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Purpose: To evaluate the outcomes of patients with Ewing's sarcoma family of tumors (ESFT) treated with modern radiotherapy techniques with MRI along with optimal chemotherapy. Methods and Materials: The records of all 60 patients with ESFT who received radiation to the primary site between 1990 and 2004 were reviewed. All patients received chemotherapy, including vincristine, doxorubicin, cyclophosphamide, ifosfamide, and etoposide. Radiation was used as the sole modality for local control in 31 patients and was given either before (n = 3) or after surgical resection (n = 26) in the remainder. All patients had MRI and CT scan-based treatment planning, and 43% received intensity-modulated radiation therapy. Radiation doses ranged from 30 Gy to 60 Gy (median, 51 Gy), and 35% received hyperfractionated radiotherapy. Results: Median age was 16 years (range, 2-40 ...

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The aim of this retrospective study was to determine the safety and efficacy of chemoembolization (TACE) as palliative treatment for patients with unresectable intrahepatic cholangiocarcinoma (CCA) and to compare the results with those in the literature. Fifteen patients with histology-proven CCA (5 men, 10 women) had received palliative treatment with TACE over a 6-year period. The treatment protocol comprised repeated TACE at a minimum of 8-week intervals. TACE was performed with a mixture of 10 ml Lipiodol and 10 mg mitomycin C injected into the tumor-supplying vessels. Follow-up investigations after 8-10 weeks comprised contrast-enhanced multislice spiral CT and laboratory control. Statistical evaluation included survival analysis using the Kaplan-Meier method. During the investigation period 58 TACEs (3.9 #+-# 3.8; 1-15) were performed in 15 patients. Mean tumor size was 10.8 #+-# 4.6 cm (range, 2.0-18.0 cm). Unifocal ...

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Purpose: The occurrence of extraosseous Ewing's sarcoma (ES) in deep soft tissues has been well described, but cases in which this tumor occurs in a primary cutaneous or subcutaneous site have rarely been reported. The superficial variant may be less aggressive than are the more common bony and deep soft tissue counterparts with an apparently favorable outcome. A retrospective review of patients with cutaneous or subcutaneous ES was conducted to analyze outcome and patterns of failure. Methods and Materials: Between July 1985 and March 1997, 14 patients with cutaneous or subcutaneous ES were treated at St. Jude Children's Research Hospital. The median age at presentation was 16 years (range 7-21 years). Anatomic locations included trunk and pelvis (7), upper or lower extremity (4), and head and neck (3). The median size of the lesion was 3 cm (range, 1-12 cm). Thirteen had definitive surgical resections, and one had biopsy ...

UK PubMed Central (United Kingdom)

Diagnostic accuracy of the currently available serum markers of cardiac injury, such as myoglobin, creatine kinase and its myocardial isoform, are altered in patients with renal failure. It is shown...Full Text Available

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ObjectiveThe aim of this study was to ascertain whether all cervical cancer patients who received adjuvant concurrent chemoradiation (CCRT) for high risk of treatment failure after...Full Text Available

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Abstract Background: Premature ovarian failure is diagnosed with a picture of amenorrhea, elevated follicle-stimulating hormone (FSH), and age under 40 years. Twenty percent (20%) of patients with premature ovarian failure have a concomitant autoimmune disease. Cases of premature ovarian failure associated with Sj?gren syndrome have been reported in the literature. Patient and method: We report a case of a 42-year-old white woman with Sj?gren syndrome and premature ovarian failure who underwent a reversal of her premature ovarian failure and restoration of normal menses using an elimination diet protocol. The patient was diagnosed with her rheumatological condition in 2005 and started on disease-modifying antirheumatoid drugs, which were taken intermittently due to a concern over medicatio...

International Nuclear Information System (INIS)

Aim of this study was to evaluate the sensitivity of virtual colonoscopy (CT colonography) in the identification of colorectal cancer and to define the limitations and the advantages of this imaging modality, as well as indications to the examination. It was examined prospectively 62 symptomatic patients aged 36 to 82 years (28 women and 34 men). All patients underwent both conventional and virtual colonoscopy on the same day; the conventional examination allowed exploration of the entire colon. Conventional colonoscopy identified 89 lesions 3-50 mm in diameter, namely 84 benign and 5 malignant lesions. No lesions were identified in 12 patients. CT colonography identified 52 of the 89 lesions, with 57.1% diagnostic accuracy. They were 11 false positives (82.5% positive predictive value and 52.2% specificity) and 37 false negatives (24.5% negative predictive value and 58.4% sensitivity). Sensitivity was ...

UK PubMed Central (United Kingdom)

AimsThe prevalence and importance of liver function test (LFT) abnormalities in a large contemporary cohort of heart failure patients have not been systematically evaluated.Full Text Available

UK PubMed Central (United Kingdom)

We describe a 59-year-old patient who developed acute renal failure because of rhabdomyolysis after extensive red fire ant bites. This case illustrates a serious systemic reaction that may occur from...Full Text Available

UK PubMed Central (United Kingdom)

Forty-six patients with end-stage renal failure were subjected to iliac crest biopsy before the initiation of a dialysis programme and regardless of the presence of skeletal symptoms....Full Text Available

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Patients with heterotaxy syndrome often have complex cardiac and extracardiac anomalies requiring further detailed diagnostic evaluation. They often present severe cardiac failure early in life. Newer radiological modalities in the form of spiral computed tomography (CT) and three-dimensional reconstruction of spiral CT allow clear definition of the anatomy of these anomalies. A 59-year-old woman was diagnosed with polysplenia and multiple anomalies in an abdominal ultrasonography (US) during a control medical examination due to a trivial dietary mistake. She was then referred to our institution for further examination of these anomalies and an additional thoraco-abdominal computed tomography (CT) examination. The patient was totally asymptomatic at the time of admission. There was no significant past history and no abnormal laboratory data. We performed abdominal, pelvic and thoracic CT examinations ...

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The evaluation of hepatic histology and treatment of hepatitis C virus (HCV)/HIV-coinfected patients is rapidly changing. HCV has become an important cause of mortality in HIV-infected patients. Consequently, assessment of liver histology in all coinfected patients is particularly important. The evaluation of hepatic histology is shifting from reliance on the liver biopsy toward noninvasive modalities. Additionally, the importance of HCV-associated morbidity and mortality in HIV-infected patients has prompted increasing numbers of these patients to be HCV treatment candidates. Prospective trials in coinfected patients have reported lower sustained virologic responses compared to HCV-monoinfected patients. Consequently, the numbers of coinfected nonresponders to pegylated interferon/ribavir...

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This book provides an analysis of pathophysiologic concepts of trauma and reviews the effectiveness of the available imaging modalities in acute trauma of various organ system. Topics covered are chest injuries; abdominal trauma; fractures of long bones; the foot and ankle; the knee; hand and wrist; the elbow; the shoulder; the pelvis hips; the spine; the skull and facial trauma and the clinical assessment of multiple injuries patients. Comparative evaluation of diagnostic techniques of radiography is discussed. Normal anatomy and bone fractures along with soft-tissue injuries are described.

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Kidney Failure, Chronic

UK PubMed Central (United Kingdom)

Aging is a risk factor for heart failure, which is a leading cause of death world-wide. Elderly patients are more likely than young patients to experience a myocardial infarction (MI) and are...Full Text Available

UK PubMed Central (United Kingdom)

The presence of DNA-anti-DNA complexes in sera from patients with systemic lupus erythematosus (SLE) was investigated by two new radioimmunoassays (RIA) developed for this purpose and by measuring the...Full Text Available

UK PubMed Central (United Kingdom)

The measurement of bone loss in patients undergoing maintenance dialysis over a period of two and a half years is reported. The tendency to lose bone is a likely event in renal failure, but depends...Full Text Available

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Context. Cardiovascular medication overdoses can be difficult to treat. Various treatment modalities are currently recommended. Objective. To describe patient outcomes and adverse events of high-dose insulin therapy in consecutive overdose patients in cardiogenic shock after implementation of a high-dose insulin protocol (1-10 U/kg/h, while avoiding or tapering off vasopressors). Methods. This is an observational consecutive case series of patients identified from a registry. Data were collected by retrospective chart review of patients treated by our toxicology service with this protocol from February 2007 until March 2010. Results. Twelve patients were treated with high-dose insulin. The mean age was 36.5 years (SD 11.7). Seven patients had pre-existing vasopressor therapy, and all were ...

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Procedures for {sup 131}I ablation in renal failure are not known. In one patient receiving dialysis, detailed dosimetry and health safety aspects were obtained. The results showed insignificant contamination of equipment, but a surprisingly significant reduction in biologic half-life of {sup 131}I due to efficient dialysis extraction. The data indicate that {sup 131}I ablation can be done safely and easily during dialysis but that much higher {sup 131}I doses must be used to achieve equivalent results to those obtained in patients with normal renal function.

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The incidence of hepatocellular carcinoma (HCC) is increasing in developed countries and the general status of HCC patients is now by far better than a few years ago, allowing physicians to propose some different treatments of these patients. Among these treatments, intra-arterial injection of 131-iodine-labelled Lipiodol could be used in palliative, curative or adjuvant settings. After a brief summary of the modalities of this treatment, requiring the collaboration of Gastro-enterologists, Oncologists, Radiologists and Nuclear Medicine physicians, the different possibilities of therapeutic uses of this new approach are described and an outlook of these developments is proposed. (author)

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There has been a steady increase in the number of revision total knee arthroplasties being performed in the United States. Hinge knee prostheses are used predominantly in complex primary or revision arthroplasties, often as salvage procedures. Significant improvement of the articulation between the rotating hinge mechanism and tibial component has decreased the stresses that contributed to earlier failures in previous generation designs. Two cases of fracture of the tibial metal post in the rotating hinge of a revision total knee arthroplasty were evaluated and treated at our institution within a 1-month period. We present our experience with this construct failure and subsequent patient management.

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BackgroundModern metal-on-metal hip resurfacing implants are being increasingly used for young and active patients, although the long-term outcome and failure mechanisms of these...Full Text Available

UK PubMed Central (United Kingdom)

Serial studies of iron transport in patients on maintenance dialysis showed normal or raised values in almost all subjects and a transient increase soon after the start of dialysis in three. These...Full Text Available

UK PubMed Central (United Kingdom)

Evaluating the systolic function of the left ventricle (LV) is important in the hemodynamic management of the critically ill patients with circulatory failure. Echocardiography is considered the standard...Full Text Available

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Udgivelsesdato: DEC 1

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Twenty-two out of 31 patients with chronic renal failure and secondary hyperparathyroidism who underwent parathyroidectomy before operation underwent non-invasive image diagnosis of parathyroid glands by computed tomography (CT), scintigraphy with /sup 201/TlCl and /sup 99m/TcO/sup 4 +/, and/or ultrasonography. CT visualized 39 of 45 parathyroid glands (86.7%), weighing more than 500 mg. Scintigraphy with a subtraction method using a computer performed the diagnosis in 19 of 27 glands (70.4%). Ultrasonography detected 21 of 27 glands (77.8%). Image diagnosis was also useful in the postoperative follow-up study. The non-invasive image diagnosis of parathyroid glands in patients with chronic renal failure is thus valuable for 1) definite diagnosis of secondary hyperparathyroidism, 2) localization, and 3) diagnosis for effectiveness of conservative treatment.

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Gallstone is a common disease with a 10% prevalence in the United States and Western Europe. However, it is only symptomatic in 20-30% of patients, with biliary pain "colic" being the most common symptom. Complications of asymptomatic gallstone disease are generally rare, with an incidence of <1 %/yr. The most common complications of gallstone disease are acute cholecystitis, acute pancreatitis, ascending cholangitis, and gangrenous gallbladder. Less frequent complications include Mirizzi syndrome, cholecystocholedochal fistula, and gallstone ileus. Mirizzi syndrome and cholecystocholedochal fistula are two manifestations of the same process that starts with impaction of a gallstone in the gallbladder neck that results in obstruction of the bile duct, causing jaundice. The gallstone may erode into the bile duct, causing cholecystocholedochal fistula. Gallstone ileus refers to small bowel obstruction resulting from the impaction of one or more gallstones after ...

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Prostate cancer can be successfully treated using dynamic adaptive external beam radiation techniques along with interstitial brachytherapy to deliver curative therapies with low urinary, rectal and erectile function morbidity. Through the use of sophisticated, state-of-the art radiographic imaging for staging and treatment planning, a precise, individual design for treatment is accomplished. Symptom management and patient education are of paramount importance and are integrated throughout the treatment process.

