Suomen Voimisteluliiton Puheenjohtaja 9/6 1962

Kirje

Variability of resting energy expenditure in healthy volunteers during fasting and continuous enteral feeding.

The magnitude of variability in resting energy expenditure (REE) during the day was assessed in nine healthy young subjects under two nutritional conditions: 1) mixed nutrient (53% carbohydrate, 30% fat, 17% protein) enteral feeding at an energy level corresponding to 1.44 REE; and 2) enteral fasting, with only water allowed. In each subject, six 30-min measurements of REE were performed using indirect calorimetry (hood system) at 90-min intervals from 9 AM to 5 PM. The mean REE and respiratory quotient were significantly (p less than .01) greater during feeding than during fasting (1.08 +/- 0.07 [SEM] vs. 1.00 +/- 0.06 kcal/min and 0.874 +/- 0.007 vs. 0.829 +/- 0.008 kcal/min, respectively). Mean postprandial thermogenesis was 4.9 +/- 0.4% of metabolizable energy administered. The intraindividual variability of REE throughout the day, expressed as the coefficient of variation, ranged from 0.7% to 2.0% in the fasting condition and from 1.2% to 4.1% in the feeding condition. There was no significant difference between the REE measured in the morning and that determined in the afternoon.

Biología y pesquería del perico o dorado Coryphaena hippurus, febrero 2010

La prospección para evaluar la biología y pesquería de Coryphaena hippurus perico o dorado, se efectuó del 10 de febrero al 1 de marzo 2010, a bordo del BIC Imarpe V. El área de extracción fue de 4°59’32,8’’ a 10°15’20,1’’S y de 79°55’16,2’’ a 84°35’04,2’’W; la captura total fue 1.500,5 kg. La CPUE varió de 0,9 a 18,2 kg/Nº Anzuelos/1000*hora efectiva de pesca. Se encontró alta selección interespecífi ca del espinel superfi cial, al capturar 87,8% de perico y 8 especies de peces, tortugas y cefalópodos. El rango de tallas para hembras fue 79 - 141 cm de LT, en machos fue 100 - 157 cm LT. El factor de condición de Fulton en machos varió de 0,30 a 0,46 y en hembras de 0,32 a 0,40. Se determinó para hembras: L∞=148,92 cm, tasa de crecimiento anual (K) 1,081, se estimó t0 = -0,076 años, el Índice de performance Ǿ= 4,38; para machos, estos parámetros fueron L∞=169,75 cm, tasa de crecimiento anual (K) de 0,893, t0 = -0,115, índice de performance Ǿ= 4,40. La curva de crecimiento en talla para hembras, indica que a un año de edad la LT es 102,4 cm y en machos 107 cm. El máximo crecimiento en peso para hembras y machos fue a 1,5 años de vida. El Índice gonadosomático (IGS) fl uctuó de 3,2 a 4,6 mostrando comportamiento heterogéneo. La proporción sexual fue de 2:1 favorable a las hembras. La fecundidad parcial fue de 324.416 ovocitos por tanda de desove. La fecundidad relativa fue 56 ovocitos/ gramo de peso corporal. El tipo de alimento fue peces, cefalópodos y crustáceos con dominancia de Exocoetus volitans (%IRI = 31,6), Argonauta spp. (%IRI = 26,4) mostrando variaciones según zonas y tallas. El consumo de alimento fue 472,7 g/ind./día correspondiente a 7,4% de su peso corporal, presentando fl uctuaciones con respecto a la talla; alimentándose en horas de la mañana, con un máximo entre las 8:00 y 9:59 horas. Se encontraron 5.762 parásitos, identifi cándose 8 especies en cuatro taxas. La prevalencia parasitaria indica que Tentacularia coryphaenae y Bathycotyle coryphaenae alcanzan el 100%, seguido por Hysterothylacium sp. 62% y Caligus coryphaenae 46%. El mayor número de parásitos se encontró en el estómago. Los peces entre 96–100 cm de LT son los más parasitados. La mayor incidencia parasitaria se encontró en la zona norte, en el tramo Paita-Salaverry. Los registros de temperatura en la columna de agua fueron de 12,7 a 27,3 °C y las ATSM de 0,2 a 4,1 °C. Por el frente oceánico se observaron comportamientos térmicos cálidos asociados a las masas de Aguas Ecuatoriales Superfi ciales y Aguas Subtropicales Superfi ciales y por la zona costera se localizaron Aguas Costeras Frías tanto en Chimbote como en Chicama con temperaturas próximas a 22,0 °C. La concentración de oxígeno disuelto superfi cial se presentó favorable para el perico.

