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
Procedures for {sup 131}I ablation in renal failure are not known. In one patientreceiving 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.
Statement of problem Porcelain fracture associated with an implant-supported, metal ceramic crown or fixed partial denture occurs at a higher rate than in tooth-supported restorations, according to the literature. Implant-specific and patient-specific causes of ceramic failure have not been fully evaluated. Purpose The purpose of this retrospective study was to evaluate the potential statistical predictors for porcelain fracture of implant-supported, metal ceramic restorations. Material and Methods Over a 6-month period, a consecutive series of patients having previously received implant-supported, metal ceramic fixed restorations were examined during periodic recall appointments. The number of supporting implants, number of dental units, type of restoration, date of prosthesis insertion, ...
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 patientsreceiving adjunctive VNS with TRD patientsreceiving treatment as usual showed significant results f...
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 patientsreceived 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 ...
Patients with end stage renal failure (ESRD) require renal replacement therapy in the form of dialysis or renal transplantation. There is an increasing number of people receiving maintenance dialysis as patients with ESRD are increasing faster than the supply of transplantable organs. The mortality rate on dialysis is 4-6 times that of the general population and is substantially reduced by transplantation. For the past 8 years, dialysis research has focused on improving patient outcomes and quality of life on dialysis. This review examines recent advances in haemodialysis and peritoneal dialysis in a historical context and considers future research possibilities. PMID:19329705
Purpose: To evaluate the effect of low-dose radiation therapy and surgery on local control in patients with Ewing's Sarcoma. Materials and Methods: Between 1979 and 1995 24 patients (ages 4-47) with Ewing's sarcoma were treated with combined modality therapy that included multi agent chemotherapy, surgical resection, and radiation therapy. Twelve patients had metastatic disease at the time of presentation (pleura = 3, lung = 5, bone 4). Tumor location was central in 16 and peripheral in 8. Multi agent chemotherapy consisted of vincristine/actinomycin D/cyclophosphamide/doxorubicin in 19. The same agents with the addition of ifosfamide and etoposide were given in 5. The extent of resection was considered to be radical in 14 and of the 16 patients who received preoperative chemotherapy, 5 were found to have a pathologic complete response. All patients with lung ...
1 Measurements of the binding of 12-alpha-[3H]-digoxin to the membranes of intact erythrocytes, erythrocytic 86rubidium uptake and intraerythrocytic sodium concentrations have been made in the red cells...Full Text Available
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 patientreceived 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%, ...
Objective was to present our 8 year experience in the prevention of the obturator nerve reflex during transurethral resection of bladder tumors. This study was performed in Ataturk University Hospital between 1999 and 2007. We retrospectively reviewed the records of 89 patients with inferolateral bladder tumors, who underwent transurethral resection under epidural or general anesthesia and requested obturator nerve reflex inhibition. Epidural anesthesia was administered to 57 patients, while the remaining 32 patients underwent general anesthesia via mask; and succinylcholine was administered prior to resection. Of the 57 patientsreceived epidural anesthesia, 18 were diagnosed as inferolateral bladder tumors during endoscopy and had to undergo general anesthesia. Obturator nerve block was attempted preoperatively in 39 patients. However, a nerve identification ...
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 ...
BackgroundProvision of consumer information and patient education are considered an essential part of chronic disease management programmes developed for patients with heart failure....Full Text Available
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 ...
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 ...
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 ...
Purpose : To evaluate whether the early pulmonary irradiation can prevent or decrease the pulmonary damage and contribute to improve ultimate survival in paraquat lung. Materials and Methods : From Jun. 1987 to Aug. 1993, thirty patients with paraquat poisoning were evaluated. Fourteen of these patients were received pulmonary irradiation(RT). All of the patients ere managed with aggressive supportive treatment such as gastric lavage, forced diuresis, antioxidant agents and antifibrosis agents. Ingested amounts of paraquat were estimated into three groups(A: minimal < about 5cc, B: mouthful 5-50 cc, C: Large > 50cc). Pulmonary irradiation was started within 24 hours after admission(from day 1 to day 11 after ingestion of paraquat). Both whole lungs were irradiated with AP/PA parallel opposing fields using C0-60 teletherapy machine. A total of 10Gy(2Gy/fr. X 5 days)was delivered without ...
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 ...
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...
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, ...
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
Background and objectives: Patientsreceiving dialysis have a high burden of cardiovascular disease. Some receive coronary artery revascularization but the optimal method is controversial.Design,...Full Text Available
Heart failure affects nearly 6 million Americans, with a half-million new cases emerging each year. Whereas up to 50% of heart failurepatients die of arrhythmia, the diverse mechanisms underlying...Full Text Available
To determine the accuracy of the intra-articular location of hyaluronic acid injection using a blind approach and to establish the usefulness of fluoroscopy-guided intra-articular injection. A fluoroscopy unit was used for 368 intra-articular injections of hyaluronic acid to 93 knees in 65 patients. Initially, blind needle positioning was conducted on the fluoroscopy table. The failure rate of the blind approach among the 368 injections was evaluated, and a relationship between the Kellgren-Lawrence grade (K-L grade) and the incidence of repeated failures using the blind approach was determined for injections to 52 knees in 37 patients who received a complete cycle of injections (five consecutive injections with a one-week interval between injections). Using a blind approach, 298 of 368 trials (81.2%) resulted in a needle tip being placed in an intra-articular location, while 70 of ...
An observational cohort study was conducted to compare the performance of the RIFLE (risk, injury, failure, loss and end-stage kidney disease), AKIN (acute kidney injury network) and conventional graded criteria to identify acute kidney injury (AKI) following SCT and to predict long-term mortality in 141 myeloablative allogeneic SCT (m-allo), 60 non-myeloablative allogeneic SCT (nm-allo) and 48 autologous SCT (auto) cases. The AKIN criteria had less ability to identify patients as having the lowest category, stage 1 (analogous to RIFLE risk): 33% (37%) in m-allo, 23% (32%) in nm-allo and 8.3% (16.7%) in auto. Cox regression showed that categories higher than the intermediate stage were independent predictors of mortality in all three definitions. The areas under receiver operating characte...
Purpose: To identify results and prognostic factors on long-term survival and local control following treatment of localized Ewing's sarcoma. Patients and Methods: Between 1979 and 2004, a total of 60 children and young adults with Ewing's sarcoma were treated. Patients with distant metastases at presentation (n = 6) and recurrent cases (n = 2) were excluded from this analysis. Patients were exclusively treated within ongoing national and international protocols CESS-81, CESS-86, EICESS-92, EURO-EWING-99. All patientsreceived local irradiation with a total dose of 45-60 Gy; in addition, 41 (79%) of the patients had local surgical procedures, 27 (52%) of them with clear margins. Results: Overall survival rates at 5 and 10 years were 56% and 45%, respectively. Patients #<=# 14 years at diagnosis had overall survival rates of 66% and 61% at ...
Two patientsreceiving maintenance dialysis therapy developed osteonecrosis, the first in the humeral head and the second in the talus. Both patients lacked known risk factors for developing osteonecrosis. A possible pathogenic role of secondary hyperparathyroidism in this disorder is suggested. Rheumatologists evaluating patientsreceiving maintenance dialysis with rheumatic manifestations should be aware of this potential complication. PMID:2185360
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...
Purpose: The results of therapy in 288 men with pathologic Stage C prostate cancer who underwent radical retropubic prostatectomy (RRP) were analyzed to determine the effects of adjuvant therapy. Methods and Materials: Twenty-seven of the 288 patientsreceived preoperative neoadjuvant hormonal therapy (leuprolide acetate). Postoperatively, 60 patientsreceived adjuvant radiotherapy (RT) to the prostate bed. Follow-up ranged from 3 to 83 months (median = 32 months). Freedom from failure (FFF) was defined as maintaining a serum PSA level of #<=# 0.3 ng/ml. Results: The FFF was 61% at 3 years and 45% at 5 years for the entire group. The FFF following RRP plus RT was 75% at 3 years and 57% at 5 years as compared to 56% at 3 years and 40% at 5 years for RRP without RT (p = 0.049). The FFF following RRP plus neoadjuvant hormonal therapy was 58% at 3 years and 40% at 5 years as compared ...
The role of radiation therapy in local tumor control and decreased incidence of pulmonary metastasis is reported in 271 patients who were entered into the Intergroup Ewing's Sarcoma Study with more than one year follow-up and on whom all radiotherapy records were reviewed. The majority of the patients were irradiated to the primary tumor with doses of 4500 to 6500 rad in five to six weeks in combination with systemic administration of three drugs (vincristine, actinomycin-D and cyclophosphamide) or four drugs (vincristine, actinomycin-D, cyclophosphamide and adriamycin). One of the groups of patients was treated with three drugs and bilateral pulmonary irradiation (1500 rad, uncorrected dose, in two weeks). Preliminary analysis shows an overall local primary tumor control of 89%. Patients with lesions in the pelvis had a local failure rate of 17% (9 of 52) and in the humerus 23% (7 ...
