal serum (MS) and amniotic fluid (AF) antigen concentrations were measured, by a microparticle EIA, in 28 pregnant women during the 2nd trimester, in 27 during the 3rd and in 34 during labor. Extremely elevated and scattered over a broad range antigen values were observed in AF, compared to those in MS samples (p < 0.0001). CEA values in both MS (100% < 5 ng/mL) and in AF did not differ significantly with advancing gestation, while CA125 in MS (6.5% > 32.5 U/mL) and in AF declined significantly with gestational age (p < 0.0001). In contrast SCC values in both MS (42.5% > 1.5 ng/mL) and in AF increased significantly with the progression of pregnancy (p < 0.0001). Amniotic fluid CA125 and less prominent SCC values were significantly higher in the 2nd trimester pregnancies, complicated by fetal anomalies, compared to those in normal pregnancies (p < 0.02 and p < 0.05 respectively). Serum CA125 was lower in the prolonged pregnancies (p < 0.05), while CEA and SCC in AF were significantly elevated (p < 0.003 and p < 0.01, respectively). A good correlation was found in CA125 and SCC values between MS and AF (r = 0.43, p < 0.0001; r = 0.32, p < 0.004 respectively), while no correlation was observed between MS and AF CEA values. In conclusion, the presence of considerable CEA, CA125 and SCC levels in amniotic fluid during pregnancy suggests their involvement in biological functions, associated with fetal development and maturation. Maternal serum CEA, in contrast to CA125 and SCC, is not influenced by pregnancy, remaining a reliable tumor marker in monitoring also pregnant cancer patients.
Abreu P, others. {m(b) at M(Z)}. Phys. Lett. 1998;B418:430-442.
In this study an attempt is made to examine and analyse the mean characteristics of the katabatic flows at the western slope foot of a 1024m high knife edge mountain using a meteorological tower and three surface meteorological stations. In addition, the frequency distribution of the occurrence of the katabatic flow over one year period is studied along the characteristics of the flow arriving in the neighbouring urban area at a distance of 1.5km. It was found that the katabatic flow occurs mainly in autumn and spring with the highest frequency in April. The flow is generally characterised by small depth as it is affected substantially by the background flow. The expected direction of the katabatic wind dominates mainly at the level of 7 m, where the influence of the background flow is minimised. At the level of 18m the wind direction shifts, due to the interaction of the katabatic wind with the background flow. The katabatic flow can penetrate at a distance of 1.5 km being substantially weakened.
In this paper, we deal with the ARIMA (Box-Jenkins) model of the gridded mean annual air temperature for the area included by the co-ordinates: 20°- 30°E, 35°- 45°N, (thus the South Balkan area, the most of its percentage covered by Greek peninsula). We analyse the gridded temperature time series which existed from 1851 to 1996. With the theoretical model's construction, we try to forecast the annual temperature till the year 2006, and the results were satisfactory enough. Also, from the analysis we found that the autocorrelation function (ASF) and the partial autocorrelation function (PASF) of the residuals were not significant, and the ARIMA model is quite reliable.
The NIGHTINGALE project, which is an EU financed project, is considered as essential in planning and implementation of strategy in training the nursing profession in using and applying healthcare information systems. Therefore, NIGHTINGALE gives a new perspective in Nursing Informatics Education in Europe. In 1997 some major goals of the NIGHTINGALE project were accomplished. These achievements are described in this document.
PURPOSE: A national study to register all working nursing personnel and nursing students; to estimate the nursing needs of the Greek population beyond the year 2000; to design a nursing resource master plan for the nursing needs of Greece.
DESIGN: First, a questionnaire was distributed to register all nursing personnel. Second, required personnel were estimated according to the population of each of the country's regions. Third, a master plan for developing nursing personnel to the year 2010 was developed.
RESULTS: The number of nursing personnel was found to be 35,715 which included 11,497 RNs and health visitors, 22,318 assistant nurses, 1,900 midwives. The number of students was 9,252. The majority of nursing personnel work in areas with the highest population. The need for nursing personnel was estimated to be 62,000: 36,300 RNs, 21,700 assistant nurses and 4,000 midwives.
CONCLUSIONS: There is a serious shortage of RNs in the Greek health services resulting in a downgrading of nursing care quality.
In a phase II study, 66 patients with advanced breast cancer (median age 56 years; range, 28 to 75 years) were treated with paclitaxel (Taxol), 175 mg/m2 infused over 3 hours, and carboplatin (Paraplatin), dosed to attain an area under the concentration-time curve (AUC) of 6 mg x min/mL; treatment was repeated every 3 weeks. A total of 38 (58%) patients had received prior adjuvant chemotherapy, 21 with a regimen containing an anthracycline or mitoxantrone (Novantrone). As of May 1997, 295 cycles of paclitaxel- carboplatin have been administered, 248 (84%) at full dose. The relative dose intensity of paclitaxel is 0.9 (range, 0.5 to 1.2). Of the 66 patients, 8 (12%) have achieved a complete response and 27 (41%) a partial response, for a total response rate of 53%. Grade 3 to 4 toxicities have included anemia (5%), leukopenia (25%), thrombocytopenia (5%), nausea/vomiting (7%), myalgias/arthralgias (4%), allergic reaction, neurotoxicity, and infection (2% each). Alopecia has been universal. Median time to progression is 8.9 months; median survival has not yet been reached. We conclude that the combination of paclitaxel and carboplatin has significant activity in advanced breast cancer and can easily be administered on an outpatient basis with manageable toxicity.
We model the acceleration of electrons at a shock front in a relativistic blazar jet and compute the radiation they emit in a post-shock region which contains a homogeneous magnetic field. The full space, time and momentum dependence of the electron distribution is used in this calculation. It is shown that the ` homogeneous'\ synchrotron model is recovered, provided the downstream speed of the plasma away from the shock front is nonrelativistic, and provided that the light travel times across the face of the shock front is unimportant. By varying the rate at which particles are picked up by the acceleration process, we calculate the time-dependence of the spectra. Since the magnetic field strength is assumed constant within the emission region, each frequency band can be identified with electrons of a particular energy. We find that for a band in which the electrons are accelerated rapidly compared to the rate at which they cool, the spectra typically harden during phases of rising flux, and soften during phases of falling flux, as has been observed in the objects PKS 2155-304 and Mkn 421. However, in a frequency band in which the timescales are comparable, the reverse behaviour is to be expected. We discuss the extent to which observations of both the stationary spectrum and the spectral variability of the synchrotron component of blazar emission can be used to constrain the model.
On two separate days eight male subjects performed a 10- or 20-s cycle ergometer sprint (randomized order) followed, after 2 min of recovery, by a 30-s sprint. Muscle biopsies were obtained from the vastus lateralis at rest, immediately after the first sprint and after the 2 min of recovery on both occasions. The anaerobic ATP turnover during the initial 10 s of sprint 1 was 129 ± 12 mmol kg dry weight-1 and decreased to 63 ± 10 mmol kg dry weight-1 between the 10th and 20th s of sprint 1. This was a result of a 300% decrease in the rate of phosphocreatine breakdown and a 35% decrease in the glycolytic rate. Despite this 51% reduction in anaerobic ATP turnover, the mean power between 10 and 20 s of sprint 1 was reduced by only 28%. During the same period, oxygen uptake increased from 1.30 ± 0.15 to 2.40 ± 0.23 L min-1, which partially compensated for the decreased anaerobic metabolism. Muscle pH decreased from 7.06 ± 0.02 at rest to 6.94 ± 0.02 after 10 s and 6.82 ± 0.03 after 20 s of sprinting (for all changes P < 0.01). Muscle pH did not change following a 2-min recovery period after both the 10- and 20-s sprints, but phosphocreatine was resynthesized to 86 ± 3 and 76 ± 3% of the resting value, respectively (n.s. 10- vs. 20-s sprint). Following 2 min of recovery after the 10-s sprint subjects were able to reproduce peak but not mean power. Restoration of both mean and peak power following the 20-s sprint was 88% of sprint 1, and was lower compared with that after the 10-s sprint (P < 0.01). Total work during the second 30-s sprint after the 10- and the 20-s sprint was 19.3 ± 0.6 and 17.8 ± 0.5 kJ, respectively (P < 0.01). As oxygen uptake was the same during the 30-s sprints (2.95 ± 0.15 and 3.02 ± 0.16 L min-1), and [Phosphocreatine] before the sprint was similar, the lower work may be related to a reduced glycolytic ATP regeneration as a result of the higher muscle acidosis.
On two separate days eight male subjects performed a 10- or 20-s cycle ergometer sprint (randomized order) followed, after 2 min of recovery, by a 30-s sprint. Muscle biopsies were obtained from the vastus lateralis at rest, immediately after the first sprint and after the 2 min of recovery on both occasions. The anaerobic ATP turnover during the initial 10 s of sprint 1 was 129 ± 12 mmol kg dry weight-1 and decreased to 63 ± 10 mmol kg dry weight-1 between the 10th and 20th s of sprint 1. This was a result of a 300% decrease in the rate of phosphocreatine breakdown and a 35% decrease in the glycolytic rate. Despite this 51% reduction in anaerobic ATP turnover, the mean power between 10 and 20 s of sprint 1 was reduced by only 28%. During the same period, oxygen uptake increased from 1.30 ± 0.15 to 2.40 ± 0.23 L min-1, which partially compensated for the decreased anaerobic metabolism. Muscle pH decreased from 7.06 ± 0.02 at rest to 6.94 ± 0.02 after 10 s and 6.82 ± 0.03 after 20 s of sprinting (for all changes P < 0.01). Muscle pH did not change following a 2-min recovery period after both the 10- and 20-s sprints, but phosphocreatine was resynthesized to 86 ± 3 and 76 ± 3% of the resting value, respectively (n.s. 10- vs. 20-s sprint). Following 2 min of recovery after the 10-s sprint subjects were able to reproduce peak but not mean power. Restoration of both mean and peak power following the 20-s sprint was 88% of sprint 1, and was lower compared with that after the 10-s sprint (P < 0.01). Total work during the second 30-s sprint after the 10- and the 20-s sprint was 19.3 ± 0.6 and 17.8 ± 0.5 kJ, respectively (P < 0.01). As oxygen uptake was the same during the 30-s sprints (2.95 ± 0.15 and 3.02 ± 0.16 L min-1), and [Phosphocreatine] before the sprint was similar, the lower work may be related to a reduced glycolytic ATP regeneration as a result of the higher muscle acidosis.
On two separate days eight male subjects performed a 10- or 20-s cycle ergometer sprint (randomized order) followed, after 2 min of recovery, by a 30-s sprint. Muscle biopsies were obtained from the vastus lateralis at rest, immediately after the first sprint and after the 2 min of recovery on both occasions. The anaerobic ATP turnover during the initial 10 s of sprint 1 was 129 ± 12 mmol kg dry weight-1 and decreased to 63 ± 10 mmol kg dry weight-1 between the 10th and 20th s of sprint 1. This was a result of a 300% decrease in the rate of phosphocreatine breakdown and a 35% decrease in the glycolytic rate. Despite this 51% reduction in anaerobic ATP turnover, the mean power between 10 and 20 s of sprint 1 was reduced by only 28%. During the same period, oxygen uptake increased from 1.30 ± 0.15 to 2.40 ± 0.23 L min-1, which partially compensated for the decreased anaerobic metabolism. Muscle pH decreased from 7.06 ± 0.02 at rest to 6.94 ± 0.02 after 10 s and 6.82 ± 0.03 after 20 s of sprinting (for all changes P < 0.01). Muscle pH did not change following a 2-min recovery period after both the 10- and 20-s sprints, but phosphocreatine was resynthesized to 86 ± 3 and 76 ± 3% of the resting value, respectively (n.s. 10- vs. 20-s sprint). Following 2 min of recovery after the 10-s sprint subjects were able to reproduce peak but not mean power. Restoration of both mean and peak power following the 20-s sprint was 88% of sprint 1, and was lower compared with that after the 10-s sprint (P < 0.01). Total work during the second 30-s sprint after the 10- and the 20-s sprint was 19.3 ± 0.6 and 17.8 ± 0.5 kJ, respectively (P < 0.01). As oxygen uptake was the same during the 30-s sprints (2.95 ± 0.15 and 3.02 ± 0.16 L min-1), and [Phosphocreatine] before the sprint was similar, the lower work may be related to a reduced glycolytic ATP regeneration as a result of the higher muscle acidosis.
Objective - To determine the degree of hypophyseal deficiency in Kallmann's syndrome, and the effects of Gn-RH priming and HRT. Patients and Methods - Seven female patients with complete Kallmann's syndrome were subjected to dynamic tests (chlorpromazine, TRH and double Gn-RH provocation test) immediately after their first admission to the hospital. In five patients the diagnosis was established for the first time (unprimed patients), while in the other two cases the diagnosis has been established earlier and the patients were already receiving hormonal replacement therapy (HRT-primed patients). In the 5 unprimed patients, 100 μg Gn-RH s.c. were administered daily for 28-32 days and the double Gn-RH test was repeated immediately after. Results - The gonadotropic response of the unprimed patients in the administration of Gn-RH was insufficient, mainly in the second stimulation, with secretory dominance of FSH (ratio LH/FSH <1), while after the monthly Gn-RH priming, the gonadotropic response to Gn-RH had improved, with a considerable increase in the peak values of plasma FSH and LH after both stimulations, and the LH/FSH ratio was reversed to >1. In the two primed patients, the gonadotropic response to Gn-RH administration was better in both stimulations than that of the unprimed patients. Conclusions - Both the short-term Gn-RH and the long-term HRT priming improve the secretory promptitude of the hypophyseal cells for both gonadotropins, while after long-term Gn-RH priming the LH-secreting cells are capable of both release and synthesis of the hormone, as can be seen by the results of the second stimulation in the Gn-RH primed patients. Consequently, for women with Kallmann's syndrome who wish to become pregnant, ovulation induction and conception can be achieved sooner and with less cost if they are previously primed.
The aim of this study was to investigate the expression of bcl-2, p53 oncoproteins, and Ki-67 antigen in a series of transitional cell bladder carcinomas and its relation to the traditional prognostic indicators and patient's survival. One hundred six cases with transitional cell carcinoma (TCC) were examined for detection of bcl-2, p53 proteins, and Ki-67 antigen (MIB1 antibody). Bcl-2 immunohisto-chemical positivity was observed in 52% of TCCs and in 577% of low-grade and 44% of high-grade TCCs. Bcl-2 was also detected in normal urothelium and dysplastic lesions with basal cell expression, showed a significant inverse correlation with overall bcl-2 positivity. The loss of bcl-2 protein expression in higher-stage TCCs was statistically significant (pt = .01). P53 protein was overexpressed in 50% of TCCs and more frequently in invasive and in carcinomas in situ than in superficial TCCs (Pt = .03). In contrast, detection of p53 was not observed in normal and dysplastic urothelium. P53 positivity was related to the degree of differentiation and to the stage of the disease (Pf = .01 and Pt = .03, respectively). Concerning Ki-67 antigen, its expression was found in 57.5% of TCCs. There was a strong overall correlation of Ki-67 with tumor stage (Pt = .002) and grade (Pf = .002). Univariate statistical analysis showed that the expression of p53 and Ki-67 was significantly correlated to poor prognosis (p = .02, P = .02, respectively). On multivariate analysis, none of these markers but only stage and grade were significantly correlated to prognosis (P = .02, respectively). These findings suggest that overexpression of bcl-2 protein may be an early event in tumorigenesis. Tumors with loss of bcl-2 positivity and overexpression of p53 and Ki-67 had an unfavorable prognosis; however, in multivariate analysis, they had no independent prognostic value.
An RT-PCR assay using primers from the 5'-UTR of the GBV-C/HGV genome was used to detect viremia, and a serological assay was used to detect past exposure to GBV-C/HGV, in sera from 106 imprisoned Greek intravenous drug users. High seroprevalence rates indicative of the parenteral route of transmission of the virus were found (32.1% for GBV-C RNA and 46.2% for anti-GBV-C E2). These rates were nonetheless lower in comparison to the corresponding rates of HCV infection markers (64.2% for HCV RNA and 77.4% for anti-HCV). Statistically significant univariate associations were observed between GBV-C-RNA positivity and younger age (P=0.006) and HCV-RNA positivity (P=0.024), as well as with higher serum alanine aminotransferase levels (P< 0.001); this latter association was shown to be independent of coinfection with HCV and of age by a multiple logistic regression model. Apparently, GBV-C/HGV had spread readily by needle-sharing in prison, while causing acute subclinical hepatitis in infected inmates. Phylogenetic analysis of the partial 5'-UTR of the GBV-C/HGV genome from 16 seropositive individuals, which delineated their grouping within genotype 2, also revealed a close genetic relationship between two sets of sequences from 4 drug addicts, 3 of whom admitted to sharing needles while imprisoned.
