Analysis of prognostic factors and efficacy of surgical treatment for non-small cell lung cancer: department of surgery NTLDRI (1998-1999)

Introduction: Surgical resection is the mainstay of curative treatment for non-small cell lung cancer. Material and methods: A retrospective analysis of the efficacy of this treatment, based on 431 patients operated from 1998 to 1999 in the Department of Surgery of the National Tuberculosis and Lung Diseases Research Institute, was accomplished. In 218 cases (51%) lobectomy was performed, in 21 cases (5%) - bilobectomy, in 188 cases (44%) - pneumonectomy and in 4 cases (1%) - wedge resection. The pIA stage was diagnosed in 70 cases (16%), pIB - in 112 (26%), pIIA - in 22 (5%), pIIB - in 110 (26%), pIIIA - in 88 (20%), pIIIB - in 13 (3%) and pIV - in 16 (4%). Results: The five-year survival rate for the whole group was 49.1%. Statistical analysis revealed better survival in patients younger than 50 (p = 0.03), in women (p = 0.01, HR = 0.63) and in cases with less extensive surgery, i.e. lobectomy, (p < 0.05). Long-term survival was significantly dependent on the disease stage (p < 0.005). Five-year survival of patients in stage IA was 81.7%, IB - 62.2%, IIA - 59.1%, IIB - 38%, IIIA - 21.3%, IIIB - 8.3% and IV - 8.3%. Tumour status (p < 0.005) and histological subtype (p < 0.005) had a significant influence on long-term survival. Five-year survival of patients with squamous cell carcinoma was 53.4%, with adenocarcinoma - 38.3%, with large cell carcinoma - 37.5%, with carcinoid - 94.7% and with other types of cancer - 39.1%. The decreased preoperative Hb level (p < 0.005, HR = 1.52), as well as blood transfusion in postoperative period (p = 0.03), were negative prognostic factors. Significantly worse prognosis was observed in the cases of R1 or R2 categories (p = 0.01) and M1 category (p < 0.005). Additionally, in multivariate Cox analysis, a decreased FEV1 lower than 80% (HR = 1.46) was a negative prognostic factor, and lack of symptoms, except cough (HR = 0.73), was a positive one. Conclusions: Univariate analysis revealed several factors worsening prognosis: male sex, age older than 50 years, lowered preoperative Hb concentration, extended surgery, advanced stage, adenocarcinoma and large cell carcinoma, T status, N status, R status, M status and blood transfusion in postoperative period. In multivariate Cox analysis lowered preoperative Hb concentration, decreased FEV1 lower than 80% pred., extended surgery (pneumonectomy), advanced stage and adenocarcinoma were negative prognostic factors. Female sex and lack of symptoms, except coughing were positive prognostic factors.Wprowadzenie: Postępowanie chirurgiczne stanowi podstawową metodę leczenia niedrobnokomórkowego raka płuca.Materiał i metody: W pracy przeprowadzono retrospektywną analizę skuteczności tego leczenia w grupie 431 chorych operowanych w Klinice Chirurgii Instytutu Gruźlicy i Chorób Płuc w Warszawie w latach 1998-1999. W 218 (50%) przypadkach wykonano lobektomię, w 21 (5%) - bilobektomię, w 188 (44%) - pneumonektomię, a w 4 (1%) - resekcję klinową. U 70 (16%) chorych rozpoznano stadium zaawansowania pIA, u 112 (26%) - pIB, u 22 (5%) - pIIA, u 110 (26%) - pIIB, u 88 (20%) - pIIIA, u 13 (3%) - pIIIB i u 16 (4%) - pIV. Wyniki: Wskaźnik 5-letniego przeżycia dla całej grupy wynosił 49,1%. Analiza statystyczna wykazała wyższy odsetek odległych przeżyć w grupie wiekowej do 50. rż. (p = 0,03), u płci żeńskiej (p = 0,01, HR = 0,63), w przypadku mniej rozległego zabiegu (lobektomia) (p < 0,005). Wskaźniki odległych przeżyć wykazywały znamienną zależność od stadium zaawansowania choroby nowotworowej (p < 0,005). Pięcioletnie przeżycie pacjentów w stadium IA wynosiło 81,7%, IB - 62,2%, IIA - 59,1%, IIB - 38%, IIIA - 21,3%, IIIB - 8,3% oraz IV - 8,3%. Typ histopatologiczny miał również znamienny wpływ na odległe przeżycia chorych (p < 0,005). Pięcioletnie przeżycie chorych na raka płaskonabłonkowego wynosiło 53,4%, na raka gruczołowego - 38,3%, na raka wielkokomórkowego - 37,5%, na rakowiaka - 94,7%, a na pozostałe typy raka - 39,1%. Wskaźnik odległego przeżycia zależał znamiennie od cechy T (p < 0,005). Obniżone wyjściowe stężenie hemoglobiny (p < 0,005, HR = 1,52) oraz przetoczenie masy erytrocytarnej w okresie pooperacyjnym (p = 0,03) były niekorzystnymi czynnikami rokowniczymi. Znamiennie gorsze rokowanie wykazano w przypadku cechy R1 lub R2 (p = 0,01) oraz cechy M1 (p < 0,005). Dodatkowo, w analizie wielowymiarowej Coxa wartość FEV1 poniżej 80% (HR = 1,46) była zmienną negatywnie wpływającą na odległe przeżycie, a brak objawów klinicznych choroby, z wyjątkiem kaszlu (HR = 0,73) - zmienną wpływającą korzystnie. Wnioski: W analizie jednowymiarowej wyłoniono następujące czynniki ryzyka: płeć męska, wiek powyżej 50. rż., obniżone stężenie Hb, zabieg operacyjny o poszerzonym zakresie, zaawansowane stadium, utkanie raka gruczołowego i wielkokomórkowego, cecha T, N, R i M oraz przetoczenie ME w okresie pooperacyjnym. Analiza wielowymiarowa Coxa wykazała następujące negatywne czynniki prognostyczne: obniżone wyjściowe stężenie Hb, wartość FEV1 poniżej 80%, zabieg operacyjny o poszerzonym zakresie (pneumonektomia), zaawansowane stadium raka, utkanie raka gruczołowego oraz następujące korzystne rokowniczo czynniki: płeć żeńska i brak objawów klinicznych, z wyjątkiem kaszlu

