Search

Purpose: The present study aimed to evaluate the accuracy of anthropometric foot measurements in predicting the diameter of the intramedullary screw for fifth metatarsal fracture fixation. Secondary aim was to identify whether the fifth metatarsal intramedullary canal diameter is correlated to the fifth metatarsal length and the foot dimensions. Methods: In 29 cadaveric feet, the maximum length of the plantar surface of the foot (PL) and the perimeter of the foot at the level of the fifth metatarsal base (PBFM) were measured using a measuring tape. Subsequently, the fifth metatarsal was excised. Using Computed Tomography scan, the metatarsal length (FML), and the horizontal (HDI) and vertical diameter (VDI) at the isthmus level were measured. The HDI values were grouped in 5 mm increments to correspond to the recommended screw diameter (RSD) for intramedullary fixation. A univariate linear regression analysis considered RSD and HDI as the dependent variables and FML, PL, PBFM as the independent variables. A multivariate regression analysis was performed to examine the predictive value of the two anthropometric measurements. A p-value < 0.05 was considered statistically significant. Results: All six univariate analyses revealed that the dependent variable was significantly correlated with the independent variable. However, the multivariate regression models showed that the anthropometric measurements were not significantly correlated with the RSD and HDI. Conclusion: The current study found an association between the fifth metatarsal intramedullary canal diameter and the fifth metatarsal length and foot anthropometric dimensions. However, the anthropometric measurements of the foot presented a low predictive value for the decision of an intramedullary screw diameter in the treatment of fractures of the base of the fifth metatarsal. [ABSTRACT FROM AUTHOR]

The neutrophil-to-lymphocyte ratio (NLR) emerged as a potential biomarker in SLE, but its association with several outcomes remains unclear. We aimed to evaluate the relationship between NLR and SLE disease activity, damage, depression, and health-related quality of life. A cross-sectional study was conducted, including 134 patients with SLE who visited the Division of Rheumatology between November 2019 and June 2021. Demographics and clinical data including NLR, Safety of Estrogens in Lupus Erythematosus National Assessment-Systemic Lupus disease activity index (SELENA–SLEDAI), Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI), physician global assessment (PhGA), patient global assessment (PGA), patient health questionnaire (PHQ)-9, patient self-rated health, and lupus quality of life (LupusQoL) scores, were collected. Patients were stratified into two groups and compared using the NLR cut-off of 2.73, the 90th percentile value of healthy individuals. The analysis included t-test for continuous variables, χ2-test for categorical variables, and logistic regression adjusting for age, sex, BMI, and glucocorticoid use. Among the 134 SLE patients, 47 (35%) had an NLR ≥ 2.73. The NLR ≥ 2.73 group had significantly higher rates of severe depression (PHQ ≥ 15), poor/fair self-rated health, and the presence of damage (SDI ≥ 1). These patients also scored significantly lower in LupusQoL domains (physical health, planning, and body image), and higher in SELENA-SLEDAI, PhGA, and PGA. Logistic regression confirmed that high NLR is associated with severe depression (PHQ ≥ 15) (OR:7.23, 2.03–25.74), poor/fair self-rated health (OR:2.77,1.29–5.96), high SELENA-SLEDAI score(≥ 4) (OR:2.22,1.03–4.78), high PhGA (≥ 2) (OR:3.76, 1.56–9.05), and presence of damage (SDI ≥ 1) (OR:2.67, 1.11–6.43). High NLR in SLE may indicate depression, worse quality of life, active disease, and the presence of damage. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the prevalence and the clinical significance of lymphadenopathy and its histological subtypes in patients with systemic lupus erythematosus. We conducted a retrospective cohort study of patients with SLE diagnosed using the 1997 ACR criteria, who were followed at our institution between 2008 and 2022. Patients were grouped based on the presence of SLE-attributed LAD and its histological phenotype, then compared in terms of demographic, clinical and laboratory characteristics. Of the 255 patients, 33.7% had SLE-attributed, 0.8% lymphoma-related and 0.4% tuberculosis-related LAD. Univariate analysis identified significant associations between the presence of LAD and fever (p < 0.0001), weight loss (p = 0.009), pericarditis (p = 0.004), myocarditis (p = 0.003), myositis (p = 0.034), leukopenia (p = 0.004), lymphopenia (p = 0.003), membranous nephritis (p = 0.004), anti-RNP (p = 0.001), anti-Smith (p = < 0.0001), and SSB antibodies (p = 0.038), and hypocomplementemia (C3:p = 0.019; C4:p < 0.0001). Logistic regression confirmed the associations of LAD with fever (OR = 3.277, 95% C.I 1.657–6.481), pericarditis (OR = 4.146, 95% C.I:1.577–10.899), membranous nephritis (OR = 3.586, 95% C.I:1.305–9.854), and leukopenia (OR = 2.611, 95%C.I:1.319–5.166), but not with weight loss, myocarditis, or myositis. Biopsy in a subset of patients (33.7% of total) revealed reactive/proliferative (62.1%) or necrotizing (37.9%) histological patterns. When we compared the histologic patterns, necrotizing LAD was associated with fever (p = 0.052), sicca (p = 0.018), and malar rash (p = 0.005). Most patients received corticosteroids, hydroxychloroquine, and/or DMARDs with relatively quick clinical improvement. In conclusion, LAD is a common SLE manifestation, associated with constitutional symptoms, myo-/pericarditis, myositis, cytopenia, and membranous nephritis. Despite relatively high prevalence of LAD in SLE, a biopsy may still be needed to rule out lymphoma. [ABSTRACT FROM AUTHOR]

