“
“OBJECTIVES: To describe disease management, health behaviour,

psychological health and quality of life (QOL) in people with chronic respiratory disease (CRD).

METHODS: We analysed data from 798 adults with CRD drawn from the Korean National Nutlin-3 ic50 Health and Nutrition Examination Survey (KNHANES) 2005: 514 subjects with asthma alone, 258 with chronic obstructive pulmonary disease (COPD) alone, and 56 with asthma and COPD.

RESULTS: Disease management and health behaviour in this cohort were poor. One third of the cohort was not seeking any medical treatment, although many were currently experiencing respiratory symptoms. Twenty-six per cent of the subjects were current smokers who averaged 0.8 packs/day. More than half of the subjects did not exercise, only half of the subjects had regular health examinations and one third of the subjects did not get enough sleep. The study population

exhibited poor psychological indices, functional health status and QOL. The combined asthma and COPD group was characterised by an increased frequency of problems related to functional status and QOL.

CONCLUSIONS: People with CRD are at high risk for functional limitations, unhealthy behaviour, poor mental status and poor QOL. A comprehensive disease management programme for people with CRD should be developed using collaborative team efforts.”
“Granulocyte learn more colony-stimulating factor (G-CSF) is a cytokine that is clinically used to treat neutropenia. G-CSF also has non-hematopoietic functions and could potentially be used to treat neuronal injury. To confirm the safety and feasibility of G-CSF administration for acute spinal cord injury (SCI), we have initiated a phase I/IIa clinical trial of neuroprotective therapy using G-CSF.

The trial included a total of 16 SCI patients within 48 h of onset. In the first step, G-CSF (5 mu g/kg/day) was intravenously administered Stem Cell Compound Library for 5 consecutive days to 5 patients. In the second step, G-CSF (10 mu g/kg/day) was similarly administered to 11 patients. We evaluated motor and sensory functions of patients using the American Spinal Cord

Injury Association (ASIA) score and ASIA impairment scale (AIS) grade.

In all 16 patients, neurological improvement was obtained after G-CSF administration. AIS grade increased by one step in 9 of 16 patients. A significant increase in ASIA motor scores was detected 1 day after injection (P < 0.01), and both light touch and pin prick scores improved 2 days after injection (P < 0.05) in the 10 mu g group. No severe adverse effects were observed after G-CSF injection.

These results indicate that intravenous administration of G-CSF (10 mu g/kg/day) for 5 days is essentially safe, and suggest that some neurological recovery may occur in most patients. We suggest that G-CSF administration could be therapeutic for patients with acute SCI.

Main plots consisted of tillage systems including no tillage (T1); minimum tillage (T2) and conventional tillage (T3). Six methods of fertilization, including farmyard manure (N1); compost (N2); chemical URMC-099 molecular weight fertilizers (N3); farmyard manure + compost (N4); farmyard manure + compost + chemical fertilizers (N5) and control (N6) were arranged in the sub plots. Results showed that the highest rates of grain nitrogen (35.5 mg/g) and grain sulfur (3.62 mg/g) were obtained in N5 treatment. Highest grain nitrogen and N/S were observed in NT treatment. The highest amount of grain yield was obtained from T2N5 treatment. Using chemical fertilizers

provided phosphorus and nitrogen and adding FYM and compost made providing micronutrient for plants and organic matter in MT plots. Highest percentage of grain oil was obtained from N1 and N2 treatments and the highest oil yield was belonged to N5, CT and MT treatments. The highest (85.12%) and lowest oleic acid (78.11%) was obtained from T2N4 and T3N3 treatments, respectively. (C) 2012 Elsevier B.V. All rights

reserved.”
“Background: Disturbances in cholesterol metabolism have been associated with hypertension and Alzheimer’s disease (AD). Epacadostat mw We recently reported increased angiotensin-converting enzyme (ACE) activity and angiotensinogen (AGT) levels in the cerebrospinal fluid (CSF) of patients with mild cognitive impairment and AD. ACE activity positively correlated with plasma and CSF 27-hydroxycholesterol (27-OH)

