Laparoscopic ileocolic resection versus infliximab treatment of distal ileitis in Crohn's disease: a randomized multicenter trial (LIR!C-trial)

Contains fulltext : 69534.pdf (publisher's version ) (Open Access)BACKGROUND: With the availability of infliximab, nowadays recurrent Crohn's disease, defined as disease refractory to immunomodulatory agents that has been treated with steroids, is generally treated with infliximab. Infliximab is an effective but expensive treatment and once started it is unclear when therapy can be discontinued. Surgical resection has been the golden standard in recurrent Crohn's disease. Laparoscopic ileocolic resection proved to be safe and is characterized by a quick symptom reduction.The objective of this study is to compare infliximab treatment with laparoscopic ileocolic resection in patients with recurrent Crohn's disease of the distal ileum with respect to quality of life and costs. METHODS/DESIGN: The study is designed as a multicenter randomized clinical trial including patients with Crohn's disease located in the terminal ileum that require infliximab treatment following recent consensus statements on inflammatory bowel disease treatment: moderate to severe disease activity in patients that fail to respond to steroid therapy or immunomodulatory therapy. Patients will be randomized to receive either infliximab or undergo a laparoscopic ileocolic resection. Primary outcomes are quality of life and costs. Secondary outcomes are hospital stay, early and late morbidity, sick leave and surgical recurrence. In order to detect an effect size of 0.5 on the Inflammatory Bowel Disease Questionnaire at a 5% two sided significance level with a power of 80%, a sample size of 65 patients per treatment group can be calculated. An economic evaluation will be performed by assessing the marginal direct medical, non-medical and time costs and the costs per Quality Adjusted Life Year (QALY) will be calculated. For both treatment strategies a cost-utility ratio will be calculated. Patients will be included from December 2007. DISCUSSION: The LIR!C-trial is a randomized multicenter trial that will provide evidence whether infliximab treatment or surgery is the best treatment for recurrent distal ileitis in Crohn's disease. TRIAL REGISTRATION: Nederlands Trial Register NTR1150

High-performance solution-processed polymer ferroelectric field-effect transistors

We demonstrate a rewritable, non-volatile memory device with flexible plastic active layers deposited from solution. The memory device is a ferroelectric field-effect transistor (FeFET) made with a ferroelectric fluoropolymer and a bisalkoxy-substituted poly(p-phenylene vinylene) semiconductor material. The on- and off-state drain currents differ by several orders of magnitude, and have a long retention time, a high programming cycle endurance and short programming time. The remanent semiconductor surface charge density in the on- state has a high value of 18 mC m(-2), which explains the large on/off ratio. Application of a moderate gate field raises the surface charge to 26 mC m(-2), which is of a magnitude that is very difficult to obtain with conventional FETs because they are limited by dielectric breakdown of the gate insulator. In this way, the present ferroelectric-semiconductor interface extends the attainable field-effect band bending in organic semiconductors.</p

An organic field-effect transistor with programmable polarity

Selective ambipolar transport in solution-processed polymer ferroelectric field-effect transistors (FeFETs) is reported. Depending on the polarization state of the ferroelectric, either remanent hole or electron accumulation is achieved in the transistor, as illustrated by a butterfly-shaped current-voltage (I-V) transfer curve (see Figure). For memory purposes, the polarity of the channel can be easily read using the change in drain current in response to a small gate voltage

High-performance solution-processed polymer ferroelectric field-effect transistors

We demonstrate a rewritable, non-volatile memory device with flexible plastic active layers deposited from solution. The memory device is a ferroelectric field-effect transistor (FeFET) made with a ferroelectric fluoropolymer and a bisalkoxy-substituted poly(p-phenylene vinylene) semiconductor material. The on- and off-state drain currents differ by several orders of magnitude, and have a long retention time, a high programming cycle endurance and short programming time. The remanent semiconductor surface charge density in the on- state has a high value of 18 mC m(-2), which explains the large on/off ratio. Application of a moderate gate field raises the surface charge to 26 mC m(-2), which is of a magnitude that is very difficult to obtain with conventional FETs because they are limited by dielectric breakdown of the gate insulator. In this way, the present ferroelectric-semiconductor interface extends the attainable field-effect band bending in organic semiconductors