The organoantimony derivative of formula trans-O,O-[Ph3SbV(Carv)2] (TPAC) (CarvH = carvacrol) is obtained by the oxidation of triphenylstibine (Ph3SbIII) with hydrogen peroxide in the presence of carvacrol (CarvH). Physical methods such as X-ray Fluorescence (XRF) spectroscopy, single crystal and powder X-ray diffraction analysis (XRD and PXRD), Attenuated Total Reflection Fourier Transform Infra-red (ATR-FTIR) spectroscopy, Thermogravimetric Differential Thermal Analysis (TG–DTA) and Differential Scanning Calorimetry (DTG/DSC), confirm the retention of the formula of TPAC throughout the sample mass in solid state, while UV–Vis spectroscopy in the solution. TPAC is the first example of carvacrol (the main ingredient of oregano) covalently bonded to any metal ion. Only the trans-O,O-[Ph3Sb(Carv)2] isomer was isolated suggesting stereo-selectivity of the preparation route. TPAC inhibits in vitro both human breast adenocarcinoma cell lines: MCF-7 (positive to hormones receptor (HR +)), MDA-MB-231 (negative to hormones receptor (HR-)) stronger than normal human fetal lung fibroblast cells (MRC-5). The MCF-7 cells morphology, DNA fragmentation, Acridine Orange/Ethidium Bromide (AO/EB) Staining, cell cycle arrest and mitochondrial membrane permeabilization tests suggest an apoptotic pathway for cell death, especially, through the mitochondrion damage. The binding type of TPAC toward the calf thymus CT-DNA was initially deduced ex vivo from the differentiation of the DNA solution viscosity. Fluorescence spectroscopy confirms the interaction mode suggested. Spectroscopic evidence (FTIR, UV–Vis) suggest that glutathione (GSH) (a tripeptide over-expressed in tumor cells) induces conversion of non-active pentavalent antimony, which is contained in TPAC, to active trivalent one, providing a new strategy for the development of targeted chemotherapeutics. [ABSTRACT FROM AUTHOR]