Karyotypic studies of bone marrow were conducted in 79 previously untreated patients with multiple myeloma who received a standard programme of chemotherapy. An abnormal karyotype was observed in 46% of patients, virtually all showing multiple abnormalities consistent with a long period of preclinical clonal evolution. Patients with an abnormal pattern showed various aberrations with hyperdiploidy in 64%, pseudodiploidy in 5% and hypodiploidy in 31%. The number of chromosomes affected ranged from two to 19 (median 10), with at least one trisomy in 83%, one monosomy in 75%, and one translocation in 42% of patients. Lymphoma-like karyotypes were present in 17% of patients with an abnormality but were not associated with atypical clinical features, such as an extramedullary mass, leukaemia, or increased serum lactate dehydrogenase. Monosomy or deletion of chromosome 13 was present in 47% of patients with an abnormal pattern, who lived for a shorter duration (median 10 months) than patients with other abnormalities (median 34 months) or with diploidy (median 35 months). The cause of the short survival of patients with monosomy or deletion of chromosome 13 was not clear, but further studies on the relationship with specific oncogenes are indicated.
The daily relationship between synoptic circulation in the lower troposphere and air quality conditions is demonstrated over the Athens Metropolitan Area (AMA) for the period between 1983 and 1995. This approach utilises eight distinct synoptic categories at the isobaric level of 850 hPa and air quality indicators with respect to O3, NO2, CO, SO2 and black smoke (BS). It is demonstrated that high concentrations of photochemical pollutants and SO2 are closely related to the synoptic scale circulation while CO and BS show a weaker correlation. The most favourable synoptic pattern for the accumulation of high concentrations is the open anticyclonic circulation and for the occurrence of extreme events the closed anticyclone. NO2 and BS present the highest frequency of severe events. The seasonal analysis reveals that the bad and extreme air quality conditions due to O3 and NO2 prevail in the warm season while during the cold season CO and SO2 events prevail. The synoptic category representing a combination of high and low pressure systems, commonly associated with an intense wind flow over the Aegean Sea in the warm period, seems to favour the accumulation of photochemical pollutants, especially O3, over the AMA. The converse relationship was found for the SO2 case. During cold periods, the synoptic category characterised by ’zonal flow’ seems to favour the development of bad conditions for NO2 and particularly CO.
Purpose: The standard treatment for patients with muscle-invasive carcinoma of the urinary bladder is radical cystectomy. While radical cystectomy cures many patients with this tumor, almost 50% of them will develop metastatic disease. Adjuvant chemotherapy has been proposed for these patients in an attempt to reduce the probability of relapse and to improve survival. To assess whether adjuvant chemotherapy does benefit patients with muscle-invasive bladder cancer, we reviewed all phase II and III studies published in the English literature over the last 20 years. Methods: A review of all published reports was facilitated by the use of Medline computer search and by manual search of the Index Medicus. Results: Several comparative, nonrandomized studies have indicated that adjuvant chemotherapy may prolong disease-free survival. Four randomized studies have been conducted and all had a suboptimal patient accrual. Three studies used a cisplatin-containing combination chemotherapy and included primarily patients with non-organ-confined transitional-cell carcinoma (TCC) of the bladder. All three studies indicated that adjuvant chemotherapy improve disease-free survival and two of them also showed improvement in event-free survival and overall survival, respectively. Conclusion: Published series have been unable to establish an undisputed benefit of adjuvant chemotherapy over radical cystectomy alone for muscle-invasive bladder cancer. The interpretation of the available data is compromised by several methodologic and statistical problems. Thus, adjuvant chemotherapy cannot be considered as a standard treatment for all patients with muscle-invasive carcinoma of the bladder. Well-designed prospective randomized studies are needed to clarify the rob of adjuvant chemotherapy in this disease. However, outside a protocol setting, there is some evidence that patients with extravesical disease or with lymph node involvement may benefit from adjuvant treatment with cisplatin-based combination chemotherapy. No data support such an approach for patients with muscle-invasive but organ-confined bladder cancer.
Although the combination of paclitaxel with doxorubicin has yielded high response rates in metastatic breast cancer, severe cardiotoxic events have been reported in several patients. The rationale for our study was to evaluate the activity of paclitaxel/doxorubicin combination in patients with this disease but to avoid excessive cardiotoxicity. Therefore, we administered 4 cycles of doxorubicin/paclitaxel followed by 6 cycles of standard cyclophosphamide, methotrexate and 5-fluorouracil (CMF) regimen. Study medication consisted of doxorubicin 60 mg/m2 as a 15-min intravenous infusion followed by paclitaxel 175 mg/m2 as a 3-hour infusion. CMF regimen consisted of cyclophosphamide 600 mg/m2 as 1-hour intravenous infusion followed by methotrexate 40 mg/m2 and 5-fluorouracil 600 mg/m2 bolus injection. The main toxicity of doxorubicin/paclitaxel treatment phase was neutropenia (WHO grade 3/4, 58%), but we observed only one cardiac adverse event. Toxicities of the CMF treatment phase were not significant. Of 24 patients evaluable for response, 2 (8%) had complete responses and 11 (46%) achieved partial response. Ten additional patients (42%) had stable disease. The median time to progression was 12 months and the median overall survival was 18.5 months. The sequential administration of doxorubicin and paclitaxel followed by CMF appeared active and well tolerated in patients with metastatic breast cancer.
The aim of this study was to evaluate the effect of increasing postnatal age on soluble intercellular adhesion molecule-1 (sICAM-1), a very early and sensitive marker of immune activation and response in the serum of newborn infants. Serum sICAM-1 was measured by EIA (T Cell Diagnostics) in 20 healthy adults (controls) and in 43 (24 females/19 males) healthy neonates, of whom 28 were full term, and 15 were born at a gestational age between 35 and 38 weeks of pregnancy, on the 1st, 5th and 30th day of life. Neonatal serum sICAM-1 values showed a very significant increase (P < 0.01) from the 1st day (137.3 ± 62.0 ng/ml) to the 5th day (259.3 ± 124.0 ng/ml) and then to the 30th day of life (415.0 ± 114.0 ng/ml), being significantly lower on the 1st day (P < 0.01), whereas significantly higher on the 30th day of life (P < 0.05), than those in healthy adults (305 ± 195 ng/ml). Serum sICAM-1 values on the 1st day of life depended on both the mode of delivery (significantly higher in neonates born vaginally) and the gestational age at birth (significantly lower in those born at a gestational age over 38 weeks). A significant strong correlation was found in sICAM-1 values between the 1st and the 5th day following delivery (r(p) = 0.77, P < 0.009). Conclusion: The results of this study demonstrate a significant rise of serum sICAM-1 during the 1st month of life in healthy neonates suggesting a progressively increased activation of the neonatal immune system.
The objective of this study is to identify and establish the day-by-day relationship between mesoscale circulation and the air quality status over the Metropolitan area of Athens for a period of 13 years and to further investigate its temporal and spatial variability. Eleven distinct mesoscale patterns are identified using a formulated methodology based on surface wind measurements. The air quality conditions are classified into seven distinct classes according to the method of the Air Quality Indicators for five main pollutants namely, O3, NO2, SO2, CO and black smoke (BS). It was found that severe and bad air quality conditions over specific parts of the examined area are associated with the weak mesoscale patterns of southern direction or calm conditions. The good and moderate conditions are established mainly under northerly airflows. The most serious pollution problem favored even by intense northerly flow is attributed to O3 during the warm period in the northern zone. High concentrations of O3, NO2 and SO2 in the warm period are remarkably related to the pure sea breeze circulation, especially in the central and northern zone.
The title C-1' radical, obtained by photolysis of the corresponding tert-butyl ketone in water, was studied spectroscopically by EPR and laser flash photolysis methods and computationally. (C) 1998 Elsevier Science Ltd. All rights reserved.
The title C-1' radical, obtained by photolysis of the corresponding tert-butyl ketone in water, was studied spectroscopically by EPR and laser flash photolysis methods and computationally.
The magnetic Compton profiles (MCPs) measured in the [100], [110], [111] and [112] directions in single-crystal nickel with an incident photon beam of energy 224 keV are presented and discussed. The momentum resolution achieved, of 0.43 atomic units, improves on previous studies by almost a factor of two, and facilitates the interpretation of the MCPs in terms of the underlying spin-dependent momentum densities. Calculations have been performed using the linear muffin-tin orbital method, within both the local spin-density approximation (LSDA) and the generalized gradient approximation (GGA). Comparison with experiment reveals the limitations of the LSDA at low momentum, where the GGA is better able to reproduce the contribution of the s- and p-like electrons. All of the calculations overestimate the moment associated with the d-like electrons, for momenta corresponding to the first Brillouin zone. We also confirm the existence of the so-called Umklapp shoulders, which derive from the Fermi surface topology.
AIMS: To determine HIV and hepatitis infection prevalence and correlates with risk behaviour. DESIGN: Cross-sectional study: voluntary, anonymous HIV, hepatitis (HCV, HBV and HDV) surveillance and questionnaire on risk factors. SETTING: Korydallos Prison, Athens and Ag. Stefanos Prison, Patra, Greece. PARTICIPANTS: Of 544 drug users imprisoned for drug related offences, all completed the questionnaire and 533 blood samples were collected. MEASUREMENTS: HIV (by anti-HIV-1), HCV (by anti-HCV), HBV (by anti-HBc, HBsAg) and HDV (by anti-HDV) prevalence. Data on demography, legal status, drug use, sharing of injecting equipment. FINDINGS: Of the 544 drug users, 375 (68.9%) had injected drugs (IDUs) at some time, 35% of whom had injected whilst in that prison. Of the 533 blood samples tested, one was positive for anti-HIV-1 (0.19%), 310 for anti-HCV (58.2%), 306/531 (57.6%) for anti-HBc, 34/527 (6.5%) for HBsAg and 12/527 (2.3%) for anti-HDV. Prevalence rates for IDUs only were 0.27% for HIV-1, 80.6% for hepatitis C, 62.7% for hepatitis B and 3.3% for hepatitis D. Ninety-two per cent of IDUs injecting in prison shared needles, indicating that IDUs inject less but share more during incarceration. Multiple logistic regression revealed needle-sharing as the most important risk factor for HCV infection in IDUs. Prior knowledge of a positive hepatitis result did not appear to inhibit IDUs from practising risky behaviours in prison. CONCLUSIONS: The epidemic of hepatitis B and C among imprisoned IDUs identified by this study constitutes a major public health problem. Prevention programmes, such as counselling, HBV vaccination, community-based methadone maintenance treatment and syringe exchange schemes, are necessary in order to prevent a further spread.
By a systematic method we construct general classes of exact and self-consistent axisymmetric magnetohydrodynamic (MHD) solutions describing flows that originate in the near environment of a central gravitating astrophysical object. The unifying scheme contains two large groups of exact MHD outflow models: (I) meridionally self-similar models with spherical critical surfaces; and (II) radially self-similar models with conical critical surfaces. This classification includes known polytropic models, such as the classical Parker description of a stellar wind and the Blandford &38 Payne model of a disc wind; it also contains non-polytropic models, such as those of winds/jets in Sauty &38 Tsinganos, Lima, Tsinganos &38 Priest, and Trussoni, Tsinganos &38 Sauty. Besides the unification of all known cases under a common scheme, several new classes emerge and some are briefly analysed; they could be explored for a further understanding of the physical properties of MHD outflows from various magnetized and rotating astrophysical objects in stellar or galactic systems.
By a systematic method we construct general classes of exact and self-consistent axisymmetric magnetohydrodynamic (MHD) solutions describing flows that originate in the near environment of a central gravitating astrophysical object. The unifying scheme contains two large groups of exact MHD outflow models: (I) meridionally self-similar models with spherical critical surfaces; and (II) radially self-similar models with conical critical surfaces. This classification includes known polytropic models, such as the classical Parker description of a stellar wind and the Blandford &38 Payne model of a disc wind; it also contains non-polytropic models, such as those of winds/jets in Sauty &38 Tsinganos, Lima, Tsinganos &38 Priest, and Trussoni, Tsinganos &38 Sauty. Besides the unification of all known cases under a common scheme, several new classes emerge and some are briefly analysed; they could be explored for a further understanding of the physical properties of MHD outflows from various magnetized and rotating astrophysical objects in stellar or galactic systems.
Objectives. To evaluate the efficacy and toxicity of single-agent docetaxel in patients with metastatic urothelial carcinoma and impaired renal function. Methods. Eleven consecutive patients previously untreated for metastatic disease with renal impairment (median serum creatinine level of 2.6 mg/dL) were treated with intravenous docetaxel 100 mg/m2 for 1 hour every 21 days. Granulocyte colony-stimulating factor was administered at a dose of 5 μg/kg/day subcutaneously from days 5 to 14. Results. Five of 11 patients achieved a partial response, with time to progression of responding patients ranging from 5 to 22 months or more. The median overall survival rate was 11 months. Renal function improved in 5 of 8 patients with tumor- related renal impairment. Toxicity was primarily hematologic, with 5 patients developing grade 3 or 4 neutropenia; nonhematologic toxicities were manageable. Conclusions. Our preliminary data indicate that single-agent docetaxel therapy may represent an effective therapeutic alternative for patients with advanced urothelial carcinoma and renal insufficiency precluding cisplatin-based combination chemotherapy.
Pretreatment values of CEA, CA125, SCC and TPS were measured in 130 women with 1) ovarian carcinoma (n = 25), 2) breast cancer (n = 20), 3) endometrial cancer (n = 14), 4) cervical squamous cell carcinoma (n = 20), 5) cervical adenocarcinoma (n = 9) and 6) benign gynaecological diseases (n = 42) in order to evaluate the usefulness of multiple markers in diagnosing and monitoring patients with gynaecological cancer. Antigen values were significantly higher in the cancer groups than those in the benign one (p < 0.0001). CEA values were significantly elevated in the 2nd and 5th groups, CA125 in the 1st and 5th, SCC in the 4th and 5th, and TPS in the 1st, 2nd and 5th compared to the remaining groups (p < 0.04-p < 0.0001). In advanced stage diseases, significantly higher antigen values, except for SCC, than those in limited rumours were measured (p < 0.05-p < 0.0001). In conclusion, our results suggest that, multiple markers may be more efficienti than the use of single markers in accurately identifying malignant from benign gynaecological diseases and in monitoring cancer patients.
Το ερώτημα, αρχικά, τέθηκε από τους συντάκτες του περιοδικού «Σύναξη» και τελικά αποτέλεσε τον τίτλο του άρθρου, στο αφιέρωμα για τη Βιοηθική. Ο σκοπός του άρθρου, που αργότερα ενσωματώθηκε μερικώς σε ανάλογο κεφάλαιο της διδακτορικής διατριβής, ήταν να φανεί εάν στο θέμα της υποβοηθούμενης αναπαραγωγής, η σύγχρονη ορθόδοξη θεολογική σκέψη επηρεάζεται από τις αποφάσεις και τις εγκυκλίους των ετεροδόξων εκκλησιών και ιδιαίτερα της Ρωμαιοκαθολικής Εκκλησίας. Με τα δεδομένα που εξετάσαμε δεν διαφάνηκε κάποιος επηρεασμός από τα ετερόδοξα κείμενα ή η ανάλογη βιασύνη στην ορθόδοξη θεολογία και στην ποιμαίνουσα εκκλησία να καταδικάσει ή να αποδεκτεί τις μεθόδους της υποβοηθούμενης αναπαραγωγής. Η μετάφραση της Κατήχησης της Ρωμαιοκαθολικής Εκκλησίας έγινε από το αγγλικό κείμενο.
The aim of this article is to describe the concept, the source, the characteristics and the main manifestations of a rather neglected issue in child development, namely egocentrism in school-age children, according to David Ekind's theory. Egocentrism takes on a unique form in each stage of cognitive development and constitutes a negative but necessary by-product of each stage. First, we describe briefly the concept, the source and the decline of egocentrism in general as well as those of the sensorimotor and the preoperational egocentrism. Then, the association between egocentrism in school-age children and concrete operational abilities is discussed. The "assumptive realities", that is, the inability to distinguish between the products of thought and the perceptual data, is analyzed as the main characteristic of concrete operational egocentrism. This form of egocentrism manifests itself as a differentiation failure between the transient and the abiding rules, between the subjective and the objective rules, and between the particular and the universal rules. With the emergence of formal operational abilities, children become able to decentrate their thought by testing hypotheses against reality and discovering their arbitrary nature. Finally, several educational implications, that is, ways through which the educator can reduce his/her students' egocentrism and facilitate their transition to higher levels of cognitive functioning, are suggested.
