Bone mineral density in breast cancer patients treated with adjuvant letrozole, tamoxifen, or sequences of letrozole and tamoxifen in the BIG 1-98 study (SAKK 21/07).

BACKGROUND: The risk of osteoporosis and fracture influences the selection of adjuvant endocrine therapy. We analyzed bone mineral density (BMD) in Swiss patients of the Breast International Group (BIG) 1-98 trial [treatment arms: A, tamoxifen (T) for 5 years; B, letrozole (L) for 5 years; C, 2 years of T followed by 3 years of L; D, 2 years of L followed by 3 years of T]. PATIENTS AND METHODS: Dual-energy X-ray absorptiometry (DXA) results were retrospectively collected. Patients without DXA served as control group. Repeated measures models using covariance structures allowing for different times between DXA were used to estimate changes in BMD. Prospectively defined covariates were considered as fixed effects in the multivariable models. RESULTS: Two hundred and sixty-one of 546 patients had one or more DXA with 577 lumbar and 550 hip measurements. Weight, height, prior hormone replacement therapy, and hysterectomy were positively correlated with BMD; the correlation was negative for letrozole arms (B/C/D versus A), known osteoporosis, time on trial, age, chemotherapy, and smoking. Treatment did not influence the occurrence of osteoporosis (T score < -2.5 standard deviation). CONCLUSIONS: All aromatase inhibitor regimens reduced BMD. The sequential schedules were as detrimental for bone density as L monotherapy.

Prognostic and predictive value of centrally reviewed Ki-67 labeling index in postmenopausal women with endocrine-responsive breast cancer: results from Breast International Group Trial 1-98 comparing adjuvant tamoxifen with letrozole.

PURPOSE: To evaluate the prognostic and predictive value of Ki-67 labeling index (LI) in a trial comparing letrozole (Let) with tamoxifen (Tam) as adjuvant therapy in postmenopausal women with early breast cancer. PATIENTS AND METHODS: Breast International Group (BIG) trial 1-98 randomly assigned 8,010 patients to four treatment arms comparing Let and Tam with sequences of each agent. Of 4,922 patients randomly assigned to receive 5 years of monotherapy with either agent, 2,685 had primary tumor material available for central pathology assessment of Ki-67 LI by immunohistochemistry and had tumors confirmed to express estrogen receptors after central review. The prognostic and predictive value of centrally measured Ki-67 LI on disease-free survival (DFS) were assessed among these patients using proportional hazards modeling, with Ki-67 LI values dichotomized at the median value of 11%. RESULTS: Higher values of Ki-67 LI were associated with adverse prognostic factors and with worse DFS (hazard ratio [HR; high:low] = 1.8; 95% CI, 1.4 to 2.3). The magnitude of the treatment benefit for Let versus Tam was greater among patients with high tumor Ki-67 LI (HR [Let:Tam] = 0.53; 95% CI, 0.39 to 0.72) than among patients with low tumor Ki-67 LI (HR [Let:Tam] = 0.81; 95% CI, 0.57 to 1.15; interaction P = .09). CONCLUSION: Ki-67 LI is confirmed as a prognostic factor in this study. High Ki-67 LI levels may identify a patient group that particularly benefits from initial Let adjuvant therapy.

Sedentarism affects body fat mass index and fat-free mass index in adults aged 18 to 98 years.

OBJECTIVE: Body mass index does not discriminate body fat from fat-free mass or determine changes in these parameters with physical activity and aging. Body fat mass index (BFMI) and fat-free mass index (FFMI) permit comparisons of subjects with different heights. This study evaluated differences in body mass index, BFMI, and FFMI in physically active and sedentary subjects younger and older than 60 y and determined the association between physical activity, age, and body composition parameters in a healthy white population between ages 18 and 98 y. METHODS: Body fat and fat-free mass were determined in healthy white men (n = 3549) and women (n = 3184), between ages 18 and 98 y, by bioelectrical impedance analysis. BFMI and FFMI (kg/m2) were calculated. Physical activity was defined as at least 3 h/wk of endurance-type activity for at least 2 mo. RESULTS: Physically active as opposed to sedentary subjects were more likely to have a low BFMI (men: odds ratio [OR], 1.4; confidence interval [CI], 0.7-2.5; women: OR 1.9, CI 1.6-2.2) and less likely to have very high BFMI (men: OR, 0.2; CI, 0.1-0.2; women: OR, 0.1; CI, 0.02-0.2), low FFMI (men: OR, 0.5; CI, 0.3-0.9; women: OR, 0.7; CI, 0.6-0.9), or very high FFMI (men: OR, 0.6; CI, 0.4-0.8; women: OR, 0.7; CI, 0.5-1.0). Compared with subjects younger than 60 y, those older than 60 y were more like to have very high BFMI (men: OR, 6.5; CI, 4.5-9.3; women: OR, 14.0; CI, 9.6-20.5), and women 60 y and older were less likely to have a low BFMI (OR, 0.4; CI, 0.2-0.5). CONCLUSIONS: A clear association was found between low physical activity or age and height-normalized body composition parameters (BFMI and FFMI) derived from bioelectrical impedance analysis. Physically active subjects were more likely to have high or very high or low FFMI. Older subjects had higher body weights and BFMI.

