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1.
J Photochem Photobiol B ; 140: 36-40, 2014 Nov.
Article in English | MEDLINE | ID: mdl-25086322

ABSTRACT

Avobenzone is one of the most common UVA-filters in sunscreens, and is known to be photounstable. Some of the strategies used to stabilize this filter present some drawbacks like photosensitization reactions. Antioxidants are widely used as cosmetic ingredients that prevent photoageing and complement the photoprotection offered by the UV-filters preventing or reducing photogenerated reactive species. The purpose of this work was to study the effect of antioxidants in the photostabilization of avobenzone. The filter dissolved in dimethyl sulfoxide or incorporated in a sunscreen formulation was irradiated with simulated solar radiation (750 W/m(2)). The tested antioxidants were vitamin C, vitamin E, and ubiquinone. The area under the curve of the absorption spectrum for UVA range and the sun protection factor (SPF) were calculated. Vitamin E (1:2), vitamin C (1:0.5) and ubiquinone (1:0.5) were the more effective concentrations increasing the photostability of avobenzone. In sunscreen formulations, the most effective photostabilizer was ubiquinone which also promoted an increase in SPF. This knowledge is important to improve effectiveness of sunscreen formulation. Antioxidants can be valuable ingredients for sunscreens with a triple activity of filter stabilization, SPF boosting and photoageing prevention.


Subject(s)
Antioxidants/chemistry , Propiophenones/chemistry , Sunscreening Agents/chemistry , Ascorbic Acid/chemistry , Chemistry, Pharmaceutical , Dimethyl Sulfoxide/chemistry , Drug Stability , Photolysis/radiation effects , Sun Protection Factor , Ubiquinone/chemistry , Ultraviolet Rays , Vitamin E/chemistry
2.
Phys Med Biol ; 54(7): 2079-92, 2009 Apr 07.
Article in English | MEDLINE | ID: mdl-19287089

ABSTRACT

The purpose of this study was to develop a novel scintillation dosimeter for in vivo dosimetry in Ir-192 brachytherapy via the pulse-counting mode. The new dosimeter was made from a plastic scintillator shaped into a hemisphere of diameter 1 mm and connected to the tip of a plastic optical fiber. The relationship between pulse counts and absorbed dose was derived based on the assumption that scintillation photons from the incident gamma ray are proportional to the absorbed dose. An equation for the conversion of pulse counts to water-equivalent dose was deduced wherein the pulse height spectrum from scintillation photons was assumed to be exponential. To confirm its accuracy, the dose rate distribution in a water phantom was measured by the present dosimeter and this was compared with Monte Carlo simulations, resulting in a discrepancy of less than 1.97%. It was found that the dosimeter has a wide dynamic range of linearity up to an order of magnitude of almost 10(3), including corrections for loss of counts due to pile-up.


Subject(s)
Plastics , Radiometry/methods , Feasibility Studies , Iridium Radioisotopes , Monte Carlo Method , Optical Fibers , Radiation Dosage
3.
Amino Acids ; 34(1): 149-53, 2008 Jan.
Article in English | MEDLINE | ID: mdl-17619121

ABSTRACT

The capability of ficin, a cystine protease, to form peptide bonds was investigated using several types of N-Boc-amino acid phenyl and naphthyl esters as acyl donor components. Enzyme-catalyzed peptide synthesis was carried out under optimized reaction conditions of pH, acyl acceptor concentration and selection of the best yield organic solvent. It used a condensation of N-Boc-Ala-OpGu and Ala-pNA as a model reaction. The products were obtained in 72-96% yield using 10 different substrates, within a few minutes of reaction time.


Subject(s)
Ficain/metabolism , Peptides/metabolism , Amino Acids/chemistry , Amino Acids/metabolism , Animals , Catalysis , Cattle , Ficus/enzymology , Hydrogen-Ion Concentration , Molecular Structure , Substrate Specificity
4.
Eur J Histochem ; 45(1): 73-84, 2001.
Article in English | MEDLINE | ID: mdl-11411868