Τα ερωτήματα που τίθενται στην εργασία είναι: α) Η παρουσία του ηττημένου αθλητή στο συνολικό έργο του Πινδάρου, β) η κατάσταση στην οποία περιέρχεται ο ηττημένος αθλητής, γ) η θεώρηση της ήττας του αθλητή κατά τον Πίνδαρο, δ) η σημασία της αγωνιστικής νίκης, ε) η εικόνα αυτής της νίκης στον Πίνδαρο, και στ) η έννοια του ηττημένου ως αντίποδα του νικητή. Τελικό ερώτημα της εργασίας είναι η αξιολογία της ήττας κατά τον ποιητή και, οι από τον άνθρωπο και τον αθλητή απορρέουσες δυνατότητες αξιοποίησης της εμπειρίας της ήττας.
In this article, we offer a brief description of the current theories of adolescent egocentrism, namely Piaget's, Elkind's and Lapsley's theories. Aspects from Blos', Mahler's and Josselson's psychodynamic views, as well as from Selman's theory of interpersonal understanding are integrated into Lapsley's theory. For each theory, the content, the source, the main forms and the developmental features of egocentrism are discussed. In conclusion, we attempt to evaluate the explanatory power of these theories and we suggest a model of adolescent egocentrism which includes physical, cognitive, social and emotional factors.
Οι Ολυμπιακοί Αγώνες αποτελούν θέμα ιδιαίτερο αγαπητό στην παιδική λογοτεχνία. Με αφορμή την έκδοση του Dargaud ‘ΑsterixauxjeuxOlympiques’ η εργασία αυτή εξετάζει τον τρόπο με τον οποίο παρουσιάζονται οι Ολυμπιακοί Αγώνες στη λογοτεχνία αυτού του είδους, το περιεχόμενο του κόμικ, καθώς επίσης και το στόχο του συγγραφέα. Επισημαίνονται τα θετικά και τα αρνητικά δεδομένα της έκδοσης, οι ιστορικές αλήθειες και οι ανακρίβειες, και, κυρίως, τα μηνύματα προς τους νέους στους οποίους απευθύνεται η έκδοση, τα οποία, λόγω και του ταυτόχρονου οπτικού ερεθίσματος, είναι ιδιαίτερα ισχυρά. Το συμπέρασμα που προκύπτει, εν τέλει, είναι οτι πίσω από την ευχάριστη ατμόσφαιρα του κόμικ, το οποίο έχει μεταφραστεί και στα αρχαία ελληνικά από τον Φάνη Κακριδή, παρουσιάζονται με μονοσήμαντο τρόπο οι Ολυμπιακοί Αγώνες, ο αρχαίος κλασικός πολιτισμός, αλλά και ο νεοελληνισμός. Ο συγγραφέας του κόμικ φέρνοντας τον συμπαθή ήρωα των Γαλατών στην Ολυμπία το 52 π.Χ. επιχειρεί να συνδέσει τους Γαλάτες με τους Ολυμπιακούς Αγώνες με τους οποίους δεν είχαν καμία σχέση, συνδέοντας έτσι τους Γάλλους με την αρχαία Ολυμπία και τον κλασικό πολιτισμό. Ο τρόπος, όμως, που χρησιμοποιεί τον ολυμπιακό μύθο και τους αθλητές της Ολυμπίας είναι ανιστόρητος, καθώς οι Ολυμπιακοί Αγώνες δεν ήταν μια αφελής ιστορία φολκλορικού χαρακτήρα, αλλά ένας θεσμός σφυρηλατημένος από την αντιφατικότητα της ανθρώπινης φύσης. Είναι εντελώς διαφορετικό να παρουσιάζεται η αντιφατικότητα της φύσης του ανθρώπου, και άλλο η βία. Ο συγγραφέας επιδιώκει τη δημιουργία ενός μύθου για τους σύγχρονους Γάλλους, ενώ το θέμα των Ολυμπιακών Αγώνων αποτελεί μόνο το πρόσχημα για τον εξωραϊσμό και την προβολή αυτού του, αλλότριου, μύθου.
We report a systematic study of lattice relaxation effects around 3d and 4sp impurities in aluminum, using the full-potential Korringa-Kohn-Rostoker Green function method. Our results for the magnetic properties of the impurities seem to resolve the discrepancy between experiment and previous calculations. In addition, the calculated atomic displacements and total volume changes are in good agreement with the corresponding experimental data.
The dynamics of a case of cyclogenesis over the central Mediterranean associated with heavy precipitation, especially over the southeast Aegean Sea, have been investigated on the basis of the analyses of two meteorological parameters, namely, the isobaric absolute and relative vorticity and the isentropic potential vorticity. On the whole, the two approaches demonstrate the important role of the upper level dynamics in the initiation of the surface cyclogenesis and seem to identify the same features: interaction of a region of positive absolute vorticity advection ahead of a 500 hPa trough with a shallow frontal system, in the first approach, and an isentropic potential vorticity anomaly at the upper levels with a low level baroclinic zone in the second approach. Furthermore, the analysis of potential vorticity identified an intense low level potential vorticity anomaly, for which there are indications that this is associated with diabatic heating and is important for the deepening of the system. This makes potential vorticity analysis preferable for forecasters. Special emphasis is given to the upper-level circulation and the vorticity field over the major European region before the surface cyclogenesis commences, since it is considered to be crucial for the forecasting of the event.
Various methods, such as address-calculation sorts, distribution counting sorts, radix sorts, and bucket sorts, use the values of the numbers being sorted to increase efficiency but do so at the expense of requiring additional storage space. In this paper, a specific implementation of bucket sort is presented whose primary advantanges are that (i) linear average-time performance is achieved with an additional amount of storage equal to any fraction of the number of elements being sorted and (ii) no linked-list data structures are used (all sorting is done with arrays). Analytical and empirical results show the trade-off between the additional storage space used and the improved computational efficiency obtained. Computer simulations show that for lists containing 1,000 to 30,000 uniformly distributed positive integers, the sort developed here is faster than both Quicksort and a standard implementation of bucket sort. Furthermore, the running time increases with size at a slower rate.
The temperature dependence of the EPR spectra of Y0.5Sm0.5 Ba2Cu3O6+x ceramic in tetragonal phase has been investigated at low temperatures. The complicated EPR spectra resulted from different paramagnetic centers: isolated divalent copper ions, exchange coupled copper pairs of ions, and molecular oxygen ions. The observed temperature dependence of the linewidth of exchange coupled copper ions has been interpreted in frames of a model of the collective motion of magnetic moments. The intensity of EPR spectra of molecular oxygen ions has shown critical behaviour at 3.60 K, where the intensity increased considerably.
The diagnostic value of antimyosin scanning in 7 patients with biopsy- proven cardiac amyloidosis was examined in this study. Antimyosin imaging was positive in all amyloid patients, with more intense uptake in patients with heart failure.
Jormakka J, van Dijk J, Jonker W, van der Mei R, Parise P, Liffredo L, Ullio M, Aarstad E, Huth P, Jensen T, et al.ATM traffic sources and core network dimensioning. IEEE ATM Workshop, Proceedings. 1997:243-252.
A case of Saharan cyclogenesis associated with the equatorward intrusion of a trough at the end of the Atlantic storm track is investigated. It is shown that a potential vorticity anomaly resulting from a baroclinic wave life cycle associated with the polar jet interacts with the low-level baroclinicity over subtropical Africa beneath the subtropical jet. It is suggested that low-latitude synoptic-scale cyclogenesis events of this type can be triggered only by upper-level potential vorticity anomalies if they have a sufficient depth scale and that the interaction may be aided by the presence of low static stability associated with a well-mixed boundary layer. A weak cold front also forms during the cyclogenesis event associated with the convergence of the baroclinicity of the polar trough front with the baroclinicity of the subtropical heat low.
The polypeptide angiogenin, a normal constituent of human plasma, might be involved in endothelium homeostasis, angiogenesis, and neovascularization accompanying various diseases. This study aimed at determining angiogenin serum concentrations in the perinatal period of healthy newborns and at forming a baseline for this protein, which in the future may serve as a diagnostic index in developmental errors of the placenta and/or newborn. One milliliter of blood was drawn on d 1 and 4 of life from 30 healthy full-term neonates, and angiogenin serum concentrations were measured by an enzyme immunoassay using a commercially available kit. In 10 cases angiogenin serum concentrations were also measured in the maternal serum before delivery and in the umbilical vein serum. Angiogenin serum concentrations (μg/L) were significantly higher in maternal serum (225.7 ± 49.6) compared with umbilical vein serum (119.0 ± 34.2) (p < 0.0002), as well as that compared with day 1 (166.4 ± 44.9) (p < 0.01) but not to d 4 neonatal serum (240.8 ± 52.6). Angiogenin serum concentrations showed a statistically significant increase from d 1 to 4 (p < 10-7), as well as from umbilical cord serum to d I neonatal serum (p < 0.0002). A statistically significant correlation existed between values in umbilical cord serum and d I neonatal serum (r = 0.84, n = 10, p < 0.002) and between those in d I and 4 neonatal serum (r = 0.37, n = 30, p < 0.04). Sex, birth weight, or mode of delivery did not influence angiogenin serum concentrations. We conclude that a rapid increase of angiogenin serum concentrations to maternal levels takes place during the first four postnatal days in healthy full-term neonates.
This paper narrates the way chemists have been using the electron to account for one of the most intriguing problems, namely the bonding of two neutral atoms to form a molecule. The chemists' attempts to account for the mechanism of the homopolar bond, first in the context of the old quantum theory and after 1926 in the context of wave mechanics, brought the specter of reductionism to physics. We argue that the chemists' successful appropriation of the electron strengthened, first, the autonomy of physical chemistry and, then, of quantum chemistry with respect to physics.
Purpose: We investigated the activity of combination chemotherapy consisting of cisplatin, ifosfamide, methotrexate and vinblastine in patients with metastatic urothelial cancer. Materials and Methods: A total of 32 consecutive patients was treated with 30 mg./m.2 cisplatin on days 1 through 3, 1.5 gm./m.2 ifosfamide with mesna on days 1 through 3, 30 mg./m.2 methotrexate and 3 mg./m.2 vinblastine on day 1 plus 5 μg./kg. granulocyte colony-stimulating factor on days 7 through 11. Courses were repeated every 21 days for a maximum of 6 cycles. Results: Major toxicity was granulocytopenia in 56% of patients, including 11 episodes of granulocytopenic fever. Anemia and thrombocytopenia developed in a third of the cases. No other significant toxicity or treatment related death was noted. An objective response was achieved in 20 patients (62.5%, 95% confidence interval 44 to 79). Median time to progression was 7 months and median survival was 13 months. Conclusions: The cisplatin, ifosfamide, methotrexate and vinblastine regimen appeared active in patients with metastatic urothelial carcinoma. This regimen was associated with significant but manageable hematological toxicity and the incidence of mucositis or renal impairment was low. Prospective randomized studies are needed to assess whether the addition of ifosfamide to other active agents will improve the survival of patients with this disease.
Consider a finite state irreducible Markov reward chain. It is shown that there exist simulation estimates and confidence intervals for the expected first passage times and rewards as well as the expected average reward, with 100% coverage probability. The length of the confidence intervals converges to zero with probability one as the sample size increases; it also satisfies a large deviations property.
In order to identify possible correlations between interleukin-6 (IL-6) and hormonal and biochemical parameters of bone metabolism, or bone density, 24 postmenopausal women were studied. Serum IL-6, estradiol, calcium, phosphorus, osteocalcin, alkaline phosphatase, the urinary secretion of calcium, phosphorus and hydroxyproline, and bone density of the lumbar spine, femur and radius were measured. No significant correlation was found between IL-6 and the biochemical parameters. A negative correlation was found between IL-6 and serum estradiol, as well as between IL-6 and bone density in 5 out of 6 sites studied. It is possible that women with high IL-6 levels, may develop lower bone mass.
McCarthy JE, Cooper MJ, Honkimäki V, Tschentscher T, Suortti P, Gardelis S, Hämäläinen K, Manninen SO, Timms DN. The cross-section for magnetic Compton scattering up to 1 MeV. Nuclear Instruments and Methods in Physics Research, Section A: Accelerators, Spectrometers, Detectors and Associated Equipment [Internet]. 1997;401:463-475. WebsiteAbstract
The energy dependence of the magnetic Compton cross-section was measured with elliptically polarised synchrotron radiation at five energies from 245.2 to 1000.5 keV at the European Synchrotron Radiation Facility (ESRF) using a recently installed superconducting wavelength shifter, the sample was ferromagnetic iron. These measurements more than double the highest photon energy previously used in synchrotron radiation studies. It was found that the integrated intensity of the spin-dependent scattering was well described by the formulae for the differential cross-section, dσ/dΩ, for free, stationary electrons. The optimisation of experiments designed to yield the spin-dependent Compton profile from the double differential cross-section, d2σ/dΩ dω is discussed.
Twenty-one women presenting with different diseases, with absolute or relative contraindications to hormonal contraception or the use of intrauterine devices, received 300-600 μg/day buserelin intranasally from the 1st to the 21st day, and 5 mg/day norethisterone acetate orally from the 16th to the 23rd day of the cycle for a total of 245 cycles. Serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol and testosterone were determined on days 3-5 and 13-15 of the cycle, while progesterone determinations and ovarian sonography were performed during the second half of the cycle. According to progesterone values, 92.7% of the treatment cycles were anovulatory, while in one cycle pregnancy was detected (0.4%). Values of serum LH, FSH and estradiol were low, and in most of the cycles ovarian follicular development was limited to follicles ≤ 11 mm. In 21 treatment cycles (9%), statistically significant increases in FSH (p < 0.0001) and LH (p < 0.02), as well as ovarian proliferation to preovulatory follicles or luteinized follicles, were found. It appears that in spite of the high cost of medication and monitoring of patients, this regimen could be useful as an alternative in cases where other forms of contraception are contraindicated or have failed.
Sarandakou A, Phocas I, Sikiotis K, Rizos D, Botsis D, Kalambokis D, Trakakis E, Chryssikopoulos A. Cytokines in gynecological cancer. Anticancer Research. 1997;17(5 B):3835 - 3839.Abstract
Background: Cytokines are considered as part of host defence to infection or injury. Material and Methods: Pretreatment values of TNF and sIL-2R were measured in 132 women with a) ovarian carcinoma (n = 25), b) breast cancer (n = 20), c) endometrial cancer (n = 15), d) cervical squamous cell carcinoma (n = 19), e) cervical adenocarcinoma (n = 11) and f) benign gynecological diseases (n = 42) in order to evaluate whether these cytokines could be useful in the discrimination of malignant from benign gynecological diseases. Results: Both TNF and sIL-2R were significantly higher in all cancer groups together (mean ± SD:30 ± 11 pg/mL and 1293 ± 465 U/mL respectively), than those in the benign group (16.0 ± 6 pg/mL and 626 ± 233 U/mL, respectively; p < 0.001), while no significant differences were found for TNF and sIL-2R values in the five cancer groups. Significantly higher cytokine values were measured in the advanced stage diseases (33 ± 11 pg/mL and 1705 ± 192 U/mL), than those in the limited cancer (26 ± 12 pg/mL, p < 0.05 and 916 (521 U/mL, p < 0.001). Conclusions: Our results suggest that, cytokines may be useful in the discrimination of malignant from benign gynecological diseases and in monitoring tumor activity in patients early in the malignancy process.
Abstract - The study described in this paper investigates the knowledge andpreferences of 176 Greek children, aged between nine and eleven, with regard tofats and oils. The results show that the majority of children cannot classify oils.butter, and margarine in the correct nutritional category. The great majority wereof the opinion that it is healthier to use olive oil, rather than than seed oils, forsalads and cooked meals. However, they also answered that seed oils are healthierthan olive oil for fried meals. No statistically significant differences between thesexes was found in the answers, except for their preferences regarding the use ofolive oil in cooked meals and salads. The results indicate that Greek children lackthe information they need to make healthy food choices. In addition, there is aneed to develop teaching strategies thatfocus on lipids and their impact on health.
The effect of antineoplastic agents on non proliferating cells of Saccharomyces cerevisiae was investigated. Non growing populations were obtained by suspending cells in saline or H2O and survival rates were determined after exposing the cells to various commercially available agents for five hours. The only agent found to be effective was Doxorubicin which reduced survival rates to less than 5% (p < 0.001). The action of this drug could be detected in only 4 minutes and was not concentration dependent, therefore it is probable that DNA damage is caused mostly by oxygen free drug radicals. Furthermore, our observations strongly imply the damage of cellular membranes is an alternative reason for cell death, with phosphatidyl-inositol being the most probable candidate target for the drug.
The scattering of a quasi two-dimensional electron gas by optical phonons in selectively doped AlxGa1−xAs/GaAs/AlxGa1−xAs quantum wells is systematically studied in order to determine the effect of phonon confinement. The electron states are calculated solving self-consistently Schrödinger and Poisson equations to obtain an accurate dependence upon the structure parameters and the temperature. We study the way the scattering is affected by the form of the phonons calculating the mobility using three models for the phonons. They are considered:m(a) as three dimensional (3D), (b) as a set of confined and interface phonons, and (c) as the normal modes of the heterostructure. The relaxation times for the electron energy subbands are calculated solving the system of Boltzmann equations. The effect of the temperature and the well width variation is also investigated. The results are in a good agreement with experimental measurements. The agreement is only slightly dependent on the model used for the phonons and becomes best when the effect of the heterostructure on the phonon modes is taken into account.