levels, an oxysterol that passes to the brain from the blood. Additionally, we showed that 27-OH and 24(S)-hydroxycholesterol (24S-OH) enhance AGT synthesis and modulate renin and ACE activities in brain cells. Objectives: To gain insight into how oxysterols affect the brain renin-angiotensin JQ1 cell line system (RAS), we analyzed the effects of 24S-OH and 27-OH on two other proteins in this system: ACE2 and Mas receptor (MasR). Methods: RT-PCR and Western blot analysis in rat primary neurons treated with either 24S-OH or 27-OH. Results: The levels of ACE2 and MasR were increased by a physiological concentration (1 mu M) of these oxysterols after 24 h. Conclusions: 24S-OH and 27-OH enhance the brain RAS by acting on different levels, from the precursor to several downstream enzymes. Our results support the idea that disturbances in cholesterol metabolism would contribute to alterations in the brain RAS, which further suggest mechanistic links between two well-known risk factors for AD: hypercholesterolemia and hypertension. Copyright (C) 2012 S. Karger AG, Basel”
“Objectives: The purpose of this study was to evaluate the utility of B-type natriuretic peptide (BNP) to predict blood pressure (BP) response in patients with renal artery stenosis (RAS) after renal angioplasty and stenting (PTRA).

ABA modified gapcp1gapcp2 gene expression, but the mutant response to the hormone differed from that observed in wild-type plants. The gene expression of the transcription factor ABI4, involved in both sugar and ABA signalling, was altered in gapcp1gapcp2, suggesting that their ABA insensitivity is mediated, at least partially, through this transcriptional regulator. Serine supplementation was able partly to restore the ABA sensitivity of gapcp1gapcp2, indicating that amino acid homeostasis and/or serine metabolism may also be important determinants in the connections of ABA with primary metabolism. Overall, these studies provide new

insights into the links between plant primary metabolism selleck and ABA signalling, and demonstrate the importance of plastidial glycolytic glyceraldehyde-3-phosphate dehydrogenase in these interactions.”
“In this article, the tip-sample interaction regimes in the presence of hysteretic forces are investigated using atomic force microscopy in the tapping mode. For this purpose, two samples that cause the formation of hysteretic forces, namely, silicon (stiff sample) with an adsorbed water film and polyethylene (compliant sample), are used. Also, for deriving the equation of motion of the microcantilever, the continuous beam model is used, and for determining the

contact forces, depending on the sample under investigation, the Derjaguin-Muller-Toporov and Johnson-Kendall-Roberts

Selleck PD-1/PD-L1 inhibitor contact mechanics models are used. The results indicate that the hysteretic interaction forces generate high-periodic and irregular responses at certain tip-sample MEK inhibitor separation distances. In fact, at these distances, a family of steady-state attractors is found that can be observed in one branch on the minimum tip-sample separation curves and in two separate branches on the average force curves. The reason for this occurrence might be the alternate formation of a liquid column between the probe tip and the sample (in the presence of ambient moisture), and for the compliant sample, the reason might be the alternate formation of an adhesion neck. In this article, the role of hysteretic forces in producing the hysteresis of the amplitude-separation curves is also explored. (C) 2011 American Institute of Physics. [doi:10.1063/1.3610789]“
“In this article, the authors discuss the 6 domains of care identified by the Institute of Medicine report, Crossing the Chasm, with examples and questions that are especially relevant to physicians caring for children who have neurologic disorders and their families.”
“Similarly to microbial pathogens, plant-parasitic nematodes secrete into their host plants proteins that are essential to establish a functional interaction. Identifying the destination of nematode secreted proteins within plant cell compartment(s) will provide compelling clues on their molecular functions.

6 %) of 185 gastric carcinomas and its expression was closely associated with GKN1 immunonegativity. There was no significant relationship between altered expression of SOX9 protein and clinicopathological parameters HIF pathway including overall survival.

These data suggest that aberrant SOX9 expression by GKN1 inactivation may be involved in the development of

sporadic gastric cancers as an early event.”
“Purpose of review

Coccidioidomycosis is a fungal infection caused by Coccidioides spp., a fungus endemic to the southwestern USA. Immunocompromised patients with coccidioidomycosis often present with atypical manifestations. We provide clinical, diagnostic, and management approaches for clinicians in nonendemic areas who might encounter coccidioidomycosis in transplant recipients.

