Role of primary surgery in advanced ovarian cancer

BACKGROUND: Major issues in surgery for advanced ovarian cancer remain unresolved. Existing treatment guidelines are supported by a few published reports and fewer prospective randomized clinical trials. METHODS: We reviewed published reports on primary surgical treatment, surgical expertise, inadequate primary surgery/quality assurance, neoadjuvant chemotherapy, interval debulking, and surgical prognostic factors in advanced ovarian cancer to help resolve outstanding issues. RESULTS: The aim of primary surgery is a well-planned and complete intervention with optimal staging and surgery. Surgical debulking is worthwhile as there are further effective treatments available to control unresectable residual disease. Patients of gynecologic oncology specialist surgeons have better survival rates. This may reflect a working 'culture' rather than better technical skills. One major problem though, is that despite pleas to restrict surgery to experienced surgeons, specialist centers are often left to cope with the results of inadequate primary surgical resections. Patients with primary chemotherapy or those who have had suboptimal debulking may benefit from interval debulking. A proposal for a better classification of residual tumor is given. CONCLUSIONS: Optimal surgical interventions have definite role to play in advanced ovarian cancers. Improvements in surgical treatment in the general population will probably improve patients' survival when coupled with improvements in current chemotherapeutic approaches

Recoverable deformation and morphology after uniaxial elongation of a polystyrene/linear low density polyethylene blend

The transient recoverable deformation ratio after melt elongation at various elongational rates and maximum elongations was investigated for pure polystyrene and for a 85 wt.% polystyrene/15 wt.% linear low density polyethylene (PS/LLDPE 85:15) blend at a temperature of 170 oC. The ratio p of the zero shear rate viscosity of LLDPE to that of PS is p = 0.059 ≈ 1:17. Retraction of the elongated LLDPE droplets back to spheres and end-pinching is observed during recovery. A simple additive rule is applied in order to extract the contribution of the recovery of the elongated droplets from the total recovery of the blend. In that way, the recoverable portion of the PS/LLDPE blend induced by the interfacial tension is determined and compared with the results of a theory based on an effective medium approximation. The effective medium approximation reproduces well the time scale of the experimental data. In addition, the trends that the recoverable deformation increases with elongational rate and maximum elongation are captured by the theoretical approac

Rheological Measurements and Structural Analysis of Polymeric Materials

Rheological measurements of polymer melts are widely used for quality control and the optimization of processing. Another interesting field of rheology is to provide information about molecular parameters of polymers and the structure build-up in heterogeneous polymeric systems. This paper gives an overview of the influence of molar mass, molar mass distribution and long-chain branching on various rheological characteristics and describes the analytical power following from established relations. With respect to applications, we discuss how rheological measurements can be used to gain insight into the thermal stability of a material. A special impact lies in the demonstration, how long-chain branching can be analyzed using rheological means like the zero-shear viscosity as a function of molar mass and strain hardening occurring in elongation. For contributions to branching analysis, the thermorheological behavior and activation energies are particularly discussed. The use of elastic quantities in the case of mechanical pretreatment effects is briefly addressed. The influence of fillers on recoverable properties in the linear range of deformation is analyzed and the role of their specific surface area for interactions described. It is shown how the fundamental results can be applied to study the state of nanoparticle dispersions obtained under special conditions. Furthermore, it is demonstrated that the findings on polymer/filler systems are the base of structure analyses in heterogeneous polymeric materials like polyvinylchloride (PVC) and acrylonitrile–butadiene–styrene copolymers (ABS)