Angiotensin II has adverse actions in heart failure including vasoconstriction, aldosterone secretion, and activation of the sympathetic nervous system. Valsartan, a potent specific angiotensin II type 1 receptor blocker, may produce beneficial effects in heart failure. The purpose of this study was to evaluate the steady-state pharmacokinetics of valsartan 40, 80, and 160 mg each given every 12 h for 7 days in heart failurepatients. Eighteen patients with chronic stable heart failure and left ventricular ejection fractions power model, showed that doubling the dose increased the AUC and Cmax 1.8 times. The pharmacokinetics of valsartan are predictable in heart failurepatients within the dose range of 40-160 mg BID. Age did not appear to have influenced the valsartan clearance in heart failure ...
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 patientsreceived intensive chemotherapy for spread...Full Text Available
AimsThe prevalence and importance of liver function test (LFT) abnormalities in a large contemporary cohort of heart failurepatients have not been systematically evaluated.Full Text Available
In a group of 32 patients with terminal renal failure the initial hypocalcaemia was corrected after two months' adequate maintenance haemodialysis. In seven patients hypercalcaemia occurred with a...Full Text Available
This paper is a progress report on the role of radiation therapy (RT) in local tumor control and the decreased incidence of pulmonary metastasis in 251 patients entered in the Intergroup Ewing's Sarcoma Study. All were followed for more that 1 year, and their RT records were reviewed. Doses to the primary tumor in the range of 4,500--6,500 rad were administered over approximately 5 to 6 weeks in combination with 4 drugs, i.e., vincristine (VCR), dactinomycin (DAC), cyclophosphamide (CY), and adriamycin, or only the first 3. One group of patientsreceived the 3 drugs and bilateral pulmonary irradiation (approximately 1,500 rad in 2 wk). Preliminary analysis showed a local primary tumor control of approximately 90%. Patients with lesions in the pelvis and humerus had local failure rates of 13% (7 of 54) and 21.4% (6 of 28), respectively. The treatment groups differed significantly in ...
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
Refractory ascites can occur in patients with various conditions. Although several procedures based on the reinfusion of ascitic fluid have been reported after the failure of bed rest, salt and water...Full Text Available
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
AimsTo determine the effect of exercise training on clinical events and health-related quality of life (HRQoL) of patients with systolic heart failure.Methods...Full Text Available
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 ...
Using plasma glutathione S-transferase measurements hepatocellular integrity was assessed in groups of hyperthyroid and hypothyroid patients before and after treatment. Ten of 14 hyperthyroid patients...Full Text Available
Patients treated with bleomycin are at risk of developing the acute adult respiratory distress syndrome post-operatively. In a prospective study of 12 patients who had received bleomycin preoperatively...Full Text Available
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
Several randomized studies have been completed in prostate cancer that show a benefit to immediate postoperative treatment in patients undergoing prostatectomy. In one of the studies, there was even...Full Text Available
The most frequent ultimate cause of death is myocardial arrest. In many cases this is due to myocardial hypoxia, generally arising from failure of the coronary macro- and microcirculation to deliver...Full Text Available
The purpose of this study was to examine the day-to-day reproducibility and single measurement reliability of peak force, time to half peak force and rate of force development indices of knee extension neuromuscular performance in patients with end-stage renal failure. Eleven self-selected patients (6 men, 5 women) receiving maintenance dialysis (dialysis history 67 +/- 42.8 month) completed 3 inter-day assessment sessions. Each comprised a standardized warm-up and 3 intermittent static maximal voluntary actions of the knee extensors of the preferred limb (45 degrees knee flexion angle [0 degrees = full knee extension]) using a specially-constructed dynamometer. Repeated measures ANOVA of coefficient of variation scores revealed significant differences between indices in their reproducibility across day-to-day trials. Post-hoc comparisons of group mean scores suggested that peak force (6.6 +/- 3.0%) ...
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
The pharmacokinetic parameters of amikacin and ceftazidime were assessed in four patients undergoing hemofiltration for septic shock. The parameters were assessed during hemofiltration and in the interim...Full Text Available
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
BackgroundThe elevated serum and peritoneal cytokine concentrations responsible for the systemic response syndrome (SIRS) and multiorgan failure in patients with severe acute pancreatitis...Full Text Available
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
Anxiety may cause adverse outcomes through physiologic pathways in patients with cardiac disease. The purpose of this dissertation was to investigate anxiety and its correlates in persons with acute myocardial infarction (AMI) and heart failure (HF). The ...
The failure of receivers has been one of the main operating problems at the White Cliffs solar thermal power plant. This Technical Note reports the results of an initial investigation that identifies the cause as having been their thermal fatiguing of the tube walls. The fatigue appears to be caused by unstable heat transfer at vapor qualities below the point where critical heat flux is generally exceeded. Methods for avoiding this problem are tested.
Purpose of reviewOsteonecrosis of the Jaw (ONJ) in an uncommon condition noted to occur in patients with cancer receiving intravenous bisphosphonates. The etiology...Full Text Available
Background:Prolonged mechanical ventilation is increasingly common. It is expensive and associated with significant morbidity and mortality. Our objective is to comprehensively characterize...Full Text Available
Abstract While substantial attention has been paid to the issue of sexual dysfunction in men on chronic dialysis, less is known about this problem in women with end-stage renal disease. We sought to assess sexual dysfunction in women on chronic dialysis and determine whether patients discuss this problem with their providers and receive treatment. We prospectively enrolled women receiving chronic hemodialysis or peritoneal dialysis in Pittsburgh, PA. We asked patients to complete the 19-item Female Sexual Function Index (FSFI) to assess sexual function and a 5-item survey that assessed whether patients had discussed sexual dysfunction with their providers and/or received treatment for this problem in the past. We enrolled 66 patients; 59 (89%) on hemodialysis and 7 (11%) on peritoneal dial...
PurposeTo determine the dosimetric impact of inter-fraction anatomical movements in prostate cancer patientsreceiving proton therapy.Full Text Available
To evaluate the efficacy of newly designed covered and non-covered coated colorectal stents for colonic decompression. Twenty-six patients, (15 palliative cases and 11 preoperative) underwent treatment for the relief of colorectal obstruction using metallic stents positioned under fluoroscopic guidance. In 24 of the 26, primary colorectal carcinoma was diagnosed, and in the remaining two, recurrent colorectal carcinoma. Twenty-one patients were randomly selected to receive either a type A or type B stent; for the remaining five, type C was used. Type A, an uncovered nitinol wire stent, was lightly coated to ensure structural integrity. Type B (flare type) and C (shoulder type) stents were polyurethane covered and their diameter was 24 and 26mm, respectively. The rates of technical success, clinical success, and complications were analyzed using the chi-square test, and to analyse the mean period of patency, the Kaplan-Meier ...
The feasibility of self-expanding nitinol stents for treatment of infragenicular arteries following unsuccessful balloon angioplasty was assessed. Options for lower limb percutaneous revascularization are limited, especially for complex vessel obstruction. Depending on the lesion and the experience of the interventionalist, the failure rate of balloon angioplasty (PTA) ranges between 10 and 40%. Until recently, no self-expanding stent for the use in the infragenicular arteries was available. This is the first report of the results for 18 consecutive patients who received 4F sheath compatible self-expanding nitinol stents following unsuccessful PTA or early restenosis. Twenty-four stents were implanted in 21 lesions for various indications residual stenosis >50% due to heavy calcification, flow-limiting dissection, occluding thrombus resistant to thrombolyis, thrombaspiration, and PTA, and early restenosis after ...
Forty-four patients with histologically proven Hodgkin's disease underwent initial treatment with extended-field radiation therapy. Nineteen of these patients also received combination chemotherapy....Full Text Available
AIMS: To examine the frequency of intraocular metastases in patients who had died of cancer, in an eye bank and necropsy population sample. METHODS: The first group included 302 cancer cases received...Full Text Available
Purpose: Patients with mycosis fungoides [cutaneous T-cell lymphoma (CTCL)] may benefit from adjuvant therapy after completing total skin electron beam therapy (TSEBT). We report the results for (T1(T2)) CTCL patients treated with adjuvant oral psoralen plus ultraviolet light (PUVA) with respect to overall survival (OS), disease-free survival (DFS), salvage of recurrence, and toxicity. Methods and Materials: Between 1974 and 1993, TSEBT was administered to a total of 213 patients with CTCL. Records were reviewed retrospectively, and a total of 114 patients were identified as having T1 or T2 disease. Radiotherapy was provided via a 6-MeV linac to a total of 36 Gy, 1 Gy/day, 4 days/week, for 9 weeks. Beginning in 1988, patients were offered adjuvant PUVA within 2 months of completing TSEBT. This was started at 0.5-2 J/m"2, 1-2 treatments/week, with a taper over 3-6 months. Therapy ...