Recent findings

With preemptive screening, heightened awareness, and targeted prophylaxis, the incidence of coccidioidomycosis in transplant recipients has decreased to 1-3% in endemic areas. Dissemination and mortality continues to be clinically significant (about 30%). Serological findings are often unreliable in transplant recipients, necessitating invasive procedures for a tissue or microbiological diagnosis. Caspase-independent apoptosis Management recommendations are similar to those for immunocompetent hosts, except that transplant

patients may require more prolonged therapy and secondary prophylaxis to prevent reactivation. The exact risk of donor-derived coccidioidomycosis is unknown. Routine KPT-8602 mw antifungal prophylaxis is not currently recommended for transplant recipients visiting or relocating to endemic areas.

Summary

Transplant recipients who travel to or reside part-time or full-time in endemic areas are at risk for both primary and reactivated

coccidioidomycosis. Clinicians in nonendemic areas should be aware that early diagnosis followed by prompt antifungal therapy could be lifesaving. Prophylactic strategies can prevent reactivation in select circumstances.”
“Rodents, such as rats and mice, are strongly tactile animals who explore the environment with their long mobile facial whiskers, or macrovibrissae, and orient to explore objects further with their shorter, more densely packed, microvibrissae. Although whisker motion (whisking) has been extensively studied, less is known about how rodents orient their vibrissal system to investigate unexpected stimuli. We describe two studies that address this question. In the first we seek to characterize how adult rats orient toward unexpected macrovibrissal contacts with objects and examine the microvibrissal exploration behavior following such contacts. We show that rats orient to the nearest macrovibrissal contact on an unexpected object, progressively homing in on the nearest contact point on the object in each subsequent whisk.

This study surveyed US transplant administrators about education provided concerning KT and LD and culturally and linguistically competent care. Transplant administrators MAPK Inhibitor Library cell line were invited to participate in an anonymous Internet-based survey about education format, education providers, promoting LD, culturally and linguistically competent care

and center characteristics. Most (61%) transplant administrators contacted (N = 280/461) completed the survey. Most administrators (91%) reported that their center provides any type of formal education in their pre-KT evaluation. Education was mostly provided by: nurses (97%), social workers (72%) and surgeons (55%), and predominantly as one-on-one (80%) versus group discussions (60%). Education was primarily delivered through written materials (93%). Written educational materials in Spanish (86%) and the provision of interpreters (82%) were emphasized over educational sessions in Spanish (39%), or employing bilingual (51%) and bicultural staff (39%). Half (55%) promoted LD as the best option. Transplant centers need to take greater efforts to consistently provide appropriate education, promote LD, and provide culturally and linguistically competent care to ensure effective communication with all patients.”
“A germyl-bridged lanthanocene

chloride, Me2Ge(Bu-t-C5H3)(2)LnCl (Ln = Nd; (Cat-Nd), was prepared and successfully used Staurosporine solubility dmso as single catalyst to initiate the ring-opening polymerization of epsilon-caprolactone (epsilon-CL) for the first time. Under mild conditions (60 degrees C,[epsilon-CL]/Ln] = 200, 4 h), Cat-Nd efficiently catalyzes the polymerization of epsilon-CL, giving poly(epsilon-caprolactone) (PCL) with high

molecular weight (MW) (>2.5 x 10(4)) in high yield (>95%). The effects of molar ratio of [epsilon-CL]/Cat-Nd, polymerization temperature and time, as well as solvent were determined ERK inhibitor order in detail. When the polymerization is carried out in bulk or in petroleum ether, it gives PCL with higher MW and perfect conversion (100%). The higher catalytic activity of this neodymocene chloride could be ascribed to the bigger atom in the bridge of bridged ring ligands. Some activators, such as NaBPh4, KBH4, AlEt3, and Al(i-Bu)(3), can promote the polymerization of epsilon-CL by Cat-Nd, which leads to an increase both in the polymerization conversion and in the MW of PCL. (C) 2011 Wiley Periodicals, Inc. J Appl Polym Sci 123: 1212-1217, 2012″
“We have performed a detailed investigation of the fabrication and switching characteristics of ZnO-based memristive devices. The effects of doping and various metal contacts have been studied. It is observed that, with the use of A1 metal contacts and ZnO:A1 layers, relatively high R(OFF)/R(ON) ratios of 200 can be achieved.

