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Dyspepsiecoli : zur Frage der bakteriellen Ätiologie der sogenannten alimentären Intoxikation
(1927)
One species of the louse genus Philopterus Nitzsch, 1818 is redescribed and illustrated: Philopterus acrocephalus Carriker, 1949 ex Acrocephalus luscinius (Quoy & Gaimard, 1830), A. melanopogon (Temminck, 1823), A. scirpaceus (Hermann, 1804), A. schoenobaenus (Linnaeus, 1758), Iduna aedon rufescens Stegmann, 1929, I. rama (Sykes, 1832), Locustella sp. and L. ochotensis (von Middendorff, 1853). Philopterus acrocephalus represents the first species of the Philopteruscomplex recorded in the family Locustellidae Bonaparte, 1854. Philopterus gustafssoni sp. nov. is described ex Regulus regulus (Linnaeus, 1758), R. regulus regulus (Linnaeus, 1758), R. regulus azoricus Seebohm, 1883, R. regulus buturlini von Loudon, 1911, R. regulus sanctaemariae Vaurie, 1954, R. regulus tristis Pleske, 1892 and R. ignicapillus (Temminck, 1820). Descriptions of both species are amended with genetic data, DNA sequences of mitochondrial cytochrome oxidase I, nuclear hyp and TMEDE6; concatenated sequences are compared to the morphologically nearest species with genetic data available, Philopterus citrinellae (Schrank, 1776) and Philopterus fringillae (Scopoli, 1772). Holotype of Philopterus reguli (Denny, 1842) is pronounced to be a straggler, determination of other known material from Regulidae is changed for Philopterus gustafssoni sp. nov.
Background: The potential anti-cancer effects of mammalian target of rapamycin (mTOR) inhibitors are being intensively studied. To date, however, few randomised clinical trials (RCT) have been performed to demonstrate anti-neoplastic effects in the pure oncology setting, and at present, no oncology endpoint-directed RCT has been reported in the high-malignancy risk population of immunosuppressed transplant recipients. Interestingly, since mTOR inhibitors have both immunosuppressive and anti-cancer effects, they have the potential to simultaneously protect against immunologic graft loss and tumour development. Therefore, we designed a prospective RCT to determine if the mTOR inhibitor sirolimus can improve hepatocellular carcinoma (HCC)-free patient survival in liver transplant (LT) recipients with a pre-transplant diagnosis of HCC. Methods: The study is an open-labelled, randomised, RCT comparing sirolimus-containing versus mTOR-inhibitor-free immunosuppression in patients undergoing LT for HCC. Patients with a histologically confirmed HCC diagnosis are randomised into 2 groups within 4-6 weeks after LT; one arm is maintained on a centre-specific mTOR-inhibitor-free immunosuppressive protocol and the second arm is maintained on a centre-specific mTOR-inhibitor-free immunosuppressive protocol for the first 4-6 weeks, at which time sirolimus is initiated. A 3-year recruitment phase is planned with a 5-year follow-up, testing HCC-free survival as the primary endpoint. Our hypothesis is that sirolimus use in the second arm of the study will improve HCC-free survival. The study is a non-commercial investigator-initiated trial (IIT) sponsored by the University Hospital Regensburg and is endorsed by the European Liver and Intestine Transplant Association; 13 countries within Europe, Canada and Australia are participating. Discussion: If our hypothesis is correct that mTOR inhibition can reduce HCC tumour growth while simultaneously providing immunosuppression to protect the liver allograft from rejection, patients should experience less post-transplant problems with HCC recurrence, and therefore could expect a longer and better quality of life. A positive outcome will likely change the standard of posttransplant immunosuppressive care for LT patients with HCC. (trial registered at www.clinicaltrials.gov: NCT00355862) (EudraCT Number: 2005-005362-36)