Pathological complete response and residual DCIS following neoadjuvant chemotherapy for breast carcinoma

Patients who have no residual invasive cancer following neoadjuvant chemotherapy for breast carcinoma have a better overall survival than those with residual disease. Many classification systems assessing pathological response to neoadjuvant chemotherapy include residual ductal carcinoma in situ (DCIS) only in the definition of pathological complete response. The purpose of this study was to investigate whether patients with residual DCIS only have the same prognosis as those with no residual invasive or in situ disease. A retrospective analysis of a prospectively maintained database identified 435 patients, who received neoadjuvant chemotherapy for operable breast cancer between February 1985 and February 2003. Of these, 30 (7%; 95% CI 5-9%) had no residual invasive disease or DCIS and 20 (5%; CI 3-7%) had residual DCIS only. With a median follow-up of 61 months, there was no statistical difference in disease-free survival, 80% (95% CI 60-90%) in those with no residual invasive or in situ disease and 61% (95% CI 35-80%) in those with DCIS only (P = 0.4). No significant difference in 5-year overall survival was observed, 93% (95% CI 75-98%) in those with no residual invasive or in situ disease and 82% (95% CI 52-94%) in those with DCIS only (P = 0.3). Due to the small number of patients and limited number of events in each group, it is not possible to draw definitive conclusions from this study. Further analyses of other databases are required to confirm our finding of no difference in disease-free and overall survival between patients with residual DCIS and those with no invasive or in situ disease following neoadjuvant chemotherapy for breast cancer.

The effect of caudal block on functional residual capacity and ventilation homogeneity in healthy children

Caudal block results in a motor blockade that can reduce abdominal wall tension. This could interact with the balance between chest wall and lung recoil pressure and tension of the diaphragm, which determines the static resting volume of the lung. On this rationale, we hypothesised that caudal block causes an increase in functional residual capacity and ventilation distribution in anaesthetised children. Fifty-two healthy children (15-30 kg, 3-8 years of age) undergoing elective surgery with general anaesthesia and caudal block were studied and randomly allocated to two groups: caudal block or control. Following induction of anaesthesia, the first measurement was obtained in the supine position (baseline). All children were then turned to the left lateral position and patients in the caudal block group received a caudal block with bupivacaine. No intervention took place in the control group. After 15 nun in the supine position, the second assessment was performed. Functional residual capacity and parameters of ventilation distribution were calculated by a blinded reviewer. Functional residual capacity was similar at baseline in both groups. In the caudal block group, the capacity increased significantly (p < 0.0001) following caudal block, while in the control group, it remained unchanged. In both groups, parameters of ventilation distribution were consistent with the changes in functional residual capacity. Caudal block resulted in a significant increase in functional residual capacity and improvement in ventilation homogeneity in comparison with the control group. This indicates that caudal block might have a beneficial effect on gas exchange in anaesthetised, spontaneously breathing preschool-aged children with healthy lungs.

Effect of thermal residual stresses on fatigue crack opening and propagation behavior in an Al/SiCp metal matrix composite

The effects of a thermal residual stress field on fatigue crack growth in a silicon carbide particle-reinforced aluminum alloy have been measured. Stress fields were introduced into plates of material by means of a quench from a solution heat-treatment temperature. Measurements using neutron diffraction have shown that this introduces an approximately parabolic stress field into the plates, varying from compressive at the surfaces to tensile in the center. Long fatigue cracks were grown in specimens cut from as-quenched plates and in specimens which were given a stress-relieving overaging heat treatment prior to testing. Crack closure levels for these cracks were determined as a function of the position of the crack tip in the residual stress field, and these are shown to differ between as-quenched and stress-relieved samples. By monitoring the compliance of the specimens during fatigue cycling, the degree to which the residual stresses close the crack has been evaluated. © 1995 The Minerals, Metals & Material Society.