Pathological complete response after neoadjuvant chemotherapy is an independent predictive factor irrespective of simplified breast cancer intrinsic subtypes: a landmark and two-step approach analyses from the EORTC 10994/BIG 1-00 phase III trial.

BACKGROUND: Pathological complete response (pCR) following chemotherapy is strongly associated with both breast cancer subtype and long-term survival. Within a phase III neoadjuvant chemotherapy trial, we sought to determine whether the prognostic implications of pCR, TP53 status and treatment arm (taxane versus non-taxane) differed between intrinsic subtypes. PATIENTS AND METHODS: Patients were randomized to receive either six cycles of anthracycline-based chemotherapy or three cycles of docetaxel then three cycles of eprirubicin/docetaxel (T-ET). pCR was defined as no evidence of residual invasive cancer (or very few scattered tumour cells) in primary tumour and lymph nodes. We used a simplified intrinsic subtypes classification, as suggested by the 2011 St Gallen consensus. Interactions between pCR, TP53 status, treatment arm and intrinsic subtype on event-free survival (EFS), distant metastasis-free survival (DMFS) and overall survival (OS) were studied using a landmark and a two-step approach multivariate analyses. RESULTS: Sufficient data for pCR analyses were available in 1212 (65%) of 1856 patients randomized. pCR occurred in 222 of 1212 (18%) patients: 37 of 496 (7.5%) luminal A, 22 of 147 (15%) luminal B/HER2 negative, 51 of 230 (22%) luminal B/HER2 positive, 43 of 118 (36%) HER2 positive/non-luminal, 69 of 221(31%) triple negative (TN). The prognostic effect of pCR on EFS did not differ between subtypes and was an independent predictor for better EFS [hazard ratio (HR) = 0.40, P < 0.001 in favour of pCR], DMFS (HR = 0.32, P < 0.001) and OS (HR = 0.32, P < 0.001). Chemotherapy arm was an independent predictor only for EFS (HR = 0.73, P = 0.004 in favour of T-ET). The interaction between TP53, intrinsic subtypes and survival outcomes only approached statistical significance for EFS (P = 0.1). CONCLUSIONS: pCR is an independent predictor of favourable clinical outcomes in all molecular subtypes in a two-step multivariate analysis. CLINICALTRIALSGOV: EORTC 10994/BIG 1-00 Trial registration number NCT00017095.

Clinical benefit and quality of life in patients with advanced pancreatic cancer receiving gemcitabine plus capecitabine versus gemcitabine alone: a randomized multicenter phase III clinical trial--SAKK 44/00-CECOG/PAN.1.3.001.

