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131.
132.
Stephan Mose Martin Karapetian Lotte Jüling-Pohlit Brigitte Taborski Ulla Ramm Marc Damrau Angelika Rahn Heinz D. Böttcher 《Strahlentherapie und Onkologie》1999,175(2):78-83
BACKGROUND: Gemcitabine (2'.2'-difluorodeoxycytidine; dFdC) is a new nucleoside analog with promising activity in different solid tumors in vivo and in vitro. As published up to now, combined with irradiation dFdC demonstrates a radiosensitizing effect on pancreas and colon carcinoma cell lines. We investigated the influence of dFdC on the radiosensitization of human squamous carcinoma cells of the cervix (HeLa-cells, ATCC CCL-2). MATERIAL AND METHODS: Under standardized conditions monolayer cultures of HeLa-cells were incubated in medium with dFdC for different times (4 to 24 hours) and exposed to different concentrations (0.003, 0.01 and 0.03 mumol/l). Irradiation (2 to 6 Gy, electron beam) followed immediately or 12 hours after dFdC-exposure. Cell survival was determined by colony forming assay. Using the linear-quadratic model cell survival curves were fit after correction for drug-induced cytotoxicity and the mean inactivation dose (MID) was calculated. Radiation enhancement was defined as the ratio MIDRT(= Control)/MIDRT + dFdC > 1. RESULTS: Exposed to gemcitabine for 4 and 8 hours and followed by immediate irradiation the radiation enhancement ratio (Table 1) is 1.07 to 1.14 and 1.04 to 1.22, respectively, if dFdC concentration is > or = 0.01 to 0.03 mumol/l. Further increase of the irradiation effect is demonstrated in cells exposed to > or = 0.003 to 0.03 mumol/l dFdC for 16 and 24 hours (radiation enhancement ratio 1.08 to 2.0 and 1.08 to 2.48, respectively) (Figure 3). If irradiation is applied 12 hours after 24-hour-exposure (0.01 and 0.03 mumol/l) the enhancement ratio was 1.18 and 1.7, respectively (Figure 4). CONCLUSIONS: In cell cultures the assays combining irradiation with dFdC demonstrate that dFdC is a potent radiation sensitizer of HeLa-cells. The effect of irradiation on cells pre-treated with non- and hardly cytotoxic concentrations of dFdC is increased in dependence of dose and time of exposure. 相似文献
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135.
Intimate partner violence has been hypothesized as a factor associated with women's risk for problems in contraception use or access. This article explores differences in contraceptive use between abused and nonabused women, using a case-control study of 225 women. Women experiencing physical and emotional abuse were more likely to report not using their preferred method of contraception in the past 12 months compared with nonabused women (OR = 1.9; 95% CI = 1.0 to 3.7). Health care providers need to consider how intimate partner violence may influence their patients' use of contraceptives, which has implications for the high risk of unintended pregnancies among abused women. 相似文献
136.
Results of long-term follow-up after curative resection of Dukes A colorectal cancer 总被引:8,自引:0,他引:8
Wichmann MW Müller C Hornung HM Lau-Werner U Schildberg FW;Colorectal Cancer Study Group 《World journal of surgery》2002,26(6):732-736
Patients with Dukes A (UICC I) colorectal cancer have a good prognosis after curative resection. It is not known, however, if the outcome is significantly different for UICC Ia and Ib patients or if patients with reduced risks of recurrences can be identified early after surgery. This is of interest, as it would permit a more cost-effective, patient-oriented, and tumor stage-oriented follow-up program. To study these questions, a prospective follow-up database, including 1375 patients after curative resection of colorectal cancer, was analyzed. A total of 296 patients with Dukes A colorectal cancer with a median follow-up of 44 months were studied. Perioperative and follow-up mortality rates were 3% and 14%, respectively. Recurrent disease developed in 10% of Dukes A patients after a disease-free interval of 16 months. Significantly more patients suffering from pT2 (UICC Ib) cancer had recurrent disease than patients with pT1 (UICC Ia) cancer (13% vs. 4%; p <0.05). Preoperative CEA levels in patients with recurrent disease were significantly higher than in long-term disease-free patients (5.3 +/- 1.8 vs. 3.5 +/- 0.6 ng/ml; p <0.05). Curative resection of recurrent disease was achieved in 38% of the patients with recurrences (4% of all patients). Survival analysis showed significantly better survival in patients with Dukes A cancer than in those at higher tumor stages (log rank, <0.0001), and only 39% of all Dukes A patients who died during follow-up had recurrent disease. Dukes A (UICC Ia and Ib) colorectal cancer was diagnosed in 22% of our patients treated for cure, and long-term survival was 86%. There were significantly fewer cases of recurrent disease after curative resection of UICC Ia (pT1N0M0) cancer, so we propose a novel, less intensive follow-up regimen for these patients, leading to a more cost-effective, patient-oriented, and tumor stage-oriented follow-up program. 相似文献
137.