The current analysis of gastrointestinal absorption phenomena relies on the concept of homogeneity. However, drug dissolution, transit and uptake in the gastrointestinal tract are heterogeneous processes since they take place at interfaces of different phases under variable stirring conditions. Recent advances in physics and chemistry demonstrate that the geometry of the environment is of major importance for the treatment of heterogeneous processes. In this context, the heterogeneous character of in vivo drug dissolution, transit and uptake is discussed in terms of fractal concepts, Based on this analysis, drugs are classified in accordance with their gastrointestinal absorption characteristics into two broad categories i.e. homogeneous and heterogeneous. The former category includes drugs with satisfactory solubility and permeability which ensure the validity of the homogeneous hypothesis. Drugs with low solubility and permeability are termed heterogeneous since they traverse the entire gastrointestinal tract and therefore are more likely to exhibit heterogeneous dissolution, transit and uptake. The high variability of whole bowel transit and the unpredictability of conventional dissolution tests for heterogeneous drugs are interpreted on the basis of the fractal nature of these processes under in vivo conditions. The implications associated with the use of strict statistical criteria in bioequivalence studies for heterogeneous drugs are also pointed out.
{In this report, we studied the immunorestorative properties of subcutaneously administered granulocyte-macrophage colony-stimulating factor (GM-CSF) in patients with refractory solid tumours receiving second-line chemotherapy. Such patients exhibit abnormal immune responses in vivo and in vitro and, therefore, it was of interest to examine the effect of GM-CSF-induced immunomodulation on clinical response. We examined patients with primary malignant carcinomas (head and neck
We present the results of a survey of neutral hydrogen emission in the Small Magellanic Cloud (SMC) with the Australia Telescope Compact Array (ATCA). The survey consists of a mosaic of 320 separate pointings of the 375-m array, resulting in a resolution of 1.6 arcmin (28 pc, for a distance of 60 kpc) over a field of 20 deg^2. The rms brightness temperature sensitivity is 1.4 K, corresponding to an Hi column density sensitivity of 4x10^18 cm^-2 for each velocity channel of width 1.6kms^-1. The Hi distribution is complex and, on scales <~1 kpc, appears to be dominated by the effects of expanding Hi shells, which are probably driven by the combined effects of supernovae and stellar winds from massive stars. The picture of the SMC that arises from the current data seems to challenge the earlier belief that the SMC consists of two or more spatially separate structures with different systemic velocities. We find that the observed multiple components are, in many cases, caused by the combined effects of the numerous shells and supershells. Altogether, we identify six supershells (defined here as those with radii greater than 300 pc) and 495 giant shells. For each of these, we measure positions, radii, velocities and expansion rates, and derive ages and kinetic energy requirements. The apparent age distribution of shells is remarkably narrow, with a mean age of 5.4Myr and an intrinsic dispersion of 2Myr. Southern shells appear to be older, on average, by 2.5Myr. The kinetic energy of the shells is a large fraction of the gravitational binding energy of the SMC, implying that further disintegration of the SMC will occur with time, and especially at the next close passage with the Large Magellanic Cloud (LMC) or the Galaxy, unless the SMC possesses a massive halo. Because of their interferometric nature, the images presented here are insensitive to structures of size >~0 deg.6, and should not be used for deriving total Hi column densities.
Objective: To evaluate the efficacy and toxicity of the combination of ifosfamide (1.5 g/m2 i.v. on days 1, 2, 3) and paclitaxel (135 mg/m2 i.v. over 3 hours on day 3) with G-CSF (5 μg/kg/d subcutaneously, days 7-11) administered every 3 weeks on an outpatient basis in patients with advanced epithelial ovarian cancer previously treated with platinum-based chemotherapy. Patients and methods: Thirty-five consecutive patients were treated, 12 of whom had previously received two regimens. Twelve of the 35 were defined as platinum-resistant and 23 as potentially platinum-sensitive. Results: Fifteen patients (43%; 95% CI: 26%-61%) achieved objective responses, five of them complete and ten partial. Objective responses occurred in 17% of the platinum-resistant patients and in 57% of those with potentially platinum-sensitive disease. The median duration of response was seven months and the median overall survival 11 months. The treatment was well tolerated and only 15% of the patients developed grade 3 or 4 neutropenia. With the exception of alopecia there were no other grade 3 or 4 toxicities. Conclusions: The combination of ifosfamide and paclitaxel was well tolerated and showed activity in patients with ovarian cancer who had previously undergone platinum-based chemotherapy.
This paper repotts on the first phase of a comparative study in Greece and the United Kingdom which is investigating the knowledge and understand ing of children aged 10 and 11 years about dietary fat and health. It is intended to use the study to develop in-service programmes for teachers based on research. The findings indicate that perceptions about fat and health held by children in the two countries are very similar. The majority of the children were able to describe the relationship between fat and health in general terms, but had limited understanding about the function of fat in the body.
The authors investigated 125 patients suffering from primary Raynaud's phenomenon by the following laboratory hematologic parameters: (1) cryofibrinogen and cryoglobulins; (2) serum albumins and immunoglobulins IgG, IgA, and IgM, as well as complement factors C3 and C4; (3) clotting inhibitors, antithrombin III, protein C and protein S, as well as α1 antitrypsin. Results were as follows: 77 (62%) patients had cryofibrinogen in their blood plasma, 50 (40%) patients had precipitation of cryoglobulins, and 65 (52%) patients had an increase of α2 globulin in the serum electrophoresis. Of the immunoglobulins, IgM was found increased in 42 patients (34%). Of the clotting time inhibitors, antithrombin III (AT III) had a lower activity in 50 (40%) patients as compared with that of normal subjects. Protein C, protein S, and α1 antitrypsin levels were lower in 21 (16.8%), 13 (10.4%), and 10 (8%) of patients, respectively. Statistical analysis of the results showed that all the protein fractions except for γ- globulin presented a statistically significant difference as compared with those of the controls (P <0.0001). Immunoglobulins IgG and IgA of the patients were significantly lower than those of the normal controls (P <0.001). The C3 and C4 factors of the complement presented statistically significant lower values (P < 0.001 and P < 0.0001 respectively). Finally, AT III appeared in lower values than those of the normal controls, being statistically significant (P < 0.0001). These results suggest that patients with primary Raynaud's phenomenon present changes in the levels of certain hematologic parameters, a fact that is probably connected with etiology. Thus further study and assessment might contribute to the diagnosis, discovery of the subjective systemic etiology, and better therapeutic management of Raynaud's phenomenon.
We present a radial velocity survey of a sample of the field population of carbon stars in the outer parts of the Small Magellanic Cloud (SMC). This first set of results includes radial velocities for 71 carbon stars, with an individual precision of +/- 2-5 km/s. The mean heliocentric velocity of the stars (excluding one very high velocity star) is 149.3+/-3.0 km/s with a velocity dispersion of 25.2 +/- 2.1 km/s. These values drop to 145.5+/-2.7 km/s and 20.6+/-1.9 km/s respectively, if we exclude the stars belonging to the Outer Wing. The velocity distribution does not show the multiple peaks seen in some samples of Population I objects. The mass of the SMC as inferred from the above velocity dispersion (without the outer Wing stars) is ~= 1.2~10^9M_{\odot}. Tables 1a and 1b are available in electronic form at the CDS via anonymous ftp 130.79.128.5 or http://cdsweb.u-strasbg.fr/abstract.html
{The Kozani earthquake (Ms = 6.6) of 13 May 1995 is the strongest event of the decade in Greece and occurred in a region of low seismic activity. Using regional data and the strong-motion record at the Kozani station, we relocate the mainshock at 40.183° N and 21.660° E, beneath the Vourinos massif at a depth of 14.2 km. We also compute a focal mechanism by body-waveform modeling at teleseismic distance, which confirms a normal mechanism. The most likely plane strikes 240° ± 1° N and dips 40° ± 1° N with a centroid depth of 11 ± 1 km. Modeling of the strong-motion record at Kozani confirms that nucleation started at the eastern termination of the bottom of the fault.Six days after the mainshock, we installed a network of 40 portable seismological stations for one week around the epicentral region. Several thousand aftershocks were recorded, among which we locate 622 with a precision better than 1 km. We compute 181 focal mechanisms that mostly show normal faulting. The aftershock seismicity is restricted between 5 and 15 km depth and defines a plane dipping north at an angle of about 35°, consistent with the mainshock mechanism. Seismic activity with the same pattern of normal fault mechanisms is also seen on an antithetic fault connected to the main one at 12 km depth, which cuts the ground surface north of the Vourinos ophiolite massif in the Siatista valley. These results suggest two possibilities for the active fault plane; either it is the Deskati fault that is flat and dips with a constant angle, and therefore the surface breaks are secondary features, or, more likely, it is the Paleohori fault that is new, of listric shape, and located ahead of the Deskati fault, which was not active during the earthquake.}
Late relapses of nonseminomatous germ cell tumors of the testicle are unusual. In such cases, chemotherapy is reported to have only modest success and surgery may be the preferred treatment modality. We report a patient who experienced relapse 11 years after the initial diagnosis of advanced testicular cancer and who achieved a sustained complete remission with salvage chemotherapy alone.
The full-potential Korringa-Kohn-Rostoker Green function method is extended to treat the lattice distortion in the vicinity of a point defect. The method is applied to predict the atomic positions in the neighborhood of d and sp substitutional impurities in Cu. Both the total energy and the Hellmann-Feynman force are used for the calculation of the ground-state configuration, while the semicore states of the impurities are treated as valence states. Our results for the atomic displacements are in very good agreement with the experimental data from extended x-ray-absorption fine-structure and lattice-parameter measurements.
Design: Determine the frequency of t(2;5)(p23;q35) in anaplastic large- cell lymphoma (ALCL), non-Hodgkin's lymphoma (NHL), Hodgkin's disease (HD), and lymphomatoid papulosis (LP). Patients and methods: The t(2;5) was detected with a long-range nested polymerase chain reaction (PCR) using 0,5 μg of DNA (60000-80000 cells), 5'-primers from the NPM gene, 3'primers from the ALK gene, agarose electrophoresis, hybridization, and autoradiography. Patients were evaluable if a 3016 base pair amplicon could be generated from tumor DNA with β-globin primers. Results: Amplicons were detected by PCR of genomic DNA from three ALCL cell lines and four primary ALCLs known to t(2;5) positive. DNA from t(2;5)-positive cell lines diluted 104-fold or 105-fold generated amplicons in 100% or 20% of reactions, respectively. Archival tumor DNA from 144 patients was amplifiable by β-globin amplicons in 126 (88%) who are considered evaluable for this study. Twenty-two had ALCL, 69 other NHLs, 30 HD, and five LP. Genomic DNA PCR detected the t(2;5) in 5 of 22 with ALCL (23%, 95% confidence intervals [95% CI] 8%-45%) but not in those with NHLs, HD, or LP. Among ALCLs the t(2;5) was confined to 5 of 20 with nodal presentations (25%, 95% CI 9%-49%), among whom it was seen in 5 of 15 with T- cell or null-cell phenotype (33%, 95% CI 12%62%), in 4 of 11 with age < 40 years (36%, 95% CI 11%-69%), and in 4 of 9 with nodal presentations, T-cell or null-cell phenotype, and age <40 years (44%, 95% CI 14%-79%). Amplicon sizes were different between cell lines and patients, reflecting unique genomic DNA breakpoints, as confirmed by DNA sequencing, and served as an internal control against specimen cross-contamination in the laboratory. Conclusions: Long-range PCR of genomic DNA detects t(2;5) only in ALCL but not in other NHLs, HD, or LP. Long-range PCR may be useful in establishing diagnosis, determining prognosis, and monitoring minimal residual disease in ALCL.
We report a systematic study of low-field galvanomagnetic properties of aluminium-based dilute alloys with 3d and 4sp impurities. The low-field magnetoresistivity tensor is determined by exactly solving the linearized Boltzmann equation for the anisotropic vector mean free path, without using any adjustable parameter. Our method of calculation is based on the on-Fermi-sphere approximation which allows us to combine the full anisotropy of the host Fermi surface, obtained by the four-orthogonal-plane-wave method, with the impurity scattering phase shifts, evaluated by self-consistent local-density-functional impurity-in-jellium calculations. Our results for the Hall coefficient and the magnetoresistance are in good agreement with the experimental data.
We report a systematic study of low-field galvanomagnetic properties of aluminium-based dilute alloys with 3d and 4sp impurities. The low-field magnetoresistivity tensor is determined by exactly solving the linearized Boltzmann equation for the anisotropic vector mean free path, without using any adjustable parameter. Our method of calculation is based on the on-Fermi-sphere approximation which allows us to combine the full anisotropy of the host Fermi surface, obtained by the four-orthogonal-plane-wave method, with the impurity scattering phase shifts, evaluated by self-consistent local-density-functional impurity-in-jellium calculations. Our results for the Hall coefficient and the magnetoresistance are in good agreement with the experimental data.
The natural radioactivity, mainly due to radium (226Ra), in phosphate fertilizers used in north-western Greece has been measured by [gamma]-spectroscopy. Also radioactivity measurements were performed in soil samples and were compared to samples from undisturbed soils. 226Ra belongs to the 238U chain and is the precursor of radon gas (222Rn). The radon concentrations in warehouses, where large quantities of fertilizers are kept, were measured with CR-39 SSNTDs. The radium concentrations in the fertilizers ranged from 0 to 4584 Bq kg-1 and the radon concentrations in warchouses were measured 540-3320 Bq m-3. The results are discussed from the radiation protection point of view.
A model for phosphocreatine (PCr) resynthesis is proposed based on a simple electric circuit, where the PCr store in muscle is likened to the stored charge on the capacitor. The solution to the second-order differential equation that describes the potential around the circuit suggests the model for PCr resynthesis is given by PCr(t) = R - [d1 · exp(-k1·t) ± d2·exp(-k2·t)], where R is PCr concentration at rest, d1, d2, k1, and k2 are constants, and t is time. By using nonlinear least squares regression, this double-exponential model was shown to fit the PCr recovery data taken from two studies involving maximal exercise accurately. In study 1, when the muscle was electrically stimulated while occluded, PCr concentrations rose during the recovery phase to a level above that observed at rest. In study 2, after intensive dynamic exercise, PCr recovered monotonically to resting concentrations. The second exponential term in the double-exponential model was found to make a significant additional contribution to the quality of fit in both study 1 (P < 0.05) and study 2 (P < 0.01).
A model for phosphocreatine (PCr) resynthesis is proposed based on a simple electric circuit, where the PCr store in muscle is likened to the stored charge on the capacitor. The solution to the second-order differential equation that describes the potential around the circuit suggests the model for PCr resynthesis is given by PCr(t) = R - [d1 · exp(-k1·t) ± d2·exp(-k2·t)], where R is PCr concentration at rest, d1, d2, k1, and k2 are constants, and t is time. By using nonlinear least squares regression, this double-exponential model was shown to fit the PCr recovery data taken from two studies involving maximal exercise accurately. In study 1, when the muscle was electrically stimulated while occluded, PCr concentrations rose during the recovery phase to a level above that observed at rest. In study 2, after intensive dynamic exercise, PCr recovered monotonically to resting concentrations. The second exponential term in the double-exponential model was found to make a significant additional contribution to the quality of fit in both study 1 (P < 0.05) and study 2 (P < 0.01).
A model for phosphocreatine (PCr) resynthesis is proposed based on a simple electric circuit, where the PCr store in muscle is likened to the stored charge on the capacitor. The solution to the second-order differential equation that describes the potential around the circuit suggests the model for PCr resynthesis is given by PCr(t) = R - [d 1 · exp(-k 1·t) ± d 2·exp(-k 2·t)], where R is PCr concentration at rest, d 1, d 2, k 1, and k 2 are constants, and t is time. By using nonlinear least squares regression, this double-exponential model was shown to fit the PCr recovery data taken from two studies involving maximal exercise accurately. In study 1, when the muscle was electrically stimulated while occluded, PCr concentrations rose during the recovery phase to a level above that observed at rest. In study 2, after intensive dynamic exercise, PCr recovered monotonically to resting concentrations. The second exponential term in the double-exponential model was found to make a significant additional contribution to the quality of fit in both study 1 (P < 0.05) and study 2 (P < 0.01).