Purpose To analyze the clinical profile, management and outcome of non-hematological tumors in head and neck region in children less than 18?years of age. Patients and methods Medical records of patients (0?18?years) presenting with non-hematological tumors of head and neck region from 2000 to 2010 were reviewed. Result Out of the 78 patients identified, 50 were males with median age of 14?years (3?months to 18?years). Histologically, 58 out of the 78 patients had malignant tumors and 20 were metastatic at presentation. Common site of tumor origin was noted as thyroid (23/78), salivary glands (21/78) and nasopharynx (13/78). Out of 78 patients, 44 patients were treated by surgery, 26 patientsreceived radiation and 13 patientsreceived chemotherapy, while 9 ...
Background and purpose: A diagnosis of malignancy and its treatment is a very stressful time for patients and their families. This study was conducted to determine the impact of more intensive written information on patients' anxiety levels. The secondary aim was to determine the impact of this information on patients' satisfaction levels. Materials and methods: This prospective randomized trial consisted of patients with a pathological diagnosis of cancer having radical radiotherapy (RT). Patients were randomized to receive the more intensive information (including written information and a telephone call from the research nurse) or not to receive the more intensive information at the time of their initial consultation with the radiation oncologist. Study questionnaires measuring anxiety (STAI form) were completed prior to their first ...
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.
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
Background and purpose It has been speculated that the prevalence of metal allergy may be higher in patients with implant failure. We compared the prevalence and cause of revisions following...Full Text Available
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
ObjectivesThis studys examined the relationship between substance use disorder (SUD) and intimate partner violence screening (IPV) and management practices in the...Full Text Available
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
A case of severe intractable angina pectoris with normal angiography is presented. Following video assisted thoracic sympathectomy the patient died of heart failure. Microvascular cardiac amyloidosis...Full Text Available
CT of the gastrointestinal tract is commonly performed after administration of a high-density diluted iodinated oral contrast material. However, because if inadequate mixing of the contrast material with the gastrointestinal contents, pseudotumor and poor mucosal visualization are frequently shown on abdominal CT. To overcome these problem, 10% corn oil emulsion (COE) is tested as an alternative oral contrast agent in 40 patients. We analyse patients tolerance, gastric mucosal visualization and discrimination of pancreas from the duodenal C-loop to 10% COE in 40 patients compared with those obtained from 35 patients, who was received high-density diluted iodinated oral contrast agent (gastrografin). The results are as follows : 1. Patients' tolerance to 10% COE is similar to that to conventional oral contrast agent. 2. Image of the gastric mucosa from ...
CT of the gastrointestinal tract is commonly performed after administration of a high-density diluted iodinated oral contrast material. However, because if inadequate mixing of the contrast material with the gastrointestinal contents, pseudotumor and poor mucosal visualization are frequently shown on abdominal CT. To overcome these problem, 10% corn oil emulsion (COE) is tested as an alternative oral contrast agent in 40 patients. We analyse patients tolerance, gastric mucosal visualization and discrimination of pancreas from the duodenal C-loop to 10% COE in 40 patients compared with those obtained from 35 patients, who was received high-density diluted iodinated oral contrast agent (gastrografin). The results are as follows : 1. Patients' tolerance to 10% COE is similar to that to conventional oral contrast agent. 2. Image of the gastric mucosa from ...
Purpose: Efficacy and safety of the own single-center experience with moderately dosed radiosurgery (SRS) for limited (one to four) brain metastases were analyzed and correlated with patient- and treatment-related variables. Patients and Methods: Between 05/1998 and 10/2006, 93 patientsreceived SRS for a total of 142 brain metastases. The median number of brain metastases treated per patient was one (range, one to four). 46 patients (49%) received initial SRS alone, 13 patients (14%) SRS with up-front whole-brain radiotherapy (WBRT), and 34 patients (37%) SRS for recurrent metastases after WBRT. Median dose was 16 Gy (range, 10-20 Gy). Results: Median overall survival (OS) was 7.5 months. The actuarial 6- and 12-month data for OS were 60% and 35%, for local brain control (LBC) 87% and 79%, and for ...
Reference failures, and their increase in affectively negative conditions (known as affective reactivity of speech), are more frequently observed in schizophrenia patients than in normal controls, but no information is available comparing schizophrenia with depression, ie, a mental disorder closely linked to the concept of affective reactivity. To address this gap in the literature, the present study compared 24 schizophrenia inpatients, 21 unipolar depression inpatients and 21 normal controls. Two 10-minute conversational speech samples (1 on negative and 1 on positive memories) were collected from each patient. The transcripts of the audiotaped interviews were analyzed blindly for frequencies of 6 types of referential failures, employing the Communication Disturbances Index, adapted for ...
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.
BackgroundAlthough self-expandable metal stent (SEMS) insertion is widely used for relief of malignant colorectal obstructions, the immediate technical and clinical failure rates of SEMSs and the associated risk factors remain largely unknown. ObjectiveTo identify rates and factors predictive of technical and clinical failure of SEMSs when their use is attempted for the decompression of malignant colorectal obstruction. DesignRetrospective chart review. SettingA tertiary-care academic medical center in South Korea. PatientsThis study involved a total of 412 patients with malignant colorectal obstruction in whom SEMS insertion was attempted. InterventionPlacement of colonic SEMSs. Main Outcome MeasurementsTechnical success and immediate and long-term clinical success rates. ResultsTechnical...
Records of 154 patients with Ewing's sarcoma treated at the National Cancer Institute were reviewed to assess the incidence and risk of developing isolated central nervous system (CNS) Ewing's sarcoma. Sixty-two of the 154 patients had received CNS irradiation and intrathecal (i.t.) methotrexate as part of their initial therapy to prevent the occurrence of isolated CNS Ewing's sarcoma. The risk of developing isolate CNS Ewing's sarcoma was greatest within the first two years after diagnosis and was approximately 10%. The overall risk of CNS recurrence in the group of patientsreceiving DNS treatment was similar to the group receiving no therapy directed to the CNS. The occurrence of isolated CNS involvement was not prevented by the use of CNS irradiation and i.t. methotrexate. Because of a lack of efficacy to the CNS irradiation regimen, current treatment ...
The incidence of anogenital malignancies is greatly increased in patients who have received a renal transplant, but this has not been well studied in patientsreceiving maintenance dialysis. Our aim was to assess the incidence of these malignancies in patients on dialysis and compare these to transplanted patients. The age standardized incidence ratio (SIR) for anogenital malignancies was calculated by comparing the observed number of malignancies to the expected number. The expected number was calculated by multiplying the age specific incidence rates for each malignancy by the person years at risk in 5-year age cohorts. Of 15,820 patients in the Australia and New Zealand data base, 8,215 had received a renal transplant. A total of 39,750 person years at risk were contributed by patients who had ...
Gastrointestinal lymphomas are almost exclusively of a non Hodgkin's type. The Western form is characterized by a higher incidence of stomach location (50 %), a MALT type (mucosa associated lymphoid tissue) (40 %), a B-cell type (90 %), and a high grade (55 %). Chronic infection with Helicobacter pylori is an important risk factor. Mediterranean lymphomas form a particular clinical and pathological entity with diffuse involvement of the small bowel and are frequently being associated with a chronic malabsorption disorder. Eradication of Helicobacter pylori in early lymphomas, and the use of tetracyclines in early Mediterranean lymphomas, have been shown to induce durable remissions. For more advanced gastric lymphomas, treatment usually consists of anthracycline-based chemotherapy followed by involved field radiotherapy. Surgery is usually reserved for complications such as perforation or bleeding, or in some selected cases for salvage after failure of non-surgical ...
This report deals with the preliminary results of trials in the DATECA project with stage I, II and III patients with non-seminomatous germ cell tumours. Stage 1 patients were randomized between infradiaphragmatic irradiation and observation. No significant difference in recurrence rates has been observed as yet. Eighteen of 95 patients had recurrence with a median time to relapse of 3 months. Fifteen patients achieved complete remission after treatment by combination chemotherapy while 3 patients are still undergoing treatment. Stage II patientsreceived 6 series of cis-platinum, bleomycin, and vinblastine. The patients were initially randomized to receive chemotherapy alone versus chemotherapy plus irradiation. Irradiation led to increased toxicity and decreased doses of the antineoplastic drugs. ...
This report deals with the preliminary results of trials in the DATECA project with stage I, II and III patients with non-seminomatous germ cell tumours. Stage 1 patients were randomized between infradiaphragmatic irradiation and observation. No significant difference in recurrence rates has been observed as yet. Eighteen of 95 patients had recurrence with a median time to relapse of 3 months. Fifteen patients achieved complete remission after treatment by combiantion chemotherapy while 3 patients are still undergoing treatment. Stage II patientsreceived 6 series of cis-platinum, bleomycin, and vinblastine. The patients were initially randomized to receive chemotherapy alone versus chemotherapy plus irradiation. Irradiation led to increased toxicity and decreased doses of the antineoplastic drugs. ...