International Nuclear Information System (INIS)

Radiology departments often underestimate the importance of protecting medical data during transmission, including the precautions taken to ensure data protection. In teleradiology, transmitted as well as stored patient data have to be signed digitally according to the currently valid regulation (Roentgenverordnung, RoeV). The DICOM standard facilitates a digital signature. So far, medical image manufacturers only announced to support this security feature. We introduce a solution that extends the feature of digital signing to older modalities. (orig.)

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Purpose: Extrahepatic cholangiocarcinoma is a rare malignancy. Despite radical resection, survival remains poor, with high rates of local and distant failure. To clarify the role of radiotherapy with chemotherapy, we performed a retrospective analysis of resected patients who had undergone chemoradiotherapy. Methods and Materials: A total of 45 patients (13 with proximal and 32 with distal disease) underwent resection plus radiotherapy (median dose, 50.4 Gy). All but 1 patient received concurrent fluoropyrimidine-based chemotherapy. The median follow-up was 30 months for all patients and 40 months for survivors. Results: Of the 45 patients, 33 underwent adjuvant radiotherapy, and 12 were treated neoadjuvantly. The 5-year actuarial overall survival, disease-free survival, metastasis-free survival, and locoregional control rates were 33%, 37%, 42%, and 78%, ...

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Soluble TWEAK is a member of the TNF-alpha family of cytokines that has been shown to predict mortality in patients with heart failure. Pulmonary artery hypertension is a devastating disease, in which right ventricular function has been shown to be the major determinant of prognosis. In this hypothesis-generating study, we sought to evaluate the potential usefulness of sTWEAK in the prediction of disease severity in patients with pulmonary artery hypertension. We therefore conducted a retrospective analysis of sTWEAK serum levels in 95 stable patients with PAH. For all patients data on hemodynamic parameters, biomarkers and functional exercise tests were available. Compared to controls, patients with PAH showed significantly decreased levels of sTWEAK [median 314?pg/ml (interquartile range...

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RIFLE criteria have been used to determine the incidence of acute kidney dysfunction (AKD) after orthotopic liver transplantation (OLT). However, no studies have focused on the incidence of AKD after OLT in patients with normal pre-OLT kidney functions. Using the RIFLE criteria, we determined the incidence and risk factors for AKD after OLT in patients with normal pre-OLT kidney function. We retrospectively analyzed the records of 112 patients who underwent OLT from January 2000 to February 2009 with normal prior kidney function. We investigated three levels of renal dysfunction outlined in the RIFLE criteria: risk (R); injury (I); and failure (F). Preoperative, intraoperative, and postoperative variables were collected. AKD occurred in 64 (57%) OLTs with risk, injury, and failure frequenc...

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Prognosis of 95 consecutive patients with non-small cell lung cancer with brain metastases were evaluated. Three factors, therapy for brain metastases, general performance status (PS) and distant metastases to other organs had significant impact on survival. Among these 3 factors, PS was independent from the other 2 factors. Significant correlation was present, however, between therapy and other organ metastases, and few patients with brain and other distant metastases received aggressive treatment for brain metastases. Cranial irradiation had significant impact on survival even in those patients with brain and other distant metastases. Cranial irradiation also reduced death from brain metastases in responders. Our results indicate that there are several subgroups with different prognosis in patients with non-small cell lung cancer with brain metastases, therefore the most beneficial treatment ...

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The aim of this review is to evaluate the role of inflammatory spine disease in patients with chronic back pain. The contribution of imaging modalities for the diagnostic evaluation of back pain is discussed. A systematic literature search based on the classification of seronegative spondyloarthropathies and rheumatoid arthritis was performed. The results of this search and the experiences in a large collective of rheumatological patients are analyzed. The prevalence of rheumatoid arthritis (1-2%) is comparable to that of spondyloarthropathies (1.9%). The etiology of these entities is not fully elucidated. Magnetic resonance imaging is increasingly used for early detection and surveillance of therapy with TNF-#alpha# antagonists. Bone marrow edema, which is only detectable with MRI, represents an early sign of inflammation. Therapy with TNF-#alpha# antagonists is based on clinical and laboratory criteria, and signs of ...

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Background. The `RISchio CArdiovascolare nei pazienti afferenti all' Area Vasta In Dialisi (RISCAVID) study is an observational and prospective trial including the whole chronic haemodialysis (HD) population in the northwest part of Tuscany (1.235 million people). The aim of the study was to elucidate the relevance of traditional and non-traditional risk factors of mortality and morbidity in HD patients as well as the impact of different HD modalities.Methods. A total of 757 HD patients (mean age 66 +- 14 years, mean dialytic age 70 +- 76 months, diabetes 19%) were prospectively followed up for 30 months and all-cause mortality, cardiovascular (CV) mortality and non-fatal CV events (acute myocardial infarction and stroke) were registered. At the time of the enrolment, demographic, clinical...

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The aim of this study was to evaluate the results of postoperative radiotherapy in a case of perihilar cholagiocarcinoma by analyzing overall survival rate, patterns of failure, prognostic factors for overall survival, and toxicity. Between January 1998 and March 2008, 38 patients with perihilar cholangiocarcinoma underwent a surgical resection and adjuvant radiotherapy. The median patient age was 59 years (range, 28 to 72 years), which included 23 men and 15 women. The extent of surgery was complete resection in 9 patients, microscopically positive margins in 25 patients, and a subtotal resection in 4 patients. The tumor bed and regional lymphatics initially received 45 Gy or 50 Gy, but was subsequently boosted to a total dose of 59.4 Gy or 60 Gy in incompletely resected patients. The median radiotherapy dose was 59.4 Gy. Concurrent ...

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Purpose: To evaluate MR imaging of the hip in patients with a clinically suspected impacted fracture of the femoral neck in cases where conventional plain films show negative or equivocal findings. Material and Methods: Twenty-seven such patients were prospectively examined by MR imaging with a 1.0 T unit, within 24 hours of admittance to hospital. A coronal T1-weighted turbo spin-echo sequence (n=27), and a coronal STIR sequence (n=25) or a coronal T2-weighted turbo spin-echo fast saturation sequence (n=2) were used. The evaluations were made by 2 radiologists with experience in musculoskeletal radiology. Results: There were 6 patients with a petrochanteric fracture, 2 without and 4 with slight displacement. Five patients had an impacted fracture of the femoral neck, and 3 had a fracture of the superior pubic bone. Of 2 patients with advanced arthrosis, i had an impacted femoral ...

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Purpose: To determine if involved field radiation (IF) is equivalent to standard whole bone radiation (SF) in local tumor control; to establish patterns of failure following treatment; and to determine response, event-free survival (EFS), and overall survival rates from multidisciplinary therapy in Ewing's sarcoma. Methods and Materials: Between 1983 and 1988, 184 children with Ewing's sarcoma were enrolled onto Pediatric Oncology Group 8346 (POG 8346). A total of 178 (97%) met eligibility criteria; 6 had pathology other than Ewing's sarcoma. Induction chemotherapy of cyclophosphamide/doxorubicin (adriamycin )(C/A) x 12 weeks was followed by local treatment either surgery or radiation therapy and C/A, dactinomycin, and vincristine for 50 weeks. Resection was advised for patients with small primary tumors if accomplished without functional loss. Forty patients were randomized to receive SF, whole bone radiation to 39.6 Gy ...

British Library Electronic Table of Contents (United Kingdom)

Background/Objectives: Cardiotoxic drug poisoning can lead to severe cardiac shock (CS) and death. B-type natriuretic peptide (BNP) is a well-established diagnostic and prognostic marker in heart failure but has never been assessed in patients with cardiotoxic drug poisoning. The aim of the study was to determine whether BNP could be useful for early stratification of patients admitted to intensive care unit. Methods: 30 consecutive patients experiencing shock and cardiotoxic drug exposure were enrolled in a prospective monocentric study and underwent at least two BNP measurements within the first 24 h after admission. Results: While BNP values on admission were poorly informative, subsequent BNP measurements (11 +- 6 h after admission) were significantly increased in patients with CS comp...

International Nuclear Information System (INIS)

To evaluate the role of positron emission tomography-computed tomography (PET-CT) in staging and determining early treatment response to chemotherapy in children with neuroblastoma (NB) and its correlation with the final outcome. Patients and Methods: Seventeen patients of NB with mean age of 51.5 months (age range 2-132 months; 14 males, 3 females) underwent serial "1"8F-fluorodeoxyglucose (FDG) PET-CT imaging. All 17 patients were for staging before any treatment. Twelve of 17 patients underwent "1"3"1I meta-iodobezylguanidine (MIBG) scan and bone scan. MIBG uptake was seen in the primary lesion in 11/12 patients. MIBG uptake in bones was seen in 3/12 patients. All bone lesions were concordant on MIBG and bone scan. Early response to chemotherapy was evaluated after two cycles using PET-CT. A 30% reduction in longest diameter was taken as cut-off value for ...

Science.gov (United States)

This study was performed to assess the possibility that patient age may independently affect improvements in health-related quality of life following percutaneous coronary intervention. One hundred five patients undergoing elective percutaneous coronary intervention at a single tertiary referral center between January 10, 2001 and January 6, 2002 were enrolled and prospectively evaluated. Health-related quality of life was assessed before and 1 year following percutaneous coronary intervention using Short Form-12 and the Seattle Angina Questionnaire. For the purpose of analysis, patients were divided according to age (younger than 60, 60-70, and older than 70 years). One hundred patients (95%) completed both questionnaires. Baseline characteristics among the age groups were similar in terms of gender, cardiac risk factors, and procedural details. All health-related quality-of-life indices demonstrated ...

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This review briefly discusses the clinical and basic science rationale for vagus nerve stimulation (VNS) in treatment-resistant depression (TRD). As the number of treatment failures for depression increases, the likelihood of achieving remission during acute treatment decreases, and the risk of relapse increases with the number of treatment failures. Two open trials of adjunctive VNS for TRD showed positive acute results and a growing benefit over time. The results of the acute randomized controlled trial were not significant for the primary outcome (response by HRSD-24), but the secondary measure (IDS-SR-30) was significant for VNS. A 12-month nonrandomized comparative analysis of patients receiving adjunctive VNS with TRD patients receiving treatment as usual showed significant results f...

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Purpose: Treatment results and the pattern of relapse were evaluated in the multimodal treatment of Ewing's sarcomas of the chest wall. Methods and Materials: In a retrospective analysis, 114 patients with non-metastatic Ewing's sarcoma of the chest wall were evaluated. They were treated in the CESS 81, CESS 86, or EICESS 92 studies between January 1981 and December 1993. The treatment consisted of polychemotherapy (VACA, VAIA, or EVAIA) and local therapy, either surgery alone (14 patients), radiotherapy alone (28 patients) or a combination of both (71 patients). The median follow-up was 46.6 months (range 5-170). A relapse analysis for all patients with local or combined relapses was performed. Results: Overall survival was 60% after 5 years, event-free survival was 50%. Thirty-seven patients had a systemic relapse (32.4%), 11 patients had ...

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...Key Phrase page for Kidney Failure: Books containing the phrase Kidney Failure Kidney Failure,Key Phrase Kidney Failure,Books containing Kidney Failure,Amazon....com: \\

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The interscalenic block technique is widely used for ambulatory shoulder surgery despite a substantial number of failures and adverse effects. We prospectively evaluated satisfaction in 40 consecutive patients who underwent open Bankart repair under a single general anesthesic performed in an ambulatory care unit. The mean age of the patients was 23 years. There were 29 men and 11 women. Patients were evaluated postoperatively with a visual analog scale of pain (in the recovery room, at the time of discharge, and the day after and 1 week after surgery) via a home assessment questionnaire that included the following: effectiveness of oral pain medication, ability to perform activities of daily life, and overall satisfaction. One patient failed to be discharged because of a feeling of faintn...

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Qualitative technetium Tc 99m bone scintigraphy using phosphate compounds and gallium 67 scintigraphy were described as a helpful means in diagnosing necrotizing external otitis (NEO). They were, however, claimed to be nonspecific. Quantitative Tc 99m methylene diphosphonate bone scintigraphy and gallium 67 scintigraphy were performed in eight patients with NEO and in 20 patients with severe external otitis, in order to prove usefulness of scintigraphy in the diagnosis of NEO. Ratios of lesion to nonlesion for bone scintigraphy were 1.67 {plus minus} 0.16 in patients with NEO and 1.08 {plus minus} 0.09 in patients with severe external otitis, and for gallium 67 scintigraphy they were 1.35 {plus minus} 0.24 in NEO patients and 1.05 {plus minus} 0.03 in patients with severe external otitis. There was no difference in uptake between diabetic ...