On Provable Algorithms for Determination of Continuous Protein Interdomain Motions from Residual Dipolar Couplings

<p>Dynamics of biomolecules over various spatial and time scales are essential for biological functions such as molecular recognition, catalysis and signaling. However, reconstruction of biomolecular dynamics from experimental observables requires the determination of a conformational probability distribution. Unfortunately, these distributions cannot be fully constrained by the limited information from experiments, making the problem an ill-posed one in the terminology of Hadamard. The ill-posed nature of the problem comes from the fact that it has no unique solution. Multiple or even an infinite number of solutions may exist. To avoid the ill-posed nature, the problem needs to be regularized by making assumptions, which inevitably introduce biases into the result.p><p>Here, I present two continuous probability density function approaches to solve an important inverse problem called the RDC trigonometric moment problem. By focusing on interdomain orientations we reduced the problem to determination of a distribution on the 3D rotational space from residual dipolar couplings (RDCs). We derived an analytical equation that relates alignment tensors of adjacent domains, which serves as the foundation of the two methods. In the first approach, the ill-posed nature of the problem was avoided by introducing a continuous distribution model, which enjoys a smoothness assumption. To find the optimal solution for the distribution, we also designed an efficient branch-and-bound algorithm that exploits the mathematical structure of the analytical solutions. The algorithm is guaranteed to find the distribution that best satisfies the analytical relationship. We observed good performance of the method when tested under various levels of experimental noise and when applied to two protein systems. The second approach avoids the use of any model by employing maximum entropy principles. This 'model-free' approach delivers the least biased result which presents our state of knowledge. In this approach, the solution is an exponential function of Lagrange multipliers. To determine the multipliers, a convex objective function is constructed. Consequently, the maximum entropy solution can be found easily by gradient descent methods. Both algorithms can be applied to biomolecular RDC data in general, including data from RNA and DNA molecules.p>

Contributors to and impact of residual shunting after device closure of atrial septal defects.

BACKGROUND: The prevalence of residual shunt in patients after device closure of atrial septal defect and its impact on long-term outcome has not been previously defined. METHODS: From a prospective, single-institution registry of 408 patients, we selected individuals with agitated saline studies performed 1 year after closure. Baseline echocardiographic, invasive hemodynamic, and comorbidity data were compared to identify contributors to residual shunt. Survival was determined by review of the medical records and the Social Security Death Index. Survival analysis according to shunt included construction of Kaplan-Meier curves and Cox proportional hazards modeling. RESULTS: Among 213 analyzed patients, 27% were men and age at repair was 47 ± 17 years. Thirty patients (14%) had residual shunt at 1 year. Residual shunt was more common with Helex (22%) and CardioSEAL/STARFlex (40%) occluder devices than Amplatzer devices (9%; P = .005). Residual shunts were more common in whites (79% vs 46%, P = .004). At 7.3 ± 3.3 years of follow-up, 13 (6%) of patients had died, including 8 (5%) with Amplatzer, 5 (25%) with CardioSEAL/STARFlex, and 0 with Helex devices. Patients with residual shunting had a higher hazard of death (20% vs 4%, P = .001; hazard ratio 4.95 [1.59-14.90]). In an exploratory multivariable analysis, residual shunting, age, hypertension, coronary artery disease, and diastolic dysfunction were associated with death. CONCLUSIONS: Residual shunt after atrial septal defect device closure is common and adversely impacts long-term survival.

Application of self-quenched JH consensus primers for real-time quantitative PCR of IGH gene to minimal residual disease evaluation in multiple myeloma.

Monitoring multiple myeloma patients for relapse requires sensitive methods to measure minimal residual disease and to establish a more precise prognosis. The present study aimed to standardize a real-time quantitative polymerase chain reaction (PCR) test for the IgH gene with a JH consensus self-quenched fluorescence reverse primer and a VDJH or DJH allele-specific sense primer (self-quenched PCR). This method was compared with allele-specific real-time quantitative PCR test for the IgH gene using a TaqMan probe and a JH consensus primer (TaqMan PCR). We studied nine multiple myeloma patients from the Spanish group treated with the MM2000 therapeutic protocol. Self-quenched PCR demonstrated sensitivity of >or=10(-4) or 16 genomes in most cases, efficiency was 1.71 to 2.14, and intra-assay and interassay reproducibilities were 1.18 and 0.75%, respectively. Sensitivity, efficiency, and residual disease detection were similar with both PCR methods. TaqMan PCR failed in one case because of a mutation in the JH primer binding site, and self-quenched PCR worked well in this case. In conclusion, self-quenched PCR is a sensitive and reproducible method for quantifying residual disease in multiple myeloma patients; it yields similar results to TaqMan PCR and may be more effective than the latter when somatic mutations are present in the JH intronic primer binding site.