ABSTRACT

In order to identify the prognostic factors that significantly influence the disease-free survival rate after surgical resection of primary breast cancers, we determined tumour and lymph node grades, and immunohistochemical staining for estrogen and progesterone receptors (ER and PR), c-erbB-2, p53, bcl-2, bax and PCNA in 76 patients. Univariate analysis showed that increased grade of tumour and lymph nodes, negative immunostaining for ER, positive immunostaining for c-erbB-2, and a high PCNA index (> or = 30%) negatively influenced the disease-free survival rate, but PR, p53, bcl-2 and bax had no predictive value. Although p53 was not an independent prognostic factor by itself, the combination of p53, bcl-2, and bax proved to correlate with the disease-free survival, with the best prognosis noted in tumours negative for p53 and positive for both bcl-2 and bax, intermediate prognosis in tumours negative for p53 and positive for either bcl-2 or bax and worst prognosis in tumors negative for p53 as well as bcl-2 and bax. Tumour grade correlated positively with PCNA index, while positive staining for ER correlated negatively with tumour grade as well as with PCNA index, although this was statistically insignificant. Immunostaining of breast cancers for bcl-2 correlated negatively with tumour grade and PCNA index. Immunostaining for c-erbB-2 correlated positively with PCNA but not with tumour grade. Immunostaining for p53 tended to correlate positively with PCNA, but not with tumour grade. Immunostaining for PR and bax did not correlate with tumour grade and PCNA index. These results suggest that in addition to tumour size and lymph node involvement, immunostaining for ER, c-erbB-2, and a high PCNA index are important prognostic factors in human breast cancer. Wild-type p53 with preserved bcl-2 and bax gene products is also a favorable prognostic factor indicating breast cancer at an early stage of cancer progression.


Subject(s)
Breast Neoplasms/pathology , Carcinoma/secondary , Adult , Aged , Aged, 80 and over , Biomarkers, Tumor/analysis , Breast Neoplasms/chemistry , Breast Neoplasms/mortality , Breast Neoplasms/surgery , Carcinoma/chemistry , Carcinoma/mortality , Carcinoma/surgery , Disease-Free Survival , Female , Humans , Immunohistochemistry , Lymph Node Excision , Lymph Nodes/chemistry , Lymph Nodes/pathology , Lymph Nodes/surgery , Lymphatic Metastasis , Middle Aged , Proliferating Cell Nuclear Antigen/analysis , Receptor, ErbB-2/analysis , Receptors, Estrogen/analysis , Receptors, Progesterone/analysis , Survival Rate
5.
Anticancer Res ; 21(6A): 3871-4, 2001.
Article in English | MEDLINE | ID: mdl-11911261

ABSTRACT

Progesterone has been used in the treatment of patients with recurrent or metastatic progesterone receptor-positive endometrial carcinoma and breast cancer. In vitro study using a breast cancer cell line, T47D, demonstrated an increase in p53 gene expression and induction of apoptosis by the administration of progesterone. Therefore, we investigated the effect of progesterone administration on the proliferation and apoptosis in a mesothelioma cell line, 211H. The expression of the progesterone receptor gene was detected in this cell line by a nested RT-PCR method. The proliferation of the cell line was suppressed after a 10-day incubation with 30 microM progesterone. In progesterone-treated 211H cells, apoptotic cells were detected by TUNEL assay and nuclear DNA fragmentation analysis. These results clearly demonstrated that progesterone administration suppressed the cell proliferation and induced apoptosis in malignant mesothelioma cells.


Subject(s)
Apoptosis/drug effects , Mesothelioma/drug therapy , Mesothelioma/pathology , Progesterone/pharmacology , Breast Neoplasms/drug therapy , Breast Neoplasms/metabolism , Breast Neoplasms/pathology , Cell Division/drug effects , DNA Fragmentation/drug effects , Humans , In Situ Nick-End Labeling , Mesothelioma/metabolism , Receptors, Progesterone/biosynthesis , Reverse Transcriptase Polymerase Chain Reaction , Tumor Cells, Cultured
7.
Int J Cancer ; 85(5): 716-9, 2000 Mar 01.
Article in English | MEDLINE | ID: mdl-10699954