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Haemangiomas usually develop within the first few weeks of life, most regressing spontaneously before the age of 7 years. Some may ulcerate or compromise a vital function, in which case systemic corticosteroids, surgery or radiotherapy may be helpful. All of these treatment modalities are associated with significant morbidity. Treatment with the 585 nm flashlamp pulsed dye laser is safe and effective in the management of superficial vascular malformations. We report seven patients, under 12 months of age, who presented with proliferative haemangiomas, causing functional impairment. Ulcerated lesions were present in four patients. The patients were treated with the 585 nm pulsed dye laser (fluences 7.0-9.25 J/cm2), at intervals of 4-8 weeks. All of the lesions showed a significant reduction in size, together with improvement in the colour and integrity of the overlying skin. Treatment with the 585 nm ...

International Nuclear Information System (INIS)

The clinical courses of heterotopic ossification (HO) as a consequence of trauma and central nervous system insults have many similarities as well as dissimilarities. Detection is commonly noted at two months. The incidence of clinically significant HO is 10%-20%. Approximately 10% of the HO is massive and causes severe restriction in joint motion or ankylosis. The most common sign and symptom are decreased range of motion and pain. The locations are the proximal limbs and joints. Sites of HO about a joint may vary according to the etiology of the HO. Roentgenographic evolution of HO occurs during a six-month period in the majority of patients. Treatment modalities include diphosphonates, indomethacin, radiation, range of motion exercises, and surgical excision. Surgical timing differs according to etiology: traumatic HO may be resected at six months; spinal cord injury HO is excised at one year; and traumatic brain injury HO is removed at 1.5 ...

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Somatostatin receptor scintigraphy (SRS) is a valuable method for the detection of somatostatin receptor-positive lesions. Most gastrinomas (over-)express the somatostatin receptor subtype 2 which can be targeted by In-111 labeled Octreotide. Different studies show a high sensitivity of SRS for the localization and staging of gastrinomas. SRS seems to be superior to other non-invasive imaging modalities and has been proven to significantly contribute to patient management. However, the sensitivity depends on the size and exact localization of the tumors. Smaller lesions and lesions located in the duodenum show a significantly lower sensitivity. In any case, SRS belongs to the routine imaging procedure for gastrinomas for localization and staging and can also be used for evaluation of the tumor progression. (author)

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Purpose: To determine if involved field radiation (IF) is equivalent to standard whole bone radiation (SF) in local tumor control; to establish patterns of failure following treatment; and to determine response, event free (EFS) and overall survival rates from multi-disciplinary therapy in Ewing's Sarcoma (ES). Materials and Methods: Between 1983 and 1988, 184 children with ES were enrolled onto POG 8346. 178 (97%) met eligibility criteria; 6 had non-ES pathology. Induction treatment of Cyclophosphamide/Adriamycin (C/A) x 12 weeks was followed by local treatment either surgery or radiation therapy (XRT) and C/A, Dactinomycin and Vincristine for 50 weeks. Resection was advised for patients with small primary tumors if accomplished without functional loss. 40 patients were randomized to receive SF, whole bone XRT to 39.6 Gy plus a 16.2 Gy boost (total 55.8 Gy) or IF to 55.8 Gy while 84 were assigned to IF XRT. Results: Of 179 ...

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Acquired cystic kidney disease (ACKD), also known as acquired renal cystic disease (ARCD,) occurs in patients who are on dialysis for end-stage renal disease. It is generally accepted that ACKD develops as a consequence of sustained uremia and can first manifest even before dialysis is initiated while the patient is still in chronic renal failure. The role of immune suppression, particularly in transplant recipients, in the development of ACKD, is still under investigation. The prevalence of ACKD is directly related to the duration of dialysis and the risk of cancer is directly related to the presence of cysts. Herein we review the current understanding of the pathophysiology and imaging implications of ACKD. (orig.)

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This paper shows the efficacy of computed radiography for major airway in pediatrics. For this purpose, we examined 40 children (range 2 weeks to 14 years; mean 2.3 years) using Fuji Computed Radiography (FCR) and radiation dose using pediatric phantom under FCR and conventional film and screen system. In comparison study with FCR and conventional film and screen system, FCR images are superior to conventional system in all cases. Scorings were done for the quality of the image of the pharynx, the trachea, and both main bronchi. In phantom study to check radiation dose, radiation dose could be reduced 1/6 of the value using high speed film and screen and 1/15 of the value using conventional speed film and screen. FCR also showed clear airway images in all cases but technical failure to evaluate the clinical lesion. These results suggest that FCR is the adequate imaging modality to evaluate the major airway in children. (author).

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Purpose: To evaluate the role of stereotactic radiosurgery (SRS) and whole-brain radiotherapy (WBRT) for the treatment of brain metastases in patients with renal cell cancer (RCC). Patients and methods: 88 patients were treated with either SRS (n = 51) or SRS + WBRT (n = 17) for one to three lesions, or with WBRT (n = 20) for more than three brain metastases. Overall survival (OS), intracerebral control (IC) and local control (LC) were retrospectively analyzed. Six potential prognostic factors were assessed: age, gender, number of brain metastases, extracerebral metastases, recursive partitioning analysis (RPA) class, and interval from tumor diagnosis to irradiation. Results: The median times for OS, IC, and LC from the time of diagnosis were 11, 9, and 10 months. The median OS times for SRS, SRS + WBRT, and WBRT were 12, 16, and 2 months. Addition of WBRT to the SRS improved IC (p = 0.032) but not OS (p = 0.703). On ...

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Purpose: A retrospective analysis was undertaken to determine the indications for, the efficacy of, and the long-term complications of two courses of total skin electron beam therapy for mycosis fungoides. Methods and Materials: A retrospective analysis of 15 patients with the pathologic diagnosis of mycosis fungoides treated in the Department of Radiation Oncology at Stanford University Medical Center between 1968 and 1990 was performed. All patients received two courses of high-dose electron beam therapy to the skin. The mean dose for the total skin treatment for the first course was 32.6 Gy and 23.4 Gy for the second course of treatment. Results: Following the first course of total skin electron beam therapy, 11 of 15 had a complete response, with a mean duration of 11.6 months. All patients received adjuvant therapies between the first and second courses of high-dose total skin electron beam therapy. The mean interval ...

Science.gov (United States)

Background: Determinants of warfarin use and anticoagulation levels in atrial fibrillation (AF) patients have not been clarified thoroughly. Methods and Results: A total of 6,324 patients with non-valvular AF and congestive heart failure, hypertension, age, diabetes, prior stroke (CHADS(2)) score ?1 were used to investigate determinants of warfarin use, and 6,932 patients with AF receiving warfarin were used to investigate determinants of international normalized ratio (INR) of prothrombin time. Target INR levels for non-valvular AF patients were 1.6-2.6 for patients aged ?70 years and 2-3 for patients aged transient ischemic attack (TIA), and had higher CHADS(2) scores than those not receiving warfarin. Determinants of warfarin use were age (?60 years), AF type (persistent and permanent), and comorbidities (congestive heart ...

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Aluminum toxicity has been implicated in the pathogenesis of a number of clinical disorders in patients with chronic renal failure on long-term intermittent hemodialysis treatment. The predominant disorders have been those involving either bone (osteomalacic dialysis osteodystrophy) or brain (dialysis encephalopathy). In nonuremic patients, an increased brain aluminum concentration has been implicated as a neurotoxic agent in the pathogenesis of Alzheimer's disease and was associated with experimental neurofibrillary degeneration in animals. The brain aluminum concentrations of patients dying with the syndrome of dialysis encephalopathy (dialysis dementia) are significantly higher than in dialyzed patients without the syndrome and in nondialyzed patients. Two potential sources for the increased tissue content of aluminum in patients ...

British Library Electronic Table of Contents (United Kingdom)

Aim: To evaluate the usefulness of routine laboratory parameters in the decision to treat refractory cardiac arrest patients with extracorporeal life support (ECLS). Methods: Sixty-six adults with witnessed cardiac arrest of cardiac origin unrelated to poisoning or hypothermia undergoing cardiopulmonary resuscitation without return of spontaneous circulation (duration: 155min [120-180], median, [25-75%-percentiles]) were included in a prospective cohort-study. ECLS was implemented under cardiac massage, using a centrifugal pump connected to a hollow-fiber membrane-oxygenator, aiming to maintain ECLS flow >=2.5l/min and mean arterial pressure >=60mmHg. Results: Forty-seven of 66 patients died within 24h from multiorgan failure and massive capillary leak. Of 19/66 patients who survived >=24h...

British Library Electronic Table of Contents (United Kingdom)

Acute kidney injury (AKI) is a common complication after allogeneic stem cell transplantation (SCT). Although various risk factors for AKI have been reported, the influence of pretransplant comorbidity on the incidence of AKI has not been well investigated. We performed a retrospective analysis of 207 consecutive patients undergoing myeloablative or nonmyeloablative SCT between 2001 and 2009, using the hematopoietic cell transplantation-specific comorbidity index (HCT-CI) as a representative of pretransplant comorbidities. According to Risk, Injury, Failure, Loss, and End-stage kidney disease (RIFLE) criteria, 158 patients (76.3%) developed AKI, and 92 patients (44.4%) developed severe AKI (RIFLE class I or class F) within 100 days after SCT. The cumulative incidence of severe AKI within 1...

British Library Electronic Table of Contents (United Kingdom)

Background: Intestinal failure (IF) is the dependence upon parenteral nutrition to maintain minimal energy requirements for growth and development. It may occur secondary to a loss of bowel length, disorders of motility, or both. Short bowel syndrome (SBS) is a malabsorptive state resulting from surgical resection, congenital defect, or diseases associated with loss of absorptive surface area. A particularly vexing problem is associated with whole bowel and/or segmental intestinal dysmotility. Motility disorders within the context of SBS and IF may relate to rapid intestinal transit secondary to loss of intestinal length, dysmotility associated with loss or poor antegrade peristalsis, or gastroparesis. Therapy may be classified into medical (prokinetic and antidiarrheal agents) and surgica...

International Nuclear Information System (INIS)

Radiation therapy has had a significant and an expanded role in the management of cancer of the pancreas during the last decade. In particular, for locally advanced disease, radiation therapy has improved the median survival of patients to 1 year. Intraoperative electron beam therapy has been applied to unresectable and resectable pancreatic cancer in an attempt to enhance local control of disease and to improve patient survival. This paper presents a survey of the role of radiation therapy in treatment of cancer of the pancreas, provides information on the radiobiological aspects of this treatment modality and details the physical and dosimetric characteristics of intraoperative radiation therapy with electrons. Presented are the design specifics of an applicator system, central axis beam data, applicator parameters, dose distribution data, shielding, treatment planning and means of verification. Emphasis is placed on the ...

International Nuclear Information System (INIS)

The accuracy is investigated of both lymphangiography and CT in detecting lymph nodes metastases in 59 patients evaluated preoperatively and subsequently submitted to surgery with selective/systemic pelvic and paraaortic lymphadenectomy. CT accuracy was also investigated in 46 patients with a clinically suspected relapse of ovarian cancer (verified by means of clinical and/or CT follow-up in 36 patients, by laparotomy in 7, by fine-needle biopsy in 1 and by necroscopy in the last 2). In the first group (previously untreated patients) the overall results in the pelvis were, respectively, for lymphangiography and CT: 94.9% vs 89.8% accuracy, 86.6% vs 60% sensitivity, 97.7% vs 100% specificity, and 92.8% vs 100%, 95.5% vs 88% positive and negative predictive values. In the paraaortic region the results were: 89.1% vs 86.5% accuracy, 73.3% vs 66.6% sensitivity, 100% specificity for both techniques, 100% ...

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Purpose: Budd-Chiari syndrome is a fairly uncommon disease in Europe. This often leads to its late diagnosis. The syndrome is characterised by portal hypertension and splanchnic congestion due to obstruction of hepatic venous outflow. This paper describes the treatment of three patients with Budd-Chiari syndrome by interventional therapeutic techniques and discusses alternative treatment modalities. Patients and Methods: The first patient presented with veno-occlusive disease and was treated by the placement of a transjugular intrahepatic portosystemic stentshunt. The second patient showed an occlusion of the major hepatic veins. After percutaneous recanalisation, a stent was placed in the right hepatic vein which remained patent. The third patient had a membranous obstruction of the right hepatic vein which was treated by percutaneous balloon dilatation. ...