We employ chordal decomposition to reformulate a large and sparse semidefinite program (SDP), either in primal or dual standard form, into an equivalent SDP with smaller positive semidefinite (PSD) constraints. In contrast to previous approaches, the decomposed SDP is suitable for the application of first-order operator-splitting methods, enabling the development of efficient and scalable algorithms. In particular, we apply the alternating direction method of multipliers (ADMM) to solve decomposed primal- and dual-standard-form SDPs. Each iteration of such ADMM algorithms requires a projection onto an affine subspace, and a set of projections onto small PSD cones that can be computed in parallel. We also formulate the homogeneous self-dual embedding (HSDE) of a primal-dual pair of decomposed SDPs, and extend a recent ADMM-based algorithm to exploit the structure of our HSDE. The resulting HSDE algorithm has the same leading-order computational cost as those for the primal or dual problems only, with the advantage of being able to identify infeasible problems and produce an infeasibility certificate. All algorithms are implemented in the open-source MATLAB solver CDCS. Numerical experiments on a range of large-scale SDPs demonstrate the computational advantages of the proposed methods compared to common state-of-the-art solvers. [ABSTRACT FROM AUTHOR]

Soil gas radon concentrations were continuously monitored from November 2016 to May 2018, close to an active fault zone in the area of Ioannina (Northwestern Greece) that gave rise to intense seismic swarms with magnitudes up to 5.3 on the Richter scale, during October 2016. Meteorologic parameters (soil and air temperature, atmospheric pressure, wind speed and rainfall) were simultaneously obtained, and their contribution to radon fluctuations was examined by partial correlation and cross-correlation analysis. Soil temperature and atmospheric pressure were found to be the parameters controlling radon concentrations, and their effect was reduced using multiple linear regression analysis. During the monitoring period, 11 spike-like anomalies were identified in the residual radon time series using the 2σ deviation criterion. The duration of the anomalies varied from < 1 day to approximately 5 days. Earthquakes of local magnitudes ML > 2.5, occurring within a distance of 100 km from the monitoring site, were collected and filtered by applying Dobrovolsky's radius approach. Most of the observed radon anomalies were likely associated with seismic events, and the precursor time ranged roughly from 2 to 15 days. [ABSTRACT FROM AUTHOR]

Template attacks are a special kind of side-channel attacks that work in two stages. In a first stage, the attacker builds up a database of template traces collected from a device which is identical to the attacked device, but under the attacker's control. In the second stage, traces from the target device are compared to the template traces to recover the secret key. In the context of attacking elliptic curve scalar multiplication with template attacks, one can interleave template generation and template matching and reduce the amount of template traces. This paper enhances the power of this technique by defining and applying the concept of online template attacks, a general attack technique with minimal assumptions for an attacker, who has very very limited control over the template device. We show that online template attacks need only one power consumption trace of a scalar multiplication on the target device; they are thus suitable not only against ECDSA and static elliptic curve Diffie–Hellman (ECDH), but also against elliptic curve scalar multiplication in ephemeral ECDH. In addition, online template attacks need only one template trace per scalar bit and they can be applied to a broad variety of scalar multiplication algorithms. To demonstrate the power of online template attacks, we recover scalar bits of a scalar multiplication using the double-and-add-always algorithm on a twisted Edwards curve running on a smartcard with an ATmega163 CPU. [ABSTRACT FROM AUTHOR]