Interpreting Breast International Group (BIG) 1-98: a randomized, double-blind, phase III trial comparing letrozole and tamoxifen as adjuvant endocrine therapy for postmenopausal women with hormone receptor-positive, early breast cancer.

The Breast International Group (BIG) 1-98 study is a four-arm trial comparing 5 years of monotherapy with tamoxifen or with letrozole or with sequences of 2 years of one followed by 3 years of the other for postmenopausal women with endocrine-responsive early invasive breast cancer. From 1998 to 2003, BIG -98 enrolled 8,010 women. The enhanced design f the trial enabled two complementary analyses of efficacy and safety. Collection of tumor specimens further enabled treatment comparisons based on tumor biology. Reports of BIG 1-98 should be interpreted in relation to each individual patient as she weighs the costs and benefits of available treatments. Clinicaltrials.gov ID: NCT00004205.

Redressement et liquidations judiciaires des entreprises (loi n ° 85-98 du 25 janvier 1985), administrateurs judiciaires

Collection : Journal officiel de la République française ; brochure 1034

Comparison of three separate antiadhesive barriers for intraperitoneal onlay mesh hernia repair in an experimental model (Br J Surg 2011; 98: 442-449).

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ORC-voimalan soveltuvuus hyödyntämään dieselvoimalan hukkalämpöä, Tekes DrNo 1549/401/98. Loppuraportti

Tässä loppuraportissa esitetään projektin "Kannattavuusanalyysi ORC-voimalan soveltamisesta hyödyntämään dieselvoimalan hukkalämpöä, Tekes DrNo 1549/401/98" tulokset. ORC-prosessilla (Organic Rankine Cycle) tarkoitetaan Rankine-prosessia, jossakiertoaineena veden asemesta on sopiva orgaaninen neste, esimerkiksi tolueeni. ORC-prosessi soveltuu hyvin nimenomaan matalalla lämpötilatasolla vapautuvan hukkalämmön hyödyntämiseen. Tutkimus liittyy vuonna 1981 aloitettuun suurnopeustekniikan tutkimushankkeeseen. Tutkimuksen lähtökohtana oli tropiikin olosuhteissa peruskuormaa ajava raskasöljykäyttöinen Wärtsilä NSD 18V46 voimalaitosmoottori, jonka hukkalämmöistä tuli kyetä tuottamaan sähköä mahdollisimman alhaisilla investointikustannuksilla. Kaukolämmöntuotanto rajattiin tämän selvityksen ulkopuolelle. Edullisimmaksi perustapaukseksi valittiin seitsemän turbogeneraattorin ORC-laitos, joka hyödyntää ainoastaan moottorin pakokaasulämpöä. Kyseisen ORC-laitoksen nettosähköteho on 1142 kW, joten se lisäisi dieselmoottorin tehoa 6,8 %. ORC-laitoksen myyntihinta olisi noin 7,67 Mmk, mikäli lauhdutin voidaan rakentaa ruostumattomasta teräksestä ja noin 9,01 Mmk, mikäli olisi käytettävä titaanilauhdutinta. ORC-laitoksen ominaisinvestointikustannus olisi siten noin 6700 mk/kW - 7900 mk/kW materiaalivalinnoista riippuen. Mainittu hinta sisältää sekä komponenttien valmistajien että systeemi-integraattorin katteet. Koska höyrystimen hinta vaikuttaa olennaisesti ORC-laitoksen hintaan, voidaan puhtailla maakaasupolton savukaasuilla arvioida ominaisinvestoinnin olevan noin 1000 mk/kW alhaisempi. Olettaen 6000 h/a huipun käyttöaika saadaan ORC:llä tuotetun sähkön hinnaksi noin 0,11 mk/kWh. Suomeen rakennettavalle ORC-laitokselle on todennäköisesti lisäksi saatavissa 30 % investointituki ja sähköveron palautus. - Teoriassa voidaan osoittaa, että dieselmoottorin tehoa voidaan ORC:llä lisätä jopa 18 %, mutta ominaisinvestointi on tällöin merkittävästi korkeampi. ORC-laitoksen turbiinin 1D suunnittelua tarkennettiin sekä laitoksen turbiini mallinnettiin CFD-laskennan (numeerisen virtauslaskennan) avulla osana tätä tutkimusta. Näin kyettiin nostamaan turbiinin hyötysuhdetta, ja CFD-laskennan perusteella voidaan nyt aikaisempaa varmemmin ennustaa turbiinin todellinen hyötysuhde. ORC-laitoksen dynaaminen simulointiohjelma saatiin niin ikään valmiiksi tämän projektin puitteissa. Simulointiohjelman avulla voitiin asettaa laitoksen säädinparametrit sekä simuloida voimalan käynnistys-, ajo- sekä häiriötilanteita. Tehtyjen simulointien perusteella tehtiin johtopäätökset laitoksen säätöjärjestelmän toimivuudesta ja tuorehöyryn tilaarvojen valinnasta.