Sustainable international business model innovations for a globalizing circular economy : a review and synthesis, integrative framework, and opportunities for future research

The global imperative has increased in recent years for international firms to respond to major threats such as unintended environmental, social, and economic problems arising from ecological destruction, population growth, and economic activity. To respond to this confluence that has created an emerging existential crisis, we identify that a globalizing circular economy (CE) is required and subsequently define a new construct: sustainable international business model innovations. In doing so, we introduce circular inputs, sharing platforms, product as a service, product use extension, and resource recovery as business models that contain the potential to reply to these grand challenges. Based on CE principles, the innovations and designs introduced are contrasted with the traditional linear economic model and are presented as actionable standardization/adaptation alternatives for companies responding to differing informal and formal international institutions. Based on the theoretical underpinnings of the resource-based, dynamic capabilities, and international business model innovation perspectives, we introduce an integrative framework that is accompanied by a series of detailed research questions to provide future research opportunities for the domain. This conceptual approach holds that international resource design influences marketing capabilities adaptation which, in turn, impacts international performance and offers a foundation from which to build the literature.© The Author(s) 2023. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.fi=vertaisarvioitu|en=peerReviewed

Constrictive bronchiolitis obliterans in patient with Castelman’s disease

A 37-year-old woman with hialin- vascular type Castelman’s disease (CD) localised in the retroperitoneal region, incompletely resected, developed progressive dyspnoea. The chest radiograph taken 3 months before the operation was normal. The chest CT scan revealed diffused bronchiectases, hyperinflation and air trapping. Pulmonary function tests disclosed severe obstructive impairment with hyperinflation. The bronchoscopic examination of the bronchial tree was normal. Cultures of sputum, bronchial washing and blood were negative. No pemphigus antibodies were found. Mycoplasmal, chlamydial and viral infections were excluded. Histological examination of specimens obtained by open lung biopsy revealed bronchiolar inflammation, submucosal bronchial fibrosis with obliteration of bronchiolar lumen. Constrictive bronchiolitis obliterans (CBO) was diagnosed. Despite slight clinical and spirometric improvements that were achieved due to corticosteroid therapy, one year later she died as a result of respiratory failure. It is widely known that patients with CD develop CBO during the course of paraneoplastic pemphigus. However we present the case of CBO and CD but without any symptoms of this condition

A multi-ingredient nutritional supplement enhances exercise training-related reductions in markers of systemic inflammation in healthy older men

We evaluated whether twice daily consumption of a multi-ingredient nutritional supplement (SUPP) would reduce systemic inflammatory markers following 6wk of supplementation alone (Phase 1), and the subsequent addition of 12wk exercise training (Phase 2) in healthy older men, in comparison to a carbohydrate-based control (CON). Tumour necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) concentrations were progressively reduced (P-time<0.05) SUPP group. No change in TNF-α or IL-6 concentrations was observed in the CON group

Reexpansion pulmonary edema and pleural bleeding after suction drainage of pneumothorax