Methods. Twenty-four healthy subjects and 16 patients with lymphedema and lipedema were studied with MRI and ultratomography. Results. In chronic lymphedema, ultrasonography revealed a statistically significant increase of the subcutaneous fat without difference in skin thickness as compared to the healthy subjects. MRI revealed in lymphedema a statistically significant increase of skin thickness + subcutaneous tissue + muscular mass (p = 0.048); in lipedema, a statistically significant increase of skin thickness and subcutaneous tissue (p < 0.0001) as compared to the healthy controls. Conclusions. MRI offers strong qualitative and quantitative parameters in the diagnosis of lymphedema and lipolymphedema, while ultrasonography is expected to improve its diagnostic efficiency with the aid of high frequency echo with more sophisticated resolution apparatus. Age, weight and height of the patient as well as duration of the disease do not seem to affect the above-mentioned parameters.
We present the results of a multidisciplinary study of the Ms = 6.2, 1995, June 15, Aigion earthquake (Gulf of Corinth, Greece). In order to constrain the rupture geometry, we used all available data from seismology (local, regional and teleseismic records of the mainshock and of aftershocks), geodesy (GPS and SAR interferometry), and tectonics. Part of these data were obtained during a postseismic field study consisting of the surveying of 24 GPS points, the temporary installation of 20 digital seismometers, and a detailed field investigation for surface fault break. The Aigion fault was the only fault onland which showed detectable breaks (< 4 cm). We relocated the mainshock hypocenter at 10 km in depth, 38 ° 21.7 ′ N, 22 ° 12.0 ′ E, about 15 km NNE to the damaged city of Aigion. The modeling of teleseismic P and SH waves provides a seismic moment Mo = 3.4 1018 N.m, a well constrained focal mechanism (strike 277 °, dip 33 °, rake − 77°), at a centroidal depth of 7.2 km, consistent with the NEIC and the revised Harvard determinations. It thus involved almost pure normal faulting in agreement with the tectonics of the Gulf. The horizontal GPS displacements corrected for the opening of the gulf (1.5 cm/year) show a well-resolved 7 cm northward motion above the hypocenter, which eliminates the possibility of a steep, south-dipping fault plane. Fitting the S-wave polarization at SERG, 10 km from the epicenter, with a 33° northward dipping plane implies a hypocentral depth greater than 10 km. The north dipping fault plane provides a poor fit to the GPS data at the southern points when a homogeneous elastic half-space is considered: the best fit geodetic model is obtained for a fault shallower by 2 km, assuming the same dip. We show with a two-dimensional model that this depth difference is probably due to the distorting effect of the shallow, low-rigidity sediments of the gulf and of its edges. The best-fit fault model, with dimensions 9 km E–W and 15 km along dip, and a 0.87 m uniform slip, fits InSAR data covering the time of the earthquake. The fault is located about 10 km east-northeast to the Aigion fault, whose surface breaks thus appears as secondary features. The rupture lasted 4 to 5 s, propagating southward and upward on a fault probably outcropping offshore, near the southern edge of the gulf. In the shallowest 4 km, the slip – if any – has not exceeded about 30 cm. This geometry implies a large directivity effect in Aigion, in agreement with the accelerogram aig which shows a short duration (2 s) and a large amplitude (0.5 g) of the direct S acceleration. This unusual low-angle normal faulting may have been favoured by a low-friction, high pore pressure fault zone, or by a rotation of the stress directions due to the possible dip towards the south of the brittle-ductile transition zone. This fault cannot be responsible for the long term topography of the rift, which is controlled by larger normal faults with larger dip angles, implying either a seldom, or a more recently started activity of such low angle faults in the central part of the rift.
Papadopoulos IN, Katsaragakis S, Kaniorou-Larai M, Stergiopoulos S, Tzilalis B, Parasi A, Androulakis G. Necrotizing soft-tissue perineal infections. The British Journal of Surgery-Supplement. 1997;84:90–91.
A 1,5-hydrogen migration of a conveniently situated alkoxyl radical affords spironucleosides which possess an unusual orthoamide structure at the anomeric position; X-ray crystallography establishes the configuration of the C-1' position.
In this paper we consider the problem of adaptive control for Markov Decision Processes. We give the explicit form for a class of adaptive policies that possess optimal increase rate properties for the total expected finite horizon reward, under sufficient assumptions of finite state-action spaces and irreducibility of the transition law. A main feature of the proposed policies is that the choice of actions, at each state and time period, is based on indices that are inflations of the right-hand side of the estimated average reward optimality equations.
Objectives. Estramustine and etoposide have been shown to inhibit the growth of prostate cancer cells in experimental models. An in vivo synergism of the two agents, when administered to patients with metastatic prostate cancer refractory to hormone therapy, has been reported. To confirm these results, we administered this combination to a large number of patients with hormone-refractory prostate cancer (HRPC). Methods. Fifty-six patients with metastatic HRPC were treated with oral estramustine 140 mg three times a day and oral etoposide 50 mg/m2/day for 21 days. Therapy was discontinued for 7 days and the cycle was then repeated. Therapy was continued until evidence of disease progression or unacceptable toxicity occurred. To control for the possible interference of an antiandrogen withdrawal effect, all patients discontinued antiandrogen therapy and were not enrolled in the study unless there was evidence of disease progression. Results. Forty-five percent of 33 patients with measurable soft tissue disease demonstrated an objective response, which included five complete and ten partial responses. Among 52 patients with osseous disease, 17% showed improvement and 50% showed stability of bone scan. Thirty patients (58%) demonstrated a decrease of more than 50% in pretreatment prostate-specific antigen (PSA) levels. The median survival of all patients was 13 months. Good pretreatment performance status, measurable disease response, improvement or stability of bone scan, and PSA response were important predictors of longer survival. Conclusions. We conclude that the combination of estramustine and etoposide is an active and well-tolerated oral regimen in HRPC.
Purpose: To determine the feasibility and toxicity of inducing autologous graft-versus-host disease (GVHD) with cyclosporine in patients with multiple myeloma undergoing autologous stem-cell transplantation. Patients and Methods: Fourteen multiple myeloma patients with a median age of 50 years (range, 41 to 63) were enrolled. The median time from diagnosis to transplant was 651 days (range, 229 to 3,353). Ten patients had primary refractory disease, two were in first remission, and two were responsive to salvage therapy. The preparative regimen consisted of thiotepa, busulfan, and cyclophosphamide. Cyclosporine was administered daily for 28 days after the stem-cell infusion, and the dose was adjusted to maintain whole-blood cyclosporine levels between 50 and 150 ng/dL in the first seven patients (low-level group) and between 150 and 300 ng/dL in the other seven patients (high-level group). Results: All patients achieved neutrophil engraftment a median of 11 days after transplant. Four patients developed ≤ grade 2 hepatic toxicity, six developed ≤ grade 2 nephrotoxicity, and four developed reversible cardiac toxicity. Only one treatment-related death occurred. Cyclosporine was withheld in seven patients for a median of 6 days because of renal and/or liver dysfunction. One patient developed clinical skin GVHD, which responded to corticosteroid therapy. Six patients developed histologic evidence of GVHD without clinical signs of GVHD (subclinical GVHD). The incidence of clinical and subclinical GVHD was similar in both cyclosporine groups. Three of 11 patients assessable for response achieved remissions. Three patients experienced disease progression 80, 160, and 354 days after transplant. Ten patients are alive without progression between 56 and 444 days after transplant. Conclusion: Induction of autologous GVHD by post- transplant cyclosporine is feasible and well tolerated in patients with multiple myeloma.
BACKGROUND. Patients with metastatic carcinoma of the uterine cervix have limited survival. Thus, new chemotherapeutic agents and combinations are needed to improve patient outcome. METHODS. Twenty-seven patients with Stage IV primary or recurrent carcinoma of the uterine cervix were assigned to chemotherapy treatment at 4-week intervals with methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC). The treatment was comprised of methotrexate, 30 mg/m2 administered intravenously (i.v.) on Days 1, 15, and 22; vinblastine, 3 mg/m2 i.v. on Days 2, 15, and 22; doxorubicin, 30 mg/m2 i.v. on Day 2; and cisplatin, 70 mg/m2 i.v. on Day 2. Granulocyte-colony stimulating factor (G-CSF) was given subcutaneously on Days 6-10 at a dose of 5 μg/kg. RESULTS. After a median of 4 cycles (a maximum of 6 in responders), the authors observed objective responses in 14 patients (52%), including 3 complete responses (11%) and 11 partial responses (41%). Median overall survival was 11 months (range, 4-15+ months), and median progression free survival of the responders was 8 months (range, 6-15+ months). Toxicity was acceptable and included neutropenia, alopecia, vomiting, and stomatitis. CONCLUSIONS. MVAC is an active regimen in the treatment of patients with advanced or recurrent carcinoma of the uterine cervix. It produced responses in one-half of the patients in this study, and it can be administered on an outpatient basis. The addition of G-CSF appears to reduce hematologic toxicity.
Purpose. To develop a new approach for describing drug dissolution which does not require the presuppositions of time continuity and Fick's law of diffusion and which can be applied to both homogeneous and heterogeneous media. Methods. The mass dissolved is considered to be a function of a discrete time index specifying successive `'generations'' (n). The recurrence equation: Phi(n+1) = Phi(n) + r(1 - Phi(n))(1 - Phi(n)X(0)/theta) was derived for the fractions of dose dissolved Phi(n) and Phi(n+1) between generations n and n + 1, where r is a dimensionless proportionality constant, X-0 is the dose and theta is the amount of drug corresponding to the drug's solubility in the dissolution medium. Results. The equation has two steady state solutions, Phi(ss) = 1 when (X-0/theta) less than or equal to 1 and Phi(ss) = theta/X-0 when (X-0/theta) > 1 and the usual behavior encountered in dissolution studies, i.e. a monotonic exponential increase of Phi(n) reaching asymptotically the steady state when either r < theta/X-0 < 1 or r < 1 < theta/X-0. Good fits were obtained when the model equation was applied to danazol data after appropriate transformation of the time scale to `'generations''. The dissolution process is controlled by the two dimensionless parameters theta/X-0 and r, which were found to be analogous to the fundamental parameters dose and dissolution number, respectively. The model was also used for the prediction of fraction of dose absorbed for highly permeable drugs. Conclusions. The model does not rely on diffusion principles and therefore it can be applied under both homogeneous and non-homogeneous conditions. This feature will facilitate the correlation of in vitro dissolution data obtained under homogeneous conditions and in vivo observations adhering to the heterogeneous milieu of the GI tract.
A postanginal Sepsis Syndrome with metastatic lung abscess caused by Fusobacterium necrophorumin a 25-year-old previously healthy man is described. The incomplete and ineffective antibiotic treatment at onset of angina ended progressively in septicaemia and metastatic infections in a 3-week time period. The early parenteral use of Metronidazole based only on the clinical picture, the Gram stain findings and the strict anaerobic feature of the blood isolate in parallel with the long-term antibiotic treatment were possibly the main reasons for the good outcome of this serious infection.
Because the outcome of patients with primary ovarian non-Hodgkin's lymphoma (NHL) is controversial, we retrospectively analyzed experience with adults seen at the University of Texas M. D. Anderson Cancer Center from 1974 to 1993. Patients were included if at least one ovary was pathologically involved, and if combination chemotherapy was used that must have included doxorubicin for intermediate grade histologies. We identified 15 patients who constituted 0.5% of all untreated NHL and 1.5% of untreated ovarian neoplasms that presented to our institution during this time. One patient refused therapy, leaving 14 assessable for response. Nine patients had intermediate- grade, 5 had highgrade, and none had low-grade NHL. One ovary was involved in 4 patients, and both in 10, in 7 of whom additional sites were involved, including supradiaphragmatic nodes in 2. Four patients had AAS I and 10 had AAS IV. Favorable (0 or 1) and unfavorable (> 1) IPI scores were seen in 5 and 9 patients, respectively. The complete remission rate for all patients was 64%, and 5-year survival and FFS for all assessable patients were 57 and 46%, respectively. We conclude that the complete remission rate and FFS of patients with ovarian NHL treated with appropriate chemotherapy appear to be similar to that of patients with other nodal NHLs. Further work is required to determine prognostic factors in ovarian NHL.
Approximately 20% of patients with multiple myeloma are recognized by chance without significant symptoms. In order to prevent morbidity with timely therapy, reliable criteria are needed that distinguish those likely to show early or late disease progression. Multiple clinical features were assessed in 101 consecutive, asymptomatic and previously untreated patients. Patients with one or more lytic bone lesions were excluded because this feature had been found previously to be associated with early progression. Multivariate analysis indicated that only serum myeloma globulin > 30 g/l. IgA protein type, and Bence Jones protein excretion > 50 mg/d remained as significant independent variables. The presence of two or more of these features signified high-risk disease with early progression (median 17 months) whereas the absence of any adverse variable was associated with prolonged stability (median 95 months) (P < 0.01). Magnetic resonance (MR) imaging of the spine was useful only in patients with one adverse feature and an intermediate time to progression (median 39 months). An abnormal pattern (40% of patients) helped to distinguish patients with an imminent complication from those with more stable disease. Because a serious complication (fracture, hypercalcaemia) occurred in 35% of patients with early disease progression, chemotherapy seems justified for selected patients with asymptomatic disease at diagnosis. The remaining patients were at such low risk for progression (median 6 years) that they may be followed safely at long intervals without treatment.
We show that relativistic bremsstrahlung and inverse Compton scattering of radio-emitting electrons can easily account for the observed γ-ray spectrum of 2EG J1857+0118 if the field strength in the shell is below ~30 μG. This source is located at the eastern border of the composite SNR W44, where the expanding radio shell is interacting with a dense molecular cloud. The nondetection of this remnant above 250 GeV implies a cutoff or steepening in the electron spectrum above ~100 GeV. The E-1.66 spectrum of this radio/γ-ray-emitting electron component is too flat to have its origin in standard first-order Fermi acceleration, but electron injection into the shell by the pulsar PSR B1853+01 over the 2 × 104 yr lifetime may explain why the Crab-like radio spectrum (Sν ~ ν-0.33) is about the hardest of all shell-type remnants. The injected energy would be sufficient to account for the required energy of 6 × 1049 ergs if the initial spin-down power of PSR B1853+01 was about 10 times larger than the present spin-down power of the Crab pulsar. A steeper Fermi electron component may be present, but the observational data are not constraining enough to provide a meaningful limit on the presence of an additional ~E-2 shell-type electron component. The predicted γ-ray contribution from high-energy proton-gas interactions is about 20% of the observed EGRET flux above 100 MeV, which confirms our conclusion that the γ-ray emission from W44 is dominated by a leptonic component.
An attempt is made to investigate the role of the jet streaks upstream an upper tropospheric diffluent trough in its evolution. A proof of the relationship that controls the rate of change of the mean absolute vorticity in the region of the diffluent trough is provided. It is demonstrated that for certain value of the rate of the increasing mean regional vorticity, a cut-off low can develop in the upper troposphere, which is likely to trigger the initiation of surface cyclogenesis, under favourable lower tropospheric conditions. Therefore, it seems that this approach offers to the operational meteorologists a simple tool to evaluate the numerical weather prediction of a cyclonic development in southern Europe and to decide for its uncritical accept or rejection when the initial atmospheric conditions in northwest Europe are similar to those described above. This diagnostic tool is then applied to the case of cyclogenesis that occurred on the 29th January 1994 in Greece, in order to demonstrate its practical significance.
Seasonal variability and the spatial distribution of sea surface temperatures (SST) and salinities (SSS) are reviewed, in relation to the prevailing climatological conditions, heat fluxes, water budget and general water circulation patterns. Within this context, consideration is given to: sea surface temperatures; air temperatures; precipitation; evaporation; wind speeds and directions; freshwater (mainly riverine) discharges throughout the Aegean; and the exchange of water masses with the Black Sea and eastern Mediterranean Sea. The investigation of satellite images, covering a 6-yr period (1988–1994), has enabled a synthesis of the monthly sea surface thermal distribution to be established. The climate of the Aegean Sea is characterised by annual air temperatures of 16–19.5°C, precipitation of about 500 mm yr−1 and evaporation of some 4 mm d−1. The Aegean has a negative heat budget (approximately −25 W m−2) and positive water balance (+ 1.0 m yr−1), when inflow from the Black Sea is considered. During the summer, the (northerly) Etesians are the dominant winds over the Sea. Mean monthly sea surface temperatures (SST) vary from 8°C in the north during winter, up to 26°C in the south during summer. SST depends mainly upon air temperature; there is a month's delay between the former and latter maxima. The sea surface salinity (SSS) varies also spatially and seasonally, ranging from less than 31 psu, in the north, to more than 39 psu, in the southeast; lower values (< 25 psu) occur adjacent to the river mouths. SSSs present their maximum differences during summer, whilst during winter and autumn the distribution of SSS is more uniform. The overall spatial SST and SSS distribution pattern is controlled by: distribution of the (colder) Black Sea Waters; advection of the (warmer) Levantine Waters, from the southeastern part of the Aegean; upwelling and downwelling; and, to a lesser extent, but locally important, freshwater riverine inflows.