5C.09: Heritability of renal function parameters and electrolyte levels in the Swiss population

OBJECTIVE: Electrolytes handling by the kidney is essential for volume and blood pressure (BP) homeostasis but their distribution and heritability are not well described. We estimated the heritability of kidney function as well as of serum and urine concentrations, renal clearances and fractional excretions for sodium, chloride, potassium, calcium, phosphate and magnesium in a Swiss population-based study. DESIGN AND METHOD: Nuclear families were randomly selected from the general population in Switzerland. We estimated glomerular filtration rate (eGFR) using the CKD-EPI and MDRD equations. Urine was collected separately during day and night over 24-hour. We used the ASSOC program (S.A.G.E.) to estimate narrow sense heritability, including as covariates in the model: age, sex, body mass index and study center. RESULTS: The 1128 participants (537 men and 591 women from 273 families), had mean (sd) age of 47.4(17.5) years, body mass index of 25.0 (4.5) kg/m2 and CKD-EPI of 98.0(18.5) mL/min/1.73 m2. Heritability estimates (SE) were 46.0% (0.06), 48.0% (0.06) and 18.0% (0.06) for CKD-EPI, MDRD and 24-hour creatinine clearance (P < 0.05), respectively. Heritability [SE] of serum concentration was highest for calcium (37%[0.06]) and lowest for sodium (13%[0.05]). Heritabilities [SE] of 24-h urine concentrations and excretions, and of fractional excretions were highest for calcium (51%[0.06], 44%[0.06] and 51%[0.06], respectively) and lowest for potassium (11%[0.05], 10%[0.05] and 16%[0.06], respectively). All results were statistically different from zero.(Figure is included in full-text article.) CONCLUSIONS: : Serum and urine levels, urinary excretions and renal handling of electrolytes, particularly calcium, are heritable in the general adult population. Identifying genetic variants involved in electrolytes homeostasis may provide useful insight into the pathophysiological mechanisms involved in common chronic diseases such as kidney diseases, hypertension and diabetes.

Propriedades tensiométricas do peritônio da paca (Cuniculus paca) a fresco e conservado em glicerina 98%

Na busca constante, tanto de material biológico alternativo para a realização de implantes, quanto de novas opções de modelos de experimentação animal, o objetivo desta investigação foi descrever o comportamento mecânico do peritônio da paca (Cuniculus paca Linnaeus, 1766) a fresco e conservado em glicerina a 98%. Amostras frescas e conservadas em glicerina por períodos de 30, 60 e 90 dias foram submetidas a testes mecânicos de tração. Quatro animais adultos, três machos e uma fêmeas, com peso corporal médio de oito quilogramas, foram utilizados para colheita das amostras de peritônio. Todos os tecidos conservados em glicerina a 98% apresentaram diminuição na rigidez e aumento na ductibilidade e tenacidade. Considerando-se a força máxima aplicada ao peritônio, evidenciou-se aumento significativo nos valores (p<0,01) das amostras conservadas por 60 e 90 dias, quando comparado ao material a fresco. Com relação a variável alongamento, notou-se aumento nos valores relativos aos materiais em glicerina em todos os tempos de conservação, verificando-se diferença significativa (p<0,01) entre os valores das amostras a fresco. A variável área também se apresentou significativa (p<0,01) entre os valores das amostras a fresco (5,40 mm²) e os preservados em glicerina pelos períodos de 30 dias (4,50 mm²), 60 dias (9,00 mm²) e 90 dias (7,20 mm²), indicando assim, que a área desta membrana aumentou em 0,033 mm² por dia. Mediante os resultados observados, concluiu-se que a glicerina 98% é uma substância eficiente para a conservação do peritônio da paca, pois melhorou suas propriedades mecânicas permitindo que as membranas suportem maiores forças de deformação. Assim, os resultados obtidos nos ensaios mecânicos do peritônio da paca sugerem sua utilização como mais uma opção de material biológico.

4. Symphonie 3-moll, op. 98

Soitinnus: orkesteri.

Ocorrência de aflatoxina M1 em leite consumido na cidade de Belo Horizonte - Minas Gerais / Brasil - agosto/98 à abril/99

Foi verificada a incidência de aflatoxina M1 (AFM1) em 61 amostras de leite coletadas em Belo Horizonte / Minas Gerais - Brasil, no período de Agosto/ 98 - Abril/ 99. A quantificação foi feita por cromatografia líquida de alta eficiência (CLAE) usando coluna de imunoafinidade como técnica de purificação. O limite de quantificação observado foi 6ng/L. As recuperações médias e coeficientes de variação foram superiores a 88,9% e inferiores a 22,4%, respectivamente. AFM1 foi encontrada em 50 (82%) das amostras analisadas, mas em níveis inferiores a 500ng/L, que é o limite máximo permitido no Brasil.