Anaerobic digestion (AD) uses a range of substrates to generate biogas, including energy crops such as globally abundant rice straw (RS). Unfortunately, RS is high in lignocellulosic material and has high to C:N ratios (~80:1), which makes it (alone) a comparatively poor substrate for AD. Co-digestion with dairy manure (DM) has been promoted as a method for balancing C:N ratios to improve RS AD whilst also treating another farm waste and co-producing a potentially useful fertiliser. However, past co-digestion studies have not directly compared RS AD microbial communities with and without DM additions, which has made it hard to assess all impacts of DM addition to RS AD processes. Here, four RS:DM ratios were contrasted in identical semi-continuous-fed AD bioreactors, and 100% RS was found to produce the highest specific methane yields (112 mL CH4/g VS/day; VS, volatile solids), which is over double yields achieved in the reactor with the highest DM content (30:70 RS:DM by mass; 48 mL CH4/g VS/day). To underpin these data, microbial communities were sequenced and characterised across the four reactors. Dominant operational taxonomic units (OTUs) in the 100% RS unit were Bacteroidetes/Firmicutes, whereas the 30:70 RS:DM unit was dominated by Proteobacteria/Spirochaetes, suggesting major microbial community shifts occur with DM additions. However, community richness was lowest with 100% RS (despite higher specific yields), suggesting particular OTUs may be more important to yields than microbial diversity. Further, ambient VFA and VS levels were significantly higher when no DM was added, suggesting DM-amended reactors may cope better with higher organic loading rates (OLR). Results show that RS AD without DM addition is feasible, although co-digestion with DM will probably allow higher OLRs, resulting in great RS throughput in farm AD units. [ABSTRACT FROM AUTHOR]

Energy-dispersive X-Ray fluorescence spectrometry was used to determine the concentrations of copper (Cu), zinc, iron and molybdenum in the liver of 76 sheep and goats from the regions of Macedonia-Thrace, northern Greece. In general, metal concentrations were in the adequate range, with one main exception of Cu-deficiency observed in all of the examined goat liver samples and Cu-toxicity found in 4 % of the sheep liver samples. One-way analysis of variance was carried out to determine significant differences among means depending on animal species, sex and age. Pearson correlation analysis was used to explore correlations between metal concentrations. The results obtained in the present study are discussed in the framework of diagnostic ranges, suggested for classifying the metal status of sheep and goats, and are compared with liver metal concentrations reported world-wide. [ABSTRACT FROM AUTHOR]

The impact of the Fukushima nuclear accident in north-western Greece was assessed through an environmental monitoring programme activated by the Nuclear Physics Laboratory of the University of Ioannina. Measurements of I were carried out in atmospheric particulate, ovine milk and grass samples. In daily aerosol samplings, radioiodine was first detected on March 25-26, 2011 and reached maximum levels, up to 294 μBq m, between April 2 and April 4, 2011. In ovine milk samples, I concentrations ranged from 2.0 to 2.7 Bq L between April 2 and April 6, 2011, while an average activity of 2.7 Bq kg was measured in grass samples on April 4, 2011. The Cs isotopes were below detection limits in all samples and could only be determined in the air, by analysis of multiple daily filters. A maximum average activity concentration of Cs amounting to 24 μBq m was measured during the period from April 5 to April 9, 2011, with the Cs/Cs activity ratio being close to unity. Activity concentrations were consistent with measurements conducted in other parts of the country and were well below those reported in May 1986 after the Chernobyl accident. The committed effective dose to the whole body and to the thyroid gland from inhalation of I was estimated for the adult and infant population and was found to be of no concern for the public health. [ABSTRACT FROM AUTHOR]

BACKGROUND: Primary duodenal adenocarcinoma is a rare entity with an uncertain biologic behaviour whose diagnosis is usually achieved by endoscopy and biopsy. However, it lacks specific symptoms and its diagnosis may be delayed with poor prognosis. Villous adenomas are considered as premalignant lesions with high risk malignant transformation. METHODS: We report a rare case of a patient with two synchronous adenocarcinomas, one of the first portion of the duodenum as a villous tumor and the other in cecum colon. The patient submitted successfully to pacreatoduodenectomy and right hemicolectomy, while postoperatively received also adjuvant chemotherapy. RESULTS: Seventeen months after the operations the patient is alive with no evidence of recurrent or metastatic disease. CONCLUSIONS: The radical resection of primary duodenal adenocarcinoma is considered the treatment of choice, which should be accompanied by adjuvant chemotherapy preventing a recurrence at distant sites. [ABSTRACT FROM AUTHOR]

