Burst abdomen (BA) is a severe complication after abdominal surgery, which often requires urgent repair. However, evidence on surgical techniques to prevent burst abdomen recurrence (BAR) is scarce. We conducted a retrospective analysis of patients with BA comparing them to patients with superficial surgical site infections from the years 2015 to 2018. The data was retrieved from the institutional wound register. We analyzed risk factors for BA occurrence as well as its recurrence after BA repair and surgical closure techniques that would best prevent BAR.:1 Abkürzungsverzeichnis 2 Einführung 2.1 Aufbau der Bauchwand und operative Zugangswege in der Abdominalchirurgie 2.1.1 Anatomie 2.1.2 Zugangswege 2.2 Wundinfektionen 2.3 Definition „Platzbauch“ 2.4 Risikofaktoren und Ursachen von Fasziendehiszenzen 2.4.1 Biochemische Einflüsse auf die Wundheilung 2.4.2 Mechanische und technische Faktoren 2.4.3 Allgemeine individuelle Faktoren 2.5 Management des Platzbauchs 2.6 Spätkomplikationen des Platzbauches 2.6.1 Narbenhernien 2.6.2 Intestinale Fisteln 2.6.3 Netzinfektion 2.6.4 Re-Dehiszenzen 3 Zielsetzung der vorliegenden Arbeit 4 Publikation 5 Zusammenfassung der Arbeit 5.1 Einleitung 5.2 Wundregister nosokomialer Wundinfektionen der Klinik für Viszeral-, Transplantations-, Thorax- und Gefäßchirurgie am Universitätsklinikum Leipzig 5.3 Risikofaktoren für Platzbäuche 5.4 Platzbauchentstehung 5.5 Chirurgische Verschlusstechnik 5.6 Re-Dehiszenzen 5.7 Limitationen der Analyse 6 Literaturverzeichnis 7 Anlagen 7.1 Darstellung des eigenen Beitrags 7.2 Selbstständigkeitserklärung 7.3 Lebenslauf 7.4 Publikationen 8 Danksagung

Background: The association of body mass index (BMI) and long-term prognosis and outcome of patients with perihilar cholangiocarcinoma (pCCA) has not been well defined. The aim of this study was to evaluate clinicopathologic and oncologic outcomes with pCCA undergoing resection, according to their BMI. Methods: Patients undergoing liver resection in curative intention for pCCA at a tertiary German hepatobiliary (HPB) center were identified from a prospective database. Patients were classified as normal weight (BMI 18.5–24.9 kg/m2), overweight (BMI 25.0–29.9 kg/m2) and obese (>30 kg/m2) according to their BMI. Impact of clinical and histo-pathological characteristics on recurrence-free survival (RFS) were assessed using Cox proportional hazard regression analysis among patients of all BMI groups. Results: Among a total of 95 patients undergoing liver resection in curative intention for pCCA in the analytic cohort, 48 patients (50.5%) had normal weight, 33 (34.7%) were overweight and 14 patients (14.7%) were obese. After a median follow-up of 4.3 ± 2.9 years, recurrence was observed in totally 53 patients (56%). The cumulative recurrence probability was higher in obese and overweight patients than normal weight patients (5-year recurrence rate: obese: 82% versus overweight: 81% versus normal weight: 58% at 5 years; p = 0.02). Totally, 1-, 3-, 5- and 10-year recurrence-free survival rates were 68.5%, 44.6%, 28.9% and 13%, respectively. On multivariable analysis, increased BMI (HR 1.08, 95% CI: 1.01–1.16; p = 0.021), poor/moderate tumor differentiation (HR 2.49, 95% CI: 1.2–5.2; p = 0.014), positive lymph node status (HR 2.01, 95% CI: 1.11–3.65; p = 0.021), positive resection margins (HR 1.89, 95% CI:1.02–3.4; p = 0.019) and positive perineural invasion (HR 2.92, 95% CI: 1.02–8.3; p = 0.045) were independent prognostic risk factors for inferior RFS. Conclusion: Our study shows that a high BMI is significantly associated with an increased risk of recurrence after liver resection in curative intention for pCCA. This factor should be considered in future studies to better predict patient’s individual prognosis and outcome based on their BMI.