PURPOSE: To compare clinical benefit response (CBR) and quality of life (QOL) in patients receiving gemcitabine (Gem) plus capecitabine (Cap) versus single-agent Gem for advanced/metastatic pancreatic cancer. PATIENTS AND METHODS: Patients were randomly assigned to receive GemCap (oral Cap 650 mg/m(2) twice daily on days 1 through 14 plus Gem 1,000 mg/m(2) in a 30-minute infusion on days 1 and 8 every 3 weeks) or Gem (1,000 mg/m(2) in a 30-minute infusion weekly for 7 weeks, followed by a 1-week break, and then weekly for 3 weeks every 4 weeks) for 24 weeks or until progression. CBR criteria and QOL indicators were assessed over this period. CBR was defined as improvement from baseline for >or= 4 consecutive weeks in pain (pain intensity or analgesic consumption) and Karnofsky performance status, stability in one but improvement in the other, or stability in pain and performance status but improvement in weight. RESULTS: Of 319 patients, 19% treated with GemCap and 20% treated with Gem experienced a CBR, with a median duration of 9.5 and 6.5 weeks, respectively (P < .02); 54% of patients treated with GemCap and 60% treated with Gem had no CBR (remaining patients were not assessable). There was no treatment difference in QOL (n = 311). QOL indicators were improving under chemotherapy (P < .05). These changes differed by the time to failure, with a worsening 1 to 2 months before treatment failure (all P < .05). CONCLUSION: There is no indication of a difference in CBR or QOL between GemCap and Gem. Regardless of their initial condition, some patients experience an improvement in QOL on chemotherapy, followed by a worsening before treatment failure.

[Voyage en Italie : 1824-1830]. , Palais Fava. Sur une échelle de 00,1 P.M. : [élévation] : [dessin] / h. L. [Henri Labrouste]

Référence bibliographique : Weigert, 55

[Voyage en Italie : 1824-1830]. , Tombeau de L. Munacius [sic] Plancus : sur une échelle de 0,010 pm : [coupe, trois profils, plan] : [dessin] / h. L. [Henri Labrouste]

Référence bibliographique : Weigert, 170

Traitement de la dépression résistante par l'association citalopram-lithium. Méthodologie d'une étude multicentrique en double aveugle et résultats préliminaires [Treatment of resistant depression with the citalopram-lithium combination. Methodology of a double-blind multicenter study and preliminary results].

Citalopram, a new bicyclic antidepressant, is the most selective serotonin reuptake inhibitor. In a number of double-blind controlled studies, citalopram was compared to placebo and to known tricyclic antidepressants. These studies have shown their efficacy and good safety. The inefficacy of a psychotropic treatment in at least 20% of depressives has led a number of authors to propose original drug combinations and associations, like antidepressant/lithium (Li), antidepressant/sleep deprivation (agrypnia), antidepressant/ECT, or antidepressant/LT3. The aim of this investigation is to evaluate the clinical effectiveness and safety of a combined citalopram/lithium treatment in therapy-resistant patients, taking account of serotonergic functions, as tested by the fenfluramine/prolactin test, and of drug pharmacokinetics and pharmacogenetics of metabolism. DESIGN OF THE STUDY: A washout period of 3 days before initiating the treatment is included. After an open treatment phase of 28 days (D) with citalopram (20 mg D1-D3; 40 mg D4-D14; 40 or 60 mg D15-D28; concomitant medication allowed: chloral, chlorazepate), the nonresponding patients [less than 50% improvement in the total score on the 21 item-Hamilton Depression Rating Scale (HDRS)] are selected and treated with or without Li (randomized in double-blind conditions: citalopram/Li or citalopram/placebo) during the treatment (D29-D35). Thereafter, all patients included in the double-blind phase subsequently receive an open treatment with citalopram/Li for 7 days (D36-D42). The hypothesis of a relationship between serotoninergic functions in patients using the fenfluramine/prolactin test (D1) and the clinical response to citalopram (and Li) is assessed. Moreover, it is evaluated whether the pharmacogenetic status of the patients, as determined by the mephenytoin/dextromethorphan test (D0-D28), is related to the metabolism of fenfluramine and citalopram, and also to the clinical response. CLINICAL ASSESSMENT: Patients with a diagnosis of major depressive disorders according to DSM III are submitted to a clinical assessment of D1, D7, D14, D28, D35, D42: HDRS, CGI (clinical global impression), VAS (visual analog scales for self-rating of depression), HDRS (Hamilton depression rating scale, 21 items), UKU (side effects scale), and to clinical laboratory examens, as well as ECG, control of weight, pulse, blood pressure at D1, D28, D35. Fenfluramine/prolactin test: A butterfly needle is inserted in a forearm vein at 7 h 45 and is kept patent with liquemine. Samples for plasma prolactin, and d- and l-fenfluramine determinations are drawn at 8 h 15 (base line). Patients are given 60 mg fenfluramine (as a racemate) at 8 h 30. Kinetic points are determined at 9 h 30, 10 h 30, 11 h 30, 12 h 30, 13 h 30. Plasma levels of d- and l-fenfluramine are determined by gas chromatography and prolactin by IRNA. Mephenytoin/dextromethorphan test: Patients empty their bladders before the test; they are then given 25 mg dextropethorphan and 100 mg mephenytoin (as a racemate) at 8 h 00. They collect all urines during the following 8 hours. The metabolic ratio is determined by gas chromatography (metabolic ratio dextromethorphan/dextrorphan greater than 0.3 = PM (poor metabolizer); mephenytoin/4-OH-mephenytoin greater than 5.6, or mephenytoin S/R greater than 0.8 = PM). Citalopram plasma levels: Plasma levels of citalopram, desmethylcitalopram and didesmethylcitalopram are determined by gas chromatography--mass spectrometry. RESULTS OF THE PILOT STUDY. The investigation has been preceded by a pilot study including 14 patients, using the abovementioned protocol, except that all nonresponders were medicated with citalopram/Li on D28 to D42. The mean total score (n = 14) on the 21 item Hamilton scale was significantly reduced after the treatment, ie from 26.93 +/- 5.80 on D1 to 8.57 +/- 6.90 on D35 (p less than 0.001). A similar patCitalopram, a new bicyclic antidepressant, is the most selective serotonin reu