Background:Children suffering from beta-thalassemia major require repeated blood transfusions which may be associated with dangers like iron overload and contraction of...Full Text Available
A substantial proportion of lymph node-negative patients who receive adjuvant chemotherapy do not derive any benefit from this aggressive and potentially toxic treatment. However, standard histopathological...Full Text Available
BackgroundThe aim of the study was to compare the prevalence and types of HIV-related oral lesions between children and adult Tanzanian patients on HAART with those not on HAART...Full Text Available
BackgroundSome breast cancer patientsreceiving anti-angiogenic treatment show increased metastases, possibly as a result of induced hypoxia. The effect of hypoxia on tumor cell...Full Text Available
Many patients who undergo hematopoietic cell transplantation (HCT) present with anemia and have received red blood cell transfusions before HCT. As a result, iron overload is frequent and appears...Full Text Available
BackgroundLittle is known about the acceptability of internet and telephone treatments, or what factors might influence patient interest in receiving treatments via...Full Text Available
The development of azole resistance in Candida albicans is most problematic in patients with AIDS who receive long courses of drug for therapy or prevention of oral candidiasis. Recently,...Full Text Available
Purpose:The oral chemotherapy cycle management program (CMP) provides clinical management support to patientsreceiving certain oral chemotherapies. The CMP includes a dose-monitoring...Full Text Available
A 74-year-old male patientreceiving ventilatory support due to aspiration pneumonia developed bilateral pneumothorax, pneumopericardium, pneumomediastinum, pneumo-retroperitoneum, and subcutaneous...Full Text Available
IntroductionThe goal of this study was to identify serum markers that are modulated by treatment with golimumab with or without methotrexate (MTX) and are associated with clinical...Full Text Available
Background: The Internet has become a popular source of health information for patients with a variety of medical concerns; however, research examining patient interactions on the Internet has been limited. Purpose: Four questions were examined in a survey study of hysterectomy patients who visited http://www.hystersisters.com: (a) Do hysterectomy patients use the support Web site because they perceive their proximal sources of social support to be inadequate? (b) What kinds of support do patientsreceive from the Web site? (c) What attributes characterize the "Hystersisters" that are perceived to be most helpful? (d) How do informational sources vary depending on the nature of the patient concern? Methods: Women (N = 137) responded to questions about social support, Web site use, and perc...
Radian received twelve sections of heat exchanger tubing from the Magma Electric Company's 10MW(e) East Mesa binary geothermal power plant. Three tube sections were received from each of four shell and tube heat exchangers (HX1, Hx6, HX8, and Hx10) of the isobutane vaporizer train. All samples were taken from the upper few rows of tubes. Two months later, four more tube sections were received. These four sections were taken from the lower rows of heat exchangers 1, 6 (two sections), and 10. Radian was requested to investigate the cause of severe pitting failure of these heat exchanger tubes. This report is part of a continuing DOE effort to gain insight into the service life of component materials employed in geothermal energy utilization.
There is limited information on the incidence of acute kidney injury (AKI) in patients with traumatic brain injury (TBI) although AKI may contribute to morbidity and mortality. We investigated the incidence of AKI in patients with moderate and severe TBI and the association of AKI with risk factors and outcomes in these patients. We studied all TBI patients over 16 years of age admitted to the two designated trauma hospitals in the state of Victoria, Australia from 1 January to 31 December 2008. Patients were included if they had head trauma and presented with a Glasgow coma scale (GCS) <13. Prospectively collected data from the hospital trauma registries, ICUs, and pathology databases were analyzed retrospectively. Risk injury failure loss end (RIFLE) criteria were used to categorize rena...
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...
Recent literature indicates that torsion of the left ventricle (LV) is a promising predictor for response to cardiac resynchronisation therapy (CRT). Among patients with severe heart failure, 45 to 75% of patients show rigid body rotation, where the base and apex rotate in the same direction, instead of normal, opposite rotation. The occurrence of this phenomenon seems to be a good indicator for response to CRT. From this review, it can be concluded that LV torsion might be a welcome addition to current selection criteria.
Abstract Tumor necrosis factor (TNF)- is a pro-inflammatory cytokine associated with psoriasis pathogenesis. Anti-TNF- therapies are effective in psoriasis. A significant weight gain has been reported in patients treated with anti-TNF- agents. The aim of the present study was to evaluate the body composition changes in psoriatic patientsreceiving anti-TNF- therapies according with disease phenotype. Forty patients affected with psoriasis were followed up for 24 weeks and divided into two groups: psoriasis vulgaris (PsO) and psoriatic arthritis (PsA). Anthropometric, blood biochemical, body composition parameters, resting metabolic rate, and disease activity indexes were measured at baseline and at week 24. After 24 weeks of anti-TNF- administration, the disease activity indexes and concen...
Summary The presence of human heterophilic antibodies against horse immunoglobulins (HHA-HI) was determined by ELISA in sera from healthy volunteers and from patients who received equine antivenom for therapy of snake bite envenoming. These patients were selected from two independent clinical studies: one in Colombia in which patientsreceived antivenom constituted by whole IgG (n=25); and the other in Brazil where an antivenom constituted by F(abprime)2 fragments was administered (n=31). Results show that healthy volunteers have antibodies, mainly of the IgG class, able to react with whole equine IgG. Additionally, patients have IgG antibodies that react both with whole equine IgG and F(abprime)2 fragments. In both clinical studies, no significant differences were observed in the HHA-HI t...
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...
Background 2009 pandemic influenza A(H1N1) has led to a global increase in severe respiratory illness. Little is known about kidney outcomes and dialytic requirements in critically ill patients infected with pandemic H1N1. Study Design Prospective observational study. Setting & Participants 50 patients with pandemic H1N1 admitted to any of 7 intensive care units in Manitoba, Canada, were prospectively followed. Outcome & Measurements Outcomes were kidney injury and kidney failure defined using RIFLE (risk, injury, failure, loss, end-stage disease) criteria or need for dialysis therapy. Results The pandemic H1N1 group was composed of 50 critically ill patients with pandemic H1N1 with severe respiratory syndrome (47 confirmed cases, 3 probable). Kidney injury, kidney failure, a...
Surface doses received by patients and operators were measured during 30 interventional radiological procedures (ten percutaneous transhepatic biliary drainages, ten percutaneous nephrostomies, ten percutaneous transluminal angioplasties). In addition, organ doses to the patient were determined using an Alderson-Rando phantom. These served as a basis for calculating the so-called somatic dose indices. It was found that the somatic radiation risk to the patient is relatively small despite prolonged periods of fluoroscopy. However, exposure of the hands and lenses of the operator could easily reach the limits thought acceptable while carrying out these procedures with additional angiography. (orig).
Therapeutic effect of p-aminobenzoic acid-N-xyloside Na (K-247) were studied. Eleven patients with a variety of solid tumors were treated with K-247 alone. K-247 was given orally 800 mg daily for 4 weeks. As for side effect of the drug, only mild gastritis was observed in a few patients. Partial response (over 25% reduction of tumor size) with a median duration of two months was observed in 3 patients. These cases were metastatic tumor of lung from the carcinoma of thyroid, metastatic tumors of lung from the carcinoma of kidney, and mediastinal tumor. In eight patients the response was classified as no change and in one patient there was progressive disease. Thus K-247 has some therapeutic activity in patients with solid tumor. Combination therapy of irradiation and administration of K-247 were also studied. In the twelve patients ...
Abstract This study explored the demographic and diagnostic features of children who were currently receiving antipsychotics compared to children who were receiving other psychotropics in a cohort of children with and without elevated symptoms of mania (ESM). Participants were recruited from 10 child outpatient mental health clinics associated with four universities. Guardians with children between 6?12 years who presented for new clinical evaluations completed the Parent General Behavior Inventory-10 Item Mania Scale (PGBI-10M). All children who scored ?12 on the PGBI-10M and a select demographically matched comparison group of patients who scored ?11 were invited to participate. Children were divided into two groups: those receiving at least one antipsychotic medication and those receivi...
To determine the proportion of rheumatoid arthritis (RA) patientsreceiving preventive health care according to US Preventive Services Task Force recommendations compared with a community-based population sample, with emphasis on dyslipidemia testing, given the increased risk of cardiovascular disease (CVD) in RA patients. Patients with RA (ICD-9 code 714.0 at ?2 office visits with a rheumatologist) and a primary care physician (PCP) at the Geisinger Health System (GHS) were identified through electronic health records. The records were searched back from 3/31/08 for the length of time required to satisfy each outcome measure. Percentages were compared with population testing rates using the Pearson Chi-square test. Eight hundred and thirty-one RA patients were compared to 169,476 subjects...
In a retrospective single-centre study 170 consecutive patients were included who received a Kotz modular prosthesis after resection of bone tumours of the proximal femur to evaluate the management of prosthetic infection. Infection occurred in 12 of 166 patients available for follow-up (six males; six females; mean age, 47?years; range, ten to 75?years) after a mean of 39?months (range, one to 166?months; infection rate, 7.2%). Mean follow-up was 54?months (range, four to 200?months). One patient died of septic shock. Two patients were treated by wound revision only. Treatment of infection in the remaining patients was one-stage revision in eight and hip disarticulation in one. Infection control by one-stage revision was achieved in five of eight patients; re-infection occurred in three p...