ABSTRACT

For specific transduction of herpes simplex virus thymidine kinase (HSV-tk) into human small-cell lung carcinoma (SCLC) cells, we explored the 5'-flanking region (-1.1 kb) of the gastrin-releasing peptide (GRP) gene as a lung cancer-specific promoter. RT-PCR analysis demonstrated expression of GRP mRNA in the SBC5 human SCLC cell line but not in the RERF human SCLC cell line, the A549 human lung adenocarcinoma cell line or the HeLa human uterine cervix epithelioid carcinoma cell line. A reporting vector containing the GRP promoter (pGL2-GRP) exhibited higher luciferase activity in SBC5 than in the other 3 cell lines. After transfecting an expression vector containing the GRP promoter-bound HSV-tk gene (pGRP-TK) into the cells, we measured their sensitivity to ganciclovir (GCV). In SBC5, pGRP-tk-transfected cells became about 100 times more sensitive to GCV than parental cells in vitro. In nude mice, tumors of pGRP-tk-transfected SBC5 regressed completely after i.p. administration of GCV. GRP promoter might be a good tool for tumor-specific transduction of suicide genes in GRP-expressing SCLC cells.


Subject(s)
Carcinoma, Small Cell/pathology , Ganciclovir/toxicity , Gastrin-Releasing Peptide/genetics , Lung Neoplasms/pathology , Promoter Regions, Genetic , Thymidine Kinase/genetics , Animals , Antiviral Agents/therapeutic use , Antiviral Agents/toxicity , Carcinoma, Small Cell/drug therapy , Cell Division/drug effects , Ganciclovir/therapeutic use , Genetic Vectors , HeLa Cells , Humans , Luciferases/biosynthesis , Luciferases/genetics , Lung Neoplasms/drug therapy , Mice , Mice, Nude , Recombinant Fusion Proteins/biosynthesis , Simplexvirus/enzymology , Transfection , Transplantation, Heterologous , Tumor Cells, Cultured
8.
Rinsho Byori ; 48(11): 993-1005, 2000 Nov.
Article in Japanese | MEDLINE | ID: mdl-11132563

ABSTRACT

Survival rate of liver transplanted patients is depending on management of postoperative complications. These complications include technical problems related to the operation, dysfunction of the allograft, and variety of medical complications. Differentiating and appropriately managing these diverse complications is a formidable challenge. Given the complexity of liver transplantation, it is not surprising that a variety of technical complication can occur following the operation. The most prominent of these include intraabdominal bleeding, hepatic artery thrombosis, portal vein thrombosis, and obstruction of or leak from the biliary anastomosis. In addition to these technical complications, each of which can result in dysfunction of the graft, there are a number of intrahepatic causes of graft dysfunction. The most common of these are allograft rejection, viral hepatitis and non-specific postoperative jaundice. In living related liver transplantation, primary graft non-function is rare. Accurate diagnosis and management of the various causes of graft dysfunction, whether intrahepatic or extrahepatic in origin, is very important.


Subject(s)
Liver Transplantation , Postoperative Care , Postoperative Complications , Blood Loss, Surgical/prevention & control , Graft Rejection/diagnosis , Graft Rejection/therapy , Hepatic Artery , Humans , Postoperative Complications/diagnosis , Postoperative Complications/therapy , Thrombosis/diagnosis , Thrombosis/therapy
9.
Intern Med ; 38(11): 887-91, 1999 Nov.
Article in English | MEDLINE | ID: mdl-10563751

ABSTRACT

CA 19-9 is a widely used tumor marker. However, an elevation in serum CA 19-9 can occur in some patients with benign disorders such as cholecystolithiasis in the absence of tumor. We treated a case of acquired ureteral stone-induced giant hydronephrosis with markedly elevated serum CA 19-9 values. After nephrectomy, the serum CA 19-9 level returned to normal. No malignant cells were found in the tissues of the resected kidney. Localization of CA 19-9 was confirmed by immunohistochemical staining of the renal pelvic mucosa. A detailed case report is presented with a review of the literature.


Subject(s)
CA-19-9 Antigen/blood , Hydronephrosis/etiology , Ureteral Calculi/complications , Adult , CA-19-9 Antigen/analysis , Female , Humans , Hydronephrosis/blood , Hydronephrosis/surgery , Kidney/pathology , Nephrectomy , Risk Factors , Ureteral Calculi/blood
10.
Bioorg Med Chem ; 7(9): 1933-40, 1999 Sep.
Article in English | MEDLINE | ID: mdl-10530942

ABSTRACT

Angelicin, a naturally occurring furanocoumarin, that showed antifungal activity, was considered as a lead structure for a group of synthetic coumarins. Antifungal activities of the synthesized coumarins and angelicin derivatives were reported against Candida albicans, Cryptococcus neoformans, Saccharomyces cerevisiae and Aspergillus niger. Human cell line cytotoxicity of several coumarins was evaluated against KB cells. Angelicin and several potent antifungals showed to be non-toxic in this assay.


