Partial nephrectomy for T1 renal cancer can achieve an equivalent oncological outcome to radical nephrectomy with better renal preservation: the way to go

INTRODUCTION: Patients who undergo partial nephrectomy have been shown to be at decreased risk of renal impairment compared with radical nephrectomy. We examined the oncological outcome of patients in our centre who underwent partial or radical nephrectomy for T1 renal cancer (7 cm or smaller), and compared the likelihood of developing chronic kidney disease. METHODS: This historical cohort study with internal comparison was conducted in a tertiary hospital in Hong Kong. A cohort of 86 patients with solitary T1 renal cancer and a normal contralateral kidney who underwent radical (38 patients) or partial (48 patients) nephrectomy between January 2005 and December 2010 was included. The overall and cancer-free survival, change in glomerular filtration rate, and new onset of chronic kidney disease were compared between the radical and partial nephrectomy groups. RESULTS: A total of 32 (84%) radical nephrectomy patients and 43 (90%) partial nephrectomy patients were alive by 31 December 2012. The mean follow-up was 43.5 (standard deviation, 22.4) months. There was no significant difference in overall survival (P=0.29) or cancer-free survival (P=0.29) between the two groups. Both groups enjoyed good oncological outcome with no recurrence in the partial nephrectomy group. Overall, 18 (21%) patients had pre-existing chronic kidney disease. The partial nephrectomy group had a significantly smaller median reduction in glomerular filtration rate (12.6% vs 35.4%; P<0.001), and radical nephrectomy carried a significantly higher risk of developing chronic kidney disease (hazard ratio=5.44; 95% confidence interval, 1.26-23.55; P=0.02). CONCLUSIONS: Compared with radical nephrectomy, partial nephrectomy can prevent chronic kidney disease and still achieve an excellent oncological outcome for T1 renal tumours, in particular T1a tumours and tumours with a low R.E.N.A.L. score.published_or_final_versio

Tenofovir disoproxil fumarate for the treatment of chronic hepatitis B monoinfection

Introduction: Resistance in nucleoside/nucleotide analog (NA) therapy has always been a challenge in the management of chronic hepatitis B (CHB). Clinical studies: Initially developed for the treatment of HIV infection, early in vitro and clinical observational studies had shown tenofovir disoproxil fumarate (TDF) to be also active against CHB. Recent data from various multicenter phase 3 and 4 clinical trials have confirmed TDF being able to achieve a high viral suppression in both NA-naive and -experienced CHB patients. There are also emerging data on the efficacy of TDF in decompensated CHB. Although there are in vitro studies identifying certain mutation loci associated with a reduced susceptibility to TDF, there have so far been no reports of virologic resistance to TDF in clinical studies. TDF has a favorable safety profile, although more long-term data would be needed. Conclusions: TDF has the makings of an 'ideal' first-line drug for the treatment of CHB. © 2011 Asian Pacific Association for the Study of the Liver.postprin

Message from general co-chairs and program co-chairs

published_or_final_versionThe 4th International Joint Conference on Computational Sciences and Optimization (CSO 2011) Kunming and Lijiang, Yunnan Province, China, April 15-19, 2011. In Proceedings of the Computational Sciences and Optimization, 2011, p. 28-30

Intelligent integration of BIPV and load management systems for modern buildings

This paper outlines the basics of load management, and highlights the possibility of maximising the contribution from the Building Integrated Photovoltaic (BIPV) power generation. It will also explain the underlying principles of a dynamic modelling approach and its application in supporting the anticipatory control strategy for load shifting. For many types of building applications, the load profiles are well matched with the BIPV generation profiles such that the BIPV power source is already acting as the peak clipping device. The application of Building Management Systems (BMS) in load shifting should consider the supply from BIPV system. Secondly, due to the thermal mass of the building, there exists time delay in the response of the power requirement of the HVAC system in the building from the solar radiation data. The BIPV system, on the contrary, is responding almost instantaneously to the solar irradiance. A dynamic BIPV model could be applied in aiding the prediction of the load profile. This paper will outline these aspects of the BIPV system as a demonstration of its application in BMS.postprintThe 8th Annual Power Symposium, Hong Kong, 19 June 2009