The aims of this study were to identify risk factors and evaluate the association with clinical outcomes of postoperative cardiac surgery-associated acute kidney injury (CSA-AKI). Data from 2488 consecutive adult patients were analyzed. Patients were classified as having CSA-AKI based on the risk, injury, failure, loss of kidney function, and end-stage kidney disease (RIFLE) criteria using peak postoperative creatinine in the postoperative intensive care unit (ICU). Multiple stepwise logistic regression analysis was used to identify independent risk factors for CSA-AKI. CSA-AKI occurred in 584 patients (23.5%). CSA-AKI patients had significantly longer aortic cross-clamp and cardiopulmonary bypass times. Furthermore, CSA-AKI patients had higher hospital mortality (5.5% vs 1.5%, PCopyright2...
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...
The solar central receiver at the Barstow Pilot Plant is a once-through steam boiler consisting of vertical arrays of Alloy 800 tubes. Water/steam leaks associated with tube bends near the receiver outlet were observed after 16 service months. The leaks resulted from through-wall cracks localized in the crown of tube bends operating in the temperature range from 550 to 650/sup 0/C. Initiation occurred on the ID (steam side) of the tube and propagated transgranular through the tube wall. Cracking was axial and circumferential; in general, the circumferential cracks were more severe than the axial cracks. Thick oxide layers showed on the ID of the receiver tubes; a 25-..mu..m thick oxide layer had formed on tubing which operated at 650/sup 0/C. In addition, an enhanced oxidation layer was observed along a narrow band in the crown of the tube. This band was up to five times thicker than the oxide elsewhere in the tube. All ...
The National Radiological Protection Board is to carry out a survey of doses received by patients from the diagnostic use of X-rays, beginning in June 1977, and carried out at over 100 National Health Service hospitals. Details are given of the reasons for carrying out the survey and the survey objectives. The survey working methods are discussed, together with methods of calculation of the genetically significant dose. The radiation doses will be measured by a thermoluminescent dosimeter developed specially for the survey. (U.K.).
Goldstein SL, Mattoo TK, Morgenstern B, Martz K, Stablein D, Talley L. Anemia and growth status in pediatric patientsreceiving maintenance dialysis after a failed renal transplant course: An NAPRTCS report.Pediatr Transplantation 2006. Copyright 2006 Blackwell Munksgaard Abstract: We conducted a retrospective review of the North American Renal Transplant Cooperative Study (NAPRTCS) Registry transplant and dialysis arms to assess anemia and growth patterns in children who returned to dialysis after a failed renal transplant from January 1, 1992 to February 3, 2004. Of the 1807 potential study subjects, 1451 had transplant removal data (TxIn vs. TxOut) available for analysis. Four hundred and twenty-one of 1451 patients (29%) had a transplant nephrectomy at the time of entry into the NAPRTC...
Background: In the German CESS-studies, Ewing's sarcoma patients with pulmonary metastases at diagnosis were considered as candidates for additional bilateral lung irradiation. We have retrospectively analyzed the impact of radiotherapy on survival. Material and methods: Out of 42 patients presenting with pulmonary metastases of Ewing's sarcoma between 1981 and June 1992, 30 were evaluable. One patient died of progressive disease prior to lung irradiation. The other patients had a complete radiographic remission either after chemotherapy (n=25) or chemotherapy plus resection of lung metastases (n=4). 22 patientsreceived bilateral lung irradiation with doses of 12 to 21 Gy (once daily 1.5 Gy or twice daily 1.25 Gy), six had no further treatment and one had bone marrow transplantation for consolidation. Results: Ten patients are in complete ...
Between 1984 and 1988, seven women with breast cancer were treated with intraoperative electron beam therapy (IOEBT). All patients were Caucasian. Patient age ranged from 37 to 62 (median 53) years. Histopathology was infiltrating duct carcinoma (6/7) or medullary carcinoma (1/7). Four tumors were staged T1 N0 MO, one T1 N1 MO, one T2 N1 MO, and one lesion was recurrent. At the time of primary lumpectomy or axillary node dissection, a dose of 10 or 15 Gy IOEBT was administered to the tumor bed with 6 or 9 MeV electrons through the lumpectomy wound. All patientsreceived 45 or 50 Gy over five to six weeks with 6 MV photons to the breast and, in four patients, to the regional nodes. Three patientsreceived adjuvant chemotherapy and tamoxifen. No post-operative complications were observed. All patients are alive as of ...
Objectives: Intra-operative cisplatin-based intra-peritoneal chemotherapy (IPC) may alter renal function in patients with advanced ovarian cancer. The aim of this study was to describe postoperative alteration of renal function after cisplatin-based IPC and to identify risk factors for moderate to severe acute renal failure. Study design: This prospective observational study was carried out on 77 consecutive patients who underwent cisplatin-based IPC procedures, with (n=23) or without (n=54) intra-peritoneal epinephrine, for advanced ovarian cancer. Postoperative renal function was assessed using serial serum creatinine measurements and was based on serum creatinine changes from pre-operative values, according to the risk, injury, failure, loss, end-stage kidney disease (RIFLE) classificat...
The first cardiac pacemaker implants occurred in the late 1950s and involved insertion of epicardial or epimyocardial leads and abdominal pulse generators. By the mid 1960s, cardiologists were making attempts to insert transvenous leads into the right ventricle. These early unipolar leads had large, polished, high polarization electrodes, no fixation device, and no lumen in which to place a stylet for lead positioning. The lead implantation procedures were usually long and the irradiation to both patient and operator excessive. Pulse generators were powered by zinc-mercury cells, which were large, unreliable, and prone to sudden output failure. Postoperative complications such as lead dislodgement, exit block, and premature power source failure were very common with most patients requiring...
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 ...
Excessive irradiation due to unexpected leakage was found on a patientreceiving electron beam therapy. The cause of this leakage was analyzed and the amount of leakage was measured for different electron beam energies. The highest leakage occurred with a 6 x 6 cm cone using a 12 MeV electron beam. The leakage dose measured along the side of the cone could be as great as 40%. Until the cones are modified or redesigned, it is advised that all patient setups be carefully reviewed to assure that no significant patient areas are in the side scatter region.
Tumour necrosis factor-alpha (TNF-?) antagonist drugs have been associated with increased risk of tuberculosis (TB). Tuberculin skin test (TST) is the most frequently used tool for identification of latent TB infection. We herein aimed to analyse the effect of TNF-? antagonists on the TST responses in a prospective study. The study group consisted of 182 patients (99 female, 83 male) who received TNF-? antagonists for various rheumatic disorders. All patients were evaluated with TST along with other parameters on the day of referral and on the 12th month visit. For those patients with a response of <5?mm induration at the initial evaluation, the TST was repeated to observe the booster effect. Out of 182 patients, 87 patients (48%) had a negative (0?4?mm) and 95 (52%) had a positive (?5?mm)...
PurposeThe purpose of the present study was to compare the effect of submucosal versus intramuscular administration of dexamethasone sodium phosphate on patients' quality of life after surgical removal of impacted lower third molars. Patients and MethodsA randomized, non-blind, clinical trial was planned. The sample was composed of patients requiring extraction under local anesthesia of a single partial bony impacted mandibular third molar with Class II or III and position B or C, according to the Pell and Gregory classification. The patients were randomly distributed into 1 of 3 groups: submucosal dexamethasone, intramuscular dexamethasone, and a control group that received no steroid. A modified translated questionnaire was used to assess the patients' perception regarding different qual...
Systemic sclerosis (SSc) is a disorder characterized by skin thickness and vasculopathy. The objective of the study was to evaluate the therapeutic effect and safety of the association of pentoxyphylline and vitamin E in SSc patients. Twelve SSc patients (American College of Rheumatology criteria) enrolled this 24-week open-label study. Patientsreceived daily 800?mg of pentoxyphylline and 800?UI of vitamin E and were evaluated at 4-week interval. The primary efficacy endpoint was the change in Modified Rodnan Skin Score (MRSS) at week 24. Nine diffuse SSc patients treated 6?months with cyclophosphamide were used as a historical control group. The mean age of the treated group was 43.6?years, and ten of 12 (84%) patients were women. Their mean MRSS reduced from 25.7 to 18.7 (p?=?0.03) at 1...
The treatment of acetabular bone defects presents a great challenge in revision total hip arthroplasty (THA). The purpose of this study was to evaluate the clinical and radiological outcome of revision THA using jumbo cups for acetabular reconstruction after applying the bone-grafting technique. We studied 17?patients with acetabular defects ranging from Type 2A to Type 3A according to Paprosky`s classification. According to the AAOS-score twelve patients were classified as Type II and five patients as Type III. Uncemented press-fit cups with an outer diameter larger than 64?mm were used in all cases. Fifteen patientsreceived morselized bone allografts. In eight patients an additional screw fixation was necessary. The mean follow-up period was 82?months (range 33?149). The mean Harris Hip...