Apitherapy: Usage And Experience In German Beekeepers

This study aimed to investigate the practice of apitherapy - using bee products such as honey, pollen, propolis, royal jelly and bee venom to prevent or treat illness and promote healing - among German beekeepers and to evaluate their experiences with these therapies. A questionnaire incorporating two instruments on beekeepers’ physical and mental health and working practice was included in three German beekeeping journals and readers were asked to complete it. The instrument included questions on the use of apitherapy. Simple descriptive methods, bivariate correlation, cross-tabulation and one-way ANOVA were used to analyze the data. Altogether 1059 completed questionnaires were received. The beekeepers reported the most effective and favorable therapeutic effects with honey, followed by propolis, pollen and royal jelly. The factors associated with successful experiences were: age, number of hives tended, health consciousness, positive experiences with one product and self-administration of treatment. Beekeepers were asked for which condition they would employ propolis and pollen. They reported that they used propolis most frequently to treat colds, wounds and burns, sore throats, gum disorders and also as a general prophylactic, while pollen was most commonly used as a general prophylactic and, less frequently, in treating prostate diseases. No adverse experiences were reported. The potential benefit of bee products is supported by the positive experiences of a large group of beekeepers who use some of these products to treat a wide range of conditions. The indications and treatments given here may be important in selecting bee products and designing future trials

Complementary and Alternative Medicine: Comparison of Current Knowledge, Attitudes and Interest among German Medical Students and Doctors

Although it has been agreed that complementary and alternative medicine (CAM) should be included in the German medical curriculum, there is no consensus on which methods and how it should be taught. This study aimed to assess needs for CAM education by evaluating current knowledge, attitudes and interests of medical students, general physicians and gynecologists. Two instruments based on established and validated questionnaires were developed. One was given to seventh semester medical students and the other to office-based doctors. Data were analyzed by bivariate correlation and cross-tabulation. Altogether 550 questionnaires were distributed—280 to doctors and 270 to medical students. Completed questionnaires were returned by 80.4% of students and 78.2% of doctors. Although 73.8% (160/219) of doctors and 40% (87/217) of students had already informed themselves about CAM, neither group felt that they knew much about CAM. Doctors believed that CAM was most useful in general medicine, supportive oncology, pediatrics, dermatology and gynecology, while students believed that dermatology, general medicine, psychiatry and rheumatology offered opportunities; both recommended that CAM should be taught in these areas. Both groups believed that CAM should be included in medical education; however, they believed that CAM needed more investigation and should be taught “critically". German doctors and students would like to be better informed about CAM. An approach which teaches fundamental competences to students, chooses specific content based on evidence, demographics and medical conditions and provides students with the skills they need for future learning should be adopted

Mesures de champ dans des écoulements complexes pour l'identification du comportement d'un polyéthylène basse densité

http://hdl.handle.net/2042/16620International audienceIn this study, we present preliminary experimental results for the evaluation and identification of constitutive equations for viscoelastic polymer melts using flow field measurements such as Laser-Doppler velocimetry and flow-induced birefringence. We focus on the influence of temperature and flow rate on the vortex size of a secondary flow of a low density polyethylene which strongly depends on balance between shear and extensional rheological properties of the material. Further work will show that this method, coupled with numerical simulations, can be applied to identify non-linear parameters of a Pom-pom like constitutive equation by using an inverse analysis procedure = On présente les premiers résultats d'une étude dont le contexte est l'évaluation et l'identification de lois de comportement par l'utilisation de méthodes de mesures de champ telles que la vélocimétrie Laser-Doppler et la biréfringence d'écoulement. On s'intéresse à l'influence de la température et du débit sur la taille de recirculations dans l'écoulement d'un polyéthylène basse densité. La taille de ces recirculations est fortement dépendante des propriétés mécaniques relatives du matériau en cisaillement et élongation. Ces mesures seront utilisées pour l'identification d'un modèle de type pom-pom par une méthode d'identification inverse

Silver ion release from antimicrobial polyamide/silver composites

Silver ion (Ag+) the versatile antimicrobial species was released in a steady and prolonged manner from a silver-filled polyamide composite system. Metallic silver powder having varying specific surface area (SSA) has been used as a resource of biocide in polyamide. Strong evidences are found showing the release of the antimicrobial species from the resulting composite upon soaking it in water due to the interaction of the diffused water molecules with the dispersed silver powder within the matrix. The Ag+ release was observed as increasing with time and concentration of the silver powder and is found to be influenced by the SSA of the silver powder, changes in the physical state of the composite specimen as a result of the water diffusion and the composite morphology. It is observed that the Ag+ release increases initially which is followed by a marginal increase between day 4 and 6. Composites containing higher amounts of silver (4 and 8 wt%) exhibit a further rise in Ag+ release from the sixth day of storage in water. Composite containing silver particles with the lowest specific surface area (0.78m2/g) showed highest Ag+ release. SEM shows a finer dispersion of the silver powder (4 wt%) having lowest SSA. However particles with higher (1.16 and 2.5m2/g) SSA possess an agglomerated morphology leading to lower Ag+ release. The composites are found to release Ag+ at a concentration level capable of rendering an antimicrobial efficac