Minimal residual disease monitoring in multiple myeloma: a comparison between allelic-specific oligonucleotide real-time quantitative polymerase chain reaction and flow cytometry.

BACKGROUND AND OBJECTIVES: Minimal residual disease (MRD) studies are useful in multiple myeloma (MM). However, the definition of the best technique and clinical utility are still unresolved issues. The aim of this study was to analyze and compare the clinical utility of MRD studies in MM with two different techniques: allelic-specific oligonucleotide real-time quantitative PCR (ASO-RQ-PCR), and flow cytometry (FCM). DESIGN AND METHODS: Bone marrow samples from 32 MM patients who had achieved complete response after transplantation were evaluated by ASO-RQ-PCR, using TaqMan technology, and multiparametric FCM. RESULTS: ASO-RQ-PCR was only applicable in 75% of patients for a variety of technical reasons, while FCM was applicable in up to 90%. Therefore, simultaneous PCR/FCM analysis was possible in only 24 patients. The number of residual tumor cells identified by both techniques was very similar (mean=0.29%, range=0.001-1.61%, correlation coefficient=0.861). However, RQ-PCR was able to detect residual myelomatous cells in 17 patients while FCM only did so in 11; thus, 6 cases were FCM negative but PCR positive, all of them displaying a very low number of clonal cells (median=0.014%, range=0.001-0.11). Using an MRD threshold of 0.01% (10(-4)) two risk groups with significantly different progression-free survival could be identified by either PCR (34 vs. 15m, p=0.04) or FCM (27 vs. 10m, p=0.05). INTERPRETATION AND CONCLUSIONS: Although MRD evaluation by ASO-RQ-PCR is slightly more sensitive and specific than FCM, it is applicable in a lower proportion of MM patients and is more time-consuming, while both techniques provide similar prognostic information.

Medición del desempeño : retorno sobre inversión, ROI; ingreso residual, IR; valor económico agregado, EVA; análisis comparado

El artículo quiere a partir de un recuento crítico de los análisis tradicionales del ROI y del IR dar una mirada analítica a estos indicadores comparándolos entre sí, mirando su alcance e importancia reales, igualmente sus problemas conceptuales y limitaciones. Al final se introduce el EVA, como medida y filosofía, mirando lo novedoso de la misma y los aspectos comunescon el ROI y el IR.

Produção de exopolissacarídeos bacterianos a partir de glicerol residual gerado na síntese de biodiesel