From 1991 to 2008, 116 living donor selleck compound liver transplantations (LDLTs) were performed. Among these, 50 were included in this study. We compared calcineurin inhibitor plus steroid treatment without BXM (n = 14, control group) and with BXM (n = 36, BXM group). Although the rates of biopsied

patients with abnormal serum biochemical tests (SBTs) were similar in the control (10/14, 71.4%) and BXM (21/36, 58.3%) groups, ACR was diagnosed in 9/10 (90.0%) patients in the control group compared with 4/21 (19.0%) patients in the BXM group. In accordance with the histopathological diagnosis, there was a significant difference in the ratios of peripheral CD4+CD25+ T cells at five wk after LDLT between patients with and without ACR in the BXM group. Next, we divided the 32 patients without ACR in the BXM group into two groups: biopsied patients with abnormal SBTs and non-biopsied patients. The donor age of the biopsied patients was significantly higher than that of the non-biopsied patients. Induction with BXM BAY 73-4506 manufacturer reduced the incidence of ACR, and unique pathological phenomena responsible for graft dysfunction after LDLT with an increased incidence of abnormal SBTs were observed.”
“Purpose: To review the recurrence patterns in patients

with primary non-small cell lung cancer (NSCLC) treated with percutaneous image-guided radiofrequency (RF) ablation.

Materials and Methods: This retrospective review was institutional review board approved and HIPAA compliant. Informed consent was waived. Data from all patients with primary NSCLC who underwent lung RF ablation from January 1998 to January 2008 were reviewed. Ninety-one patients were identified. Ten patients with no posttreatment imaging results and two patients with multiple treated lung cancers were excluded. There were 79 tumors in 79 patients ( mean age, 75 years). Mean tumor size was 2.5 cm ( range, 1-5.5 cm). Fifteen FK228 research buy (19%) tumors were central, and 64 (81%) tumors were peripheral. Nineteen (24%) patients underwent adjuvant external beam radiation, and nine (11%) patients underwent concomitant brachytherapy. Correlation of computed tomography

and positron emission tomography imaging studies with biopsy results, tumor size, location, and stage was performed. Patterns of recurrence were classified as local, intrapulmonary, nodal, mixed ( local and nodal), and distant.

Results: Forty-five (57%) patients demonstrated no evidence of recurrence at follow-up imaging (range, 1-72 months; mean, 17 months). Recurrence was seen in 34 (43%) patients (range, 2-48 months; mean, 14 months). Recurrence after RF ablation was local in 13 (38%), intrapulmonary in six (18%), nodal in six (18%), mixed in two (6%), and distant metastases in seven (21%) cases. Median disease-free survival was 23 months. Sex, tumor location, and radiation therapy were not associated with risk of recurrence. Increasing tumor size (P = .

001) and 10% (P < 0.001) for a one-category difference in baseline PA in men and women, respectively.

Conclusion: Our results suggest that a higher level of PA reduces abdominal adiposity independent of baseline and changes in body weight and is thus a useful strategy for preventing chronic diseases and premature deaths. Am J Clin Nutr 2011;93:826-35.”
“By using the impedance spectroscopy (IS) and optical electric-field-induced second

harmonic generation (EFISHG) measurement, interfacial carrier relaxation in pentacene/C-60 double-layer organic solar cell (OSC) has been analyzed. The IS measurements showed that the interfacial carrier relaxation time was diminished https://www.selleckchem.com/products/hsp990-nvp-hsp990.html 70 times under photo illumination, due to the increase of carrier

density caused by the photovoltaic effect. The equivalent circuit analysis using a Maxwell-Wagner effect model well accounted for the IS results. On the other hand, the EFISHG measurements directly probed the interfacial carrier JNJ-26481585 datasheet behaviors caused by the photovoltaic effect. The results showed the suppression of the Maxwell-Wagner type carrier relaxation in OSCs by applying a voltage corresponding to the open circuit voltage V-oc. EFISHG measurement coupled with IS measurement provides a clear physics picture of interfacial phenomena related to the photovoltaic effect in OSCs. (c) 2011 American Institute of Physics. [doi: 10.1063/1.3642964]“
“Background: This study was undertaken to prospectively evaluate the impact of partial portal decompression on renal haemodynamics and renal function

in patients with cirrhosis and portal hypertension.

Methods: Fifteen consecutive patients (median age 49 years) with cirrhosis underwent partial portal decompression through portacaval shunting or transjugular intrahepatic portosystemic shunting (TIPS). Cirrhosis was caused by alcohol in 47%, hepatitis C in 13%, both in 33% and autoimmune factors in 7% of patients. Child class was A in 13%, B in 20% and C in 67% of patients. The median score on the Model for End-stage Liver Disease (MELD) was 14.0 (mean 15.0 +/- 7.7). Serum creatinine (SrCr) and creatinine clearance (CrCl) were determined pre-shunt, 5 days after shunting and 1 year after shunting. Colour-flow Doppler ultrasound CP-456773 supplier of the renal arteries was also undertaken with calculation of the resistive index (RI) and pulsatility index (PI). Changes in the portal vein-inferior vena cava pressure gradient with shunting were determined.