Twenty-two patients with vertebral primaries were registered in the Intergroup Ewing's Sarcoma Study between 1973 and 1977. The radiation doses to the primary tumors ranged between 3800 and 6200 rad. All patientsreceived intensive combination chemotherapy. After a followup ranging between 14 and 62 months, 14 patients remained disease-free. All patients with primary tumor of the cervical and dorsal spine remained disease-free. Of eight patients with lesions in the distal spine, (sacrococcygeal region) six developed recurrence, in three a local recurrence was observed despite doses of 6000 rad or higher. Doses of 5000 rad or less (in addition to combination chemotherapy as used in the Intergroup Ewing's Study) appear adequate in controlling the primary tumors of the proximal segments of the spinal column.
Purpose: Radiotherapy (RT) has been the predominant local treatment for Ewing's sarcoma of bone at the University of Florida. Twice-daily hyperfractionated RT was initiated in 1982 to improve local control and functional outcome. This retrospective review compares the results of once-daily vs. twice-daily RT in patients with primary Ewing's sarcoma of an extremity, with emphasis on functional outcome. Methods and Materials: Between June 1971 and January 1990, 37 patients were treated at the University of Florida for nonmetastatic Ewing's sarcoma of bone with a primary lesion in an extremity. Three patients underwent amputation. Of 34 patients treated with RT, 31 had RT alone and 3 had a combination of RT and local excision. Before 1982, 14 patientsreceived once-daily RT; since 1982, 17 patients have received twice-daily ...
The authors have evaluated bone mineral content in the vertebral spongiosa by means of Computed Tomography. The method proposed by Genant and Cann [17, 18] has been applied to examine 164 healthy volunteers and 108 patients. Both healthy males and females showed a progressive bone mineral loss increasing with age; the bone mineral loss was most severe in females during the 4th and 5th decade of life. Pathology included patients with osteoporotic fractures (vertebral and femural neck), patients with partial gastrectomy, renal failure, primary hyperparathyroidism, Cushing syndrome, corticosteroid therapy. Bone mineral values were significantly lower in most pathologic groups. Computed Tomography proves thus to be a valuable method to assess bone mineral content and to identify patients at risk for fractures.
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...
Background Aluminium phosphide tablets popularly known, as ?celphos? is a highly toxic fumigant used as insecticide for preservation of food grains. India is an agricultural country and celphos tablets are easily available to psychologically vulnerable young people. It is swallowed with suicidal intent and death comes in minutes. Patients and methods In this series there were seven patients with tracheo esophageal complications out of 342 patients reviewed. Four patients had esophageal stricture and three had stricture plus tracheo esophageal fistulas. Types of symptoms including progressive dyshagia and extent of respiratory symptoms were evaluated. Nutrition status and success or failure of dilatation at the time of endoscopy was taken into account. The criteria for oesophageal replaceme...
Plasma triglyceride turnover was measured during steady-state conditions in 22 postoperative patients. Nine had received nutritional support with an enteral regimen, seven had received an equivalent regimen as continuous parenteral nutrition, and six received the same parenteral regimen as a cyclical infusion. After 5 days of nutritional support, each patientreceived an intravenous bolus of tritiated glycerol. Plasma radiolabeled triglyceride content was measured during the subsequent 24 hours. The data were analyzed by means of a simple deterministic model of plasma triglyceride kinetics and compared with the results obtained by stochastic analysis. The rates of hepatic triglyceride secretion obtained by deterministic analysis were higher than those obtained by the stochastic approach. However, the mode of delivery of the nutritional regimen did not affect the ...
The purpose was to compare the findings of multi-detector computed tomography (MDCT) in prosthetic valve disorders using the operative findings as a gold standard. In a 3-year period, we prospectively enrolled 25 patients with 31 prosthetic heart valves. MDCT and transthoracic echocardiography (TTE) were done to evaluate pannus formation, prosthetic valve dysfunction, suture loosening (paravalvular leak) and pseudoaneurysm formation. Patients indicated for surgery received an operation within 1 week. The MDCT findings were compared with the operative findings. One patient with a Bjoerk-Shiley valve could not be evaluated by MDCT due to a severe beam-hardening artifact; thus, the exclusion rate for MDCT was 3.2% (1/31). Prosthetic valve disorders were suspected in 12 patients by either MDCT or TTE. Six patientsreceived an operation that ...
Transplantation has emerged as the therapy of choice for many patients with end organ failure. One of the major goals is to tailor immunosuppressive therapy to the individual needs of every patient to balance the risk for rejection and over-immunosuppression. This will require diagnostic tools that can detect harmful processes in the allograft early, and that can be measured repeatedly. This review will consider recent advances in our understanding of the molecular nature of these processes and how this information is being utilized to design novel diagnostic assays to non-invasively monitor allografts. Highlighted is the need for large-scale prospective multi-centre studies to validate assays that show early promise in single centre studies.
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.)
This work is a retrospective study of 86 patients with squamous cell (51) and basal cell (35) carcinoma of the face. The median age was 67 years. The staging is as following: 31 cases T{sub 1} and T{sub 2}, 55 patients T{sub 3} and T{sub 4}. All patients were considered NO. Electron beam was used in all cases and energy ranged from 5 to 15 MeV depending on the thickness of the tumor. The total tumor dose was 60-70 Gy delivered in 6 weeks. In 7 cases of very old patients the authors have used concentrated irradiation: 3 patientsreceived 21 Gy in one fraction and 4 patients 48 Gy in 8 fractions. 96.8% patients T{sub 1} i T{sub 2} are NED contrary to 56.4% T{sub 3} i T{sub 4}. Cosmetic results were considered as good in 52, fairly good in 7 and bad in 2 patients.
Purpose We evaluated low-contrast injection protocols for coronary computed tomography angiography (CTA) using a 64-detector scanner and the test bolus technique. Materials and methods We randomly assigned 60 patients undergoing coronary CTA to one of two contrast material (CM) injection protocols. For the lowcontrast dose protocol (Plow), the patientsreceived injections of iohexol-350 [0.7 ml/kg body weight (BW)] during 9 s, and the test-bolus technique was used. Under the conventional protocol (Pconv), they received iohexol-350 (1.0 ml/kg BW) during 15 s, and bolus tracking was used. We compared the protocols for attenuation values in the ascending aorta and coronary arteries and for the amount of CM required. Results There was no significant difference in the mean CT attenuation of the...
PurposeTo evaluate the effect of vitrectomy timing on outcomes for patients with crystalline retained lens fragments receiving vitrectomy 3+ days after cataract surgery. DesignSystematic review and meta-analysis of retrospective interventional cases series. MethodsSearches of MEDLINE (English, 1/1/85 through 7/30/2010) and article reference lists. Articles were screened for patients with crystalline retained lens fragments after surgery for age-related cataracts, discussion of vitrectomy timing, and, for the meta-analysis, patient totals for at least 1 outcome and multiple time periods, 10+ patients, and mean follow-up ?3 months. Outcomes included visual acuity, retinal detachment, increased intraocular pressure, intraocular infection/inflammation, cystoid macular edema, and corneal...
Abstract Purpose: To evaluate the efficacy of transvesical obturator nerve block (ONB) in the prevention of obturator nerve reflex and leg jerking during transurethral resection of bladder tumors (TURBT). Patients and Methods: A total of 60 patients were studied, in whom the transurethral resection of tumors on the posterolateral bladder wall were performed under spinal anesthesia (SA). The patients were randomly divided into two groups. In the first group, we performed transvesical ONB and SA together, while the second group received only SA. The patients underwent TURBT using monopolar cautery. Incidence of leg jerking was registered and compared in these two groups. We used a nerve stimulator to detect the obturator nerve next to the lateral bladder wall. The obturator nerve was identif...
We aimed to investigate the effects of local anesthetics soaked in Merocel nasal packs on hemorrhage and pain after septoplasty. The methodology includes a prospective double-blind study that was conducted in patients undergoing septoplasty because of nasal septal deviation. The study included 143 patients. The patients were divided into four groups. Each group received 1% lidocaine?+?0.000625% adrenalin, 0.375% ropivacaine, 0.25% bupivacaine as study groups or 0.9% sodium chloride as a control group in their Merocel packs postoperatively. The local anesthetics or sodium chloride were reapplied at the eighth postoperative hour. Each patient was given a questionnaire where verbal analog score and amount of postoperative hemorrhage was noted. The statistical analysis was performed using two ...
