208 research outputs found
Mist, Mood and Invisibility in Photography
Studium humanitní vzdělanosti - Kreativní modulLiberal Arts and Humanities - Creative ModuleFaculty of HumanitiesFakulta humanitních studi
Facijalni karcinom Merkelovih stanica: prikaz dvaju slučajeva i pregled literature
Merkel cell carcinoma is an aggressive tumor of the skin deriving from neuroendocrine cells with unpredictable clinical behavior and poor clinical outcome. Merkel cell carcinoma is relatively rare with some 600 cases reported, but seemingly with an increasing incidence due to the increased sun exposure and immunosuppression. There are increasing reports of Merkel cell carcinoma occurring in transplant patients receiving immunosuppressive therapy. We present two cases of Merkel cell carcinoma of the facial skin, one of them in a patient who received immunosuppressive therapy. According to the literature, standard therapy for Merkel cell carcinoma includes large scale surgical excision of the primary tumor, neck dissection for palpable nodes, and in most cases subsequent radiotherapy. This article also reviews some recent reports of Merkel cell carcinoma regarding the diagnosis, clinical course and therapeutic modalities.Karcinom Merkelovih stanica je agresivan tumor kože koji nastaje iz neuroendokrinih stanica i ima nepredvidivo kliničko ponašanje te lo. klinički ishod. Karcinom Merkelovih stanica je relativno rijedak, s nekih 600 objavljenih slučajeva, no čini se da mu incidencija raste zbog sve većeg izlaganja sunčevom zračenju i imunosupresiji. Sve je više izvješća o karcinomu Merkelovih stanica u bolesnika s transplantatima koji primaju imunosupresivne lijekove. Prikazujemo dva slučaja karcinoma Merkelovih stanica na koži lica, jedan od njih u bolesnice koja je primala imunosupresivne lijekove. Prema literaturi, standardna terapija kod karcinoma Merkelovih stanica sastoji se od opsežne kirurške ekscizije primarnog tumora, disekcije vrata zbog opipljivih čvorova i u većini slučajeva naknadne radioterapije. U ovom radu dajemo pregled novijih izvješća o karcinomu Merkelovih stanica u odnosu na dijagnostiku, klinički tijek i mogućnosti liječenja
Immediate tumor resection in patients with locally advanced gastroesophageal adenocarcinoma with nonresponse to chemotherapy after 4 weeks of treatment versus resection after completion of chemotherapy (OPTITREAT trial, DRKS00004668): study protocol for a randomized controlled pilot trial
Background: Neoadjuvant chemotherapy is a standard of care for patients with adenocarcinoma of the esophagus and stomach in Europe, but still only 20–40 % respond to therapy and the critical issue; how to treat nonresponding patients is still unclear. So far, there is no randomized trial evaluating the impact of early termination of neoadjuvant chemotherapy and immediate tumor resection in nonresponding patients with locally advanced gastroesophageal cancer on postoperative outcome. With this exploratory pilot trial, we want to get first estimates about the effect of discontinuation of chemotherapy with the aim to plan and conduct a further definitive trial. Methods/design: OPTITREAT is designed as a single-center, randomized controlled pilot trial with two parallel study groups. Four weeks after starting neoadjuvant chemotherapy in all patients, clinical response will be assessed by endoscopy and endosonographic ultrasound. Then, nonresponding patients (n = 84) will be randomized in a 1:1 ratio to intervention group with stopping chemotherapy and immediate tumor resection or control group with completion of chemotherapy before surgery. Outcome measures are overall survival, R0 resection rate, perioperative morbidity and mortality, histopathological response, and quality of life. Statistical analysis will be based on the intention-to-treat population. Due to the study design as an explorative pilot trial, no formal sample size calculation was performed. The planned total sample size of 120 patients is considered ethical and large enough to show the feasibility and safety of the concept. First data on differences between the study groups in the defined endpoints will also be generated. Discussion: Individualized therapy is of utmost interest in the treatment of locally advanced gastroesophageal adenocarcinoma as less than half of the patients show objective response to current chemotherapy regimens. The findings of the OPTITREAT trial will help to get first data about clinical response evaluation followed by immediate tumor resection in nonresponding patients after 4 weeks of neoadjuvant chemotherapy. Based on the results of this pilot study, a future confirmatory trial will be planned to prove efficacy and evaluate significance. Trial registration: German Clinical Trial Register number: DRKS0000466
Interventions for intermittent exotropia.