Przedstawiono przypadek 26-letniego chorego z dużą samoistną lewostronną odmą opłucnową, której objawy wystąpiły 5 dni przed przyjęciem do szpitala. Leczenie drenażem ssącym zostało powikłane narastającymi w ciągu pierwszych 24 godzin rozprężeniowym obrzękiem płuca (ROP) i krwawieniem do lewej jamy opłucnowej. W czasie przeprowadzonej torakotomii wykazano obecność wieloogniskowego sączenia krwi z powierzchni opłucnej. Zarówno związek czasowy, jak i charakter tego krwawienia mógł sugerować patomechanizm podobny do stwierdzanego w ROP. W wyniku zastosowanego leczenia objawowego w ciągu kolejnych dni uzyskano poprawę stanu chorego i regresję zmian radiologicznych. Wśród czynników ryzyka ROP wymienia się młody wiek, wielkość odmy i utrzymywanie się jej ponad 3 dni, jak w prezentowanym przypadku. W celu obniżenia tego ryzyka proponuje się wolniejsze rozprężanie płuca, bez użycia lub ze zmniejszonym ciśnieniem drenażu ssącego w początkowej fazie leczenia. Pneumonol. Alergol. Pol. 2011; 79, 2: 127-131We present a case of 26 years old man with large spontaneous pneumothorax of about 5 days duration. Application of suction drainage was complicated by unilateral reexpansion pulmonary edema (REPE) and hemothorax developed during first 24 hours of treatment. On thoracotomy multifocal superficial pleural bleeding was seen which was probably attributed to the pathomechanisms similar to suggested in reexpansion pulmonary edema. The patient received supplemental oxygen therapy and completely recovered during next few days. The patient presented typical risk factors of REPE including: young age, large and prolonged pneumothorax. In such cases chest tube should be initially left off suction to prevent REPE. Pneumonol. Alergol. Pol. 2011; 79, 2: 127-13

One week of bed rest leads to substantial muscle atrophy and induces whole-body insulin resistance in the absence of skeletal muscle lipid accumulation

Short ( < 10 days) periods of muscle disuse, often necessary for recovery from illness or injury, lead to various negative health consequences. The current study investigated mechanisms underlying disuse-induced insulin resistance, taking into account muscle atrophy. Ten healthy, young males (age: 23 ± 1 years; BMI: 23.0 ± 0.9 kg · m−2) were subjected to 1 week of strict bed rest. Prior to and after bed rest, lean body mass (dual-energy X-ray absorptiometry) and quadriceps cross-sectional area (CSA; computed tomography) were assessed, and peak oxygen uptake (VO2peak) and leg strength were determined. Whole-body insulin sensitivity was measured using a hyperinsulinemic-euglycemic clamp. Additionally, muscle biopsies were collected to assess muscle lipid (fraction) content and various markers of mitochondrial and vascular content. Bed rest resulted in 1.4 ± 0.2 kg lean tissue loss and a 3.2 ± 0.9% decline in quadriceps CSA (both P < 0.01). VO2peak and one-repetition maximum declined by 6.4 ± 2.3 (P < 0.05) and 6.9 ± 1.4% (P < 0.01), respectively. Bed rest induced a 29 ± 5% decrease in whole-body insulin sensitivity (P < 0.01). This was accompanied by a decline in muscle oxidative capacity, without alterations in skeletal muscle lipid content or saturation level, markers of oxidative stress, or capillary density. In conclusion, 1 week of bed rest substantially reduces skeletal muscle mass and lowers whole-body insulin sensitivity, without affecting mechanisms implicated in high-fat diet–induced insulin resistance

A Multi-Ingredient Nutritional Supplement in Combination With Resistance Exercise and High-Intensity Interval Training Improves Cognitive Function and Increases N-3 Index in Healthy Older Men: A Randomized Controlled Trial