Although several investigations have shown a relationship between increased epicardial adipose tissue (EAT) and atrial fibrillation (AF), the association between EAT and ventricular tachycardia (VT) has not been evaluated. We investigated the association between EAT and post-ablation VT recurrence. In this study, sixty-one consecutive patients (mean age=62.0±13.9) undergoing VT ablation with pre-procedural cardiac magnetic resonance imaging (MRI) were recruited. EAT thickness was measured using cardiac MRI in the right and left atrioventricular grooves (AVGs), RV free wall, anterior, inferior, and superior interventricular grooves (IVGs). During a mean follow-up period of 392.9±180.2 days, post-ablation VT recurrence occurred in 15 (24.6%) patients. EAT thickness was significantly higher in the VT recurrence group than that in the non-recurrent VT at the right (18.7±5.7 vs. 14.1±4.4 mm; p=0.012) and left (13.3±3.9 vs. 10.4±4.1; p=0.020) AVGs. The best cut-off points for predicting VT recurrence were calculated as 15.5 mm for the right AVG (area under ROC curve=0.74) and 11.5 mm for the left AVG (area under ROC curve=0.72). Multivariate Cox regression analysis showed that pre procedural right AVG-EAT (HR: 1.2; 95% CI: [1.06-1.39], p=0.004) was the only independent predictor of VT recurrence after adjustment for covariates. Kaplan–Meier analysis showed a difference for post-ablation VT recurrence between the two groups with right AVG-EAT thickness cut-off value of <15.5 mm versus ≥15.5 mm (log-rank, p=0.003). Based on the finding of this study, we suggested a new possible imaging marker for risk stratification of post-ablation VT recurrence. A higher EAT may be associated with VT recurrence after catheter ablation of VTs.:Epicardial Adipose Tissue Anatomy Embryology Physiology and Pathophysiology Measurement of EAT EAT and heart disorders Future direction VT Catheter Ablation History of VT ablation Catheter ablation for VT in structural and non-structural heart Outcome of VT catheter ablation Predictors of VT recurrence after catheter ablation Objectives of the thesis Publication Summary References

No description available.

No description available.

No description available.

Despite increasing levels of military spending and a growing number of recurring conflicts, research has until now failed to consider the impact of arms transfers on the durability of peace. Investigating the recurrence of conflicts allows us to delve deeper into the enduring impact of arms transfers, shedding light on whether weapons induce, suppress, or merely postpone conflict relapse. This thesis studies the impact of post-conflict arms transfers on the likelihood of conflict recurrence, hypothesizing that the effect is conditional on the outcome of the previous conflict. By conducting a multinomial logistic regression analysis, the initial results of this study imply that post-conflict arms transfers can have a stabilizing effect, regardless of whether the initial conflict ended in a military victory or a negotiated settlement. However, a closer analysis of results implies that the advantages and disadvantages of arms transfers are highly contextual and depend on a series of factors that may fuel or contain violence.