Background: The objective of this study was to examine whether there was an association between acute rejection (AR) and nitric oxide (NO) levels and also to evaluate the clinical impact of NO measurement as a noninvasive marker for early detection of AR. Methods: Fifty consecutive patients aged 17-62 years old received a living-related kidney graft. Serum levels of total nitrite and nitrate (NOx) were measured 30 min after graft reperfusion (NOx 1) and on days 1 (NOx 2), 5 (NOx 3), and 10 (NOx 4) post-transplantation (Tx). If clinically indicated, graft biopsy was performed. Results: Acute humoral rejection was diagnosed by biopsy on 3rd post-Tx day in one patient. His serum NOx 2 levels were remarkably higher (380%) compared with his NOx 1 measurement. At the same time, NOx 1-2 measurements in uncomplicated group showed lower levels (−12%). Additionally, during the first month post-Tx, 5 cases of acute cellular rejection (ACR) were diagnosed. The mean percent change of NOx 3-4 levels in ACR group was 180.7 versus 16.1 in uncomplicated patients ( P < 0.01). In addition, >70 μmol/L change in NOx levels in consecutive samples had a sensitivity of 100% and a specificity of 97.7% in predicting AR episodes. Conclusion: Our study reports significant increase in serum NOx levels in episodes of AR. NOx might be an useful noninvasive marker for early diagnosis of AR. [ABSTRACT FROM AUTHOR]

This paper reviews some recent research in “behavioural economics” with an application to environmental issues. Empirical results from behavioural economics provide a reminder that human behaviour is context-dependent, implying that policy may go awry if based upon models of behaviour which are inappropriate to the contexts in which decisions are made. Recognizing that agents may, in some contexts, systematically make mistakes raises challenging questions about the role of “paternalism” in government policy. The paper considers the research into hyperbolic discounting, and examines the implications for environmental policy. We develop a model of resource management under hyperbolic discounting, which shows that if a planner is unable to commit to a policy, the temptation to re-evaluate the policy in future could lead to an inadvertent collapse in the stocks of a natural resource. [ABSTRACT FROM AUTHOR]

We conducted a prospective study to determine whether expression of telomerase reverse transcriptase (hTERT) is associated with recurrence-free-survival (RFS) or development of invasive disease in patients with high risk superficial bladder cancer (SBC) that received adjuvant BCG immunotherapy. Thirty patients with high-grade T1 tumors were evaluated. Pre-BCG TURBT and post-BCG specimens were analyzed for hTERT nucleolar expression by immunohistochemistry. Post-BCG hTERT expression was statistically significantly lower than pre-BCG hTERT expression. Pre-BCG hTERT nucleolar staining in more than 75% of cells was associated with worse RFS (9 months vs. not yet reached, P = 0.05), while post-BCG hTERT nucleolar staining in more than 50% of the cells was associated with worse RFS (6 months vs. not yet reached, P = 0.001) and development of invasive disease. In multivariate analysis, post-BCG hTERT expression was independently associated with RFS and development of invasive disease. Immunohistochemical evaluation of hTERT may help define a subset of high risk SBC patients that will eventually fail BCG and may therefore benefit from early salvage cystectomy. [ABSTRACT FROM AUTHOR]