PurposeTo conduct a retrospective analysis within a large university teaching hospital, comparing outcomes between patientsreceiving either radical surgery or radiotherapy as curative treatment for bladder cancer.Patients and MethodsBetween March 1996 and December 2000, 169 patients were treated radically for muscle-invasive bladder cancer. Data were collected from patient notes. Statistical analyses were performed using Kaplan-Meier methods and Cox proportional hazards regression analysis to compare radiotherapy and surgical outcome data.ResultsThere was no difference in overall, cause-specific, and distant recurrence-free survival at 5 years between the two groups, despite the radiotherapy group being older (median age, 75.3 years vs. 68.2 years). There were 31 local bladder recurrences...
BACKGROUND: Epinephrine injection is the most common endoscopic therapy for peptic ulcer bleeding. Controversy exists concerning the optimal dose of proton pump inhibitors (PPI) for patients with bleeding peptic ulcers after successful endoscopic therapy. The objective of this study was to determine the optimal dose of PPI after successful endoscopic epinephrine injection in patients with bleeding peptic ulcers. METHODS: A total of 200 peptic ulcer patients with active bleeding or nonbleeding visible vessels (NBVV) who had obtained initial hemostasis with endoscopic injection of epinephrine were randomized to receive omeprazole 40 mg infusion every 6 h, omeprazole 40 mg infusion every 12 h or cimetidine (CIM) 400 mg infusion every 12 h. Outcomes were checked at 14 days after enrollment. RE...
Ex vivo expanded peripheral blood progenitor cells (PBPC) have been shown to provide rapid neutrophil engraftment, and in some patients, to eliminate neutropenia after transplantation to support high-dose chemotherapy. However, the effect of expansion culture on stem cell content and potential loss of stem cells caused by induction of differentiation remains a concern. We have transplanted 21 patients with breast cancer with expanded autologous PBPC, with 11 patientsreceiving expanded PBPC as their sole hematopoietic cell source. In these studies, the CD34+ cells were selected and cultured for 10 days in defined media containing 100 ng/mL each of recombinant human stem cell factor (rhSCF), recombinant human granulocyte colony stimulating factor (rhG-CSF), and recombinant human megakaryocy...
Thirty-nine previously untreated patients with squamous cell carcinoma of the tongue were treated by irradiation or a combination of irradiation and surgery, with or without chemotherapy, between January 1971 and December 1980. All of the patients had a follow-up period of at least nine years. Twenty-two patients were men and 17 were women. The average age was 50.1 years, with a range of 30 to 74 years. The absolute five-year survival rate was 82.1% and the cumulative ten-year survival rate 76.9% for these 39 patients. Cervical node metastases were clinically found on admission in 14 patients whose five-year survival rate was 64.3%, whereas it was 92.0% for 25 patients without metastasis. The absolute five-year survival rate decreased from 92.3% for patients with stage I lesions to 90.9%, 87.5% and 42.9% for those with stage II, stage III ...
Twenty-four high-risk Ewing's sarcoma patients were treated on an intensive combined modality protocol including low-dose fractionated total body irradiaiton (TBI) and autologous bone marrow infusion (ABMI). Twenty patients (83%) achieved a complete clinical response to the primary and/or metastatic sites following induction therapy. The median disease-free interval was 18 months, and nine patients remain disease-free with a follow-up of 22 to 72 months. Local failure as a manifestation of initial relapse occurred in only three patients (15%), each having synchronous distant failure. Eight patients failed initially with only distant metastases, usually within 1-2 years following a complete clinical response. Two patterns of granulocyte recovery following consolidative therapy (including TBI and ABMI) were recognized. The time to platelet ...
The effect of various forms of treatment of renal osteodystrophy was evaluated in 25 dialysis patients by quantitative bone scintigraphy, using 99m-Tc-HEDP. The results were compared with those of biochemical and bone morphometric studies. The total skeletal activity (TSA) decreased in 5 patients after transplantation, in 11 after parathyroidectomy and in 6 out of 9 treated conservatively, but did not normalize in any of the patients. Bone morphometric evaluation of treatment, which could be performed in 19 of the 20 patients who did not receive a transplant, demonstrated a reduction in the degree of hyperparathyroidism in 17 patients (89 percent). Osteoid excess was reduced in 13 patients (68 percent) but an evident reduction of osteomalacic osteoid, i.e. improvement of osteomalacia, occurred in only 4 patients (21 ...
The effect of various forms of treatment of renal osteodystrophy was evaluated in 25 dialysis patients by quantitative bone scintigraphy, using 99m-Tc-HEDP. The results were compared with those of biochemical and bone morphometric studies. The total skeletal activity (TSA) decreased in 5 patients after transplantation, in 11 after parathyroidectomy and in 6 out of 9 treated conservatively, but did not normalize in any of the patients. Bone morphometric evaluation of treatment, which could be performed in 19 of the 20 patients who did not receive a transplant, demonstrated a reduction in the degree of hyperparathyroidism in 17 patients (89 per cent). Osteoid excess was reduced in 13 patients (68 per cent) but an evident reduction of osteomalacic osteoid, i.e. improvement of osteomalacia, occurred in only 4 patients (21 ...
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 ...
Full text: Certain groups of patients have been excluded from ventilation lung scanning due to their inability to comply with instruction. Tetley Manufacturing have recently developed a Positive Ventilation Delivery System (PVDS) which assists in delivering Technegas to patients who are unable to cooperate fully. The aim of this study is to evaluate the PVDS in the clinical setting. Fifteen frail aged and psychogeriatric patients (n=l 5), mean age 78 years (range 60-93), were ventilated with Technegas using the PVDS. The decision to ventilate the patient with the PVDS was based on an initial assessment of the patients ability to comply with instructions, or failure of the conventional ventilation method, to produce an adequate count rate. Technegas was prepared in the usual manner and then delivered to the patients lungs by squeezing a black ...
Between 1973 and 1978 combined radiotherapy and chemotherapy were given to 22 patients with histologically proven Ewing's sarcoma. The combined chemotherapy consisted of cyclophosphamide, vincristin, adriamycin, as well as dacarbazine in some cases. The neoplasm was a localized one at the beginning of treatment in 14 of the 22. These patientsreceived high-voltage rediotherapy to the primary focus at a focal dose between 42 and 55 Gray (4200-5500 rad), followed by chemotherapy. After 6-8 treatment cycles, adriamycin was replaced by methotrexate. Nine of the 14 patients survived without recurrence for 12 to over 59 months. Eight patients had extensive metastases at the beginning of treatment: they at first received only chemotherapy, followed by radiotherapy or operation, as indicated. Full clinical remission was achieved in five of them: in three this remission ...
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...
Background.There are no suitably powered epidemiological studies of `transient azotaemia' (TA). The objective of this study was to describe the epidemiology of TA and its independent association with hospital mortality. We hypothesized that TA would be associated with an independent increase in the risk of death. Methods.We retrospectively studied all patients admitted to a university-affiliated hospital in Australia between January 2000 and December 2002. Patients were excluded if they were <15 years old, were on chronic dialysis, had kidney transplant or if their length of hospital stay was <24 hours. We defined TA as rapidly recovering acute kidney injury (AKI) (return to no-AKI risk, injury, failure, loss, end stage (RIFLE) class within 72 hours of onset). We performed descriptive and ...
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...
Fifty patients scheduled to undergo IVF received a standard anesthetic of fentanyl and propofol for induction, followed by propofol infusion, with Bispectral index values and modified Ramsey sedation scores recorded at 5-minute intervals for the duration of anesthesia care. Moderate sedation was found only transiently during the first 5-10 minutes of the oocyte retrieval, but thereafter the level of sedation increased, with deep sedation and general anesthesia measured in all patients as determined by both the Bispectral index scores and lack of response to painful stimulation.
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...
The evaluation of radiotherapy and surgery as exclusive local treatment in comparably selected subgroups of patients with Ewing's sarcoma on the basis of the CESS 86-data. In the German multicenter Ewing's sarcoma study CESS 86, treatment consisted for four 9-week-courses of VACA- or VAIA-chemotherapy plus local therapy. VACA (vincristine, actinomycin D, cyclophosphamide, adriamycin) was given in low-risk extremity tumors with a tumor volume below 100 cm"3. Highrisk patients with central lesions or a tumor volume >100 m"3 received VAIA (ifosfamide instead of cyclophosphamide). Local therapy started after one complete chemotherapy course in week 10. Based on an individual decision in each patient, local therapy was either radical surgery or resection plus postoperative irradiation with 45 Gy or definitive radiotherapy with 60 Gy. Because of poor results with radiotherapy in a preceeding study, it was ...
Purpose: To examine the role of brachytherapy in the treatment of cholangiocarcinomas in a relatively large group of patients. Methods and Materials: Using the Surveillance, Epidemiology and End Results database, a total of 193 patients with cholangiocarcinoma treated with brachytherapy were identified for the period 1988-2003. The primary analysis compared patients treated with brachytherapy (with or without external-beam radiation) with those who did not receive radiation. To try to account for confounding variables, propensity score and sensitivity analyses were used. Results: There was a significant difference between patients who received radiation (n = 193) and those who did not (n = 6859) with regard to surgery (p < 0.0001), race (p < 0.0001), stage (p < 0.0001), and year of diagnosis (p <0.0001). Median survival for ...