International Nuclear Information System (INIS)

Purpose: To quantify left ventricular function derived from retrospectively ECG-gated multislice spiral CT (MSCT) data sets in comparison to MRI. Materials and Methods: In 16 patients (14 males, 2 females, mean age 56.8 #+-# 11.5 years), retrospectively ECG-gated MSCT angiography of the coronary arteries and breath-hold steady state free precession cine MRI were performed. From MSCT data-sets, 20 axial image series were reconstructed every 5% of the RR interval. Multiplanar images were reformatted in the short axis orientation from axial images. End-systolic and end-diastolic images were selected. From these images end-systolic volume (ESV), end-diastolic volume (EDV) and stroke volume (SV) as well as the ejection fraction (EF) and myocardial mass (MM) were determined using the Simpson's method and compared with MRI. Furthermore, image quality was assessed for both imaging modalities using a four point grading scale. Results: All parameters ...

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To evaluate the feasibility and clinical effectiveness of using a polyurethane-covered expandable nitinol stent in the palliative treatment of malignant duodenal obstruction. Under fluoroscopic guidance, a polyurethane-covered expandable nitinol stent was placed in 12 consecutive patients with malignant duodenal obstructions. All presented with severe nausea and recurrent vomiting. The underlying causes of obstruction were duodenal carcinoma (n=4), pancreatic carcinoma (n=4), gall bladder carcinoma (n=2), distal CBD carcinoma (n=1), and uterine cervical carcinoma (n=1). The sites of obstruction were part I (n=1), part II (n=8), and III (n=3). Due to pre-existing jaundice, eight patients with part II obstructions underwent biliary decompression prior to stent placement. An introducer sheath with a 6-mm outer diameter and stents 16 mm in diameter were employed, and to place the stent, and after-loading technique was used. Stent placement was ...

Science.gov (United States)

Two experiments examined the role of compatibility of input and output (I-O) modality mappings in task switching. We define I-O modality compatibility in terms of similarity of stimulus modality and modality of response-related sensory consequences. Experiment 1 included switching between 2 compatible tasks (auditory-vocal vs. visual-manual) and between 2 incompatible tasks (auditory-manual vs. visual-vocal). The resulting switch costs were smaller in compatible tasks compared to incompatible tasks. Experiment 2 manipulated the response-stimulus interval (RSI) to examine the time course of the compatibility effect. The effect on switch costs was confirmed with short RSI, but the effect was diminished with long RSI. Together, the data suggest that task sets are modality specific. Reduced switch costs in compatible tasks may be due to special linkages between input and output ...

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Purpose To evaluate disease failure patterns and overall survival (OS) of women with triple-negative (TN) breast cancer who underwent breast-conserving therapy (BCT) and to understand the relationship of TN tumors with other prognostic factors. Patients and Methods The Surveillance, Epidemiology, and End Results (SEER) registry identified 562 women diagnosed and/or treated with unilateral invasive breast cancer during 2003?2004 at three Emory hospitals. After medical record review, 193 eligible women, with all tumor types, received BCT. Primary endpoints (local, regional, and distant recurrences) and secondary endpoint (OS) were evaluated using chi-square tests and Cox proportional hazards models. Results Of the 193 women, 33 (17.1%) had TN tumors and 160 (82.9%) had non-TN tumors. Patient...

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Paraquat is a nonselective contact herbicide of great toxicological importance, being associated with high mortality rates, mainly due to respiratory failure. We report the case of a 22-year-old male admitted to the emergency room with a sore throat, dysphagia, hemoptysis, and retrosternal pain after the ingestion of 50 mL of a paraquat solution, four days prior to admission. Chest CT scans revealed pulmonary opacities, pneumomediastinum, pneumothorax, and subcutaneous emphysema. The patient was submitted to two cycles of immunosuppressive therapy with cyclophosphamide, methylprednisolone, and dexamethasone. The pulmonary gas exchange parameters gradually improved, and the patient was discharged four weeks later. The clinical and tomographic follow-up evaluations performed at four months after discharge showed that there had been further clinical improvement. We also present a brief review of the literature, as well as a ...

Science.gov (United States)

An increased compendium of drugs useful in ocular motor system dysfunction has expanded our capacity to treat selected ocular motility disorders. Adjunctive therapeutic modes (e.g., Fresnel prisms and orthoptic exercises) can also be beneficial. PAN and see-saw nystagmus can be treated with baclofen. Downbeat nystagmus may respond to clonazepam therapy, and prisms may help if the nystagmus can be modified with convergence. Congenital nystagmus may respond minimally to drugs (e.g., baclofen), but prisms or surgical procedures, or both, are still the primary treatment modalities. Innovar may be helpful in patients with severe, incapacitating vestibular disorders, and scopolamine alone or in combination with promethazine may be beneficial in patients with milder ambulatory acute peripheral vestibular disorders. Benign positional vertigo is best treated initially with positional exercises before drug therapy is instituted. ...

International Nuclear Information System (INIS)

The solid-pseudopapillary tumor (SPT) of the pancreas is a rare type of exocrine pancreatic neoplasm. SPT predominantly affects young women and female children, and is usually discovered incidentally. This tumor is generally benign with a low incidence of malignancy. A 13-year-old girl was admitted to the hospital with a few weeks' history of mild abdominal pain and jaundice. On physical examination, there was no palpable mass. The laboratory tests showed increased SR, CRP, high bilirubin, amylase and lipase serum levels. Ultrasound imaging revealed a solid lesion in the region of the pancreatic head. On MRI, precise tumor localization in the head of the pancreas with pancreatic duct dilatation and compression of the common bile duct were visualized. Pancreaticoduodenectomy and cholecystectomy was performed with good clinical outcome. Microscopic and immunohistochemical studies indicated that tumor cells were typical of SPT without any signs of malignancy. After surgical treatment, the ...

International Nuclear Information System (INIS)

Purpose: The aim of this study was to demonstrate the typical appearance of ganglioneuromas in computer-assisted tomography (CT), and magnetic resonance imaging (MRI). Material and methods: Retrospective analysis of diagnostic imaging (9 CT, 6 MRI) in 9 children aged 3 to 15 years with the histological diagnosis of ganglioneuroma. Results: The tomographies showed large (max. 13.4 cm in diameter) round or oval tumors with sharp delineation. The sites of the tumors were the retroperitoneum (5), the mediastinum (3), and the adrenal gland (1). Intraspinal tumor involvement occurred in 4 cases. On comparing CT with MRI, MRI was more accurate in defining the intraspinal involvement. The ganglioneuromas were of hypodense appearance in the native CT scan and showed moderate enhancement upon administration of contrast media. In five patients tumor calcifications with a disseminated sprinkled pattern were seen in CT. In MRI T_1-weighted scans the tumors were homogeneous and ...

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We investigated the efficacy of combined FDG-PET/CT imaging for the diagnosis of small-size uveal melanomas and the feasibility of combining separate, high-resolution (HR) FDG-PET with MRI for its improved localization and detection. Patients, methods: 3 patients with small-size uveal melanomas (0.2-1.5 ml) were imaged on a combined whole-body PET/CT, a HR brain-PET, and a 1.5 T MRI. Static, contrast-enhanced FDG-PET/CT imaging was performed of head and torso with CT contrast enhancement. HR PET imaging was performed in dynamic mode 0-180 min post-injection of FDG. MRI imaging was performed using a high-resolution small-loop-coil placed over the eye in question with T2-3D-TSE and T1-3D-SE with 18 ml Gd-contrast. Patients had their eyes shaded during the scans. Lesion visibility on high-resolution FDGPET images was graded for confidence: 1: none, 2: suggestive, 3: clear. Mean tumour activity was calculated for summed image ...

International Nuclear Information System (INIS)

Colerectal cancer (CRC) is the second commonest cancer in the Western World. Successful treatment relies significantly on accurate detection and staging of primary disease as well as the early identification of the presence and extent of recurrence. Morphological imaging techniques, particularly computed tomography (CT), are well established and widely available to carry out these tasks in addition to predicting and monitoring response to therapy. This review analyses the current inadequacies for imaging CRC and critically assesses the potential role of functional imaging with positron emission tomography (PET). It was reviewed the current literature, to use the experience from the firs 1000 PET studies carried out at the institution and the perspective of surgical colleagues. It was found little evidence for the use of 2-["1"8F]fluoro-2-deoxy-D-glucose (FDG)-PET for screening asymptomatic individuals and current modalities appear better suited for detection of ...

Science.gov (United States)

Recent studies have shown Y chromosome microdeletions associated with male infertility. The factors responsible for Y chromosome microdeletions in spermatozoa remain unresolved. However, the environmental pollutants are known to damage DNA in differentiating and maturing germ cells in the male reproductive tract. Therefore, the aim of this study was to investigate the effects of seminal hexachlorocyclohexane (HCH) and its isomers, an environmental pollutant, in 50 fertile and 50 infertile males in relation to semen quality and the incidence of Y chromosome microdeletion in azoospermic factor (AZF) region. As compared to control, an increased HCH level and significantly decreased semen quality were observed in the infertile males. A positive significant association was found between sperm count with alpha-HCH and beta-HCH in the infertile males. A negative significant association was observed between sperm counts with gamma-HCH in asthenospermia patients and with ...

International Nuclear Information System (INIS)

In 1981, the German Society of Pediatric Oncology initiated a multi-institutional study for the treatment of Ewing's sarcoma. The protocol (Cooperative Ewing's Sarcoma Study, CESS 81) consisted of four courses of a four-drug-regimen (VACA), each course taking nine weeks. Local therapy (radical surgery or resection plus irradiation or radiotherapy alone) was performed after the second course. The results of CESS 81 can be summarized as follows: VACA-chemotherapy is effective in controlling systemic disease. Initial tumor mass and response to initial chemotherapy are of major prognostic value for local control and survival. Permanent local control is a problem, especially in irradiated patients. The high local failure rate in irradiated patients in CESS 81 could be attributable to the following reasons: Late start of local therapy (after 18 weeks of chemotherapy), uneven distribution of prognostic parameters: Large tumors ...

Science.gov (United States)

Experience in the diagnosis and treatment of infertility has led to an increased understanding of the prominent role male factors play in many couples' inability to conceive. While many forms of male factor infertility are amenable to treatment, for some patients there is no corrective therapy available. For this reason, a great deal of attention has been focused on developing technologies for semen processing and sperm utilization in cases of decreased semen quality. One area of research is the development of more sophisticated methods of assessing sperm function, as well as methods of sperm preparation. Progress is also being made in the application of technologies such as intrauterine insemination and in vitro fertilization in the treatment of male factor infertility. Such developments have improved prospects for fertility among patients suffering from decreased semen quality, as well as those suffering from such disorders as ejaculatory ...

International Nuclear Information System (INIS)

In the years 2004 and 2005, Korea became a prospective nation noteworthy in the world through the epochal development of genetic engineering in our country. Obstinate or incurable diseases were expected to be healed in a few years by a Korean geneticist. So many worldwide patients of obstinate or incurable diseases took notice of the research outcomes and organized an aid association to collect supporting funds. World renowned journals such as 'Nature' and 'Science' published Dr. Hwang's theses. A long and distant way remedy to obstinate diseases seemed to be closer at hand so early. However, a stem cell fraud case emerged throughout the world in late 2005, the pride of the Korean people was destroyed. With this as a momentum, voices of self reflection by scientific circles were raised. The purpose of this study is not in finding the truth of the stem cell research but to propose an effective management and control measures for the future in planning, implementing, ...

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Thalassaemic patients are in need of frequent assessment of bone age because of growth failure and pubertal disorders. To compare the ''rapid'' Greulich and Pyle (G and P) method with the third edition of the Tanner and Whitehouse (TW3) method for determining skeletal maturity and predicting final height in thalassaemic patients. A total of 191 radiographs from 58 patients (28 male, 30 female) were retrospectively evaluated by two investigators, one for each method. In 47 radiographs from 15 patients having attained their adult height, predicted final height was calculated according to each method. The mean bone ages determined by both the G and P and TW3 methods were lower than mean chronological age, although the differences were not statistically significant (10.04 {+-} 3.69 years and 9.98 {+-} 3.39 years vs. 10.78 {+-} 3.96 years, ...

International Nuclear Information System (INIS)

Purpose: We present an update analysis of the multiinstitutional Ewing's sarcoma study CESS 86. Methods and Materials: From January 1986 through June 1991, 177 patients with localized Ewing's sarcoma of bone, aged 25 years or less, were recruited. Chemotherapy consisted of four 9-week courses of vincristine, actinomycin D, cyclophosphamide, and adriamycin (VACA) in low-risk tumors (extremity tumors =# 100 cm"3). Local therapy was an individual decision in each patient and was either radical surgery (amputation, wide resection) or resection plus postoperative irradiation with 45 Gy or definitive radiotherapy with 60 Gy (45 Gy plus boost). Irradiated patients were randomized concerning the type of fractionation in either conventional fractionation (once daily 1.8-2.0 Gy, break of chemotherapy) or hyperfractionated split-course irradiation simultaneously with the VACA/VAIA chemotherapy (twice daily 1.6 Gy, break of 12 days ...