Results: With shunting, the portal vein-inferior vena cava gradients dropped significantly, with significant increases in PI in the early period after shunting. Creatinine clearance improved in the early post-shunt period. However, SrCr levels did not significantly improve. At 1 year after shunting, both CrCl and SrCr levels tended towards pre-shunt levels and the increase in PI did not persist.

Discussion: Partial portal decompression improves mild to moderate renal dysfunction in patients with cirrhosis.

55 to 109.67 mg equivalents of ascorbic acid/g fresh weight. For both two solvents, Bejo exhibited the highest this website phenolic content and total antioxidant activity, while Baydh El Hamam presented the lowest. A positive linear correlation between total antioxidant activity and phenolic contents was observed (R-2 = 0.83; R-2 = 0.74 for acetone/H2O and methanol/H2O, respectively).

The antioxidant activity of acetone/H2O and methanol/H2O extracts was carried using DPPH

radical-scavenging activity and reducing power. These results showed that dates had strongly scavenging activity on DPPH reaching 90.12% in methanol/H2O from Deglet Nour. Whereas, acetone/H2O showed the best reducing power which Bejo was significantly higher than the other varieties.

This study demonstrates the potential antioxidant activity with Tunisian date, that we can use these natural extracts as food additives in replacement of synthetic compounds. (C) 2012 Elsevier B.V. All rights reserved.”
“Chlorination of 3,6-di-tert-butyl-1,2-benzoquinone in a two-phase catalytic system (CH(2)Cl(2), HCl- H(2)O, H(2)O(2), Bu(4)NCl) led to halogen addition at the C=C bond, and subsequent dehydrochlorination of the adduct gave 3,6-di-tert-butyl-4-chloro-1,2-benzoquinone. Chlorination of the latter

afforded 3,6-di-tert-butyl-4,5-dichloro-1,2-benzoquinone.”
“Objectives: Hybrid aortic arch repair procedure was introduced to reduce invasiveness in high-risk Stem Cell Compound Library patients with aortic arch pathology. The good results are expanding its application, but endoleak, particularly

17DMAG purchase type I, remains its Achilles’ heel.

Design: We describe our experience with hybrid treatment of aortic arch diseases focussing on techniques and results to avoid type I endoleak.

Materials and Methods: A total of 15 high-risk patients with zone 0-2 aortic arch pathology underwent supra-aortic debranching on ascending aorta and proximal aortic arch reinforcement with a Dacron prosthesis. Metachronously, the procedure was completed with endovascular stent grafting (ESG).

Results: Median age was 70 years with a mean European System for Cardiac Operative Risk Evaluation (EuroSCORE) of 12.7 +/- 6.8. One patient died between aortic debranching and ESG. Mean time between surgical debranching and ESG was 32 +/- 27.7 days. No major neurological events occurred. Mean length of the landing zone for ESG was 3.8 +/- 0.8 cm. Computed tomography (CT) angiography scan performed soon after operation, and at 3, 6, and 12 months did not show any type I endoleak.

Conclusions: Supra-aortic debranching on ascending aorta with proximal aortic arch reinforcement is a useful step to ensure a safe landing zone for ESG, reducing risk early to midterm of endoleak. Longer term follow-up is required to confirm the viability of this technique. (C) 2010 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Herein, we report a novel approach for neurotransmission modification in vivo by transplantation of stem cells engineered to take up the neurotransmitter dopamine (DA) efficiently through the action of the human dopamine transporter (hDAT). As a functional

test in mice, we used voluntary alcohol consumption, which is known to release DA in nucleus accumbens Bucladesine molecular weight (NAC), an event hypothesized to help maintain drug-seeking behavior. We reasoned that reducing extracellular DA levels, by engrafting into NAC DA-sequestering stem cells expressing hDAT, would alter alcohol intake.