Integration of BIPV systems and load management

This paper outlines the basics of load management, and highlights the possibility of maximising the contribution from the Building Integrated Photovoltaic (BIPV) power generation. It will also explain the underlying principles of a dynamic modelling approach and its application in supporting the anticipatory control strategy for load shifting. For many types of building applications, the load profiles are well matched with the BIPV generation profiles such that the BIPV power source is already acting as the peak clipping device. The application of Building Management Systems (BMS) in load shifting should consider the supply from BIPV system. Secondly, due to the thermal mass of the building, there exists time delay in the response of the power requirement of the HVAC system in the building from the solar radiation data. The BIPV system, on the contrary, is responding almost instantaneously to the solar irradiance. A dynamic BIPV model could be applied in aiding the prediction of the load profile. This paper will outline these aspects of the dynamic model developed as a demonstration of its application.postprintThe International Conference on Electrical Engineering 2009

Future prevention and treatment of chronic hepatitis B infection

Vaccination for hepatitis B virus (HBV) infection and treatment for chronic hepatitis B, while effective for primary prevention and control of the disease, still have their limitations. Global coverage of HBV immunization needs improvement. Several patient populations are noted to have suboptimal seroprotective rates after HBV vaccination. There are currently several potential new vaccines undergoing animal and human studies, most notably vaccines containing immunostimulatory DNA sequences. Long-term nucleoside analogue therapy is necessary in achieving permanent virologic suppression. Potential new treatments explore new mechanisms of action, including the inhibition of hepatitis B surface antigen release, targeting antifibrotic mechanism, and immunomodulation through novel interferons and therapeutic vaccines. The clinical application of potential new vaccines and therapies would enhance the prevention of HBV infection and treatment of chronic hepatitis B. © 2012 by Lippincott Williams & Wilkins.postprin

Diagnostic accuracy of mediastinal width measurement on posteroanterior and anteroposterior chest radiographs in the depiction of acute nontraumatic thoracic aortic dissection

We aimed to explore the diagnostic accuracy of various mediastinal measurements in determining acute nontraumatic thoracic aortic dissection with respect to posteroanterior (PA) and anteroposterior (AP) chest radiographs, which had received little attention so far. We retrospectively reviewed 100 patients (50 PA and 50 AP chest radiographs) with confirmed acute thoracic aortic dissection and 120 patients (60 PA and 60 AP chest radiographs) with confirmed normal aorta. Those who had prior history of trauma or aortic disease were excluded. The maximal mediastinal width (MW) and maximal left mediastinal width (LMW) were measured by two independent radiologists and the mediastinal width ratio (MWR) was calculated. Statistical analysis was then performed with independent sample t test. PA projection was significantly more accurate than AP projection, achieving higher sensitivity and specificity. LMW and MW were the most powerful parameters on PA and AP chest radiographs, respectively. The optimal cutoff levels were LMW = 4.95 cm (sensitivity, 90 %; specificity, 90 %) and MW = 7.45 cm (sensitivity, 90 %; specificity, 88.3 %) for PA projection and LMW = 5.45 cm (sensitivity, 76 %; specificity, 65 %) and MW = 8.65 cm (sensitivity, 72 %; specificity, 80 %) for AP projection. MWR was found less useful and less reliable. The use of LMW alone in PA film would allow more accurate prediction of aortic dissection. PA chest radiograph has a higher diagnostic accuracy when compared with AP chest radiograph, with negative PA chest radiograph showing less probability for aortic dissection. Lower threshold for proceeding to computed tomography aortogram is recommended however, especially in the elderly and patients with widened mediastinum on AP chest radiograph. © 2012 The Author(s).published_or_final_versio

The clinical longevity of cantilever resin-bonded bridges

published_or_final_versio

Properties of Si-SiO2 interface traps due to low-energy Ar+ backsurface bombardment in n-channel nitrided MOSFETs

Flicker noise in backsurface gettered, nitrided n-channel MOSFETs is characterized over a wide range of temperatures and biases. The gettering time ranged from 10 to 40 minutes. The noise power spectra for devices with different gettering times are compared to the ungettered devices which serve as the control. It is found that flicker noise is reduced by backsurface gettering for short gettering times. A rebound in the noise magnitude is observed for long gettering times. Investigations of the temperature dependencies of the noise power spectra indicates that the low-frequency noise arises from thermal activation of carriers to traps at the Si-SiO2 interface. Backsurface gettering results in the modification of the energy distribution of the interface traps, probably due to stress relaxation at the Si-SiO2 interface.published_or_final_versio

Levels of HBV DNA and not HBsAg are associated with biochemical flares after HBeAg seroconversion

BACKGROUND: The role of HBsAg levels in predicting subsequent flares in chronic hepatitis B patients after HBeAg seroconversion is not known METHODS: Serum HBsAg and HBV DNA levels were determined in 224 CHB patients at 6-12 months after spontaneous HBeAg seroconversion. Serum HBV DNA levels were performed using Cobas Taqman assay. HBsAg titers were determined using Roche Elecsys HBsAg II ...postprin