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Technical innovations such as the availability of movable patient platforms and the introduction of 32-channel systems have made whole-body MRI for tumor staging feasible. In addition, the development of dual-modality PET/CT systems offers the opportunity to perform anatometabolic tumor staging with whole-body coverage in a single session. Based on an increase in patient survival when applying a stage-adapted therapy in different malignant diseases the relevant question relates to the accuracies of whole-body MRI and whole-body PET/CT for TNM staging. This review article addresses whole-body tumor staging with MRI and FDG-PET/CT with special emphasis on diagnostic accuracies for staging different malignant diseases. (orig.) [German] Technische Neuerungen, wie die Verfuegbarkeit beweglicher Tischaufsaetze oder die Einfuehrung von 32-Kanal-Systemen, haben die Ganzkoerperbildgebung mit der MRT ermoeglicht. Die Entwicklung ...

International Nuclear Information System (INIS)

Purpose: For planning the therapeutic strategies and estimating the prognosis in esophageal cancer, N-staging is very important. To date, MRI still is of minor importance as imaging modality of the mediastinum despite promising developments in the past, like ECG-gating or 'averaging' sequences, e.g. LOTA (Long-term averaging), which facilitate mediastinal and thoracic MR-imaging. In a prospective approach, the value of MRI based N-staging was examined with respect to LOTA-sequences. Material and Methods: Within from weeks prior to esophagectomy, standardized MRI of the esophagus was performed in 15 patients (10 squamous-cell-carcinomas and 5 adenocarcinomas) using a 1.5 T whole body scanner. Imaging quality was classified based on depiction of aortic wall or tracheal wall layers. Criteria for malignant infiltration were a diameter of more than 15 mm or a round appearance of a lymph node together with GD-DTPA enhancement. All data were blinded ...

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Aim of this retrospective study was to assess the capability of contrast-enhanced helical computerised tomography (CT) in sigmoid diverticulitis, especially relative to selection of the appropriate treatment. The findings of 41 patients were reviewed from 1998 to 1999 June. Contrast-enhanced helical CT is the imaging modality of choice in assessing mild or severe acute diverticulitis because it provides useful information for appropriate treatment planning in the emergency setting. This technique is most useful in questionable cases and in patients with suspected severe diverticulitis where a choice must be made between different treatment options. [Italian] Scopo di questo studio retrospettivo e' illustrare i molteplici aspetti radiologici della flogosi diverticolare sigmoidea con tomografia computerizzata (TC) spirale, con specifico riguardo alle implicazioni terapeutiche che scaturiscono dall'analisi e ...

British Library Electronic Table of Contents (United Kingdom)

Partial adrenalectomy is usually performed for the treatment of bilateral pheochromocytomas and in case of sporadic, monolateral tumors, to minimize the risk of adrenal failure, especially in younger patients. Due to the lack of consistent series, many issues such as correct surgical indications and technical aspects still need to be debated. From 2007 to 2010 we performed four unilateral partial adrenalectomies (3 aldosterone-producing adenomas and 1 cortisol-producing adenoma), and three bilateral subtotal adrenalectomies, consisting in total adrenalectomy on one side and partial adrenalectomy on the contralateral gland (3 bilateral pheochromocytomas in MEN IIa). In case of single tumor, partial adrenalectomy was carried out without adrenal vein ligation and the results were similar to t...

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be extremely limited or even negative due to higher maritime transport costs leading to a modal shift back to

International Nuclear Information System (INIS)

From 1981 up to February 1985, a total of 93 protocol patients entered the study CESS 81. The protocol recommended an initial 18-week period of polychemotherapy (VACA) followed by local therapy and two additional cycles of chemotherapy. Local therapy consisted either of radical surgery or of incomplete resection plus postoperative irradiation with 36 Gy or of radiotherapy alone (46 and 60 Gy). Centrally located lesions were always irradiated with 60 Gy. This article summarizes the data after 5 years. Data of 93 patients were analysed in October 1986 after a median follow-up of 37 months. The projected 5-year survival is 50%. The relapse rate was 42%, distant relapses occurred in 19%, local (plus distant) relapses in 23%. Most of the relapses occurred during the first 3 years of observation. Failure rate was high in patients undergoing irradiation alone (44%). Initial tumour mass (> 100 ml) and ...

International Nuclear Information System (INIS)

This study was designed to identify abnormalities in the hepatic-arterial/portal-venous scintiangiogram (SA) in alcoholic hepatitis (AH). SA's were performed in 35 patients with acute alcoholic hepatitis (AAH), 8; acute alcoholic hepatitis superimposed on cirrhosis (A/C), 14; and cirrhosis (C), 13. Posterior flows were done with a bolus of 10 mCi Tc-99m sulfur colloid with computer time-activity curves over the liver and left kidney. Curves were analyzed for per cent of hepatic arterial (HA) and portal venous contribution using the slope ratio method. Hepatic arterialization was estimated from the angle of the HA component of the curve. Reversal of the relative contribution of the hepatic and portal components of total flow were seen in all groups. Although quite severe in AH, the degree of reversal could not be used to differentiate among the groups. The average HA angle in AAH was 48.3 +- 8.1, in A/C 41.5 +- 10.6, and in C 30.4 +- 12.1. In reviewing the data of ...

International Nuclear Information System (INIS)

Thirty-seven patients with primary nonresectable intrahepatic cholangiocarcinoma (57% with prior treatment and/or metastasis) were prospectively treated with external radiation, chemotherapy, and "1"3"1I labelled anti-CEA. Therapy began in all trials with whole liver irradiation (21.0 Gy, 3.0 Gy/Fx, 4 days/week, 10 MV photons) with alternate treatment day chemotherapy (Adriamycin, 15 mg + 5-FU, 500 mg). One month after external beam therapy, chemotherapy was given (Adriamycin, 15 mg + 5-FU, 500 mg) followed the next day by the first administration of "1"3"1I anti-CEA. The treatment schedule used was 20 mCi day 0; 10 mCi day 5 as an outpatient. This schedule was derived from tumor dose estimates which indicated that 20 mCi (8-10 mCi/mg IgG) was sufficient to achieve tumor saturation with a tumor effective half-life of 3 to 5 days, depending upon the species of animal from which the antibody was obtained. The median tumor dose for the 20 mCi + 10 mCi regimen was 6.2 ...

International Nuclear Information System (INIS)

Full text: A 51-year-old woman with end stage renal failure secondary to Haemolytic Uraemic syndrome underwent a cadaveric renal transplant. A routine post transplant DTPA scan was performed which demonstrated satisfactory renal transplant perfusion and function. Incidental note was made of tracer uptake in the pelvis in the mid-line, which was suspected to be a uterine fibroid. This was confirmed on ultrasonography and at surgery. One week post transplantation the patient became acutely unwell and at laparotomy a perforated diverticular abscess was drained. Intraoperatively the transplant kidney was examined and the surgeon thought there was a area of infarction. This was confirmed on biopsy. As the patient's creatinine was rising a repeat DTPA study was performed. Perfusion and function of the transplant kidney was virtually absent while Doppler studies showed no flow. The patient however continued to ...

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Modern imaging technologies visualize different aspects of disease in a non-invasive way. Considerable progress has been made in the fusion of images from different imaging modalities using software approaches. One goal of fusion software is to align anatomical and functional images and allow improved spatial localization of abnormalities. The resulting correlation of the anatomical and functional images may clarify the nature of the abnormality and help diagnose or stage the underlying disease. Whereas successful image fusion software has been developed for the brain, only limited success has been achieved for image alignment in other parts of the body. The development and current status of alternative approaches are presented. Dual-modality imaging is described with devices where two modalities are combined and mounted in a single gantry. The use of existing scanner technology ensures that no compromises are made in the ...

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Failure of a dam is something we hope never happens. But if a failure occurs, it`s important to study the circumstances in order to expand our knowledge base, and then apply what we learn to other structures.

UK PubMed Central (United Kingdom)

Heart failure has been singled out as an emerging epidemic, which could be the result of increased incidence and/or increased survival leading to increased prevalence. Knowledge of the responsibility...Full Text Available

UK PubMed Central (United Kingdom)

Congestive heart failure (CHF) is a leading cause of morbidity and mortality. CHF is marked by atrial and ventricular enlargement and reduced cardiac contractility, as well as an association...Full Text Available

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Aim: Treatment of carcinoma of the uterine cervix by remote afterloading brachytherapy has been accompanied with new isotopes having dose rates different from the classical low-dose rate (LDR) radium source. The dose rate conversion factor from LDR to high-dose rate (HDR) found to be around 0.54 in most studies. As regards medium-dose rate (MDR) brachytherapie, the published data are very few and the experience is still short. In this study the experience of Osaka University Hospital with micro-HDR-Selectron and Selectron-MDR, as a preliminary report of the clinical trial, is presented. Results: The 3-year survival and loco-regional control rates for both modalities were nearly equivalent (62% and 67% for HDR and 68% and 74% for MDR)(totally 45 patients). The cumulative rectal and bladder complication rates were the same in both groups (29% at 3 years), with only 1 patient (MDR-group) developed grade 3 rectal and bladder ...

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This paper presents a new method for simultaneously selecting the power system stabilizer (PSS) parameters in multimachine power systems. Design of local output feedback power system stabilizer using local signal of the generator (e.g. speed or power) is formulated as a decentralized modal control (DMC) problem. Exact model reduction based on modal control theory is proposed to make the determination of PSS parameters highly efficient. Results obtained from the coordinated tuning of the parameters of three power system stabilizers equipped on a multimachine power system show that exact assignment of the eigenvalues associated with the poorly damped electromechanical modes can be achieved in a very efficient manner.

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Hystreosalpingogram of 375 patients with infertility were reviewed with reference to radiological feature of each pathology and a comparative study of hysterosalpingography and laparoscopy in 36 patients was presented. This results were as follows;1. In 375 cases of infertility, 191 cases (50.9%) were primary infertility and 181 cases (49.1%) were secondary infertility. 2. The peak age distribution was 26 to 30 year old group in 211 cases (56.3%), and the peak duration of infertility was less than 3 years in 256 cases (68.3%). 3. Abnormal uterine findings were 115 cases (30.7%) and there were 73 cases of filling defects, 13 cases of irregularity, 12 cases of uterine flexion, 11 cases of congenital anomaly, and 9 cases of hypoplasia among them. 4. Abnormal tubal findings were 196 cases (52.3%) and there were 103 cases of simple obstruction, 69 cases of hydrosalpinx, and 50 cases of peritubal adhesion among them. 5. Intravasation of contrast ...

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This paper discusses how to overcome failures and pitfalls in software configuration management. (LSP)

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Power system components, especially components failure, can significantly affect the reliability of a power system. Data about failure rate in electrical products were obtained from products life testing and analyzed in order to predict reliability. The distribution curve fitting method was used to estimate failure probability. Ten relays of different life times have been used to illustrate the validity of this analytical technique. 3 refs., 3 tabs.

KoreaScience (Korea)

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Science.gov (United States)

Seventeen eyes of patients who were being followed by their ophthalmologists for aphakic (8 eyes) or pseudophakic (9 eyes) cystoid macular edema (CME) were examined on referral. All eyes showed retinal detachment (RD), and eight eyes had CME with RD. Most RDs were inferior and shallow. Proliferative vitreoretinopathy (PVR) was noted in 15 eyes (88.2%). There was history of vitreous loss during the last intraocular surgery in 88.2% eyes. Visual acuity ranged from 20/40 to hand movements. Fundus view was hazy in most eyes, and indirect ophthalmoscopy was most useful in detecting RD. Retinal reattachment with scleral buckling and/or vitrectomy was achieved in 16 eyes (94.1%). Postoperative visual recovery was jeopardized due to longstanding macular detachment of greater than 1 month in 11 eyes (64.7%). Eight eyes (47%) achieved 20/50 vision whereas 25% did not improve to better than 20/400. Factors leading to failure in making the correct ...