We aimed to evaluate the effect of multi-ingredient nutritional supplementation, with and without exercise training, on cognitive function in healthy older men. Forty-nine sedentary men [age: 73 ± 6 years (mean ± SD); body mass index: 28.5 ± 3.6 kg/m2] were randomized to consume a supplement (SUPP n = 25; 1500 mg n-3 polyunsaturated fatty acids, 30 g whey protein, 2.5 g creatine, 500 IU vitamin D, and 400 mg calcium) or control beverage (CON n = 24; 22 g maltodextrin) twice daily for 20 weeks consisting of Phase 1: SUPP/CON followed by Phase 2: 12-week resistance exercise training plus high-intensity interval training, while continuing to consume the study beverages (SUPP/CON + EX). At baseline, 6 weeks, and 19 weeks we assessed cognitive function [Montréal Cognitive Assessment (MOCA)], memory [word recall during the Rey Auditory Verbal Learning Test (RAVLT)], executive functions (working memory inhibition control), and nutrient bioavailability. We did not observe changes to any aspect of cognitive function after Phase 1; however, significant improvements in the following cognitive function outcomes were detected following Phase 2: MOCA scores increased (6 weeks: 23.5 ± 3.3 vs. 19 weeks: 24.4 ± 2.5, p = 0.013); number of words recalled during the RAVLT increased (6 weeks: 6.6 ± 3.6 vs. 19 weeks: 7.6 ± 3.8, p = 0.047); and reaction time improved (6 weeks: 567 ± 49 ms vs. 19 weeks: 551 ± 51 ms, p = 0.002). Although between-group differences in these outcomes were not significant, we observed within-group improvements in composite cognitive function scores over the course of the entire study only in the SUPP group (Δ = 0.58 ± 0.62, p = 0.004) but not in the CON group (Δ = 0.31 ± 0.61, p = 0.06). We observed a progressive increase in n-3 index, and a concomitant decrease in the ratio of arachidonic acid (ARA) to eicosapentaenoic acid (EPA) within erythrocyte plasma membranes, in the SUPP group only. At week 19, n-3 index (r = 0.49, p = 0.02) and the ARA:EPA ratio (r = -0.44, p = 0.03) were significantly correlated with composite cognitive function scores. Our results show that 12 weeks of RET + HIIT resulted in improved MOCA scores, word recall, and reaction time during an executive functions task; and suggest that a multi-ingredient supplement combined with this exercise training program may improve composite cognitive function scores in older men possibly via supplementation-mediated alterations to n-3 PUFA bioavailability

A bibliometric study of the literature on technological innovation: an analysis of 60 international academic journals

This paper aims to contribute to the debate on technological innovation, organization and work. Although technological innovation remained a debated topic in the academic literature during the past years, its implications for organizational processes seem still not sufficiently theorized and empirically investigated. By using two complementary journals’ rankings a search in the ISI Web of Science platform from 1985 through 2013 was performed. To analyze the 998 scientific retrieved contributions a bibliometric analysis has been conducted, adopting also Social Network Analysis tools. Our results reveal a significant growth of the technological innovation literature over the investigated period, the multidisciplinarity of the field and, particularly, the relevance of management and business & economics contributions. Overall, this study offers a broad overview of the literature on technological innovation and emphasizes the opportunity to investigate the role of technological innovation within the organizational life.This paper aims to contribute to the debate on technological innovation, organization and work. Although technological innovation remained a debated topic in the academic literature during the past years, its implications for organizational processes seem still not sufficiently theorized and empirically investigated. By using two complementary journals’ rankings a search in the ISI Web of Science platform from 1985 through 2013 was performed. To analyze the 998 scientific retrieved contributions a bibliometric analysis has been conducted, adopting also Social Network Analysis tools. Our results reveal a significant growth of the technological innovation literature over the investigated period, the multidisciplinarity of the field and, particularly, the relevance of management and business & economics contributions. Overall, this study offers a broad overview of the literature on technological innovation and emphasizes the opportunity to investigate the role of technological innovation within the organizational life.Monograph's chapter

Increased FAT/CD36 Cycling and Lipid Accumulation in Myotubes Derived from Obese Type 2 Diabetic Patients

BACKGROUND: Permanent fatty acid translocase (FAT/)CD36 relocation has previously been shown to be related to abnormal lipid accumulation in the skeletal muscle of type 2 diabetic patients, however mechanisms responsible for the regulation of FAT/CD36 expression and localization are not well characterized in human skeletal muscle. METHODOLOGY/PRINCIPAL FINDINGS: Primary muscle cells derived from obese type 2 diabetic patients (OBT2D) and from healthy subjects (Control) were used to examine the regulation of FAT/CD36. We showed that compared to Control myotubes, FAT/CD36 was continuously cycling between intracellular compartments and the cell surface in OBT2D myotubes, independently of lipid raft association, leading to increased cell surface FAT/CD36 localization and lipid accumulation. Moreover, we showed that FAT/CD36 cycling and lipid accumulation were specific to myotubes and were not observed in reserve cells. However, in Control myotubes, the induction of FAT/CD36 membrane translocation by the activation of (AMP)-activated protein kinase (AMPK) pathway did not increase lipid accumulation. This result can be explained by the fact that pharmacological activation of AMPK leads to increased mitochondrial beta-oxidation in Control cells. CONCLUSION/SIGNIFICANCE: Lipid accumulation in myotubes derived from obese type 2 diabetic patients arises from abnormal FAT/CD36 cycling while lipid accumulation in Control cells results from an equilibrium between lipid uptake and oxidation. As such, inhibiting FAT/CD36 cycling in the skeletal muscle of obese type 2 diabetic patients should be sufficient to diminish lipid accumulation

Enhanced Sarcolemmal FAT/CD36 Content and Triacylglycerol Storage in Cardiac Myocytes From Obese Zucker Rats

International audienc