Benzyldialkylphosphinimide : 6. Mitt. über Sila-Riechstoffe und Riechstoff-Isostere

Die Titelverbindungen (E) C6H5CH2-PRR' = NH (R,R = Methyl, Ethyl) wurden entsprechend der in den Schemata 2 und 3 aufgezeigten Wege mit guten Ausbeuten dargestellt und in ihrer Struktur durch Elementaranalysen, lH- und 31P-NMR-, Massen- und IR-Spektren abgesichert. Sie lassen sich unter vermindertem Druck nicht destillieren, sondern zersetzen sich bereits ab l00°C thermisch unter Stilbenbildung. Von Deuterochloroform werden sie in C6H5CH2-PRR' = ND übergeführt. Diese Reaktionen lassen auf Umlagerungen C6H5CH2-PRR' = NH C6H5CH = PRR'-NH2 schließen. Die Verbindungen E riechen nach chlorierten Kohlenwasserstoffen mit metallischer Beinote und somit völlig anders als die isosteren Silanole C6H5CH2-SiRR'-OH mit ihrer intensiv blumigen Note. Diese Beobachtungen stehen im Gegensatz zu der Geruchstheorie von AMOORE, wonach Größe und Gestalt eines Duftstoffmoleküls für deren Geruchsqualität bestimmend sind.The title compounds (E) C6H5CH2-PRR' = NH (R, R = methyl, ethyl) were prepared according to schemes 2 and 3 and confirmed in their structure by elemental analysis, lH and 31P NMR, mass and infrared spectra. They are not distillable and decompose at temperatures higher than l00°C forming stilbene, and they are transformed by deuterochloroform into C6H5CD2-PRR' = ND. The reactions point to rearrangements C6H5CH2-PRR' = NR C6H5CH = PRR'-NH2. The compounds E have the odour of chlorinated hydrocarbons with a metallic side note and quite a different quality of smell in comparison with the isosteric silanols C6H5CH2-SiRR'-OH with their flowery note of high intensity. The observations are contrary to the theory of AMOORE ("Size and shape of molecules rule their smell qualities")

Cancer of the endometrium: current aspects of diagnostics and treatment

BACKGROUND: Endometrial cancer represents a tumor entity with a great variation in its incidence throughout the world (range 1 to 25). This suggests enormous possibilities of cancer prevention due to the fact that the incidence is very much endocrine-related, chiefly with obesity, and thus most frequent in the developed world. As far as treatment is concerned, it is generally accepted that surgery represents the first choice of treatment. However, several recommendations seem reasonable especially with lymphadenectomy, even though they are not based on evidence. All high-risk cases are generally recommended for radiotherapy. METHODS: A literature search of the Medline was carried out for all articles on endometrial carcinoma related to diagnosis and treatment. The articles were systematically reviewed and were categorized into incidence, etiology, precancerosis, early diagnosis, classification, staging, prevention, and treatment. The article is organized into several similar subheadings. CONCLUSIONS: In spite of the overall good prognosis during the early stages of the disease, the survival is poor in advanced stages or recurrences. Diagnostic measures are very well able to detect asymptomatic recurrences. These only seem justified if patients' chances are likely to improve, otherwise such measures increases costs as well as decrease the patients' quality of life. To date neither current nor improved concepts of endocrine treatment or chemotherapy have been able to substantially increase patients' chances of survival. Therefore, newer concepts into the use of antibodies e.g. trastuzumab in HER2-overexpressing tumors and the newer endocrine compounds will need to be investigated. Furthermore, it would seem highly desirable if future studies were to identify valid criteria for an individualized management, thereby maximizing the benefits and minimizing the risks