British Library Electronic Table of Contents (United Kingdom)

PurposeWe investigated the efficacy and safety of degarelix treatment and the effects of switching from leuprolide to degarelix in an ongoing extension study with a median 27.5-month followup of a pivotal 1-year prostate cancer trial. Materials and MethodsPatients who completed a 1-year pivotal phase III trial continued on the same monthly degarelix maintenance dose (160 or 80 mg in 125 each), or were re-randomized from leuprolide 7.5 mg to degarelix 240/80 mg (69) or 240/160 mg (65). Data are shown on the approved degarelix 240/80 mg dose. The primary end point was safety/tolerability and the secondary end points were testosterone, prostate specific antigen, luteinizing hormone and follicle-stimulating hormone responses, and prostate specific antigen failure and progression-free survival....

UK PubMed Central (United Kingdom)

A major goal in perceptual neuroscience is to understand how signals from different sensory modalities are combined to produce stable and coherent representations. We previously investigated interactions...Full Text Available

UK PubMed Central (United Kingdom)

Multimodality imaging with PET/CT and SPECT/CT has become commonplace in clinical practice and in preclinical and basic medical research. Do other combinations of imaging modalities have a similar...Full Text Available

UK PubMed Central (United Kingdom)

BACKGROUND: Although the importance of lymphatic function is well recognized, the lack of real-time imaging modalities limits our understanding of its role in many diseases. In a phase...Full Text Available

UK PubMed Central (United Kingdom)

Due to the widespread clinical use of imaging modalities such as ultrasonography, computed tomography and magnetic resonance imaging (MRI), previously unsuspected liver masses are increasingly being...Full Text Available

UK PubMed Central (United Kingdom)

Oncolytic viruses (OVs) represent a relatively novel anti-cancer modality. Like other new cancer treatments, effective OV therapy will likely require combination with conventional treatments. In order...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundThis in vitro study was conducted to compare the accuracy of two digital image receptors in identifying the location of tip of a fine endodontic file and radiographic apex...Full Text Available

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The failure took place on a welded elbow pipe which exhibited a catastrophic transverse rupture. The failure was located on the welding HAZ region, parallel to the welding path. Branching cracks were detected at the edge of the rupture area. Deposits of corrosion products were also spotted. The optical microscope analysis showed the presence of transgranular failures which were related to the stress corrosion cracking (SCC) and were predominantly caused by the welding residual stress. The significant difference in hardness between the welded area and the pipe confirmed the findings. Moreover, the failure was also caused by the low Mo content in the stainless steel pipe which was detected by means of spark emission spectrometer. (orig.)

Science.gov (United States)

An exact solution method for the free vibration problem of thin circular cylindrical shells is presented. The differential equations of motion are solved directly with the use of simple Fourier series as the modal displacement functions. Stokes' transformation is exploited to obtain correct series expressions for the derivatives of the Fourier series. From this method an explicit expression of the exact frequency equation can be obtained for any kind of boundary conditions. The accuracy of the present method is checked against available data. The proposed method is then used to find the modal characteristics of the thermal liner of the Fast Test Reactor (FTR). The numerical results obtained are compared with finite element method solutions. (auth)

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Minimally invasive thermotherapies for focal tissue destruction on the basis of laser-, microwave-, focused ultrasound-, or cryogeninduced changes of tissue temperature represent an alternative to surgical tissue ablation, particularly in the treatment of tumors. The thermotherapy modalities listed necessitate indirect guidance and monitoring, since they often do not lend themselves to immediate visual control. In the brain, in head and neck tumors, in the liver, and in the prostate, MRI reliably and accurately delineates both the positions of interstitial thermotherapy applicators and - in contrast-enhanced, T1-weighted images - the perfusion defects in tissue necrosis induced by thermotherapy. The transfer of results of in-vitro and in-vivo model studies to assess interstitial temperature and lesion development during thermotherapy to the actual treatment of patients, however, is still in an initial phase. Further development of both rapid ...

Science.gov (United States)

The natriuretic peptides are considered to be cardioprotective; however, their receptors have not been identified in human myocardium using radiolabeled analogs. Dendroaspis natriuretic peptide (DNP) has been recently identified as a new member of this peptide family and is thought to be less susceptible to enzymatic degradation. Therefore, we have developed the novel radiolabeled analog [125I]-DNP and used this to localize high-affinity (K(D)=0.2 nmol/L), saturable, specific binding sites in adult human heart (n=6) and coronary artery (n=8). In competition binding experiments, atrial natriuretic peptide and brain type natriuretic peptide had greater affinity for [125I]-DNP binding sites than C-type natriuretic peptide and the natriuretic peptide receptor (NPR)-C ligand, cANF. This rank order of potency suggested binding of [125I]-DNP was specific to NPR-A. Messenger RNA encoding NPR-A was identified in left ventricle and coronary artery smooth muscle, and expression was confirmed by ...

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PMID:9410608

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To compare the accuracy in the detection and staging of various malignant tumors with high resolution whole-body MRI using parallel imaging with whole-body dual-modality PET-CT. Preliminary results of an interim analysis from a prospective, blinded study are presented, in which 20 patients (mean age 59 years, range 27-77 years) with different oncological diseases underwent whole-body dual modality FDG-PET-CT screening for tumor search or staging in case of confirmed or suspected metastatic disease. All patients also underwent whole-body MRI imaging with the use of parallel imaging (iPAT). High-resolution coronal T1w- and STIR-sequences of 5 body levels with 512 x 512 matrix, axial fast T2w imaging of lung and abdomen (HASTE), contrast-enhanced dynamic and static T1w-sequences of liver, brain, abdomen, and pelvis were performed. Using a 32-channel whole-body MRI scanner (Magnetom Avanto, Siemens Medical ...

UK PubMed Central (United Kingdom)

BackgroundThe rhizomes of Cynodon dactylon are used for the treatment of heart failure in folk medicine. In the present study, we investigated the effects of hydroalcoholic...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundAlthough dilated cardiomyopathy (DCM) is a leading cause of heart failure (HF), the mechanism underlying DCM is not well understood. Previously, it has been demonstrated...Full Text Available

UK PubMed Central (United Kingdom)

Premature menopause, ovarian failure younger than 40 years of age, is relatively rare but may preclude childbearing for some women who delay attempts at fertility. We present five kindreds in which...Full Text Available

Energy Technology Data Exchange (ETDEWEB)

The reliability of an electrical power system is influenced by the operation of circuit-breaker (CB). A good indicator of circuit-breaker condition is its switching time. Based on it some of the critical circuit-breaker irregularities can be detected and removed before they develop to a failure. In this paper, the evaluation of time measurements (timings) in case of different failures will be carried out for two circuit-breaker solutions, i.e. with spring and hydraulic drive. Moreover, the relationships between switching time and failure type/location will be derived. Thereby, the influence of failure trend will also be taken into account. (author)

International Nuclear Information System (INIS)

Presented are the results of the investigation of the kinetics and micromechanism of the failure in impact bending of oriented-crystallized specimens having the eutectic composition Ni_3Al-Ni_3Nb and of the bimetal composed of 45 steel + M3 copper. The failure kinetics was studied by high-speed filming, whereas the fractures were studied by electron fractography. The particularities of the failure of the laminar-type composite materials were found. Analyzed was the effect of the kinetic factors and the mechanism of failure upon its energy consumption.

Science.gov (United States)

... with the additional US funds supporting Islamic ... the FATA and NWFP, keeping Pakistan's government and ... Without these madrassas, the TTP is left ...

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... which extend beyond the upper airway. These include attention deficit hyperactivity disorder, learning disorders, failure to thrive, and enuresis. Tonsillectomies ...

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Stability concerns of the Par Pond Dam, an embankment structure in the Savannah River Site complex, resulted in a comprehensive evaluation of the state of its integrity. Specifically, excessive seepage through the embankment, slope failure due to an earthquake event as well as liquefaction potential of the embankment and the foundation are addressed and the potential of failure is evaluated. Lastly, remedial benefits of the addition of a berm structure are also assessed.

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A case study is presented about the failure of a stainless steel blade reinforcing band in a steam turbine. The inspection results and analysis of samples of material are discussed. Being pitting corrosion and cracks the main defects found, a study of chemical composition and heat treatment state of the steel is made and findings are related to type of failure. (orig.)

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Image registrations that are based on similarity measures simply adjust the parameters of an appropriate spatial transformation model until the similarity measure reaches an optimum. The numerous similarity measures that have been proposed in the past are differently sensitive to imaging modality, image content and differences in the image content, selection of the floating and target image, partial image overlap, etc. In this paper, we evaluate and compare 12 similarity measures for the rigid registration. To study the impact of different imaging modalities on the behavior of similarity measures, we have used 16 CT/MR and 6 PET/MR image pairs with known 'gold standard' registrations. The results for the PET/MR registration and for the registration of CT to both rectified and unrectified MR images indicate that mutual information, normalized mutual information and the entropy correlation coefficient are the most accurate ...

British Library Electronic Table of Contents (United Kingdom)

In the field of Living Probabilistic Safety Assessment (LPSA) the reliability data updating is an important factor. In risk analysis equipment failure data is needed to estimate the frequencies of events contributing to risk posed by a facility. Five years data of emergency diesel generator (EDG) of Daya Bay Nuclear Power Plant (NPP) has been studied in this paper. The data updating process has been done by using two methods, i.e., the classical method and Bayesian method. The aim of using these methods is to calculate the operational failure rate (@l) and demand failure probability (p). The results show that the operational failure rate is 1.7E-3 per hour and the demand failure probability is 2.4E-2 demand per day for Daya Bay NPP. By comparing the results obtain from classical and Bayesi...

British Library Electronic Table of Contents (United Kingdom)

The main goal of local drug delivery is to increase the concentration of a specific therapeutic agent in a target tissue with minimal nontarget distribution. Compared to systemic therapy, local drug delivery provides a high level of therapeutic efficacy with minimal systemic effects. The current primary imaging modality for drug delivery has been x-ray angiography, but it has major limitations including anatomical ambiguity and inability to visualize the targeted tissues. Due to these inherent problems, MR guidance has been explored as an alternative imaging modality for guiding and monitoring of drug therapy. Recently, interventional MR (XMR) systems have been implemented that have both dual x-ray and MRI capabilities in a single suite and allow for real-time interventional procedures to ...

British Library Electronic Table of Contents (United Kingdom)

Many studies on multisensory processes have focused on performance in simplified experimental situations, with a single stimulus in each sensory modality. However, these results cannot necessarily be applied to explain our perceptual behavior in natural scenes where various signals exist within one sensory modality. We investigated the role of audio-visual syllable congruency on participants? auditory localization bias or the ventriloquism effect using spoken utterances and two videos of a talking face. Salience of facial movements was also manipulated. Results indicated that more salient visual utterances attracted participants? auditory localization. Congruent pairing of audio-visual utterances elicited greater localization bias than incongruent pairing, while previous studies have repor...

International Nuclear Information System (INIS)

Positron emission tomography (PET) is the gold standard for non-invasive assessment of myocardial viability and allows accurate detection of coronary artery disease by assessment of myocardial perfusion. Magnetic resonance imaging (MRI) provides high resolution anatomical images that allow accurate evaluation of ventricular structure and function together with detection of myocardial infarction. Potential hybrid PET/MR tomography may potentially facilitate the combination of information from these imaging modalities in cardiology. Furthermore, the combination of anatomical MRI images with the high sensitivity of PET for detecting molecular targets may extent the application of these modalities to the characterization of atherosclerotic plaques and to the evaluation of angiogenetic or stem cell therapies, for example. This article reviews studies using MRI and PET in parallel to compare their performance in cardiac applications together with the ...

British Library Electronic Table of Contents (United Kingdom)

We outline a neo-Meinongian framework labeled as Modal Meinongian Metaphysics (MMM) to account for the ontology and semantics of fictional discourse. Several competing accounts of fictional objects are originated by the fact that our talking of them mirrors incoherent intuitions: mainstream theories of fiction privilege some such intuitions, but are forced to account for others via complicated paraphrases of the relevant sentences. An ideal theory should resort to as few paraphrases as possible. In Sect.?1, we make this explicit via two methodological principles, called the Minimal Revision and the Acceptability Constraint. In Sect.?2, we introduce the standard distinction between internal and external fictional discourse. In Sects.?3?5, we discuss the approaches of (traditional) Meinongia...

International Nuclear Information System (INIS)

Fetal MRI examines non-invasively the unborn fetus. Ultrafast MRI sequences effectively suppress fetal motion. Multiple case reports and studies have shown that fetal MRI is particularly helpful in the evaluation of the central nervous system. The high contrast-to-noise ratio, the high spatial resolution, the multiplanar capabilities, the large field of view and the simultaneous visualisation of fetal and maternal structures have proven to be advantageous. Fetal MRI is particularly helpful in the evaluation of the normal and pathological development of the brain. Despite the fact that no side effects have been reported or are to be expected, the use of MRI during pregnancy is still limited to the second and third trimester of pregnancy. Magnetic resonance imaging contrast media are not to be used as it passes the placenta. Ultrasound remains the primary screening modality for fetal pathology; fetal MRI can serve as an adjunct or second-line imaging ...