Vascular endothelial growth factor (VEGF) overexpression has been associated with advanced stage and poor survival in several cancers. Additionally, CD-105 (endoglin) was proposed as a marker of neovascularization in solid malignancies. The aim of the present study was to (1) evaluate the VEGF and CD-105 expression in gastric carcinoma, (2) determine the role of VEGF gene sequence variations in VEGF expression in gastric carcinoma, and (3) correlate the results of VEGF and CD-105 expression with other standard prognostic parameters, such as size, grade, stage of the disease, metastases, and patient survival. VEGF and CD-105 expression were evaluated in 100 unrelated gastric cancer patients using immunohistochemistry. For the genotyping, DNA was isolated from the blood of the gastric cancer patients and from 100 healthy individuals. The genotyping was performed by polymerase chain–restriction fragment length polymorphism analysis. VEGF protein was strongly expressed in the cytoplasm of 36% of the gastric carcinoma samples tested. In all cases, high VEGF expression was accompanied with high endoglin expression. Our results revealed no statistical significant association of any VEGF gene polymorphism with the VEGF and endoglin expression. The correlation of VEGF/CD-105 expression with the clinicopathological parameters of gastric cancer showed that the high expression of VEGF/CD015 was correlated only with lymph node metastasis ( P = 0.028). The Kaplan-Meier survival curves have shown a clear association of overall survival after diagnosis of gastric cancer with high VEGF, as well as high CD-105 expression. Our results support that VEGF and CD-105 are closely relevant to lymph node metastasis and act as two valuable indicators of prognosis. [ABSTRACT FROM AUTHOR]

Reactive oxygen species (ROS) are important mediators of cellular damage and lipid peroxidation is the most important expression of ROS-induced oxidative stress. Recent studies have suggested that increased plasma malondialdehyde (MDA) levels are a consequence of specific immunosuppressive therapies. This study aims at investigating the relation between oxidative stress and immunosuppressive therapies in renal transplant patients with stable renal function and uneventful postoperative course. The study group included 26 renal patients. Two groups of renal transplant recipients, treated with a different combination of immunosuppressive agents were studied (Group A: CyA, MMF, Steroids and Basiliximab, Group B: Tacrolimus, MMF, Steroids and Daclizumab). All patients had an uneventful postoperative course. Plasma MDA levels were measured before transplantation, 1 and 6 months after. Plasma concentration of endogenous creatinine (Cr) was used as a measure of stable renal function. Levels of MDA were increased before the transplantation in all renal patients (MDA: 7.81 ± 4.81, normal levels: 2.23–4.08 nmol/ml, P < 0.05). Combined therapy with CyA was associated with high values of MDA at 6 months measurement after transplantation. However this tendency of increased MDA levels did not achieve a statistical significance (Group A: 6.97 vs. 9.06 nmol/ml, P>0.05). On the contrary, statistically significant diminution of MDA levels was observed in Group B patients (Tacrolimus–MMF–steroids) at 6 months measurement after transplantation. (Group B: 8.61 vs. 4.11 nmol/ml, P<0.02<0.05). Immunosuppressive combined therapy with CyA was associated with the high values of MDA that were measured posttransplantly. Our study provides strong evidence that Tacrolimus is significantly associated with improved free radical metabolism. [ABSTRACT FROM AUTHOR]

Objective: To investigate the efficacy and toxicity of gemcitabine administration followed by the combination of fluorouracil (5-FU) modulated by folinic acid in patients with advanced, symptomatic pancreatic cancer. The main objective was to estimate tumour response and any improvement in patients' quality of life. Patients: The study included 48 evaluable patients with metastatic disease with no prior chemotherapy. The study duration was 3 years. Interventions: Gemcitabine 1000 mg/m2 intravenously was given on days 1 and 8 followed by fluorouracil 350 mg/m2 intravenously as a bolus biologically modulated by folinic acid 350 mg/m2 intravenously given on days 1,2, 8 and 9 in order to develop the conditions for any potential drug synergism. The regimen was administered every 3 weeks for 1 year or until disease progression. Results: Objective partial responses were documented in ten (21 %) patients (95% CI 10.5, 35). Twenty-two (46%) patients had stable disease while 16 (33%) patients had progressive disease. The median response duration was 8 months (range 4-20). The median time to progression was 6 months (range 2-24), while the median survival of the group was 7 months (range 3-36) and the probability of surviving beyond 12 months was 20%. Of the 44 patients with tumour-related symptoms who were considered evaluable for clinical-benefit response, 28 (70%) patients had pain improvement, 25 (52%) patients had improvement of their performance status, and nine (2 8%) patients experienced weight gain during treatment. Serum concentrations of cancer antigen (Ca-19-9) were decreased by more than 50% in 14 (37%) of the 38 assessable patients. Chemotherapy was well tolerated, with mild myelotoxicity. Gastrointestinal toxicity was moderate with mild mucositis. Conclusion: The regimen of gemcitabine and fluorouracil administered in this study was well tolerated and showed a moderate antitumour activity and a significant palliative effect on tumour-related symptoms. Because fluoruracil is a low toxicity combination agent for gemcitabine, other forms of the two-drug combination warrant further investigation. [ABSTRACT FROM AUTHOR]