6.2

Airborne particles can come from a variety of sources and contain variable chemical constituents. Some particles are formed by natural processes, such as volcanoes, erosion, sea spray, and forest fires, while other are formed by anthropogenic processes, such as industrial- and motor vehicle-related combustion, road-related wear, and mining. In general, larger particles (those greater than 2.5 μm) are formed by mechanical processes, while those less than 2.5 μm are formed by combustion processes. The chemical composition of particles is highly influenced by the source: for combustion-related particles, factors such as temperature of combustion, fuel type, and presence of oxygen or other gases can also have a large impact on PM composition. These differences can often be observed at a regional level, such as the greater sulphate-composition of PM in regions that burn coal for electricity production (which contains sulphur) versus regions that do not. Most countries maintain air monitoring networks, and studies based on the resulting data are the most common basis for epidemiology studies on the health effects of PM. Data from these monitoring stations can be used to evaluate the relationship between community-level exposure to ambient particles and health outcomes (i.e., morbidity or mortality from various causes). Respiratory and cardiovascular outcomes are the most commonly assessed, although studies have also considered other related specific outcomes such as diabetes and congenital heart disease. The data on particle characteristics is usually not very detailed and most often includes some combination of PM2.5, PM10, sulphate, and NO2. Other descriptors that are less commonly found include particle number (ultrafine particles), metal components of PM, local traffic intensity, and EC/OC. Measures of association are usually reported per 10 μg/m3 or interquartile range increase in pollutant concentration. As the exposure data are taken from regional monitoring stations, the measurements are not representative of an individual's exposure. Particle size is an important descriptor for understanding where in the human respiratory system the particles will deposit: as a general rule, smaller particles penetrate to deeper regions of the lungs. Initial studies on the health effects of particulate matter focused on mass of the particles, including either all particles (often termed total suspended particulate or TSP) or PM10 (all particles with an aerodynamic diameter less than 10 μm). More recently, studies have considered both PM10 and PM2.5, with the latter corresponding more directly to combustion-related processes. UFPs are a dominant source of particles in terms of PNC, yet are negligible in terms of mass. Very few epidemiology studies have measured the effect of UFPs on health; however, the numbers of studies on this topic are increasing. In addition to size, chemical composition is of importance when understanding the toxicity of particles. Some studies consider the composition of particles in addition to mass; however this is not common, in part due the cost and labour involved in such analyses.