British Library Electronic Table of Contents (United Kingdom)

The objective of this study was to develop full body CAD geometry of a seated 50th percentile male. Model development was based on medical image data acquired for this study, in conjunction with extensive data from the open literature. An individual (height, 174.9?cm, weight, 78.6???0.77?kg, and age 26?years) was enrolled in the study for a period of 4?months. 72 scans across three imaging modalities (CT, MRI, and upright MRI) were collected. The whole-body dataset contains 15,622 images. Over 300 individual components representing human anatomy were generated through segmentation. While the enrolled individual served as a template, segmented data were verified against, or augmented with, data from over 75 literature sources on the average morphology of the human body. Non-Uniform Rational...

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Purpose: The aim of this study was to demonstrate the typical appearance of ganglioneuromas in computer-assisted tomography (CT), and magnetic resonance imaging (MRI). Material and methods: Retrospective analysis of diagnostic imaging (9 CT, 6 MRI) in 9 children aged 3 to 15 years with the histological diagnosis of ganglioneuroma. Results: The tomographies showed large (max. 13.4 cm in diameter) round or oval tumors with sharp delineation. The sites of the tumors were the retroperitoneum (5), the mediastinum (3), and the adrenal gland (1). Intraspinal tumor involvement occurred in 4 cases. On comparing CT with MRI, MRI was more accurate in defining the intraspinal involvement. The ganglioneuromas were of hypodense appearance in the native CT scan and showed moderate enhancement upon administration of contrast media. In five patients tumor calcifications with a disseminated sprinkled pattern were seen in CT. In MRI T{sub 1}-weighted scans the tumors were homogeneous ...

Science.gov (United States)

Practitioners who care for pregnant women face dilemmas when their patients use illicit drugs, reject medical recommendations, or cause fetal harm. Many ethics scholars characterize those situations as maternal-fetal conflicts. In conflict-based models, maternal rights are considered to conflict with fetal rights, or moral obligations owed to pregnant women are considered to conflict with those owed to their fetuses. I offer an alternative model of pregnancy ethics by applying relational and equality-based moral theories to situations of fetal harm by pregnant women. In this model, clinicians faced with ethical dilemmas should attempt to understand pregnant women and their decisions within their broad social networks and communities, ask how the clinician's personal standpoint influences outcomes judged to be ethical, and determine whether the clinician's ethical formulations reduce or enhance existing gender, class, or racial inequality. This model focuses on the ...

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This probabilistic analysis of WIPP TRUDOCK crane failure is based on two sources of failure data. The source for operator errors is the report by Swain and Guttman, NUREG/CR-1278-F, August 1983. The source for crane cable hook breaks was initially made by WIPP/WID-96- 2196, Rev. O by using relatively old (1970s) U.S. Navy data (NUREG-0612). However, a helpful analysis by R.K. Deremer of PLG guided the authors to values that were more realistic and more conservative, with the recommendation that the crane cable/hook failure rate should be 2.5 x 10-6 per demand. This value was adopted and used. Based on these choices a mean failure rate of 9.70 x 10-3(1/yr) was calculated. However, a mean rate by itself does not reveal the level of confidence to be associated with this number. Guidance to making confidence calculations came from the report by Swain and Guttman, who stated that ...

International Nuclear Information System (INIS)

A case of metastatic Ewing's sarcoma to the skull is presented, demonstrating the superiority of magnetic resonance imaging over other imaging modalities to exclude CNS involvement. Precise delineation of different tumor components in extradural location contained in an intact dural rim together with compressed cortex showing no signs of tumorous involvement constituted an MRI appearance allowing us to exclude tumor outgrowth into the brain. (orig.).

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Out of one hundred cases of the urinary bladder abnormalities examined by this method, CT staging and pathological correlations were investigated in 61 cases of the urinary bladder neoplasms. Accuracy of CT staging was 87% in this series with possible exception of 6 cases involving the bladder base and dome. CT scan using this method is the most reliable procedure to determine the treatment modalities of the urinary bladder tumors.

UK PubMed Central (United Kingdom)

Hyperglycemia frequently occurs with acute medical illness, especially among patients with cardiovascular disease, and has been linked to increased morbidity and mortality in critically ill patients....Full Text Available

International Nuclear Information System (INIS)

The TS-1 and TS-2 TREAT transient experiments subjected a low burnup (2 MWd/kg) and a medium burnup (58 MWd/kg), respectively, FFTF irradiated fuel pin to unprotected 5 cents/s overpower transient conditions. The fuel pin failure response was similar in the two tests, which demonstrated a large margin to failure (P/P_0 > 3) and a favorable upper level failure location. Thus, for these transient conditions, burnup effects on transient performance appeared to be minimal in the range tested. Pin disruption in the medium burnup TS-2 test was more severe due to the higher fission gas pressurization, but failure occurred at only a 5% lower power level than for the low burnup TS-1 fuel pin. Both tests exhibited axial extrusion of molten fuel to the region above the fuel column several seconds before pin failure, demonstrating a potentially beneficial inherent safety mechanism to delay ...

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This paper presents a method for the optimal design of high voltage transmission lines taking into consideration shielding and backflashover failure rates. The minimization of suitably defined performance indices, which relate the failures caused by lightning in a transmission line to both line insulation level and tower footing resistance, is aimed. Optimum values for both line insulation level and tower footing resistance are calculated. The method is applied on several operating Hellenic transmission lines of 150 and 400kV, respectively, carefully selected among others, due to their high failure rates during lightning thunderstorms. Special attention has been paid on open loop lines, where a possible failure could bring the system out of service causing significant problems. The obtained design parameters, which reduce the failure rates caused by lightning, are compared with the ...

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A wood/polymer composite was produced by impregnating Ramin wood with methyl methacrylate monomer and subsequently polymerizing it by gamma irradiation. To assess the improvement in compression strength of the wood caused by the polymer impregnation, a microbuckling compression failure mechanism was used to model the compression failure of the composite. Such a mechanism was found to predict a linear relationship between the compression strength and the percentage polymer impregnation (by weight). Uniaxial compression test results at 45({plus minus}5)% and 90({plus minus}5)% relative humidity levels, after being statistically analysed, showed that such a linear relationship was valid for up to 100% polymer impregnation. (author).

Science.gov (United States)

Oak Ridge National Laboratory (ORNL) has for over ten years provided materials testing and failure analysis services to various coal conversion and utilization facilities in the United States. ORNL was involved in these types of activities at all four of the major coal liquefaction pilot plants. This paper presents a summary of activities at Wilsonville over the past two and one-half years. Some details of these activities are discussed below. Failure analysis of elastomers, stainless steels, and alloys is discussed. 6 refs., 9 figs., 13 tabs.

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A fuel plate examination was conducted in the hot cell and canal to determine the possible failure modes for three plates leaking fission products. The plates were irradiated in the Extended Life Aluminide Fuel (ELAF) program in support of university research reactor goals to increase the limits presently allowed. The examination indicated pitting corrosion to be the failure mode. Other failure modes such as: (a) nonbonded swelling, (b) excessive fuel swelling, and (c) overheating of the plates were not observed.

Science.gov (United States)

Ultimate Compressive Strength = 3000.0 psi. 3.0 Failure Criteria. The structural criteria used to evaluate the combustor components was chosen ...

Science.gov (United States)

of the Intelligent Control System (ICS) for reusable rocket engines. .... the incoming measurements with corresponding estimates, a sensor failure can be ...

Science.gov (United States)

The location of defective LMFBR fuel pins by the determination of gas tag isotopic ratios is discussed. The application of this method to the FFTF Reactor briefly described.

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Corrosion failures in circuits of foreign NPPs are considered. According to American statistics there are more corrosion failures in two-circuit NPPs than in NPPs with one circuit. Steam generators mostly suffer from ''corrosion denting''. Lately pitting corrosion becomes a potentially serious problem. Steam generator vertical tubes are mainly subjected to this corrosion type. Attention is drawn to intercrystalline corrosion. The causes of corrosion are described. The problem of optimization of structural materials is discussed to reduce corrosion failures as well as other methods of decreasing corrosion failures. Organization of nondestructive testing, increased requirements to water and steam purity are of great importance.

Science.gov (United States)

... position must not be penalized in their NCO Evaluation Report (NCOER). ... failure to perform MOS-, SQI-, or ASI-related duties after counseling. ...

KoreaScience (Korea)

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PMID:19955450

KoreaScience (Korea)

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KoreaScience (Korea)

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UK PubMed Central (United Kingdom)

Carcinoma in situ in the contralateral testis was diagnosed in 27 of 500 patients (5.4%) with unilateral testicular germ cell cancer. Eight of the 27 patients received intensive chemotherapy for spread...Full Text Available

British Library Electronic Table of Contents (United Kingdom)

ObjectiveWe sought to determine the clinical outcomes of patients undergoing surgical aortic valve replacement with hemodynamically confirmed severe pulmonary hypertension and aortic stenosis and compare them with the outcomes of patients not undergoing aortic valve replacement and patients undergoing aortic valve replacement with mild-to-moderate pulmonary hypertension. MethodsA total of 317 patients with severe aortic stenosis (aortic valve area 35 mm Hg) was present in 81 patients, of whom 35 (43.2%) underwent surgical aortic valve replacement. We compared the clinical outcomes of these 35 patients with the 46 patient...

International Nuclear Information System (INIS)

Failure of multiple components due to a common cause represents one of the most important issues in evaluation of system reliability or unavailability. The frequency of such events has relatively low expectancy, when compared to random failures, which affect individual components. However, in many cases the consequence is a direct loss of safety system or mitigative safety function. For this reason, the modeling of a common cause failure (CCF) and its presentation in fault tree structure is of the uttermost importance in probabilistic safety analyses (PSA). Amongst the different techniques available to reduce the impact of common cause failures, the most important operations related technique, is that of staggered testing. In the TAPP 3,4 Level-1 PSA it was found that the contribution of Common Cause Failures to the Core Damage Frequency (CDF) was significant. The Common Cause ...

Science.gov (United States)

Only a small number of radiation accidents in the United States have been severe enough to result in multi-organ failure (MOF). Medical details of selected medical misadministration and criticality cases are reviewed, with an emphasis on pathophysiology. The four criticality cases are particularly relevant for analysis of MOF, since medical treatment was supportive and did not appreciably alter the clinical evolution of radiation injury. PMID:15975871

Energy Technology Data Exchange (ETDEWEB)

This report contains the results of a survey of reactor coolant pump shaft seal reliability. The survey sample is representatively large (approx. = 27% of total US commercial plant population) and includes the three industry seal suppliers (Bingham-Williamette, Byron Jackson, and Westinghouse). Operationally incurred/induced problems and seal redesign parameters are identified. Failure hypotheses in the form of fault trees have been developed to describe the failure mechanisms. Recommendations are made for seal reliability improvement.

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Probabilistic assessment methods can be used to identify specific plant vulnerabilities. Application of such methods can also facilitate selection among system design alternatives available for safety enhancements. The quality of assessment results is however strongly dependent on realistic and accurate input data for modelling of system component behaviour and failure modes during conditions to be assessed. Use of conservative input data may not lead to results providing guidance on safety upgrades. Adequate input data for probabilistic assessments seems to be lacking for at least failure modes of some electrical components when exposed to a fire. This report presents an attempt to improve the situation with respect to such input data. In order to take advantage of information in existing documentation of fire incident occurrences some of the lessons learned from the fire at Browns Ferry Nuclear Power Plant on March 22, 1975 are discussed in ...

International Nuclear Information System (INIS)

Power devices such as MOSFETSs and IGBTs, include parasitic structures that can give rise to destructive failures such as breakdown and latch-up. To determine a suitable strategy for device radiation hardening, simulation software like MEDICI-2D can be used to model the effects of technological modifications and device parameters that are difficult to measure experimentally. (authors).

Energy Technology Data Exchange (ETDEWEB)

On February 9, 1995 ComEd experienced a pipe type cable failure on 138kV line 13717. Line 1737 is a bulk power transmission cable circuit connecting The Fisk and Crawford generating stations located within city limits. The line is approximately 4.5 miles long and was originally installed in 1975. This line is forced cooled, has 2,500 KCMIL copper conductors with 505 mils of paper insulation in an 8 inch pritec coated steel pipe. The splices are constructed with Voltalit castings. The failure occurred approximately 3,500 feet from Crawford Station. It was easy to locate the failure since the cable joint casing was breached resulting in the loss of approximately 2,600--2,700 gallons of dielectric fluid. Upon field examination B Phase was determined to have failed. The failure occurred 12 inches inside the casing in an area where it was impossible to install a long connector or add an additional short ...