BACKGROUND: The clinical management of intermittent exotropia has been discussed frequently in the literature, but there is a lack of clarity regarding the indications for intervention, the most effective type and if there is a time point at which it should be carried out. OBJECTIVES: The objective of this review was to analyse the effects of various surgical and non-surgical treatments in randomised trials of people with intermittent exotropia, to report intervention criteria and determine the significance of factors such as age with respect to outcome. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials - CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) on The Cochrane Library (2006, Issue 1), MEDLINE (1966 to March 2006), EMBASE (1980 to March 2006) National Research Register (2006, Issue 1), PubMed (searched on 13 March 2006; last 90 days) and LILACS (Latin American and Caribbean Literature on Health Sciences) (1966 to 2002). We manually searched the British Orthoptic Journal, proceedings of the European Strabismological Association (ESA), International Strabismological Association (ISA) and American Academy of Paediatric Ophthalmology and Strabismus meeting (AAPOS). We contacted researchers who are active in the field for information about further published or unpublished studies. There were no language restrictions in the manual or electronic searches. SELECTION CRITERIA: We included randomised controlled trials of any surgical or non-surgical treatment for intermittent exotropia. DATA COLLECTION AND ANALYSIS: Each review author independently assessed study abstracts identified from the database and manual searches. Author analysis was then compared and full papers for appropriate studies were obtained. MAIN RESULTS: We found one randomised trial that was eligible for inclusion. This trial showed that unilateral surgery was more effective than bilateral surgery for correcting basic intermittent exotropia. AUTHORS' CONCLUSIONS: The available literature consists mainly of retrospective case reviews which are difficult to reliably interpret and analyse. The one randomised trial included found unilateral surgery more effective than bilateral for basic intermittent exotropia but there remains a need for more carefully planned clinical trials to be undertaken to improve the evidence base for the management of this condition
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Real-time spatial characterization of micrometer-sized X-ray free-electron laser beams focused by bendable mirrors
A real-time and accurate characterization of the X-ray beam size is essential to enable a large variety of different experiments at free-electron laser facilities. Typically, ablative imprints are employed to determine shape and size of μm-focused X-ray beams. The high accuracy of this state-of-the-art method comes at the expense of the time required to perform an ex-situ image analysis. In contrast, diffraction at a curved grating with suitably varying period and orientation forms a magnified image of the X-ray beam, which can be recorded by a 2D pixelated detector providing beam size and pointing jitter in real time. In this manuscript, we compare results obtained with both techniques, address their advantages and limitations, and demonstrate their excellent agreement. We present an extensive characterization of the FEL beam focused to ≈1 μm by two Kirkpatrick-Baez (KB) mirrors, along with optical metrology slope profiles demonstrating their exceptionally high quality. This work provides a systematic and comprehensive study of the accuracy provided by curved gratings in real-time imaging of X-ray beams at a free-electron laser facility. It is applied here to soft X-rays and can be extended to the hard X-ray range. Furthermore, curved gratings, in combination with a suitable detector, can provide spatial properties of μm-focused X-ray beams at MHz repetition rate
Ion emission from plasmas produced by femtosecond pulses of short-wavelength free-electron laser radiation focused on massive targets: an overview and comparison with long-wavelength laser ablation
Evolution of Multidrug Resistance during Staphylococcus aureus Infection Involves Mutation of the Essential Two Component Regulator WalKR
Antimicrobial resistance in Staphylococcus aureus is a major public health threat, compounded by emergence of strains with resistance to vancomycin and daptomycin, both last line antimicrobials. Here we have performed high throughput DNA sequencing and comparative genomics for five clinical pairs of vancomycin-susceptible (VSSA) and vancomycin-intermediate ST239 S. aureus (VISA); each pair isolated before and after vancomycin treatment failure. These comparisons revealed a frequent pattern of mutation among the VISA strains within the essential walKR two-component regulatory locus involved in control of cell wall metabolism. We then conducted bi-directional allelic exchange experiments in our clinical VSSA and VISA strains and showed that single nucleotide substitutions within either walK or walR lead to co-resistance to vancomycin and daptomycin, and caused the typical cell wall thickening observed in resistant clinical isolates. Ion Torrent genome sequencing confirmed no additional regulatory mutations had been introduced into either the walR or walK VISA mutants during the allelic exchange process. However, two potential compensatory mutations were detected within putative transport genes for the walK mutant. The minimal genetic changes in either walK or walR also attenuated virulence, reduced biofilm formation, and led to consistent transcriptional changes that suggest an important role for this regulator in control of central metabolism. This study highlights the dramatic impacts of single mutations that arise during persistent S. aureus infections and demonstrates the role played by walKR to increase drug resistance, control metabolism and alter the virulence potential of this pathogen
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