Final results of the SAKK 16/00 trial: a randomized phase III trial comparing neoadjuvant chemoradiation to chemotherapy alone in stage IIIA/N2 non-small cell lung cancer (NSCLC).

Aim: One standard option in the treatment of stage IIIA/N2 NSCLC is neoadjuvant chemotherapy followed by surgery. We investigated in a randomized trial whether the addition of neoadjuvant radiotherapy would improve the outcome. Here we present the final results of this study. Methods: Patients (pts.) with pathologically proven, resectable stage IIIA/N2 NSCLC, performance status 0-1, and adequate organ function were randomized 1:1 to chemoradiation (CRT) with 3 cycles of neoadjuvant chemotherapy (cisplatin 100 mg/m2 and docetaxel 85 mg/m2 d1, q3weeks) followed by accelerated concomitant boost radiotherapy (RT) with 44 Gy in 22 fractions in 3 weeks, or neoadjuvant chemotherapy alone (CT), with subsequent surgery for all pts. The primary endpoint was event-free survival (EFS). Results: 232 pts. were randomized in 23 centers, the median follow-up was 53 months. Two thirds were men, median age was 60 years (range 37-76). Histology was squamous cell in 33%, adenocarcinoma in 43%. Response rate to CRT was 61% vs. 44% with CT. 85% of all pts. underwent surgery, 30-day postoperative mortality was 1%. The rate of complete resection was 91% (CRT) vs. 81% (CT) and the pathological complete remission (pCR) rate was 16% vs. 12%. The median EFS was 13.1 months (95% CI 9.9 - 23.5) for the CRT group vs. 11.8 months (95% CI 8.4 - 15.2) in the CT arm (p 0.665). The median overall survival (OS) with CRT was 37.1 months (95% CI 22.6 -50), with CT 26.1 months ( 95% CI 26.1 - 52.1, p 0.938). The local failure rate was 23% in both arms. In the CT arm 12 pts. were given postoperative radiotherapy (PORT) for R1 resection, 6 pts. received PORT in violation of the protocol. Pts. with a pCR, mediastinal downstaging to ypN0/1 and complete resection had a better outcome. Toxicity of chemotherapy was substantial, especially febrile neutropenia was common, whereas RT was well tolerated. Conclusions: This is the first completed phase III trial to evaluate the role of induction chemoradiotherapy and surgery, in comparison to neoadjuvant CT alone followed by surgery. RT was active, it increased response, complete resection and pCR rates. However, this failed to translate into an improvement of local control, EFS or OS. Notably, surgery after induction treatment was safe, including pneumonectomy. The overall survival rates of our neoadjuvant regimen are very encouraging, especially for a multicenter setting. Disclosure: M. Pless: Advisory Board for Sanofi; R. Cathomas: Advisory Board Sanofi D.C. Betticher: Advisory Board Sanofi. All other authors have declared no conflicts of interest.

Design of salient pole PM synchronous machines for a vehicle traction application – Analysis and

This doctoral thesis presents a study on the development of a liquid-cooled frame salient pole permanent-magnet-exited traction machine for a four-wheel-driven electric car. The emphasis of the thesis is put on a radial flux machine design in order to achieve a light-weight machine structure for traction applications. The design features combine electromagnetic and thermal design methods, because traction machine operation does not have a strict operating point. Arbitrary load cycles and the flexible supply require special attention in the design process. It is shown that accurate modelling of the machine magnetic state is essential for high-performance operation. The saturation effect related to the cross-saturation has to be taken carefully into account in order to achieve the desired operation. Two prototype machines have been designed and built for testing: one totally enclosed machine with a special magnet module pole arrangement and another through-ventilated machine with a more traditional embedded magnet structure. Both structures are built with magnetically salient structures in order to increase the torque production capability with the reluctance torque component. Both machine structures show potential for traction usage. However, the traditional embedded magnet design turns out to be mechanically the more secure one of these two machine options.

Voiteluohjeita Packard 6 ja 120

kuv., 15 x 11 cm