A phase II study of combination paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ)/gemcitabine was conducted in patients with non-small cell lung cancer (NSCLC) who had failed first-line docetaxel- or cisplatin-based chemotherapy. Eligibility criteria included histologically confirmed measurable stage IIIB or IV NSCLC and previous exposure to docetaxel- or cisplatin-based regimens, World Health Organization performance status between 0 and 2, adequate hematologic parameters, and adequate hepatic, renal, and cardiac function. Gemcitabine (900 mg/m2) was given on days 1 and 8 as a 30-minute infusion; paclitaxel (175 mg/m2) was administered on day 8 as a 3-hour infusion after appropriate premedication. Granulocyte colony-stimulating factor (150 microg/m2 subcutaneously) was given on days 9 to 15. Treatment was repeated every 3 weeks until patients experienced disease progression. From October 1995 to December 1996, 26 patients with advanced NSCLC were enrolled (three stage IIIB, 23 stage IV). All 26 patients were assessable for toxicity, and 24 were evaluable for response. Two complete (8%) and five partial (21%) responses were observed, for an overall response rate of 29% (95% confidence interval, 11% to 47%). The median duration of response was 2.5 months and the median survival was 8 months. A median of three courses per patient was administered, and the median interval between courses was 21 days. The median delivered dose was 579 mg/m2/wk gemcitabine and 54.5 mg/m2/wk paclitaxel, corresponding to a relative dose intensity of 0.97 and 0.96, respectively. Grade 3/4 neutropenia occurred in two patients (8%). Grade 3 conjunctivitis occurred in one (4%) patient and grade 2/3 neurotoxicity in eight (31%) patients. Grade 3/4 and grade 2 fatigue occurred in four (15%) and eight (31%) patients, respectively. Other toxicities were mild to moderate. These preliminary results suggest that the paclitaxel/gemcitabine combination is an active and well-tolerated salvage regimen in patients with NSCLC previously treated with docetaxel- or cisplatin-based chemotherapy. The paclitaxel/gemcitabine combination merits further evaluation as first-line treatment.
A phase II study of combination paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ)/gemcitabine was conducted in patients with non-small cell lung cancer (NSCLC) who had failed first, line docetaxel- or cisplatin- based chemotherapy. Eligibility criteria included histologically confirmed measurable stage IIIB or IV NSCLC and previous exposure to docetaxel, or cisplatin-based regimens. World Health Organization performance status between 0 and 2, adequate hematologic parameters, and adequate hepatic, renal, and cardiac function. Gemcitabine (900 mg/m2) was given on days 1 and 8 as a 30-minute infusion; paclitaxel (175 mg/m2) was administered on day 8 as a 3-hour infusion after appropriate premedication. Granulocyte colony- stimulating factor (150 μg/m2 subcutaneously) was given on days 9 to 15. Treatment was repeated every 3 weeks until patients experienced disease progression. From October 1995 to December 1996, 26 patients with advanced NSCLC were enrolled (three stage IIIB, 23 stage IV). All 26 patients were assessable for toxicity, and 24 were evaluable for response. Two complete (8%) and five partial (21%) responses were observed, for an overall response rate of 29% (95% confidence interval, 11% to 47%). The median duration of response was 2.5 months and the median survival was 8 months. A median of three courses per patient was administered, and the median interval between courses was 21 days. The median delivered dose was 579 mg/m2/wk gemcitabine and 54.5 mg/m2/wk paclitaxel, corresponding to a relative dose intensity of 0.97 and 0.96, respectively. Grade 314 neutropenia occurred in two patients (8%). Grade 3 conjunctivitis occurred in one (4%) patient and grade 213 neurotoxicity in eight (31%) patients. Grade 314 and grade 2 fatigue occurred in four (15%) and eight (31%) patients, respectively. Other toxicities were mild to moderate. These preliminary results suggest that the paclitaxel/gemcitabine combination is an active and well-tolerated salvage regimen in patients with NSCLC previously treated with docetaxel, or cisplatin-based chemotherapy. The paclitaxel/gemcitabine combination merits further evaluation as first-line treatment.
AIM: To investigate the significance of IgM antibody to hepatitis C virus (HCV) core antigen (IgM anti-HCV core) in chronic hepatitis C. METHODS: In a group of 112 patients with histologically proven chronic hepatitis C positive for HCV RNA, IgM anti-HCV core level was studied by a sensitive semi-quantitative enzyme immunoassay. Quantitation of serum HCV RNA was done by a second generation bDNA assay and determination of HCV genotype by RT-PCR and reverse hybridization. RESULTS: IgM anti-HCV core was detected in 72 (64.3%) of the 112 patients. ALT levels were significantly higher in IgM anti-HCV core positive than negative patients. No other significant difference was observed in any of the patients' characteristics between IgM anti-HCV core positive and negative groups. On the contrary, IgM anti-HCV core level was found to be significantly higher in females than in males, in patients with moderate or severe chronic hepatitis, in patients with high HCV RNA levels and in patients infected with HCV genotype 1b. Moreover, IgM anti-HCV core level was significantly correlated with age and ALT level. Multiple regression analysis showed that IgM anti-HCV core level was significantly related only to the HCV genotype (p=0.001), histological grade (p=0.017) and ALT level (p=0.038). CONCLUSIONS: Our data support the hypothesis that IgM anti-HCV core level is associated mainly with HCV genotype and secondly with liver disease necroinflammatory activity. These associations may have implications in the pathogenesis of chronic hepatitis C.
Sifianou M. Silence and politeness. Silence: interdisciplinary perspectives. 1997;10:63–84.
The spin density in the Heusler alloy Cu2MnAl, has been studied in a Compton scattering experiment with 92 keV circularly polarized synchrotron radiation on the high-energy beamline at ESRF. The conduction electrons were found to have a negative spin polarization of 0.4 μB which is at variance with the deduction of a positive moment from earlier neutron data; neither was any evidence found for a 3d spin moment on the copper site. The spin moment on the Mn site at room temperature was determined as 3.25 μB, which is in agreement with neutron data. The spin-dependent Compton profiles for the [100], [110] and [111] directions, reported here, show anisotropy in the momentum density which is in good agreement with new KKR calculations based on a ferromagnetic ground state. By combining charge- and spin-dependent Compton data the momentum space anisotropies in the majority and minority bands have been analysed. Both the majority and minority spin densities are anisotropic.
We present a theoretical analysis of the photonic band structure of fcc colloidal crystals in relation to experimentally available transmission spectra of finite slabs of such crystals.
Antoniou EA, Rizos D, Achilleos O, Sarandakou A, Phocas I, D'Silva M, Papadimitriou J, McMaster P, Neuberger J. Thyroid hormone in liver allograft rejection. Transplantation Proceedings. 1997;29(1-2):503 - 504.
General theoretical arguments and various analytic self-similar solutions have recently shown that magnetized and rotating astrophysical outflows may become asymptotically cylindrical, in agreement with observations of cosmical jets. A notable common feature in all such self-consistent, self-similar MHD solutions is that before final cylindrical collimation is achieved, the jet passes from a stage of oscillations in its radius, Mach number and other physical parameters. It is shown that under rather general assumptions this oscillatory behaviour of collimated outflows is not restricted to the few specific models examined so far, but instead seems to be a rather general physical property of an MHD outflow that starts non-cylindrically before it reaches collimation. It is concluded thence that astrophysical jets are topologically stable to small-amplitude, time-independent perturbations in their asymptotically cylindrical shape. Also, similarly to the familiar fluid instabilities, these oscillations may give rise to brightness enhancements along jets.
General theoretical arguments and various analytic self-similar solutions have recently shown that magnetized and rotating astrophysical outflows may become asymptotically cylindrical, in agreement with observations of cosmical jets. A notable common feature in all such self-consistent, self-similar MHD solutions is that before final cylindrical collimation is achieved, the jet passes from a stage of oscillations in its radius, Mach number and other physical parameters. It is shown that under rather general assumptions this oscillatory behaviour of collimated outflows is not restricted to the few specific models examined so far, but instead seems to be a rather general physical property of an MHD outflow that starts non-cylindrically before it reaches collimation. It is concluded thence that astrophysical jets are topologically stable to small-amplitude, time-independent perturbations in their asymptotically cylindrical shape. Also, similarly to the familiar fluid instabilities, these oscillations may give rise to brightness enhancements along jets.
The Internet was born in December of 1969 and has grown phenomenally since. Its graphically interactive, user-friendly modality, the World Wide Web (WWW), is younger and growing even more explosively. By its nature, the WWW is a tool ideally and uniquely suited for the advancement education. This paper describes the design, development and the implementation of a Web Site for supporting the education of the students in the Faculty of Nursing at the University of Athens.
Carcinoembryonic antigen (CEA), CA125, and squamous cell carcinoma antigen (SCC) were evaluated in paired vaginal fluid and serum samples from 69 women, mean age 40.6 (20-78) years. Fifteen of the subjects were normal females (controls), 12 were pregnant, 20 had benign gynecological diseases, 5 presented severe cervical dysplasias and 17 suffered from cancer of the genital tract. Highly elevated CEA, CA125 and SCC concentrations (median, range) were found in vaginal fluid: 186 ng/ml (12-5 420); 890 U/ml (54-65 000); 1 600 ng/ml (27-13 000) respectively, compared with those in the paired serum samples: 1 ng/ml (0.5-8.6); 12 U/ml (3.0-1 590); 1 ng/ml (0.3-19). Vaginal fluid CEA, CA125 and SCC values were significantly different among the five studied groups (p < 0.0002; p < 0.02; p < 0.002 respectively), being significantly higher in the patients with benign gynecological diseases, compared with those in the patients with malignancies of the genital tract (p < 0.0001; p < 0.02; p < 0.005), and those in controls (p < 0.02; p < 0.007; p < 0.02 respectively). The results of this study suggest that: 1) CEA, CA125 and SCC seem to be normal constituents of vaginal fluid. 2) The distribution of CEA, CA125 and SCC between vaginal fluid and the circulation is affected by pregnancy, inflammation and cancer of the genital tract.
We present a model of the spectra of gamma-ray emitting blazars in which a single homogeneous emission region both emits synchrotron photons directly and scatters them to high (gamma-ray) energy before emission (a `synchrotron self-Compton' or SSC model). In contrast to previous work, we follow the full time dependent evolution of the electron and photon spectra, assuming a power-law form of the electron injection and examine the predictions of the model with regard to variability of the source. We apply these computations to the object Mkn 421, which displayed rapid variability in its X-ray and TeV emission during a multiwavelength campaign in 1994. This observation strongly implies that the same population of electrons produces the radiation in both energy bands. By fitting first the observed quiescent spectrum over all 18 orders of magnitude in frequency, we show that the time dependence of the keV/TeV flare could have been the result of a sudden increase in the maximum energy of the injected electrons. We show also that different types of flare may occur in this object and others, and that the energy band most sensitive to the properties of the acceleration mechanism is the X-ray band.
With current treatment modalities, most patients with early stage Hodgkin's disease (HD) can be cured. Patients destined to relapse, usually do so within 3 years after treatment completion. Late relapses do occur but disease recurrence beyond 15 years is extremely rare. We report a patient with clinical stage IIA nodular sclerosis HD, originally treated with radiotherapy alone, who relapsed 24 years after the initial diagnosis. Our patient's case indicates the possible need for lifelong surveillance of patients with Hodgkin's disease.
We present the results of a survey of neutral hydrogen emission in the Small Magellanic Cloud (SMC) with the Australia Telescope Compact Array (ATCA). The survey consists of a mosaic of 320 separate pointings of the 375-m array, resulting in a resolution of 1.6arcmin (28pc, for a distance of 60kpc) over a field of 20deg2. The rms brightness temperature sensitivity is 1.4K, corresponding to an H I column density sensitivity of 4x18cm-2 for each velocity channel of width 1.6km/s. The HI distribution is complex and, on scales <=1kpc, appears to be dominated by the effects of expanding H I shells, which are probably driven by the combined effects of supernovae and stellar winds from massive stars. The picture of the SMC that arises from the current data seems to challenge the earlier belief that the SMC consists of two or more spatially separate structures with different systemic velocities. We find that the observed multiple components are, in many cases, caused by the combined effects of the numerous shells and supershells. Altogether, we identify six supershells (defined here as those with radii greater than 300pc) and 495 giant shells. For each of these, we measure positions. radii, velocities and expansion rates, and derive ages and kinetic energy requirements. The apparent age distribution of shells is remarkably narrow, with a mean age of 5.4Myr and an intrinsic dispersion of 2Myr. Southern shells appear to be older, on average, by 2.5Myr. The kinetic energy of the shells is a large fraction of the gravitational binding energy of the SMC, implying that further disintegration of the SMC will occur with time, and especially at the next close passage with the Large Magellanic Cloud (LMC) or the Galaxy, unless the SMC possesses a massive halo. Because of their interferometric nature, the images presented here are insensitive to structures of size >=0.6°, and should not be used for deriving total H I column densities (1 data file).
The European Union retained the WISECARE project "Work flow Information Systems for European nursing CARE" for funding. The project focuses on the use of telematics technology for clinical and resource management in oncology care in hospitals. This paper outlines the impact of introducing this kind of advanced nursing informatics application on the management of nursing knowledge. Three shift in knowledge management that will get high attention in WISECARE, are identified. The first is the shift from knowledge dissemination to knowledge sharing. The second is the shift from individual knowledge to organisational knowledge. The third is the shift from deductive, prescriptive knowledge as seen in guidelines, protocols to more inductive, experience based knowledge. The paper emphasizes that the real impact of information technology is not in the automation of existing processes but on the discovery of new ways of organisation and living.
We study Compton upscattering of low-frequency photons in a converging flow of thermal plasma. The photons escape diffusively, and electron scattering is the dominant source of opacity. We solve the equation of radiative transfer in the case of spherical, steady state accretion into black holes numerically and approximately analytically. Unlike previous work on this subject, we consider the inner boundary at a finite radius, and this has a significant effect on the emergent spectrum. It is shown that the bulk motion of the converging flow is more efficient in upscattering photons than thermal Comptonization, provided that the electron temperature in the flow is of order a few keV or less. In this case, the spectrum observed at infinity consists of a soft component coming from input photons that escaped after a few scatterings without any significant energy change and of a power law that extends to high energies and is made of those photons that underwent significant upscattering. The luminosity of the power law is relatively small compared to that of the soft component. The more reflective the inner boundary is, the flatter the power-law spectrum becomes. The spectral energy power-law index for black hole accretion is always higher than 1, and it is approximately 1.5 for high accretion rates. This result tempts us to say that bulk motion Comptonization might be the mechanism behind the power-law spectra seen in black hole X-ray sources.
In this article, we present ways of applying a well-known systemic technique, reframing and paradox, in the management of problematic situations in the school. The rationale, the utility, and the advantages of this technique are described. We discuss notions such as the many different interpretations of the same behavior, the vicious cycle of the interactions and the circular causality, the cooperative perspective, the therapeutic double bind, the self-fulfilling prophecy, the reframing of relapses, etc. We also present two case studies that illustrate the use of the reframing technique in the school context.
Ο συγγραφέας είχε γράψει είκοσι έτη πριν από το παρόν άρθρο ότι: "τὰ οἰκονομικὰ θεμέλια τοῦ κεμαλικοῦ κράτους ὑπονομεύονται συστηματικῶς ἀπὸ τὴν διείσδηση ἰσλαμικῶν κεφαλαίων. Ἂν ἡ κατάκτησις μιᾶς χώρας ἀρχίζει ἀπὸ τὴν οἰκονομία της, ἡ κεμαλικὴ κοσμικὴΤουρκία ἔχει ἤδη χάσει τὸ παιγνίδι μὲ τὴν ἰσλαμικὴν ταὐτότητά της". Το παρόν άρθρο, γράφεται το 1999 και αναφέρεται στα ισλαμικά κεφάλαια, τα οποία κατακτούν την τουρκική οικονομία.
Στο άρθρο αυτό παρουσιάζονται οι κυριότερες μέχρι σήμερα θεωρητικές απόψεις, καθώς και τα ερευνητικά ευρήματα για το συναίσθημα της μοναξιάς του παιδιού σχολικής ηλικίας. Πιο συγκεκριμένα, περιγράφονται τα ευρήματα για τον τρόπο με τον οποίο το παιδί αντιλαμβάνεται, βιώνει και αντιμετωπίζει το συναίσθημα αυτό και συζητούνται οι προσπάθειες για την ψυχομετρική αξιολόγηση του φαινομένου. Στη συνέχεια, ανασκοπούνται τα ευρήματα για τη σχέση της μοναξιάς με διάφορες κρίσιμες παραμέτρους, όπως: η ηλικία, το φύλο, η θέση του παιδιού στην ομάδα των συνομηλίκων του, οι φιλίες, η αντίληψη του παιδιού για τις κοινωνικές του δεξιότητες, τα χαρακτηριστικά της συμπεριφοράς του, η απόδοση αιτίων για τις κοινωνικές επιτυχίες και αποτυχίες και η κατάθλιψη. Τέλος, διατυπώνονται συμπεράσματα για το επίπεδο στο οποίο βρίσκεται η κατανόηση της μοναξιάς των παιδιών και για πιθανά κενά στη σχετική θεωρητική και ερευνητική ενασχόληση.