Contexte : Le cancer de l’ovaire est considéré comme le cancer gynécologique le plus meurtrier au Canada et dans de nombreux pays. La majorité des femmes, en rémission après un cancer de l’ovaire, auront une récidive, fragilisant leur pronostic. Il existe un manque de connaissances sur la relation entre les facteurs modifiables et la survie au cancer de l’ovaire. L’alimentation semble jouer un rôle protecteur pour la survie au cancer du sein et du colon. En revanche, pour le cancer de l’ovaire, les études demeurent insuffisantes et controversées. Objectif : Nous avons souhaité examiner la relation entre la qualité de l’alimentation post-diagnostique précisément après le traitement et la récidive chez les survivantes du cancer de l’ovaire. Méthodes : Un total de 98 femmes diagnostiquées d’un cancer de l’ovaire épithélial de haut grade ont été recrutées à partir de l’étude de cohorte prospective sur les Habitudes de vie et le Pronostic du cancer de l’Ovaire au Québec (HPROQ). La qualité de l’alimentation à 6 et 10 mois post-traitement a été évaluée selon le Canadian - Healthy Eating Index 2005 (C-HEI 2005). Les rapports de risque instantanés (HR) et les intervalles de confiance à 95% (IC 95%) ont été obtenus selon le modèle à risque proportionnel de Cox pour examiner la relation entre la qualité de l’alimentation à 6 mois post-traitement et la récidive après un cancer de l’ovaire. Une seconde analyse a été réalisée en incluant les données du score C-HEI 2005 à 6 et à 10 mois post-traitement selon le modèle de Cox dépendant du temps. Résultats : Sur un suivi médian de 1,7 an, 47 participantes (48%) ont récidivé. Les résultats démontrent un HR proche de la valeur nulle pour la relation entre la qualité de l’alimentation élevée à 6 mois post-traitement et la récidive après un cancer de l’ovaire (HR tertile de score C-HEI 2005 le plus élevée versus le plus bas : 1,14, IC 95% : 0,52-2,54). Pour l’analyse de la régression de Cox dépendante du temps, le HR suggère une diminution du risque entre la qualité de l’alimentation élevée et la récidive du cancer de l’ovaire épithélial de haut grade (HR tertile de score C-HEI 2005 le plus élevée versus le plus bas : 0,76, IC 95% : 0,34-1,71). En revanche, face au manque de précision, comme en témoignent les larges intervalles de confiance, on ne peut pas exclure la possibilité que l’association observée soit due au hasard ou encore que l’association n’existe pas dans la population de référence. Conclusion : Nous avons observé une association nulle entre la qualité de l’alimentation à 6 mois post-traitement et la récidive après un cancer de l’ovaire. En tenant compte de la variabilité de l’alimentation à plus long terme, le HR suggère une diminution du risque entre la qualité de l’alimentation et la récidive après un cancer de l’ovaire. Toutefois, il est difficile de conclure à des interprétations robustes, en raison de l’imprécision de nos résultats. Par conséquent, les résultats ne sont pas assez informatifs pour émettre des recommandations nutritionnelles auprès des survivantes du cancer de l’ovaire. / Background: Ovarian cancer is the deadliest gynecological cancer in Canada and many other countries. Most women in remission from ovarian cancer diagnosis, will have a recurrence, compromising their prognosis. There is a lack of knowledge about the association between modifiable factors and ovarian cancer survival. Diet may play a protective role in breast and colon cancer survival, but studies on ovarian cancer survival remain insufficient and controversial. Objective: We investigated the relationship between diet quality post-diagnosis specially after treatment and recurrence in ovarian cancer survivors. Methods: A total of 98 women diagnosed with high-grade epithelial ovarian cancer were recruited in the Lifestyle Habits and Prognosis of Ovarian Cancer in Quebec (HPROQ) prospective cohort study. Diet quality at 6 and 10 months post treatment was evaluated according to the Canadian Healthy Eating Index - 2005 (C-HEI 2005). Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using the Cox proportional hazards model to examine the relationship between diet quality at 6 months post-treatment and recurrence after ovarian cancer. A second analysis was performed for C-HEI 2005 at 6 and at 10 months post-treatment, using Cox time-dependent analysis. Results: During a median follow-up of 1.7 years, 47 participants recurred. The results showed an hazard ratio (HR) near to the null value for the association between diet quality at 6 months post-treatment and recurrence after ovarian cancer, (HR for highest versus lowest tertile C-HEI 2005 score: 1.14, 95% CI: 0.52-2.54). For Cox time-dependent analysis, the HR suggests a reduced risk between high diet quality and recurrence of high-grade epithelial ovarian cancer (HR tertile of highest versus lowest 2005 C-HEI score: 0.76, 95% CI: 0.34-1.71). However, given the lack of precision, as shown by the wide confidence intervals, we cannot exclude the possibility that the observed association is due to chance, or that the association does not exist in the reference population. Conclusion: We observed a null association between diet quality at 6 months post-treatment and recurrence after ovarian cancer. Adjusting for longer-term dietary variation, HR suggests a reduced risk between high diet quality and ovarian cancer recurrence. However, due to the imprecision of our results, it is difficult to conclude robust interpretations. Consequently, the results are not sufficiently informative to provide dietary recommendations for ovarian cancer survivors.

