Low Dose Cytosine Arabinoside Regimen for Overt Leukemia, Hypoplastic Leukemia and Myelodysplastic Syndromes : Hypoplastic Leukemia Responds Best.

In a series of 38 patients consisting of 13 with overt acute leukemia, 14 with hypoplastic leukemia, and 11 with myelodysplastic asyndromes (MDS), responsiveness to low dose cytosine arabinoside (LDAC) regimen was investigated to clarify the disease type most benefitted. LDAC was continuously administered intravenously at dose 0.2mg/kg/day and continued as long as possible to meet the pre-assigned target point of 5% marrow blasts which was confirmed by weekly marrow aspiration. Overall response rate was 47%; complete remission (CR) being 31% and partial remission (PR) 16%. CR rate was significantly different between the disease types ; 69% in hypoplastic leukemia, 23% in overt leukemia and 0% in MDS (p=0.01). In hypoplastic leukemia the survival time was significantly longer in the LDAC-treated cases compared with 15 historical control cases treated with supportive care only ; median survial being 750 days in the former and 250 days in the latter (p=0.01). In overt leukemia only three M2 AML cases obtained CR ; two of them were treated during hypoplastic phase induced by intensive chemotherapy. All CR cases eventually achieved the target point after 20 to 42 days (median 26) of LDAC administration. Substantial toxicity of LDAC was evident, but most cases tolerated well. The present investigation suggests that hypoplastic leukemia is the disease type most sensitive to LDAC regimen. Stratification of the elderly leukemia patients should be considered for this regimen

CO2 Capture Test for A Moving-bed System Utilizi g Low-temperature Steam

AbstractIn the process of capturing CO2 from flue gas (combustion exhaust gas), the lowering of CO2 capture energy is considered a significant issue. If some or all of the CO2 capture energy can be compensated with the waste heat, a significant energy saving is possible. In our proposed CO2 adsorption process, because the CO2 is captured using low-temperature steam, an energy-s ving process that makes it is easy to utilize the waste heat can be created. In this paper, we conduct bench tests aimed at developing a mo ing-bed system suitable for large-scale plants in order to verify the performance of the adsorbent. The results demonstrated that an moving-bed system could be established to capture 1.6t/day of CO2 from coal combustion exhaust gas

National trends in the outcomes of subarachnoid haemorrhage and the prognostic influence of stroke centre capability in Japan: retrospective cohort study

Objectives To examine the national, 6-year trends in in-hospital clinical outcomes of patients with subarachnoid haemorrhage (SAH) who underwent clipping or coiling and the prognostic influence of temporal trends in the Comprehensive Stroke Center (CSC) capabilities on patient outcomes in Japan.Design Retrospective study.Setting Six hundred and thirty-one primary care institutions in Japan.Participants Forty-five thousand and eleven patients with SAH who were urgently hospitalised, identified using the J-ASPECT Diagnosis Procedure Combination database.Primary and secondary outcome measures Annual number of patients with SAH who remained untreated, or who received clipping or coiling, in-hospital mortality and poor functional outcomes (modified Rankin Scale: 3–6) at discharge. Each CSC was assessed using a validated scoring system (CSC score: 1–25 points).Results In the overall cohort, in-hospital mortality decreased (year for trend, OR (95% CI): 0.97 (0.96 to 0.99)), while the proportion of poor functional outcomes remained unchanged (1.00 (0.98 to 1.02)). The proportion of patients who underwent clipping gradually decreased from 46.6% to 38.5%, while that of those who received coiling and those left untreated gradually increased from 16.9% to 22.6% and 35.4% to 38%, respectively. In-hospital mortality of coiled (0.94 (0.89 to 0.98)) and untreated (0.93 (0.90 to 0.96)) patients decreased, whereas that of clipped patients remained stable. CSC score improvement was associated with increased use of coiling (per 1-point increase, 1.14 (1.08 to 1.20)) but not with short-term patient outcomes regardless of treatment modality.Conclusions The 6-year trends indicated lower in-hospital mortality for patients with SAH (attributable to better outcomes), increased use of coiling and multidisciplinary care for untreated patients. Further increasing CSC capabilities may improve overall outcomes, mainly by increasing the use of coiling. Additional studies are necessary to determine the effect of confounders such as aneurysm complexity on outcomes of clipped patients in the modern endovascular era