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1.
PURPOSE: We designed a phase I-II trial of three active agents, paclitaxel, ifosfamide, and vinorelbine, in advanced non-small-cell lung cancer (NSCLC) to: 1) define the dose-limiting toxicities (DLT) and maximum tolerated dose (MTD) of paclitaxel with filgrastim (G-CSF) support; and 2) determine the overall response rate and median survival of patients treated on this regimen. PATIENTS AND METHODS: We treated cohorts of patients with stage IIIB or IV NSCLC with ifosfamide 1.2-1.6 g/m2/day x 3 and vinorelbine 20-25 mg/m2/day x 3 and escalating doses of paclitaxel at 100-175 mg/m2 on day 2 with G-CSF support on a 21-day cycle. One prior experimental single-agent chemotherapy regimen was allowed. RESULTS: Fifty-six patients, were enrolled on this trial: 27 on the phase I portion of the study and an additional 29 at the recommended phase II dose (RPTD). Thirteen patients had received prior chemotherapy. Paclitaxel doses of 175 mg/m2 and 150 mg/m2 produced dose-limiting myelosuppression, and the RPTD was determined to be paclitaxel 135 mg/m2 with ifosfamide 1.2 g/m2/day on days 1-3 and vinorelbine 20 mg/m2/ day on days 1-3 with G-CSF support. The overall response rate was 18%, with a median survival of 6.1 months. Six of 35 patients (17%) treated at the RPTD achieved a partial response to therapy. Grade IV neutropenia was observed in 19 of 35 patients at this dose, with eight patients suffering febrile neutropenia. CONCLUSIONS: This non-cisplatin-containing three-drug regimen has substantial toxicity and low activity in advanced NSCLC, and does not seem to improve on prior regimens. It is unclear whether the lack of efficacy relates to an antagonistic reaction between the specific drugs, administration schedule, or to subtherapeutic doses of the individual agents.  相似文献   
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Anguilla is a UK overseas (non-independent) territory in the Caribbean. It is a small middle-income island with a population of 13 000, and recent statistics indicate that it is more dependent on tourism than any other country or territory in the world. Rapid population growth and development have placed more emphasis on the need for human health and environmental protection. For the first time, a systematic water-quality monitoring programme has been developed, based on the realities of the local situation, e.g. low resource base, limited capabilities, dependence on household rainwater catchment, storage cisterns, and a poor water-supply network. Development of the programme incorporated the key themes of pragmatic, realistic, incremental, responsive, and consultative approaches.  相似文献   
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Containment structures have several regions in which the continuity of the cylindrical pressure boundary is interrupted, e.g., shell penetrations, discontinuous stiffeners, and changes in the shell thickness. Significant strain concentrations can occur in these areas of discontinuity. The Sandia National Laboratories 1:8-scale steel containment equipment hatch was analyzed as an example of an eccentricity at a stiffener intersection.A portion of the as-built 1:8-scale model was modeled with the ANSYS general purpose finite element program using triangular, thin shell finite elements. The overall size of the model was determined from Saint-Venant type considerations of the stress field around the hatch. Shell elements were used to model the ring and formed stiffeners. Geometric and material nonlinear behavior were included. The model was loaded using discrete load steps up to a pressure of 165 psig. At this pressure, the maximum strain was 19.7 percent in the formed stiffener near its intersection with the ring stiffener. The finite element solution demonstrated the very localized nature of the strain field near the ring/formed stiffener intersection.In an attempt to reduce analysis costs, a small portion of the 1:8-scale model immediately surrounding the ring/formed stiffener intersection was selected for further analysis. Two smaller models, a ring/formed stiffener intersection and a ring/circular stiffener intersection, were studied. The models were significantly smaller than the regions used previously. A comparison of the two intersection models showed that the circular stiffener is a more efficient configuration.  相似文献   
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The current, most frequently employed, commercial route to produce hydroxyapatite prosthetic coatings is plasma spraying. However, this has several important limitations especially for textured surfaces. Low temperature methods of coating fabrication such as cathodic electrodeposition are attractive alternatives. However, quantitative characterisation of the phase composition of thin electrodeposited coatings can be problematic. An X-ray diffraction method, which provides quantitative compositional information without reference to external or internal standards, is introduced and validated. The method can also be applied when Bragg peaks from the supporting substrate are apparent within the data and preferred orientation can be tolerated. This method has been used to examine in detail the microstructure of electrodeposited coatings which are compared directly with those formed by a commercial plasma spraying process.We show that, unlike the plasma sprayed coatings, the electrodeposited material consists of a single crystalline phase (hydroxyapatite) and a significantly reduced amorphous phase. The electrodeposited coatings also possess significantly more microstrain and a smaller crystallite size than the corresponding plasma sprayed material.  相似文献   
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Skim and whole milk powders were manufactured at lab scale by spray freeze drying (SFD), using liquid nitrogen as the cryogen. The polydispersity of droplet/particle sizes was limited using an encapsulator nozzle to atomize the feed. Particle morphology was examined using a scanning electron microscope. Samples were compared with equivalent spray-dried powders in tests of wettability and dissolution in water. The spray freeze-dried powders were found to be highly porous, with a uniform structure of pores throughout the entire particles. When tested in water, SFD skim milk powders wetted roughly three times as fast as industrially spray-dried agglomerated skim milk powders and were observed to dissolve rapidly by breaking down into smaller particles.  相似文献   
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Accurate estimates of the propagation impairments that affect link quality and availability and determine signal interference fields are essential for the reliable design of telecommunication systems and the efficient use of the electromagnetic spectrum. Recent announcements by commercial entities of their intent to use Ka-band spectrum to supply satellite services have heightened interest in propagation data and models for these frequencies. This paper provides a brief overview of Ka-band Earth-satellite systems and requirements in relation to the need for specific types of propagation data  相似文献   
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Psoralens and sunlight have been used by the Egyptians and Indians for hundreds of years for treating vitiligo. The combination of oral psoralens and artificial ultraviolet A (PUVA) therapy was approved for managing severe psoriasis by the Food and Drug Administration in 1982. Since then, PUVA therapy has been an effective modality for treating many cutaneous conditions (psoriasis, atopic dermatitis, vitiligo, and mycosis fungoides). However, proper knowledge and administration of PUVA therapy are vital to treatment success and reducing side effects.  相似文献   
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The consumer health plan value survey: round two   总被引:2,自引:0,他引:2  
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