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A 25m wind turbine blade was tested to failure when subjected to a flapwise load. With the test setup, it was possible to test the blade to failure at three diffe-rent locations. The objective of these tests is to learn about how a wind turbine blade fails when exposed to a large flapwise load and how failures propagate. The report shows also results from ultra sonic scan of the surface of the blade and it is seen to be very useful for the detection of defects, especially in the layer between the skin laminate and the load carrying main spar. Acoustic emission was successfully used as sensor for the detection of damages in the blade during the test. The report contains measurements of the total deflection of the blade, the local deflection of the skin and the load carrying main spar and also measurement of strain all as a function of the applied load and up to failure of the blade. The 'post ...

International Nuclear Information System (INIS)

As part of the Nondestructive Evaluation Reliability Program sponsored by the US Nuclear Regulatory Commission, the Pacific Northwest Laboratory is developing a method that uses risk-based approaches to establish in-service inspection plans for nuclear power plant components. This method uses probabilistic risk assessment (PRA) results and Failure Modes and Effects Analysis (FEMA) techniques to identify and prioritize the most risk-important systems and components for inspection. The Surry Nuclear Power Station Unit 1 was selected for pilot applications of this method. The specific systems addressed in this report are the reactor pressure vessel, the reactor coolant, the low-pressure injection, and the auxiliary feedwater. The results provide a risk-based ranking of components within these systems and relate the target risk to target failure probability values for individual components. These results will be used to guide the development of ...

International Nuclear Information System (INIS)

Protected cultures are widespread along the Lebanese narrow coastline, encouraged by mild winter conditions. Although one of the most intensive production systems, water and nutrients managements are mostly empirical, based on the experience of the grower himself or of his workers. So far, water has been available in Lebanon, but it will become scarce within ten years. The conservation of water quality by a rational addition of nutrients is particularly relevant to protected cultures. This is important as greenhouses are developed on imported shallow soils that could be fragile and highly vulnerable to pollution. Sound management includes the amount and the forms of fertilizers as well as the modality of fertigation. An experiment was conducted during two spring seasons in a location along the northern coast in a typical unheated greenhouse. The cucumber response to two frequencies and modalities of fertigation was followed: continuous T2C and ...

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Sixty-six cases of histologically proven hepatocellular carcinomas (HCC) were studied by MRI. Detectability was better by MRI than by CT, especially in the tumor under 2 cm in diameter. The capsule was detected in all cases of HCC over 3 cm in diameter. The capsule was able to be diagnosed only by dynamic MRI study in some cases. High intensity on the T1-weighted image and iso or low intensity on the T2-weighted image suggested that the nodule was adenomatous hyperplasi (AH) or well differentiated HCC. MRI is concluded to be an essential modality in the diagnosis of HCC. (author).

International Nuclear Information System (INIS)

Mass distributions of fragments in the low-energy fission of nuclei from "1"8"7Ir to "2"1"3At have been analysed. This analysis has shown that shell effects in symmetric-mode fragment mass yields from the fission of pre-actinide nuclei could be described if one assumes the existence of two strongly deformed neutron shells in the arising fragments with neutron numbers N_1#approx#52 and N_2#approx#68. A new method has been proposed for quantitatively describing the mass distributions of the symmetric fission mode for pre-actinides with A#approx#180-220. (orig.)

International Nuclear Information System (INIS)

Periosteal Ewing's sarcoma is an uncommon, but well documented origin of this malignant condition with radiography signs, different from intramedullary growing tumours. Imaging modalities like CT or MRI supply proof of macroscopically intact endosteal cortical surface and free medullary cavity in long bones affected by this periosteal type of malignancy. Definite confirmation is valid after a careful microscopic investigation of the resected specimen. The prognosis of this type of Ewing's sarcoma may be favourable than that of the central type. Early diagnosis and therapy are thus essential. A clinical survey of six observations is given. (orig.).

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In the Wajima lung cancer screening program conducted under the auspices of Kanazawa University Hospital, Fuji Computed Radiography (FCR) was utilized in a new chest radiography trial. The results of the screening program are that the necessity of repeat examinations due to poor image quality are less common and the method enables detection of small pulmonary nodular shadows which are possibly candidates for surgery. Oblique chest X-ray with FCR is remarkably effective for the detection and the identification of small lesions. However, the disadvantage of slow processing and high cost must be fully satisfied if FCR is to become a new imaging modality for mass screening.

CERN Document Server

Focusing and resonance properties of two-dimensional small-size hemielliptic lenses made of different materials are studied numerically in order to estimate the influence of internal reflections on the radiation characteristics of dielectric lens antennas. Accuracy of in-house made algorithms based on combination of geometrical and physical optics and FDTD in the analysis of optical and modal effects in the behavior of such lenses is tested by comparison with the exact solution obtained using the Muller boundary integral equations. The range of applicability for the approaches is discussed.

British Library Electronic Table of Contents (United Kingdom)

Customer Relationship Management (CRM) systems can help organizations manage customer interactions more effectively. Like many new technologies, CRM has been accompanied by vendor hype and stories of implementation failure. Work on critical success factors (CSFs) should encourage more appropriate implementation practice; however many CSF studies conclude with a list of factors but provide little further guidance. In particular, there is a need for stronger theoretical models of the entire CRM innovation process which can be used by managers to understand better the underlying causes of success and failure. This paper adopts a novel approach to this problem by firstly developing a conceptual model of CRM innovation and then converting this model into a dynamic simulation model. Some early s...

International Nuclear Information System (INIS)

The fatigue life variability of the #alpha#+#beta# titanium alloy, Ti-6Al-2Sn-4Zr-6Mo increased with decreasing stress level. The variability in life was found to be due to segregation of lives due to two failure mechanisms. A bimodal cumulative distribution model was shown to accurately describe the combined failure modes. The nominal failure processes for the two regimes were similar, with crack nucleation occurring in equiaxed #alpha#p particles, irrespective of life or stress level. However the variability in life was not controlled by the size of the crack-nucleating #alpha#p, but rather by the ability of the material to distribute deformation and avoid early crack nucleation.

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Carbon steel is frequently used to construct concentrated sulphuric acid storage tanks. This paper discussed the corrosion performance of carbon steel tanks and outlined the underlying mechanisms responsible for major corrosion modes. Analyses of hydrogen grooving and dilute acid corrosion failure mechanisms were presented. Recent corrosion-induced leak failures were also discussed. The use of anodic protection and organic coatings as a corrosion control measure was also evaluated. The results of laboratory studies that were conducted to understand corrosion-induced failures showed that carbon steel electrodes exhibited transpassive corrosion at relatively high anodic potentials, while stainless steel electrodes exhibited transpassive corrosion at anodic potentials less than 1 V. It was concluded that corrosion-induced leaks can be prevented by using anodic protection and baked phenolic coating technologies. 23 refs., 9 ...

International Nuclear Information System (INIS)

The aim of the risk assessment consists of a comparative security evaluation for the SNR-300 and the PWR Biblis B. The failure analysis focusses on the reactor core; in addition, possible fission product release from the spent fuel pits is examined. By reliability analyses, the frequency of events leading to incidents is determined together with the probability of core destruction. In the accident analysis, the kind and frequency of failure of the activity barriers, i.e., primary system (reactorvessel) and inner and outer containment are investigated for the various incident sequences. The radionuclide release into the environment is classified into five different release categories. Besides internal failures, external causes (especially earthquakes and plane crashes) are considered under the aspect of their risk contribution. (RF).

British Library Electronic Table of Contents (United Kingdom)

Premature Failure of a Riata Defibrillator Lead. A 63-year-old woman with a St. Jude Medical Riata 1570 right ventricular lead complained of intermittent hiccups 2 months after implant. Interrogation revealed elevated pacing threshold and diaphragmatic stimulation. Pacing and shock lead impedances remained stable. No inappropriate sensing was noted. Fluoroscopic examination of the lead revealed a thin radio-opaque wire seen between the 2 defibrillator coils away from the main body of the lead. After extraction, a tear in the insulation of the lead was noted allowing the inner wire to protrude. This case illustrates a novel mechanism of insulation failure without inappropriate sensing or impedance change.-(J Cardiovasc Electrophysiol, Vol. 22, pp. 1070-1072, September 2011)

Energy Technology Data Exchange (ETDEWEB)

An availability assessment of the principal systems of the Heber Geothermal Power Plant has been carried out based on the final issue of the process descriptions, process flow diagrams, and the approved for design P and IDs prepared by Fluor Power Services, Inc. (FPS). The principal systems are those which contribute most to plant unavailability. The plant equivalent availability, considering forced and deferred corrective maintenance outages, was computed using a 91 state Markov model to represent the 29 principal system failure configurations and their significant combinations. The failure configurations and associated failure and repair rates were defined from system/subsystem availability assessments that were conducted using the availability assessments based on the EPRI GO methodology and availability block diagram models. The availability and unavailability ranking of the systems and major equipment is presented.

Energy Technology Data Exchange (ETDEWEB)

The reliability analysis of the Fast Flux Test Facility reactor shutdown system was reevaluated. Failure information based on five years of plant operating experience was used to verify original reliability numbers or to establish new ones. Also, system modifications made subsequent to performance of the original analysis were incorporated into the reevaluation. Reliability calculations and sensitivity analyses were performed using a commercially available spreadsheet on a personal computer. The spreadsheet was configured so that future failures could be tracked and compared with expected failures. A number of recommendations resulted from the reevaluation including both increased and decreased surveillance intervals. All recommendations were based on meeting or exceeding existing reliability goals. Considerable cost savings will be incurred upon implementation of the recommendations.

Energy Technology Data Exchange (ETDEWEB)

Analyses were performed of the safety-related performance of the reactor protection system (RPS) at U.S. Westinghouse and General Electric commercial reactors during the period 1984 through 1995. RPS operational data from these reactors were collected from the Nuclear Plant Reliability Data System (NPRDS) and Licensee Event Reports (LER). The common-cause failure (CCF) modeling in the fault trees developed for these studies and the analysis and use of common-cause failure data were sophisticated, state-of-the-art efforts. The overall CCF effort helped to test and expand the limits of the U.S. Nuclear Regulatory Commission's CCF methodology.

UK PubMed Central (United Kingdom)

One hundred and fifty patients requiring maintenance haemodialysis were investigated to determine the incidence and pattern of tuberculosis. Twenty patients were found to have tuberculosis, giving an...Full Text Available

UK PubMed Central (United Kingdom)

By analyzing the data of 459 patients who completed the Supportive Care Needs Survey (SCNS), the prevalence, medical and non-medical predictors of unmet needs were investigated. Breast cancer patients...Full Text Available

UK PubMed Central (United Kingdom)

Background:Encouragement of stroke patients to resume driving is important to promote their reintegration into the community. Limited rehabilitation has been performed in this regard,...Full Text Available

UK PubMed Central (United Kingdom)

OBJECTIVE: To evaluate prospectively the efficacy of a single fraction of high-dose radiotherapy in patients with Kaposi's sarcoma. PATIENTS: Between 1994 and 2004, 47 patients with Kaposi's sarcoma...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundAcute kidney injury (AKI) is associated with increased short-term mortality of septic patients; however, the exact influence of AKI on long-term mortality in such patients...Full Text Available

UK PubMed Central (United Kingdom)

OBJECTIVE: To assess the motor function of the left, supposedly unaffected, limbs of patients with an acute right vascular hemiplegia. METHODS: Fifteen patients with an acute vascular right hemiplegia...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundDiagnostic delay in patients with tuberculosis (TB) leads to ongoing TB transmission, higher mortality rates and increased patient and government health expenditure. Qualitative...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundCompared to healthy controls, cancer patients have a higher risk of unemployment, which has negative social and economic impacts on the patients and on society at large....Full Text Available

UK PubMed Central (United Kingdom)

Background & objectives: Fatigue is a debilitating symptom experienced by patients undergoing dialysis, but there is only limited information on its prevalence and its association with patient...Full Text Available

UK PubMed Central (United Kingdom)

Patients do considerable information work. Technologies that help patients manage health information so they can play active roles in their health-care, such as personal health records, provide...Full Text Available

UK PubMed Central (United Kingdom)

The increased risk of thrombosis in patients with active cancer has multiple causes. Acute thrombosis of the aorta is an exceedingly rare but potentially devastating complication in patients with cancer...Full Text Available