Copyright of Langenbeck's Archives of Surgery is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Normal and streptozotocin-diabetic rats have been maintained for 6-11 months on completely balanced, reconstituted diets in which the sole source of carbohydrate was either 68% corn starch or 68% sucrose. The retinal vascular system was isolated by trypsin digestion and examined histologically for the presence of tortuosity and irregularity of capillary diameter, increased PAS-positive deposits, microaneurysms, loss of pericytes, endothelial proliferation, acellularity and strand formation. None of these pathological changes occurred in normal rats fed a starch-rich diet, but all developed to a similar extent in the sucrose-fed normal rats and the starch-fed diabetic group. The changes were more severe in sucrose-fed diabetic rats after 6 months. In all groups the retinopathy progressed with time. The possibility that a factor common to both the ingestion of a sucrose-rich diet and streptozotocin diabetes in rats has been considered since, histologically, the retinopathy observed was identical both with respect to severity and rate of development in normoglycaemic, sucrose-fed and hyperglycaemic, starch-fed diabetic rats. [ABSTRACT FROM AUTHOR]

Recent advances in biochemical pharmacology have revealed the basis for the biological modulation of 5-fluorouracil (5-FU) by methotrexate (MTX) and folinic acid (FA). Sequential use of MTX given 24 h prior to 5-FU has resulted in enhanced cell kill in vitro and in vivo. In addition, administration of FA prior to 5-FU has led to potentiation of 5-FU action by stabilization of the ternary complex of thymidine synthase. In the present randomized study, two groups of patients with advanced colorectal cancer were treated as follows: 43 patients (pts) in group A received 5-FU + FA, whereas 45 pts in group B received 5-FU + FA + MTX. The dosage was as follows: group A received FA i. v. at 300 mg/m per day, prior to i. v. 5-FU at 500 mg/m per day on days 1 - 4; group B was given MTX i. v. at 130 mg/m per day on day 0, followed 24 h later by FA at 15 mg q6h × 6, and 5-FU + FA was started on day 1 and given at the same doses and schedule described for group A. Objective responses were achieved by 8/43 pts in group A (1 complete response and 7 partial responses) and by 18/45 pts in group B (3 complete and 15 partial responses), all occurring in the liver. There was no significant difference in the median time to progression (group A 6.1 months, group B 6.8 months) or the median survival (group A 9.2 months, group B 10.3 months). Toxicity was significantly greater in group B [grade 2 - 3 mucositis 20% versus only 2% in group A ( P <0.0001); grade 3 diarrhea in group B 15% versus 3% in group A ( P <0.001)]. According to our results, double biological modulation of 5-FU with MTX + FA led to an enhanced response rate with increased toxicity as compared with the 5-FU + FA regimen given at less than its maximally tolerated dose. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 72-year-old man admitted because of a febrile illness with significant anorexia and fatigue. The patient suffered from moderately advanced Parkinson's disease, which was diagnosed 11 years ago. The article discusses retroperitoneal fibrosis, inflammatory aneurysm of the abdominal aorta, and perianeurysmal retroperitoneal fibrosis.