A busca por combustíveis alternativos, tais como os biocombustíveis, torna-se necessária devido à crescente demanda por combustíveis em todos os setores da atividade humana, sendo que quase toda energia consumida no mundo provém do petróleo, uma fonte limitada, que emite grande quantidade de gases poluentes. Devido à grande diversidade de culturas oleoginosas no país, o Brasil demonstra potencial para substituição do diesel pelo biodiesel. No processo de obtenção deste, o óleo vegetal sofre uma transesterificação, sob a ação de um catalisador básico e na presença de um álcool, formando três moléculas de ésteres metílicos ou etílicos de ácidos graxos, que constituem o biodiesel em sua essência, liberando uma molécula de glicerol, que é o coproduto mais abundante desta reação. Sendo assim, a utilização do glicerol residual é uma ótima alternativa para agregar valor à cadeia produtiva do biodiesel, minimizar os danos de um possível descarte inadequado, além de diminuir os custos do processo. Com este intuito, este trabalho propõe o uso do glicerol residual como fonte de carbono para produção de exopolissacarídeos (EPSs). Para tal, foram utilizadas linhagens de bactérias mencionadas na literatura como produtoras de EPSs de importância comercial, sendo elas: Xanthomonas campestris pv. mangiferaeindicae IBSBF 1230, Pseudomonas oleovarans NRRL B-14683, Sphingomonas capsulata NRRL B-4261 e Zymomonas mobilis NRRL B-4286. Os cultivos foram realizados em meio apropriado para cada micro-organismo, e como fontes de carbono foram testadas a sacarose, o glicerol residual e uma mistura de ambos na proporção de 1:1 m/m. Os meios foram inoculados com suspensão da bactéria em estudo, sendo avaliados parâmetros relativos ao crescimento celular e à produção de EPSs. Para X. campestris pv. mangiferaeindicae, foram determinadas algumas propriedades reológicas e térmicas dos EPSs produzidos com as diferentes fontes de carbono, bem como o índice de emulsificação com diferentes óleos vegetais. X. campestris apresentou uma concentração de EPSs em torno de 4 g.L-1 em todos os meios estudados, comportamento similar ao da bactéria P. oleovorans, diferindo apenas no meio contendo sacarose (0,8 g.L-1 ). S. capsulata apresentou uma maior concentração de EPSs em meios contendo sacarose e a mistura de sacarose com glicerol residual, em torno de 3,4 g.L-1 , e em meio contendo glicerol residual este valor caiu para 1,7 g.L-1 . Já Z. mobilis apresentou um melhor resultado em meio contendo sacarose e glicerol residual, atingindo 1,3 g.L-1 , sendo que em meio contendo somente sacarose e glicerol residual estes valores foram inferiores alcançando 0,2 e 0,7 g.L-1 , respectivamente. Quase todas as bactérias atingiram a fase estacionária em 24 h de cultivo e o pH permaneceu praticamente constante, sendo verificada uma queda mais acentuada somente para Z. mobilis. O comportamento reológico foi similar para as xantanas produzidas nos diferentes meios, entretanto a viscosidade inicial foi maior com o meio a sacarose (637 cP), seguido da mistura de sacarose com glicerol residual (279 cP) e glicerol residual (60 cP). O IE24 foi superior quando utilizado o óleo de milho, atingindo valores de 97, 72 e 64 % em sacarose, mistura de sacarose com glicerol e glicerol residual, respectivamente. Desta forma, pode-se afirmar que a mudança na fonte de carbono afeta estas propriedades.

Suplementação do solo com lodo de esgoto: efeito de aplicações frequentes e residual na produtividade do milho.

RESUMO: Neste trabalho foi avaliada a dinâmica do N mineral e a produtividade do milho em solo que vem, a longo tempo, recebendo aplicações de lodos de esgoto provenientes das estações de Tratamento de Franca e de Barueri, ou que recebeu lodo de esgoto por certo período de tempo. As aplicações iniciaram-se em 1999 a taxas que variaram na dose recomendada, tomando-se como base os requerimentos da planta em N, até uma taxa 8 vezes maior. Nos anos de 2004 e 2005 os lodos não foram aplicados. Em 2006 e 2007 somente foi aplicado o lodo de Franca. Os resultados deste trabalho referem-se às coletas de solo feitas no ano agrícola 2007/2008. Os tratamentos com lodo foram comparados com o tratamento com fertilização mineral (FM) e com o tratamento testemunha (T), que não recebeu fertilizantes e nem lodo. Os teores de N no solo aumentaram com as doses do lodo de Franca, o que não ocorreu com o lodo de Barueri. As produtividades do milho foram maiores nos tratamentos com o lodo de Franca e não diferiram com as doses aplicadas. Nos tratamentos com o lodo de Barueri as produtividades foram menores que as obtidas com o lodo de Franca, mas foram semelhantes às obtidas no tratamento com FM. A menor produtividade foi obtida no tratamento T. Os maiores teores de N totais nos grãos foram obtidos nos tratamentos com o lodo de Franca sem diferença entre as doses.

Predicted residual activity of rilpivirine in HIV-1 infected patients failing therapy including NNRTIs efavirenz or nevirapine

This is an open access article under the CC BY-NC-ND license - http://creativecommons.org/licenses/by-nc-nd/4.0/