No / Objectives Previous studies have demonstrated that intravesical administration of apaziquone (EOquin) has ablative activity against superficial bladder cancer marker lesions with 8 out of 12 complete responses recorded. We present a comparison between the rates of tumor recurrence before and after treatment with apaziquone. Methods The rate of tumor recurrence after treatment with apaziquone was compared with each patient's historical record of recurrences obtained from a retrospective analysis of the patients' case notes. The time to each recurrence event before apaziquone treatment and the time to the first recurrence after apaziquone treatment were recorded, and the data were analyzed using a population-averaged linear regression model using Stata Release, version 9.2, software. Results Of the eight complete responses obtained in the Phase I study, tumor recurrence occurred in 4 patients and the remaining 4 patients remained disease free after a median follow-up of 31 months. The time to the first recurrence after apaziquone treatment was significantly longer (P <0.001) compared with the historical pattern and recurrence interval before apaziquone. Before apaziquone instillation, the mean ± SE recurrence rate and tumor rate per year was 1.5 ± 0.2 and 4.8 ± 1.2, respectively, and these decreased to 0.6 ± 0.25 and 1.5 ± 0.8, respectively, after apaziquone treatment (P <0.05). Conclusions The results of this study indicate that early recurrences after treatment with apaziquone are infrequent and the interval to recurrence is significantly greater compared with the historical recurrence times for these patients. Larger prospective randomised trials are warranted to confirm these results. Aapaziquone (EOquin, USAN, E09, 3-hydroxy-5-aziridinyl-1-methyl-2[indole-4,7-dione]¿prop-¿-en-¿-ol) belongs to a class of anticancer agents known as bioreductive drugs that require metabolism by cellular reductases to generate a cytotoxic species.1 Although it is chemically related to mitomycin C, apaziquone has a distinctly different mechanism of action and preclinical activity profile.1 and 2 The initial optimism generated by its preclinical activity profile rapidly evaporated after the demonstration that intravenously administered apaziquone was clinically inactive against a range of solid tumors in Phase II clinical trials.3 and 4 Several possible explanations were considered for its lack of efficacy, but poor drug delivery to the tumor because of the rapid pharmacokinetic elimination of apaziquone in conjunction with relatively poor penetration through avascular tissue was considered to be the principal reason.5 On the basis of the rationale that intravesical administration would circumvent the problem of drug delivery and any apaziquone absorbed into the blood stream would be rapidly cleared,6 a Phase I-II clinical pilot study of intravesical administration of apaziquone to superficial bladder tumors was established.7 The results of that trial demonstrated that intravesically administered apaziquone has ablative activity against superficial bladder transitional cell carcinoma (TCC) marker lesions.7 These results were confirmed and extended in a Phase II clinical trial of 47 patients with superficial bladder TCC, in which complete responses were obtained in 67% of patients.8 Because all the enrolled patients in the original trial7 had had multiple recurrences after previous intravesical chemotherapy and/or immunotherapy, the purpose of the present study was, first, to report the recurrences that occurred after apaziquone treatment and, second, to study the effect of apaziquone instillation on the recurrence rate by statistically comparing these results with the historical pattern of recurrences for each patient before treatment with apaziquone.

在這篇論文裡，我們將要討論一類古典的問題，這類問題已經經由許多方法解決，例如：遞迴關係式、差分方程式、尤拉公式等等。接著我們歸納低維度的特性，並藉由定義出一組方程式-標準n維空間分割系統-來推廣這些特性到一般的$n$維度空間中。然後我們利用演算法來提供一個更直接的組合論證法。最後，我們會把問題再細分成有界區域與無界區域的個數。 / In this article, we will discuss a class of classical questions had been solved by Recurrence Relation, Difference Equation, and Euler's Formula, etc.. And then, we construct a system of equations -Standard Partition System of n-Dimensional Space- to generalize the properties of maximizing the number of regions made up by k partitioner in an n-dimensional space and look into the construction of each dimension. Also, we provide a more directly Combinatorial Argument by Algorithm for this kind of question. At last, we focus on the number of bounded regions and unbounded regions in sense of maximizing the number of regions.