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Die prognostische Bedeutung der Lungenfunktionsuntersuchung bei Patienten mit kleinzelligem Lungenkarzinom
Get PDFPro Jahr erkranken ca. 7500 Patienten erstmalig an einem kleinzelligen Lungenkarzinom (SCLC - Small cell lung cancer). Das kleinzellige Lungenkarzinom macht 15 bis 17 Prozent aller Lungenkarzinome aus. Das mediane Alter zum Zeitpunkt der Diagnosestellung liegt zwischen 66 und 68 Jahren. Das Rauchen zählt zu den Hauptrisikofaktor des kleinzelligen Lungenkarzinoms und nahezu alle Patienten waren Raucher.
Das kleinzellige Lungenkarzinom ist einer der aggressivsten bösartigen Tumore der Lunge mit schlechter Prognose. Ohne Behandlung führt es in unter 3 Monaten zum Tod. Mit einer Chemotherapie erhöht sich das mediane Überleben auf 7 bis 10 Monate. Nach einem Jahr leben nur noch 20 bis 40 Prozent der Patienten. Das kleinzellige Lungenkarzinom metastasiert früh und zeigt eine schnelle Progression.
In 80 Prozent der Fälle ist der Krebs bereits metastasiert und die Patienten zeigen durch Metastasen bedingte Symptome (bevorzugt in Lunge, Leber, Gehirn, Nebenniere und Knochen). Die Basisdiagnostik beim Lungenkarzinom umfasst die Anamnese inklusive klinischer Untersuchung, eine Laboruntersuchung, eine Röntgenthorax Untersuchung, eine Spiral - CT Untersuchung (Oberbauch bis Nebennieren), die Bronchoskopie und die Sonografie des Abdomens.
Die Spirometrie ist eine einfache und nicht- invasive Lungenfunktionsuntersuchung mit der man die dynamischen Lungenvolumina während der maximalen Inspiration und der Exspiration sowie die Atemflussverhältnisse messen kann. Mittels Spirometrie wird zum Einen die kontinuierliche Atmung aufgezeichnet und zum Anderen werden durch unterschiedlich angeleitete Atemmanöver bestimmte Lungenvolumina und Atemstromstärken gemessen. Um exakte Ergebnisse zu erzielen, ist eine gute Mitarbeit des Patienten Grundbedingung und auch die Anleitungen der untersuchenden Person spielen eine wichtige Rolle.
Die Bodyplethysmographie ist ein Verfahren zur Bestimmung von statischen Volumina und Atemwegswiderständen. Durch diese Untersuchung wird die funktionelle Residualkapazität bestimmt und so die Bestimmung des Residualvolumens ermöglicht. Durch das Zusammenzählen von Residualvolumen und Vitalkapazität ergibt sich die totale Lungenkapazität. Ein entgegengesetzter Zusammenhang zwischen der Lungenfunktion und dem Risiko ein Lungenkarzinom zu entwickeln konnte bereits mehrfach belegt werden. Studien zeigen, dass bereits eine geringe Verminderung der Einsekundenkapazität (FEV1) als signifikanter prädiktiver Wert für die Entwicklung eines Lungenkarzinoms herangezogen werden kann und das Risiko signifikant erhöht ist.
In dieser Arbeit wurde eine Kohorte mit insgesamt 205 Patienten und einem histologisch gesicherten kleinzelligen Lungenkarzinom retrospektiv untersucht. Dazu wurden patientenspezifische Charakteristika, tumorspezifische Parameter, sowie therapeutische Maßnahmen hinsichtlich ihrer Signifikanz auf das Patientenüberleben untersucht. Der zentrale Teil der Arbeit befasste sich mit den prätherapeutischen Lungenfunktionsparametern (Spirometrie, Bodyplethysmographie, Diffusionsmessung) der Patienten und die Auswirkungen einer erweiterten prätherapeutischen Lungenfunktionsprüfung bei diesen Patienten.
Die Auswertungen erfolgten mittels vergleichender und deskriptiver Analysen, sowie uni- und multivariater Überlebensanalysen. Eine durch spirometrische Lungenfunktionsdaten gemessene Atemwegsobstruktion hatte in der untersuchten Kohorte keinen Einfluss auf das Überleben. Dahingegen zeigte ein emphysematischer Phänotyp, im Sinne einer überblähten Lunge und eines verminderten Gasaustauschs, bei SCLC-Patienten ein signifikant vermindertes Gesamtüberleben. Die aussagekräftigsten Cut-off-Werte waren RV/TLC >= 60% sowie DLCOc ≤ 50%. Auf der Grundlage der vorgestellten Ergebnisse empfehlen wir bei allen Patienten zum Zeitpunkt der Diagnosestellung eine erweiterte prätherapeutische Untersuchung mittels Bodyplethysmographie und Messung der Diffusionskapazität. Darüber hinaus stellen eine konsequente Atemphysiotherapie, die Optimierung der Behandlung mit Bronchodilatatoren und die Raucherentwöhnung effektive Methoden dar, um die Lungenüberblähung bei diesen Patienten zu verringern und die Ergebnisse zu verbessern
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
Author Under Sail The Imagination of Jack London, 1893-1902
No full textIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Intro -- Title Page -- Copyright Page -- Dedication -- Contents -- Acknowledgments -- Introduction -- 1. Spirit Truth -- 2. From Absorption to Theatricality and Back Again -- 3. "I Will Build a New Present" -- 4. Sons as Authors -- 5. Fathers as Publishers -- 6. The Daughter as Author -- 7. Lovers as Authors -- 8. At Sea with the Family -- 9. Yellow News, Yellow Stories -- 10. The Return Home -- Notes -- Bibliography -- Index -- About Jay WilliamsIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Description based on publisher supplied metadata and other sources.Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, YYYY. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries
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