The purpose of this study was to examine the allocation of nursing time to various activities of registered and assistant nurses during the day shift. Twenty-three registered (RN) and eighteen assistant nurses (AN) working in medical and surgical wards of five large hospitals were studied. The findings have shown that the most frequent activities performed were; indirect care representing 35.6% of the time, direct care representing 23.8% of the time, personal activities representing 16.8% of the time, and direct nursing interventions representing 8.2% of the time. Cross-tabulation revealed that RNs provided direct care less frequently and indirect care more frequently than ANs (25.3 activities per RN and 27.5 per AN, 62.1 activities per RN and 32.6 per AN, respectively). Many indirect care activities were found to be the responsibility of the head nurse (64), secretary (465), and others (104). Less expected results were the minimal amounts of time spent on both education and research activities (1.3% and 0.0% respectively). Nurse managers have to free nurses from subsidiary work and to find mechanisms to distribute nursing valuable time more efficiently.
Anaplastic large cell lymphoma (ALCL) is a distinct clinicopathologic variant of intermediate grade non-Hodgkin's lymphomas (NHL) composed of large pleomorphic cells that usually express the CD30 antigen and interleukin (IL)- 2 receptors, and is characterized by frequent cutaneous and extranodal involvement. With variable frequency ALCL bear the t(2;5)(p23;q35) chromosomal translocation that fuses the nucleophosmin (NPM) gene on chromosome 5q35 to a novel protein kinase gene, Anaplastic Lymphoma Kinase (ALK), on chromosome 2p23. We determined the frequency of this translocation with e novel DNA polymerase chain reaction (PCR) technique using 0.5 μg of genomic DNA, 5'-primers derived from the NPM gene and 3'-primers derived from the ALK gene and hybridization with internal probes. The presence of amplifiable DNA in the samples was tested with the inclusion in the PCR reaction of oligonucleotide primers designed to amplify a 3016-bp fragment from the β-globin locus. NMP-ALK fusion amplicons were detected using DNA isolated either from all three ALCL cell lines tested, or from all four primary ALCL tumors known to contain the t(2;5)(p23;q35) translocation. Nested amplicons were detected by hybridization in 100% of specimens diluted 104-fold and in 20% of those diluted 105-fold. We subsequently examined archival genomic DNA from 20 patients with ALCL, 39 with diffuse large cell, 2 with mantle cell, 20 with peripheral T cell, 13 with low-grade NHL, 31 with Hodgkin's disease (HD), and 6 with lymphomatoid papulosis. Fusion of the NPM and ALK genes was detected in three of 18 patients with ALCL who had amplifiable DNA (17%, 95% confidence intervals 4% to 41%), but not in any patients with other NHL, HD, or lymphomatoid papulosis. The amplicon sizes were different in all cell lines and patients reflecting unique genomic DNA breakpoints. We conclude that with genomic DNA-PCR the rearrangement of the NPM and ALK loci is restricted to patients with ALCL. Further studies are needed to determine the prognostic significance of the NPM-ALK rearrangement, to determine whether its detection can aid in the differential diagnosis between ALCL, Hodgkin's disease, and lymphomatoid papulosis, and to establish the usefulness of the genomic DNA PCR in the monitoring of minimal residual disease in those patients whose tumors bear the t(2;5).
In this study we have used high resolution parallel electron energy loss spectroscopy (PEELS) and X-ray excited optical luminescence (XEOL) to investigate the chemical nature of the luminescence centre in fresh and aged porous silicon. We find that regardless of the non-stoichiometric oxides which were observed by PEELS in our fresh porous silicon layers, Si-Si bonded material is involved in the luminescence process. However, in the case of aged porous silicon both Si-Si and Si-O bonded material are involved.
Fludarabine monophosphate (Fludara) is a purine analogue which entered clinical trials in 1982. Although inactive in solid tumors, Fludara has marked activity in indolent lymphoproliferative disorders. The exact mechanism of action of Fludara is uncertain. Fludara has been established as the most active single agent in chronic lymphocytic leukemia (CLL) in single arm and comparative clinical trials. The activity has been demonstrated in both previously treated and initially treated patients. Marked activity has been noted in patients with low grade lymphoma, in particular, those with a follicular morphology and in Waldenstrom's macroglobulinemia. Combinations of fludarabine with alkylating agents, anthracyclines, and anthraquinones have led to clinically useful combination approaches. The ability of fludarabine to modulate the levels of the triphosphate form of cytosine arabinoside (ara-C) in acute leukemia cells has led to the development of combinations of fludarabine and ara-C. These combinations have demonstrated marked activity in treatment of relapsed and previously untreated patients with acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS). The ability to modulate the activity of pyrimidines and to inhibit repair of DNA damage caused by alkylating agents, anthracyclines, and other DNA active drugs suggest that the future of fludarabine will be in combination approaches to modulate the activity of other agents. These activities may extend its role to use in solid tumors.
a-i.r Inhibin, has been recently proposed as a useful tumor marker for mucinous ovarian carcinomas (Ca), as the widely used tumor marker for ovarian malignancies, CA125 is efficient only in nonmucinous ovarian Ca, and, together with CEA, fails to detect minimal disease and show long half-life in serum after successful surgery. Moreover, conflicting evidence has been reported as to whether inhibin in ovarian malignancies is the biologically active dimer α-βA inhibin or the inactive free α-subunits and inhibin precursors. Serum α-βA i.r inhibin, CA125 and CEA were measured preoperatively and 8 days postoperatively in 39 postmenopausal patients with ovarian cancer (13 mucinous, 15 serous and 11 difference other ovarian Ca) in comparison with 20 age-matched healthy women (Controls), 18 patients with benign ovarian tumors and 10 patients with nonovarian gynecological malignancies. Serum α-βA i.r inhibin values were very low in controls (0.121 U/ml; 0.060-0.250) while they were greatly elevated in both benign (67% sensitivity) and malignant ovarian tumors (100% sensitivity in mucinous Ca, 80% in serous and 90.9% in other ovarian, 0.250 U/ml). In contrast, in non-ovarian malignancies no increased values of α-βA inhibin were found (0% sensitivity). Our results on the sensitivity of CA125 and CEA are in agreement with previous studies. After successful surgery the very high concentrations of α-βA i.r inhibin were reduced very rapidly (8 days) to normal postmenopausal values in contrast to those of CA125 and CEA, that remained elevated. Serum α-βA i.r inhibin seems to be very useful in monitoring after treatment the patients with any type of ovarian malignancy and specifically those with mucinous ovarian cancer.
The purpose of this investigation was to study the factors that may affect the position of the center of resistance and center of rotation. A two-dimensional computer model of the periodontal ligament was developed. The model permitted the simulation of an isotropic (responding in the same manner regardless of the direction of the applied force) and nonisotropic periodontal ligament and allowed changes in root shape and in position and direction of force application. The center of resistance was found to depend on the distribution of root surface area. For a model of the upper central incisor, it was located at 42% of the root length measured from the alveolar crest. The presence of anisotropy in the periodontal ligament significantly affected the position of the center of resistance, which was in this case also affected by the direction of the applied force. Forces passing through the center of resistance produced translation of the modeled tooth in a direction not necessarily the same as the direction of the applied force. Tipping forces produced much larger stresses than forces causing translation. Simulation of periodontal involvement resulting in loss of attachment increased the stresses exerted on the periodontal ligament. The model permitted easy assessment of various factors that may influence the position of the center of resistance of teeth and revealed a potentially large variability in the position of the center of resistance and center of rotation, caused by variation of the properties of the periodontal ligament.
This study examined the contribution of phosphocreatine (PCr) and aerobic metabolism during repeated bouts of sprint exercise. Eight male subjects performed two cycle ergometer sprints separated by 4 min of recovery during two separate main trials. Sprint 1 lasted 30 s during both main trials, whereas sprint 2 lasted either 10 or 30 s. Muscle biopsies were obtained at rest, immediately after the first 30-s sprint, after 3.8 min of recovery, and after the second 10-and 30-s sprints. At the end of sprint 1, PCr was 16.9 ± 1.4% of the resting value, and muscle pH dropped to 6.69 ± 0.02. After 3.8 min of recovery, muscle pH remained unchanged (6.80 ± 0.03), but PCr was resynthesized to 78.7 ± 3.3% of the resting value. PCr during sprint 2 was almost completely utilized in the first 10 s and remained unchanged thereafter. High correlations were found between the percentage of PCr resynthesis and the percentage recovery of power output and pedaling speed during the initial 10 s of sprint 2 (r = 0.84, P < 0.05 and r = 0.91, P < 0.01). The anaerobic ATP turnover, as calculated from changes in ATP, PCr, and lactate, was 235 ± 9 mmol/kg dry muscle during the first sprint but was decreased to 139 ± 7 mmol/kg dry muscle during the second 30-s sprint, mainly as a result of a ~45% decrease in glycolysis. Despite this ~41% reduction in anaerobic energy, the total work done during the second 30-s sprint was reduced by only ~18%. This mismatch between anaerobic energy release and power output during sprint 2 was partly compensated for by an increased contribution of aerobic metabolism, as calculated from the increase in oxygen uptake during sprint 2 (2.68 ± 0.10 vs. 3.17 ± 0.13 l/min; sprint 1 vs. sprint 2; P < 0.01). These data suggest that aerobic metabolism provides a significant part (~49%) of the energy during the second sprint, whereas PCr availability is important for high power output during the initial 10 s.
This study examined the contribution of phosphocreatine (PCr) and aerobic metabolism during repeated bouts of sprint exercise. Eight male subjects performed two cycle ergometer sprints separated by 4 min of recovery during two separate main trials. Sprint 1 lasted 30 s during both main trials, whereas sprint 2 lasted either 10 or 30 s. Muscle biopsies were obtained at rest, immediately after the first 30-s sprint, after 3.8 min of recovery, and after the second 10-and 30-s sprints. At the end of sprint 1, PCr was 16.9 ± 1.4% of the resting value, and muscle pH dropped to 6.69 ± 0.02. After 3.8 min of recovery, muscle pH remained unchanged (6.80 ± 0.03), but PCr was resynthesized to 78.7 ± 3.3% of the resting value. PCr during sprint 2 was almost completely utilized in the first 10 s and remained unchanged thereafter. High correlations were found between the percentage of PCr resynthesis and the percentage recovery of power output and pedaling speed during the initial 10 s of sprint 2 (r = 0.84, P < 0.05 and r = 0.91, P < 0.01). The anaerobic ATP turnover, as calculated from changes in ATP, PCr, and lactate, was 235 ± 9 mmol/kg dry muscle during the first sprint but was decreased to 139 ± 7 mmol/kg dry muscle during the second 30-s sprint, mainly as a result of a 45% decrease in glycolysis. Despite this 41% reduction in anaerobic energy, the total work done during the second 30-s sprint was reduced by only 18%. This mismatch between anaerobic energy release and power output during sprint 2 was partly compensated for by an increased contribution of aerobic metabolism, as calculated from the increase in oxygen uptake during sprint 2 (2.68 ± 0.10 vs. 3.17 ± 0.13 l/min; sprint 1 vs. sprint 2; P < 0.01). These data suggest that aerobic metabolism provides a significant part ( 49%) of the energy during the second sprint, whereas PCr availability is important for high power output during the initial 10 s.
This study examined the contribution of phosphocreatine (PCr) and aerobic metabolism during repeated bouts of sprint exercise. Eight male subjects performed two cycle ergometer sprints separated by 4 min of recovery during two separate main trials. Sprint 1 lasted 30 s during both main trials, whereas sprint 2 lasted either 10 or 30 s. Muscle biopsies were obtained at rest, immediately after the first 30-s sprint, after 3.8 min of recovery, and after the second 10-and 30-s sprints. At the end of sprint 1, PCr was 16.9 ± 1.4% of the resting value, and muscle pH dropped to 6.69 ± 0.02. After 3.8 min of recovery, muscle pH remained unchanged (6.80 ± 0.03), but PCr was resynthesized to 78.7 ± 3.3% of the resting value. PCr during sprint 2 was almost completely utilized in the first 10 s and remained unchanged thereafter. High correlations were found between the percentage of PCr resynthesis and the percentage recovery of power output and pedaling speed during the initial 10 s of sprint 2 (r = 0.84, P < 0.05 and r = 0.91, P < 0.01). The anaerobic ATP turnover, as calculated from changes in ATP, PCr, and lactate, was 235 ± 9 mmol/kg dry muscle during the first sprint but was decreased to 139 ± 7 mmol/kg dry muscle during the second 30-s sprint, mainly as a result of a 45% decrease in glycolysis. Despite this 41% reduction in anaerobic energy, the total work done during the second 30-s sprint was reduced by only 18%. This mismatch between anaerobic energy release and power output during sprint 2 was partly compensated for by an increased contribution of aerobic metabolism, as calculated from the increase in oxygen uptake during sprint 2 (2.68 ± 0.10 vs. 3.17 ± 0.13 l/min; sprint 1 vs. sprint 2; P < 0.01). These data suggest that aerobic metabolism provides a significant part ( 49%) of the energy during the second sprint, whereas PCr availability is important for high power output during the initial 10 s.
Adam W, others. {Current achievements of the DELPHI ring imaging Cherenkov detector}. {Proceedings, 2nd International Workshop on Ring Imaging Cerenkov Detectors: Techniques and results of Cherenkov light imaging in high-energy physics (RICH 1995): Uppsala, Sweden, June 12-16, 1995}. 1996;A371:12-15.
An attempt is made to identify and investigate the structure, behaviour and synoptic characteristics of cyclogenesis over the Aegean Sea. A simple, realistic and easily used methodology of identification, in an analytical form, was established. This combines two types of criteria: synoptic and dynamic/thermodynamic. Six synoptic categories that could favour cyclogenesis over the Aegean Sea are distinguished according to the synoptic criteria. Grid-point values of geopotential height and temperature are used to calculate the dynamic/thermodynamic criteria, which are used to identify potential cases of cyclogenesis with respect to the thermodynamic prerequisites and the time continuance. It is demonstrated that cyclogenesis over the Aegean Sea is not as rare as was believed. The majority of cases result from the prevalence of a south-westerly flow, a long-wave trough and a closed system over the Aegean Sea. The cyclogenesis appears to occur primarily in the cold period of the year, mainly from October to May, and to have a small intensity and lifetime.
A potentiometric method for the in vitro adsorption kinetic study of an ionic micromolecule to charcoal, based on the continuous direct monitoring of the micromolecule free concentration by means of an ion-selective electrode (ISE), has been developed. A chlorpromazine ISE was constructed and used to study the adsorption kinetics of the drug on pure activated charcoal and two commercial formulations (Ultracarbon tablets and Carbomix powder). The method consists of the rapid addition of a slurry containing the charcoal into the drug solution under stirring at pH 1.2 (to simulate a gastric fluid environment) and continuous recording of the electrode potential until the establishment of equilibrium The drug free concentration at appropriate time intervals was calculated from the recorded adsorption curve acid the apparent adsorption rate constant was estimated assuming first order kinetics. Within run RSD of the estimates ranged from 0.3 to 12% (mainly less than 5%), while between run RSD (n=3) ranged from 1 to 19% (mainly less than 10%). A linear relationship was found between the apparent adsorption rate constants and the amount of charcoal used with slopes following the rank order activated charcoal>Ultracarbon tablets>Carbomix powder. These results were explained on the basis of different surface areas of the adsorbents. The work proved the usefulness of ion-selective potentiometry in adsorption studies and can be extended to other ionic drugs for which selective electrodes can be constructed.