Dioxin levels in imported dairy products

De resultaten worden beschreven van een studie naar de gehalten van PCDD's en PCDF's in geimporteerde zuivelproducten. In november 1995 zijn door de Regionale Inspecties Gezondheidsbescherming monsters geimporteerde melk en kaas verzameld van verschillende producenten in Duitsland, Belgie en Frankrijk. De monstername werd uitgevoerd bij belangrijke importeurs van Franse kaas en supermarkten met een groot marktaandeel, gesitueerd in verschillende regio's verspreid over Nederland. Uit de ingezamelde melkmonsters werden zestien tijdgemiddelde mengmonsters samengesteld van melk geproduceerd door fabrieken gelegen in diverse regio's in Duitsland en Belgie. Daarnaast werd in het analyseprogramma een monster Franse schapenkaas opgenomen, alsmede een drietal mengmonsters van verschillende typen Franse kaas geproduceerd op basis van koemelk. De chemische analyse omvatte de bepaling van de zeventien 2,3,7,8-chloorgesubstitueerde PCDD- en PCDF-congeneren in de vette fractie van de monsters. Uit de congeneer-specifieke gegevens is een dioxinegehalte uitgedrukt in toxische equivalenten van 2,3,7,8-TCDD (TEQ's) afgeleid, waarbij gebruik is gemaakt van de Internationale Toxiciteits Equivalentie Factoren (i-TEF's). In alle onderzochte monsters werden dioxinegehalten aangetoond die ruim beneden de warenwetnorm van 6 pg (i)-TEQ/g vet liggen. De dioxinegehalten in melk geimporteerd uit Duitsland liepen uiteen van 0.3 tot 1.2 pg (i)-TEQ/g melkvet. De gehalten in de Belgische melkmonsters varieerden van 1.4 tot 2.7 pg (i)-TEQ/g vet, en de gehalten in de Franse kazen lagen tussen 0.5 en 1.2 pg (i)-TEQ/g vet. Als de waargenomen gehalten worden vergeleken met eerder gerapporteerde gegevens over consumptiemelk verzameld in Nederland in de periode 1992-1993, waarin de dioxinegehalten varieerden van 0.9-2.1 pg (i)-TEQ/g vet (Liem et al., 1996), suggereren de meetgegevens lagere gehalten in Duitse en hogere gehalten in Belgische melk. De representativiteit van de onderzochte monsters kent echter enige restricties. Op grond hiervan kan daarom niet worden beoordeeld in hoeverre de verschillen statistische betekenis hebben. De verschillen zijn echter gering. Daarom bestaat er op grond van de gegevens voortvloeiend uit dit onderzoek geen aanleiding om nader onderzoek uit te voeren.Results are presented from a study on the occurrence of PCDDs and PCDFs in imported dairy products. In November 1995, samples of consumer milk and cheese imported from different producers in Germany, Belgium and France have been collected by Regional Inspectorates for Health Protection at major importers and supermarkets in various regions distributed over the Netherlands. Milk samples have been aggregated into sixteen pooled samples of milk representing time-averaged samples originating from different producers located in various regions in Germany and Belgium. In addition, one sample of French sheep cheese and three composites of different types of French cheese based on cows milk have been included in the analytical programme. Chemical analyses included determinations of the 2,3,7,8-chlorine substituted PCDD and PCDF congeners in the lipid fraction of the samples. From the congener-specific data, a dioxin concentration expressed in toxic equivalents of 2,3,7,8-TCDD (TEQs) has been derived by use of the International Toxic Equivalency Factors (i-TEFs). For all samples investigated, measured dioxin levels were well below the Dutch standard of 6 pg (i)- TEQ/g fat. The study revealed dioxin levels in imported consumer milk from Germany, varying between 0.3 and 1.2 pg (i)-TEQ/g fat. Dioxin levels in milk samples from Belgium ranged between 1.4 and 2.7 pg (i)-TEQ/g fat, and dioxins in French cheese were found at levels between 0.5 and 1.2 pg (i)-TEQ/g fat. If the observed levels are compared with earlier reported levels in consumer milk collected in the Netherlands in the period 1992-1993 of 0.9-2.1 pg (i)-TEQ/g fat (Liem et al., 1996), this study suggests lower levels in imported milk from Germany and higher levels in imported milk from Belgium. Some restrictions should, however, be taken into account concerning the representativity of the investigated samples. As a consequence, the statistical significance of the observed differences can not be assessed. However, the differences are small. Hence, there is no reason to conduct supplementary studies.IG

What causes aberrant salience in schizophrenia? A role for impaired short-term habituation and the GRIA1 (GluA1) AMPA receptor subunit

The GRIA1 locus, encoding the GluA1 (also known as GluRA or GluR1) AMPA glutamate receptor subunit, shows genome-wide association to schizophrenia. As well as extending the evidence that glutamatergic abnormalities have a key role in the disorder, this finding draws attention to the behavioural phenotype of Gria1 knockout mice. These mice show deficits in short-term habituation. Importantly, under some conditions the attention being paid to a recently presented neutral stimulus can actually increase rather than decrease (sensitization). We propose that this mouse phenotype represents a cause of aberrant salience and, in turn, that aberrant salience (and the resulting positive symptoms) in schizophrenia may arise, at least in part, from a glutamatergic genetic predisposition and a deficit in short-term habituation. This proposal links an established risk gene with a psychological process central to psychosis and is supported by findings of comparable deficits in short-term habituation in mice lacking the NMDAR receptor subunit Grin2a (which also shows association to schizophrenia). As aberrant salience is primarily a dopaminergic phenomenon, the model supports the view that the dopaminergic abnormalities can be downstream of a glutamatergic aetiology. Finally, we suggest that, as illustrated here, the real value of genetically modified mice is not as ‘models of schizophrenia’ but as experimental tools that can link genomic discoveries with psychological processes and help elucidate the underlying neural mechanisms