Sari Miettinen Ulla Ashorn Juhani Lehto Elina Viitanen 《The International journal of health planning and management》2011,26(1):e1-e16
The main purpose of this article is to analyse the institutional and political structures of the Finnish rehabilitation entity and the governmental efforts to improve the governance of the rehabilitation policy. Rehabilitation in Finland is a complex welfare system which has undergone several coordination attempts during the last two decades. The centrality of the coordination of this welfare system is obvious. Based on the content analysis of three Government's rehabilitation reports from 1994 to 2002 and their background papers, this article provides two main findings. First, the rehabilitation entity seems to be based on different funding strategies, different governing and different coordination models between the rehabilitation subsystems. Second, the governance discourse in the reports seems to be unchanging with a predominantly hierarchical mode. The article concludes with a discussion on the challenges to coordinate this kind of a complex welfare system as an entity and also how to overcome those challenges. Copyright © 2010 John Wiley & Sons, Ltd. 相似文献
138.
Ulla‐Karin Schn 《Scandinavian journal of caring sciences》2010,24(3):557-564
Scand J Caring Sci; 2010; 24; 557–564 Recovery from severe mental illness, a gender perspective Background and research objectives: Recovery from mental illness is an individual process characterized by regaining a positive sense of self and developing a new meaning. Knowledge concerning differences between male and female recovery processes is, however, limited. The objective of this study was to determine gender diversity in what individuals described as decisive factors for their recovery. Subjects and methods: In this qualitative study based on grounded theory, 30 first‐person accounts of recovery from mental illness are examined. After informed consent from the participants, data were collected through in‐depth interviews with people in recovery from psychosis, bipolar disorders or personality disorders. Results: The results show that in spite of structural gender inequalities, female gender norms seem to be an advantage in the recovery process. The female participants were focused on making sense and meaning in their recovery process, while the male participants were focused on control over symptoms and reinforcement of traditional roles such as occupation and independence. Another result showed psychiatric hospitalization to mainly contribute to male recovery processes. Conclusion: These results provide new insights into gender as an important factor in understanding recovery processes and in providing care to facilitate these processes. 相似文献
139.
The study provides new knowledge about the longitudinal factorial invariance of the Maslach Burnout Inventory‐General Survey (MBI‐GS). In order to investigate the factor structure of the MBI‐GS and its invariance across time, a full panel data with two measurements gathered among employees with job‐related psychological health problems was used. Consistent with previous study findings, the results indicated that the correlated three‐factor model of the MBI‐GS (i.e. exhaustion, cynicism and professional efficacy) showed a better fit with the data than the alternative factor models. The correlated three‐factor structure was invariant across time, indicating that the scale has good construct validity, thus producing evidence that the MBI‐GS is a valid scale to measure job burnout. The novel finding of the study was that the professional efficacy dimension was a more central symptom of the burnout syndrome than previous research evidence among healthy employees has established. Copyright © 2011 John Wiley & Sons, Ltd. 相似文献
140.
Pirkko-Liisa Kellokumpu-Lehtinen Ulla Puistola Outi Paija Eeva Taimela Outi Hirvonen Sari Raassina Henrik Riska 《Supportive care in cancer》2011,19(1):149-153