Objectives. For patients with prostate specific antigen (PSA) values of 4-10 ng/mL, some urologists perform prostatic biopsies depending upon the findings of digital rectal examination (DRE) and transrectal ultrasonography (TRUS), and others perform biopsies on most of these men regardless of the findings of DRE and TRUS. The purpose of this study was to examine whether the information given by the measurement of the ratio of free to total (F/T) PSA can alter decision-making on prostatic biopsy. Methods. One hundred and two (102) men with PSA values between 4 and 10 ng/mL, were included in this study. All men were examined with DRE and TRUS; a F/T PSA ratio was also measured, and six prostatic biopsies were taken from each patient. Results. In 102 men who were biopsied, 22 (21.5%) prostatic carcinomas were identified. Among these 22 cancer patients, 13 had abnormal findings in DRE and/or TRUS and would have been biopsied and diagnosed anyway. If we use only the F/T PSA ratio (cut-off value 0.20) to decide whom to biopsy, we would have diagnosed 16/22 cancers; the difference between these two procedures was not statistically significant (P = 0.17). If we decide to biopsy those patients who have abnormal findings in DRE and/or TRUS and those who have a F/T PSA ratio <0.20, we would diagnose 20/22 cancers (P = 0.05) and at the same time, reduce the unnecessary biopsies from 80 to 41 (48%). With a PSA value between 4 and 10 ng/mL and no findings in DRE and TRUS and at the same time with a F/T PSA ratio ≤0.20, we would have to perform biopsies in 20.5 men to find one cancer. On the other hand, in patients with suspicious findings in DRE and/or TRUS and a F/T PSA ratio <0.20, in every two men that we biopsy we would find one cancer. Conclusion. We believe that among patients with PSA values between 4 and 10 ng/mL after performing DRE and TRUS, the additional information of F/T PSA ratio can help since it increases the number of cancers detected and reduces the number of unnecessary biopsies.
The cytotoxic effects of a 22 h treatment with four antineoplastic agents in the yeast Saccharomyces cerevisiae ATCC 2366 were investigated. Two agents, doxorubicin and 5-fluorouracil (5-FU), were effective in decreasing the colony-forming ability of yeast cells. Following examination under the light microscope, the effect of doxorubicin appeared to be, at least partially, due to killing of yeast cells whereas the effect of 5-FU was rather due to changes in cell structure leading to abnormal bud formation. For amsacrine (AMSA) and melphalan, cytotoxicity was totally absent. In the presence of diltiazem the above described effects were not significantly changed. When verapamil was added in the culture medium the cytotoxic activity of doxorubicin and 5-FU did not change. However, following treatment with AMSA in combination with verapamil, cell survival was significantly decreased whereas the presence of verapamil increased the yeast survival which was observed after melphalan treatment.
Background: This investigation war undertaken to study: a) the adsorption characteristics of chlorpromazine to activated charcoal and its formulations Carbomix(R) powder and Ultracarbon(R) tablets at gastric pH; b) the effect on chlorpromazine adsorption of polyethylene glycol and its combination with electrolyte lavage solution; c) the effect of the order of addition of polyethylene glycol-electrolyte lavage solution. Method: Ion selective electrode potentiometry, bared on the selective, direct and continuous response of a chlorpromazine-ion selective electrode to the concentration of the free drug, was used. Successive additions of microvolumes of a chlorpromazine solution were made into a charcoal slurry in acidic medium of pH 1.2 with measurement of the chlorpromazine-ion selective electrode potential at equilibrium Results: The maximum adsorption capacity values of activated charcoal, Carbomix and Ultracarbon, were 297, 563, and 382 mg/g respectively, while the affinity constant values were 40.2, 70.4, and 40.5 L/g, respectively. The adsorption of chlorpromazine to each of the Ultracarbon and Carbomix components was compared to the total adsorption of the formulations. The addition of polyethylene glycol-electrolyte lavage solution causes a slight desorption of chlorpromazine from activated charcoal at gastric pH, more pronounced when polyethylene glycol-electrolyte lavage solution follows the addition of activated charcoal, suggesting the possibility of a nonspecific binding of chlorpromazine to polyethylene glycol. The amount of chlorpromazine adsorbed to Carbomix and Ultracarbon was not significantly affected at gastric pH by the presence of polyethylene glycol or polyethylene glycol-electrolyte lavage solution added either concurrently or sequentially to these formulations.
The effects of active recovery on metabolic and cardiorespiratory responses and power output were examined during repeated sprints. Male subjects (n = 13) performed two maximal 30-s cycle ergometer sprints, 4 min apart, on two separate occasions with either an active [cycling at 40 (1)% of maximal oxygen uptake; mean (SEM)] or passive recovery. Active recovery resulted in a significantly higher mean power output (W̄) during sprint 2, compared with passive recovery [W̄] 603 (17) W and 589 (15) W, P < 0.05]. This improvement was totally attributed to a 3.1 (1.0)% higher power generation during the initial 10 s of sprint 2 following the active recovery (P < 0.05), since power output during the last 20 s sprint 2 was the same after both recoveries. Despite the higher power output during sprint 2 after active recovery, no differences were observed between conditions in venous blood lactate and pH, but peak plasma ammonia was significantly higher in the active recovery condition [205 (23) vs 170 (20) μmol·l-1; P < 0.05]. No differences were found between active and passive recovery in terms of changes in plasma volume or arterial blood pressure throughout the test. However, heart rate between the two 30-s sprints and oxygen uptake during the second sprint were higher for the active compared with passive recovery [148 (3) vs 130 (4) beats min-1; P < 0.01) and 3.3 (0.1) vs 2.8 (0.1) l·min-1; P < 0.01]. These data suggest that recovery of power output during repeated sprint exercise is enhanced when low-intensity exercise is performed between sprints. The beneficial effects of an active recovery are possibly mediated by an increased blood flow to the previously exercised muscle.
The effects of active recovery on metabolic and cardiorespiratory responses and power output were examined during repeated sprints. Male subjects (n = 13) performed two maximal 30-s cycle ergometer sprints, 4 min apart, on two separate occasions with either an active [cycling at 40 (1)% of maximal oxygen uptake; mean (SEM)] or passive recovery. Active recovery resulted in a significantly higher mean power output (W̄) during sprint 2, compared with passive recovery [W̄] 603 (17) W and 589 (15) W, P < 0.05]. This improvement was totally attributed to a 3.1 (1.0)% higher power generation during the initial 10 s of sprint 2 following the active recovery (P < 0.05), since power output during the last 20 s sprint 2 was the same after both recoveries. Despite the higher power output during sprint 2 after active recovery, no differences were observed between conditions in venous blood lactate and pH, but peak plasma ammonia was significantly higher in the active recovery condition [205 (23) vs 170 (20) μmol·l-1; P < 0.05]. No differences were found between active and passive recovery in terms of changes in plasma volume or arterial blood pressure throughout the test. However, heart rate between the two 30-s sprints and oxygen uptake during the second sprint were higher for the active compared with passive recovery [148 (3) vs 130 (4) beats min-1; P < 0.01) and 3.3 (0.1) vs 2.8 (0.1) l·min-1; P < 0.01]. These data suggest that recovery of power output during repeated sprint exercise is enhanced when low-intensity exercise is performed between sprints. The beneficial effects of an active recovery are possibly mediated by an increased blood flow to the previously exercised muscle.
Background. Skeletal complications are a major clinical manifestation of multiple myeloma. These complications are caused by soluble factors that stimulate osteoclasts to resorb bone. Bisphosphonates such as pamidronate inhibit osteoclastic activity and reduce bone resorption. Methods. Patients with stage III multiple myeloma and at least one lytic lesion received either placebo or pamidronate (90 mg) as a four-hour intravenous infusion given every four weeks for nine cycles in addition to antimyeloma therapy. The patients were stratified according to whether they were receiving first-line (stratum 1) or second-line (stratum 2) antimyeloma chemotherapy at entry into the study. Skeletal events (pathologic fracture, irradiation of or surgery on bone, and spinal cord compression), hypercalcemia (symptoms or a serum calcium concentration ≥12 mg per deciliter [3.0 mmol per liter]), bone pain, analgesic-drug use, performance status and quality of life were assessed monthly. Results. Among 392 treated patients, the efficacy of treatment could be evaluated in 196 who received pamidronate and 181 who received placebo. The proportion of patients who had any skeletal events was significantly lower in the pamidronate group (24 percent) than in the placebo group (41 percent, P<0.001), and the reduction was evident in both stratum 1 (P=0.04) and stratum 2 (P=0.004). The patients who received pamidronate had significant decreases in bone pain and no deterioration in performance status and quality of life. Pamidronate was well tolerated. Conclusions. Monthly infusions of pamidronate provide significant protection against skeletal complications and improve the quality of life of patients with stage III multiple myeloma.
An attempt is made to find the dynamical and physical characteristics of the atmospheric circulation which contributed to the development of a great storm in the vicinity of Greece on 5 October 1989. The surface cyclogenesis could be considered as a consequence of an upper-tropospheric minor wave which formed upstream on the eastern flank of a blocking-type anticyclone which was centred over Britain and dominated the atmospheric circulation over western Europe. This minor wave formed three days before the initiation of the surface cyclogenesis and could be explained by the theory of ’a dynamically unstable ridge’. As the wave moved south-eastwards, an elongated trough formed in the upper troposphere. The southernmost part of this elongated trough was disrupted by dynamical processes, leading finally to the formation of a cut-off low. When the area of positive relative vorticity advection due to the low became superimposed upon a shallow frontal surface lying across southern Greece in the afternoon of 4 October 1989, a deep depression developed at the surface between Crete and Athens during the next 12 hours. To further elucidate the role played by the forcing conditions at the upper levels in the surface cyclogenesis, the potential vorticity has been analysed.
Purpose. To point out the importance of heterogeneity in drug distribution processes and develop a noncompartmental approach for the description of the distribution of drug in the body. Methods. A dichotomous branching network of vessels for the arterial tree connected to a similar venous network was used to describe the heterogeneity of blood flow in the successive generations of the networks. The relevant kinetics of drug distribution in the well perfused and the deep tissues was considered to take place under well stirred (homogeneous) and understirred (heterogeneous) conditions, respectively. Results. A `'homogeneous model'' with classical kinetics (which is mathematically equivalent with the one-compartment model) was developed for these drugs which are confined to well perfused (''well stirred'') spaces. A `'heterogeneous model'' was proposed for the drugs reaching understirred spaces using a decreasing with time rate coefficient (fractal kinetics) to model the diffusion of drug under heterogeneous conditions. The analysis of the model equations revealed that the homogeneous model can be considered as a special case of the heterogeneous model. Concentration-time plots of multiexponential type were generated using the heterogeneous model equation. The empirically used power functions of time for the analysis of calcium clearance curves, were found to be similar to the equation adhering to the heterogeneous model. Fittings comparable to multiexponential models were obtained when the heterogeneous model equation with only one adjustable parameter was applied to six sets of long period calcium data. Conclusions. The heterogeneous processes of drug distribution in the body can obey the principles of fractal kinetics. Calcium clearance curves were analysed with the heterogeneous model. The validity of multicompartmental models which are based on the concept of homogeneity to describe drug distribution should be reconsidered.
Geopolitics is the geographical and analytical method which studies and describes the power distribution and control of the influence zones on the planet. It is important to stress that whoever controls the international commercial routes also controls the planet. What does this concept mean in the case of Aegean Sea? The Aegean is a sea route and an air passage extending from the Mediterranean Sea and Europe to the Dardanelles and to the Turkish ports in the East. Moreover, while the Aegean Sea exerts a geopolitical influence on Greece and Turkey, it is also -in a practical and not in a legal sense- a sea and an air passage serving the former Soviet Republics, such as Ukraine and Russia, and connecting, as far as transports are concerned, the commercial flow between Europe and Asia.
We review the hadronic model for Active Galactic Nuclei (AGN). This model, which can be applied to all AGN, advocates the acceleration of protons to ultrarelativistic energies by shock fronts which are formed a few Schwarzschild radii away from the central black hole. The necessary consequences of this hypothesis are discussed. These include the formation of electromagnetic cascades which are initiated by the injection of secondary electrons and photons inside the source, as well as the production and escape of neutrons and neutrinos. As a result of the neutron escape we emphasize that AGN can be sources of TeV radiation.
Shock waves associated with shell type supernova remnants are considered to be possible sites of cosmic ray acceleration. Since shocks are capable of accelerating electrons in addition to protons one anticipates both species to contribute to the high energy radiation expected from these objects. Adopting a simple model for particle acceleration we calculate in a self-consistent manner the time-dependent synchrotron and inverse Compton radiation of high energy electrons assumed either to be accelerated directly by the shock wave or to be injected at high energies as secondaries from the hadronic collisions of relativistic protons with the circumstellar material. We deduce that for standard supernova parameters the TeV flux produced from neutral pion decay is about the same order as the flux expected from directly accelerated electrons.
More effective and safer regimens are needed for patients who have advanced multiple myeloma resistant to or relapsing despite prior treatment with alkylating agents and VAD. We treated 58 such patients using the combination of twice daily cyclophosphamide (total dose 1.8 g/m2) and VAD (hyperCVAD). Treatment was given to outpatients followed by G-CSF at 5 μg/kg/d until granulocyte recovery. Twenty-three patients responded (40%), with a median duration of granulocyte depression to less than 500/μl of 4 days and a mortality rate of 2%. The median survival time for all patients was 15 months, and the median remission time of responding patients was 8 months. Patients who had low LDH, low B2M, or primary resistant disease lived significantly longer than patients without these features. The combination of fractionated cyclophosphamide and VAD provided an effective and safe rescue treatment for many patients who had advanced myeloma resistant to standard therapies.
Alexopoulos D, Olympios C, Christodoulou J, Fakiolas C, Foussas S, Cokkinos DV. Hyperventilation test in syndrome X. Angiology. 1996;47:131–137.
A wide range of pharmacological actions has been attributed to the anthracyclins. In this study we examined their effect on serum lipids in experimental animals in parallel with histological alterations. Three Wistar rat groups were injected with doxorubicin, epirubicin or normal saline once a week for 12 weeks. Total serum lipids, cholesterol, triglycerides, HDL-cholesterol, transaminases, proteins and alkaline phosphatase were assayed weekly. A proportion of the animals were sacrificed at the same time points and the cardiac muscle, large vessels, liver and abdominal muscle were stained and examined under light microscopy. Serum lipids were found to increase gradually, starting after 8 weeks of drug administration, until the end of the experiment. Tissue damage was noted in the cardiac muscle, abdominal muscle and large vessels, also following an increasing trend. Doxorubicin had a more pronounced effect than epirubicin on both serum lipid increase and tissue destruction. These alterations may contribute to anthracyclin-related cardiac damage.
The prediction of propagation and motion of thunderstorm activity, especially when heavy rainfall accumulation amounts could occur, is a matter of great importance. The objective of this study is to examine the possibility of using the environmental wind data for the problem of assessing predictability of the propagation and movement of thunderstorms in northern Greece. The propagation of radar thunderstorm echoes (radar echo reflectivity maxima) and cell movement (fine radar echo patterns) were determined for the spring and summer thunderstorms in 1992 and 1993 (April to September). Radar data were used by examining and analyzing digitally recorded plan position indicator for the entire time that the radar was operated. Multicell and single-cell thunderstorms were identified and thunderstorm propagation and cell motion were calculated for each. Environmental winds at standard levels of 850, 700, and 500 hPa were considered and, additionally, a mean 0- to 6-km layer density-weighted wind was also examined. In northern Greece, winds and radar thunderstorm echoes rarely moved from the clockwise sector 070° to 220° (ENE - SW). The movement of thunderstorm cells was not only steered by the 700-hPa level wind but was also well represented by the wind at the 500-hPa level and by the average wind in the layer 0-6 km. Using standard levels, cell motion can be determined by adding 5° to 500-hPa wind direction and reducing the 500-hPa wind speed by 30%. With the use of the mean 0- to 6-km density-weighted wind, cell motion can be represented by adding 5° to the 0- to 6-km wind direction and increasing 35% the 0- to 6-km wind speed. The propagation of multicell and single-cell thunderstorm echoes was very similar, in spite of initial expectations, and was approximately equal to the cell motion, suggesting that the new cells grew on all sides of existing multicell thunderstorms. The majority of northern Greece thunderstorms do not propagate significantly and their motion is substantially translational and similar to cell motion. However, in cases of severe thunderstorms, propagation was indicated. Characteristic cases of storm propagation are presented and vertical wind shear is investigated as a particularly important factor in influencing storm structure and evolution and the resulting storm propagation.
UNLABELLED: The purpose of this study was to investigate the availability of intensive care unit (ICU) beds and the number of requests, the number and categories of nursing staff, the nursing care required, and the time spent in various nursing activities.
METHODS: 19 district general hospitals were studied. The characteristics of the units and their nursing personnel were recorded. The availability of ICU beds, the frequency of bed requests, and the way of patient admission in the ICUs were studied retrospectively for 1 year and prospectively for 2 weeks. The staffing level of direct care for 36 patients was studied to determine the time required for direct nursing care.
RESULTS: the distribution of intensive care beds was: GICU 108, CICU 114, PSICU 30. During 1991, 12363 patients were admitted and 12172 of them were discharged; 3 628 patients stayed less than 2 days while the average length of stay was 12.5 days. In 1992, during the 2-week period, there were 303 requests for an admission to ICUs and of these 150 requests could not be met because of lack of ICU beds. The mean staffing level was 2.3 nurses per bed (to cover the three shifts). The mean nursing time required for direct nursing care of each patient per shift was found to be 6 hours for GICU patients, 5.3 for CICU, and 6.0 for PSICU patients.