Subject(s)
Antifungal Agents/chemical synthesis , Antifungal Agents/pharmacology , Coumarins/chemical synthesis , Coumarins/pharmacology , Antifungal Agents/chemistry , Aspergillus niger/drug effects , Candida albicans/drug effects , Cell Line , Cell Survival/drug effects , Coumarins/chemistry , Cryptococcus neoformans/drug effects , Microbial Sensitivity Tests , Molecular Structure , Saccharomyces cerevisiae/drug effects , Spectrum Analysis
12.
Chest ; 114(4): 1203-4, 1998 Oct.
Article in English | MEDLINE | ID: mdl-9792596

ABSTRACT

A recurrent pericardial cyst manifested as an enlarging cardiophrenic cyst and was reexcised with the aid of video-assisted thoracic surgery. Video-assisted thoracic surgical excision can be a safe and effective approach, but complete excision should be performed to avoid recurrence.


Subject(s)
Mediastinal Cyst/surgery , Thoracic Surgical Procedures/methods , Video Recording , Adult , Endoscopy , Female , Follow-Up Studies , Humans , Mediastinal Cyst/diagnostic imaging , Recurrence , Safety , Thoracoscopy , Tomography, X-Ray Computed
13.
Chest ; 114(1): 229-35, 1998 Jul.
Article in English | MEDLINE | ID: mdl-9674474

ABSTRACT

BACKGROUND: Although the indications for extracorporeal membrane oxygenation (ECMO) have been extended, ECMO has yet to be used as a respiratory support system during thoracic surgery. The purpose of this experimental study was to investigate whether veno-right ventricular (veno-RV) ECMO can be used for thoracic surgery without mechanical ventilation. METHODS: Acute experimental study: Veno-RV ECMO as total lung support was maintained for 60 min without mechanical ventilation in six dogs. A venous drainage cannula was inserted in the superior cavoatrial junction through the right femoral vein and a venous return cannula was inserted in the right ventricle through the right jugular vein. The veno-RV ECMO system comprised a centrifugal pump and membrane oxygenator. Survival model: After veno-RV ECMO had been established in three dogs, a two-ring thoracic tracheal segment was resected and the tracheal ends were anastomosed by video-assisted thoracic surgery without ventilation. RESULTS: In the acute study, when the veno-RV ECMO flow was maintained at 100 mL/kg/min, all six dogs remained hemodynamically stable and the arterial oxygen saturation was maintained at more than 98%, despite total lung collapse. In the survival study, all three dogs made an uneventful postoperative recovery. CONCLUSION: Video-assisted tracheal surgery can be performed without conventional respiratory support. Veno-RV ECMO as total lung support may become an alternative respiratory management device for thoracic surgery.


Subject(s)
Extracorporeal Membrane Oxygenation/methods , Thoracic Surgical Procedures , Anastomosis, Surgical , Animals , Catheterization/instrumentation , Disease Models, Animal , Dogs , Drainage/instrumentation , Endoscopy , Equipment Design , Extracorporeal Membrane Oxygenation/instrumentation , Femoral Vein , Heart Atria , Heart Ventricles , Hemodynamics , Jugular Veins , Oxygen/blood , Oxygenators, Membrane , Respiration, Artificial , Survival Rate , Thoracoscopy , Thoracotomy , Trachea/surgery , Vena Cava, Superior , Video Recording
14.
Talanta ; 46(4): 671-8, 1998 Aug.
Article in English | MEDLINE | ID: mdl-18967191