Methods: We have generated a neural stem cell line stably expressing the hDAT. Uptake kinetics of DA were determined to select a clone for transplantation. These genetically

modified stem cells (or cells transfected with a construct lacking the hDAT sequence) were transplanted bilaterally into the NAC of wild-type mice trained to consume 10% alcohol in a two-bottle SIS3 price free-choice test for alcohol consumption. Alcohol intake was then ascertained for 1 week after transplantation, and brain sections through the NAC were examined for surviving grafted cells.

Results: Modified stem cells expressed hDAT and uptaken DA selectively via hDAT. Mice accustomed to drinking 10% ethanol by free choice reduced their alcohol consumption after being transplanted with hDAT-expressing stem cells. By contrast, control

stem cells lacked that effect. Histologic examination revealed surviving stem cells in the NAC of all engrafted brains.

Conclusions: Our findings represent proof of principle suggesting that genetically GDC-0973 manufacturer engineered stem cells can be useful for exploring the role of neurotransmitters (or other signaling molecules) in alcohol consumption and potentially in other aspects of brain function.”
“Aims: An optimal utilisation rate for palliative radiotherapy in newly diagnosed cancers will be useful in the planning and delivery of cancer services and has not been reported to date. The aim of this study was to estimate the proportion of new cases of cancer that should receive palliative radiotherapy as their first course of radiotherapy at some time during the course of their illness.

Materials and methods: A previously developed model depicting indications for radiotherapy was merged with Australian cancer epidemiological data and re-analysed to identify palliative or radical treatment end points. Palliative radiotherapy end points were further divided by treatment site. The optimal palliative radiotherapy utilisation rates were compared with actual radiotherapy utilisation data for newly diagnosed cancers.

Results: Fourteen per cent of all new cancer cases should optimally receive palliative radiotherapy as their first course of radiotherapy treatment.

“
“A total of 35 actinomycetes was isolated from soil samples collected after fire operations at agricultural sites under shifting cultivation in northeast India. More than one-half of these isolates were observed in viable but nonculturable

(VBNC) state. Five isolates were always seen embedded with slimy bacteria during subculture; 11 morphologically distinct and cultivable isolates were subjected to characterization and identification. The isolates developed circular to irregular colonies of between 3 and 6 mm on tryptone yeast extract agar plates at 28 A degrees C following 7 days of incubation. The isolates could survive at temperatures between 4 and 50 A degrees C (optimum 28 A degrees C), and pH 5-11 (optimum 8). The isolates varied in cell morphology, utilization of carbon sources, sensitivity to antibiotics, and see more salt tolerance. Based on 16S rRNA sequencing, the isolates revealed maximum similarity to the genus Streptomyces (9), and to Kitasatospora and Nocardia (1 each). Several isolates were found to be positive for production of lytic (chitinase and glucanase) and industrially important (amylase, lipase, and protease) enzymes. The occurrence of actinomycetes in VBNC state and embedded with bacteria was attributed

to coping mechanisms associated with these organisms under stress (high temperature) conditions. The cultivable cultures extend the opportunity for further investigations on ecological resilience during fire operations.”
“Doses www.selleckchem.com/products/beta-nicotinamide-mononucleotide.html Nutlin-3a in vivo and schedules of the combination of S-1 and cisplatin for the treatment of advanced gastric cancer (AGC) have not been standardized. We therefore evaluated the efficacy and

feasibility of a 3-week schedule of S-1 and cisplatin in patients with AGC, as well as assessing factors prognostic of patient outcomes.

A total of 159 patients with AGC were treated with S-1 (40 mg/m(2) bid on days 1-14) and cisplatin (60 mg/m(2) IV on day 1) between January 2004 and December 2008.

Median follow-up duration was 20.0 months (range, 11.4-48.5 months), during which time 129 patients (81.1%) died. Patients received a median 6 cycles of chemotherapy (range, 1-19 cycles). Among the 59 patients with measurable disease, 1 achieved a complete response (1.7%) and 24 (40.7%) had partial responses, giving an overall response rate of 42.4% (95% CI, 23.0-61.8%). The median progression-free survival (PFS) was 5.8 months (95% CI, 4.8-6.9 months), and the median overall survival (OS) was 11.3 months (95% CI, 9.6-13.0 months). Multivariate analysis showed that initial metastasis, bone metastasis, and liver metastasis were independent prognostic factors for reduced PFS, whereas poor performance status, initial metastasis, and bone metastasis were prognostic for reduced OS. Application of a previous prognostic model showed that observed PFS and OS survival curves for patients in various risk groups differed significantly (P < 0.001 each).