ABSTRACT

A sensitive analytical method for the simultaneous assay of nitrate and nitrite in water and some fruit samples is presented. The method is based on nitrite determination using the diazotization-coupling reaction by column preconcentration and on the reduction of nitrate to nitrite using the Cd-Cu reductor column. Nitrite is diazotized with sulfanilamide (SAM) in the pH range 2.0-5.0, sulfamethizole (SM) in pH 1.8-5.6 and sulfadimidine (SD) in pH 1.8-4.0 in a hydrochloric acid medium to form water-soluble colourless diazonium cations. These cations were coupled with sodium 1-naphthol-4-sulfonate (NS) in the pH range 9.0-12.0 for the SAM-NS system, pH 8.6-12.0 for the SM-NS system and pH 9.4-12.0 for the SD-NS system to be retained on naphthalene-tetradecyldimethylbenzylammonium (TDBA)-iodide (I) adsorbent packed in a column. The solid mass is dissolved out from the column with 5 ml of dimethylformamide (DMF) and the absorbance is measured by a spectrophotometer at 543 nm for SAM-NS, 537 nm for SM-NS and 530 nm for SD-NS. The calibration graph was linear over 30-600 ng NO(2)-N and 22-450 ng NO(3)-N in 15 ml of final aqueous solution (i.e. 2-40 ng NO(2)-N ml(-1) and 1.5-30 ng NO(3)-N ml(-1) in aqueous sample) for three systems. The detection limits were 1.4 ng NO(2)-N ml(-1) and 1.1 ng NO(3)-N ml(-1) for SAM-NS, 1.2 ng NO(2)-N ml(-1) and 0.89 ng NO(3)-N ml(-1) for SM-NS, 1.0 ng NO(2)-N ml(-1) and 0.75 ng NO(3)-N ml(-1) for SD-NS, respectively. The concentration factor is eight for SAM-NS and SM-NS, and 12 for SD-NS. Interferences from various foreign ions have been examined and the method was successfully applied to the determination of low levels of nitrate and nitrite in water and some fruit samples.

15.
Thorac Cardiovasc Surg ; 45(2): 100-1, 1997 Apr.
Article in English | MEDLINE | ID: mdl-9175230

ABSTRACT

Although surgical intervention for advanced lung cancer invading the aortic wall is challenging, we successfully carried out such radical surgery under cardiopulmonary bypass as previously reported in this journal. One patient has now been followed for more than 5 years after the operation, so that we conclude if there is no evidence of metastatic cancer in selected patients then complete resection should be attempted using circulatory support, with the hope of an occasional cure.


Subject(s)
Aorta, Thoracic , Carcinoma, Squamous Cell/secondary , Cardiopulmonary Bypass/methods , Lung Neoplasms/pathology , Vascular Neoplasms/secondary , Carcinoma, Squamous Cell/diagnostic imaging , Carcinoma, Squamous Cell/surgery , Humans , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/surgery , Male , Middle Aged , Tomography, X-Ray Computed , Vascular Neoplasms/diagnostic imaging , Vascular Neoplasms/surgery
16.
Kyobu Geka ; 50(4): 283-5, 1997 Apr.
Article in Japanese | MEDLINE | ID: mdl-9095587

ABSTRACT

Lobectomy under a thoracoscope is a minimally invasive surgery and full consideration must also be given to the length of access thoracotomy and the number of access ports inserted. On the other hand, securing a full visual field within a limited access and treating the pulmonary artery/vein and bronchus safely and for sure are needed. However, it would not be too much to say that the easiness of lobectomy under a thoracoscope depends on the length of access thoracotomy and the number of access ports inserted. In the experiment this time we discussed an approach to the access area in lobectomy under a thoracoscope in our cases.


Subject(s)
Endoscopy/methods , Pneumonectomy/methods , Thoracoscopy , Aged , Female , Humans , Lung Diseases, Fungal/surgery , Lung Neoplasms/surgery , Male , Middle Aged , Minimally Invasive Surgical Procedures , Video Recording
17.
Eur Radiol ; 7(4): 586-8, 1997.
Article in English | MEDLINE | ID: mdl-9204347

ABSTRACT

Pulmonary amyloidoma is a rare disease which is usually found incidentally on chest radiographs in asymptomatic, elderly people. Amyloid nodules may be solitary or much more commonly multiple. There have been many reports of radiological findings of pulmonary amyloidosis; however, those have not been characteristic. We report the findings on CT and MRI of a proven primary pulmonary amyloidoma in an asymptomatic 76-year-old woman. The low intensity of the lesion on T2-weighted images may be useful in the differential diagnosis from bronchogenic carcinoma.


Subject(s)
Amyloidosis/diagnosis , Lung Diseases/diagnosis , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Aged , Amyloidosis/diagnostic imaging , Carcinoma, Bronchogenic/diagnosis , Diagnosis, Differential , Female , Humans , Lung/diagnostic imaging , Lung/pathology , Lung Diseases/diagnostic imaging , Lung Neoplasms/diagnosis
18.
Int J Artif Organs ; 20(10): 557-61, 1997 Oct.
Article in English | MEDLINE | ID: mdl-9422490

ABSTRACT

A special lung support technique is required during carinal or tracheal surgery Veno-venous extracorporeal membrane oxygenation (ECMO) has become an accepted technique for temporary lung support. Therefore, the purpose of our experiments was to evaluate the effect of veno-venous ECMO (veno-right ventricle bypass) without ventilatory support. In five mongrel dogs, two venous drainage cannula were inserted into the superior vena cava through the right jugular vein and the inferior vena cava through the right femoral vein. In addition, a venous return cannula was inserted into the right ventricle (RV) through the right jugular vein. The veno-right ventricle (veno-RV) bypass system was composed of a centrifugal pump and membrane oxygenator; pump flow was maintained at 88 +/- 14 ml/kg/min. Excellent hemodynamics and good oxygenation were obtained. On the basis of these results, we conclude that veno-RV bypass may be used as lung support during pulmonary surgery even though the native lung is not ventilated during the veno-RV bypass procedure.


Subject(s)
Extracorporeal Membrane Oxygenation/methods , Heart Bypass, Right , Lung/surgery , Animals , Blood Gas Analysis , Dogs , Femoral Vein/physiology , Hemodynamics , Jugular Veins/physiology , Lung/pathology , Pulmonary Ventilation , Vena Cava, Inferior/physiology
19.
Nihon Kyobu Geka Gakkai Zasshi ; 44(7): 959-64, 1996 Jul.
Article in Japanese | MEDLINE | ID: mdl-8741556

ABSTRACT

We report a 61-year-old male patient who was admitted to our hospital for treatment of a rapidly growing tumor on the anterior chest. Chest roentgenography and chest CT scan showed a mass lesion extending to the subcutaneous tissue over the sternum. Although no primary lesion was revealed by subsequent examination and needle biopsy, en-bloc resection of the chest wall tumor was performed because the patient complained of chest pain and the tumor was growing rapidly. Reconstruction of the chest wall was performed using Marlex mesh and bonecement, and the skin defect was repaired with a rectus abdominis musculocutaneous flap. No complications were observed. The pathological diagnosis of the resected specimen was a metastatic sternal tumor from a primary hepatocellular carcinoma. However, postoperative evaluation failed to detect the primary lesion in the liver. Nine months after the operation, the patient remains alive and well without evidence of hepatocellular carcinoma or recurrence. To our knowledge, reports of solitary sternal metastasis from unknown primary hepatocellular carcinoma seem to be rare.


Subject(s)
Bone Neoplasms/secondary , Carcinoma, Hepatocellular/secondary , Neoplasms, Unknown Primary/pathology , Sternum , Aged , Humans , Male
20.
Kyobu Geka ; 49(6): 433-7;discussion 437-40, 1996 Jun.
Article in Japanese | MEDLINE | ID: mdl-8847837

ABSTRACT

Surgical and late follow-up results were compared between 40 elderly patients over 70-years-old (group I) and 43 patients aged from 65 to 69-years-old (group II) with acquired valvular heart disease. There was one hospital death in group I, and two hospital deaths in group II. There was no difference between group I and group II in the rate of hospital mortality of the occurrence of the surgical complications. Postoperative respiratory failure did not occur even in the elderly patients with preoperatively impaired vital capacity (%VC below 60%). Postoperative cardiac function after aortic valve replacement for aortic stenosis in elderly patients more significantly improved in comparison with preoperative function. Survival rate was 62% in group I and 78% in group II from actual survival curve at 9 year after surgery by Kaplan-Meier method. Late survival rate and cardiac event free rate were not significantly different between group I and II. Surgical results in elderly patients with valvular heart disease were satisfactory.


Subject(s)
Heart Valve Diseases/mortality , Heart Valve Diseases/surgery , Age of Onset , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Male , Prognosis , Survival Rate
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