Comprehensive geriatric care should receive nation-wide attention in order to realize its objectives. An analysis of patient problems at the Geriatirc Clinic, Tygerberg Hospital and Goodwood Aftercare Hospital is presented. The training of personnel, with full motivation of the community, to render health services to the aged is discussed. PMID:7368010
The study compares the doses absorbed by the dentomaxillary area in spiral CT and panoramic examinations. The dose measurements demonstrate that patientsreceive smaller doses with panoramic radiography than with spiral CT with Dentascan. After following for some variations from instrumental differences, they are in substantial agreement with literature data. Further investigations are needed considering the radiobiological risk related to the growing spread of Dentascan examinations.
BackgroundNo consensus evidence-based guidelines for the routine laboratory monitoring of children with JIA receiving non-steroidal anti-inflammatory drugs (NSAIDs) exist. The purpose...Full Text Available
The feasibility of using desferrioxamine (DF), an iron chelator, as a therapeutic agent against paraquat (PQ/sup + +/) toxicity in male Sprague-Dawley rats was explored, based on the rationale of limiting toxic hydroxyl radical production from hydrogen peroxide by removing redox-active iron. Body weights, mortality, and lung histopathology were followed for periods up to 14 days after intraperitoneal injection of PQ/sup + +/ (20 or 25 mg/kg body weight) with or without concurrent daily subcutaneous injections of DF (300 mg/day). Animals receiving PQ/sup + +/ showed the expected typical patterns of mortality and of lung histopathology, namely: marked edema, subpleural hemorrhage, acute inflammation, perivascular mononuclear cell infiltrates, sloughing of alveolar and bronchiolar lining cells, and diffuse interstitial fibrosis. Desferrioxamine alone was non-toxic. Surprisingly, results when both PQ/sup + +/ and DF were administered indicated a ...
Eight patients who had received megavoltage therapy for Cushings' disease 5-12 years previously have been reviewed. The long term response to this therapy was assessed with respect to efficacy of treatment in inducing continued remission and disturbance of hypothalamic-pituitary function. One patient showed clear evidence of relapse of Cushings' disease. One patient had unequivocal hypopituitarism. Basal levels of growth hormone (GH), TSH, LH, and FSH were not statistically different from controls, but provocative testing revealed significant abnormalities of response of cortisol/ACTH, GH, prolactin and LH. Six out of eight patients had absent diurnal cortisol variation and five patients had elevated serum prolactin levels. Thus, in this group of patients normal pituitary-adrenal function has not been satisfactorily restored. It is clear ...
Eight patients who had received megavoltage therapy for Cushings' disease 5-12 years previously have been reviewed. The long term response to this therapy was assessed with respect to efficacy of treatment in inducing continued remission and disturbance of hypothalamic-pituitary function. One patient showed clear evidence of relapse of Cushings' disease. One patient had unequivocal hypopituitarism. Basal levels of growth hormone (GH), TSH, LH, and FSH were not statistically different from controls, but provocative testing revealed significant abnormalities of response of cortisol/ACTH, GH, prolactin and LH. Six out of eight patients had absent diurnal cortisol variation and five patients had elevated serum prolactin levels. Thus, in this group of patients normal pituitary-adrenal function has not been satisfactorily ...
Most radiologists accept that modest doses of irradiation (4500-5000 rad/4 1/2-5 weeks) can control subclinical regional lymph node metastases from squamous cell carcinomas of the head and neck and adenocarcinomas of the breast. There have been few reports concerning elective irradiation of the ilioinguinal region. Between October 1964 and March 1980, 91 patients whose primary cancers placed the ilioinguinal lymph nodes at risk received elective irradiation at the University of Florida. Included are patients with cancers of the vulva, penis, urethra, anus and lower anal canal, and cervix or vaginal cancers that involved the distal one-third of the vagina. In 81 patients, both inguinal areas were clinically negative; in 10 patients, one inguinal area was positive and the other negative by clinical examination. The single significant complication was a bilateral femoral neck fracture. ...
Some studies suggest that giving radiation therapy after surgery for hilar cholangiocarcinoma improves the survival rate; however, many of these studies did not specify numbers of subjects or provide an impartial analysis. Thus, we evaluated the effectiveness of radiation therapy as adjuvant treatment after surgery and attempted to establish appropriate adaptation standards. We reviewed the records of 69 patients who underwent surgery for hilar cholangiocarcinoma between June 1980 and April 1998. Thirty-nine patients were treated with surgery followed by radiation therapy and 30 were treated with surgery alone. The clinicopathologic features that might have influenced prognosis were similar in the patients who received radiation therapy and those who did not. Radiation as adjuvant therapy did not have a beneficial effect on overall survival (P=0.554, log-rank test); however, it tended to improve ...
Summary Penile injury is common as an emergency and should be accurately diagnosed and treated. We analysed 22 patients with penile injury admitted to the emergency unit of Dubrava University Hospital during a 4-year period. According to the American Association for the Surgery of Trauma five-grade classification of penile injuries, there were 14 grade I, 6 grade II and 2 grade III cases. Diagnosis was mainly based on clinical and ultrasonography findings, and in some cases on cavernosography. Nineteen patients underwent immediate surgery and three patientsreceived conservative therapy. On outpatient follow up, sexual function was assessed by use of the 5-item International Index of Erectile Function (IIEF-5) test at 3 and 12-months of injury. At 3-month follow up, moderate, mild and no e...
Knee osteoarthritis (OA) is a common degenerative joint disorder and a major cause of pain and disability. The hypothesis tested in this study was that the passion fruit peel extract (PFP), a flavonoid-rich dietary supplement, would reduce symptoms due to knee OA. Thirty-three OA patients were enrolled in a randomized, double-blind, placebo-controlled trial with parallel-group design. Patientsreceived either placebo or PFP pills (150 mg, daily) in a double-blinded fashion for 2 months. The OA clinical symptoms were evaluated monthly with Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index. In the PFP group, there was a significant improvement in total WOMAC score and WOMAC subscale score of physical function after 30 days and pain after 60 days. At 60 days, reductions o...
Objectives To delineate the safety and tolerability profile of methylphenidate and atomoxetine in children and adolescents with attention deficit hyperactivity disorder (ADHD) monitored for more than 1?year. Design A cohort study analyzing data from the national ADHD register on patients from the Lombardy Region treated with MPH or atomoxetine. Participants A total of 229 children (median age 11?years, range 6?17), enrolled in 15 regional centers between June 2007 and May 2010. Results The prevalence rate of pharmacological treatment for ADHD was 0.23%, whereas the estimated ADHD prevalence in the population was 0.95%. In total, 73.8% of patients had been treated with atomoxetine (10?90?mg daily) or MPH (10?75?mg daily); 22% of patients also received an additional psychotropic drug. Of the...
The objective of this study was to evaluate the association between the number of blood cultures collected and the appropriateness of care for suspected bacteremic community-acquired urinary tract infection (UTI) in the elderly. We retrospectively evaluated the medical records of 129 patients with UTI >65?years old admitted to a large community-based training hospital in Japan from 1 January 2006 to 31 December 2009. We assessed the association between the number of blood cultures collected and the appropriateness of care received, as well as other factors. Two-thirds of the patients were women, and patients >85?years old accounted for 45.0% of the cases. Most of the organisms isolated from the urine and blood were Escherichia coli (65.4?67.0%). More than two blood cultures were collected ...
A number of diagnostic X-ray units in Poland were subjected to analysis. The air kerma on X-ray tables was measured for the X-ray parameters used routinely during lumbo-sacral spine radiography of standard adult patient. Measurements of air kerma were performed using TLD made of lithium-fluoride. The doses received by patients in different X-ray departments can differ more than two orders of magnitude (from 0.42 mGy up to 72.11 mGy), for the same X-ray examination. The dose can be significantly reduced if fluorescent screens made from components of rare earth are used. (author). 10 refs, 1 fig., 2 tabs.
The risk of cyber attacks on process control networks (PCN) is receiving significant attention due to the potentially catastrophic extent to which PCN failures can damage the infrastructures and commodity flows that they support. Risk management addresses the coupled problems of (1) reducing the likelihood that cyber attacks would succeed in disrupting PCN operation and (2) reducing the severity of consequences in the event of PCN failure or manipulation. The Network Security Risk Model (NSRM) developed in this article provides a means of evaluating the efficacy of candidate risk management policies by modeling the baseline risk and assessing expectations of risk after the implementation of candidate measures. Where existing risk models fall short of providing adequate insight into the efficacy of candidate risk management policies due to shortcomings in their structure or formulation, the NSRM provides model structure and ...
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 patientsreceived 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 patientsreceived adjuvant therapies between the first and second courses of high-dose total skin ...
This study was a retrospective evaluation of the efficacy of stereotactic radiosurgery (SRS) in patients with >4 metastases to the brain. Materials and Methods: Between January 2004 and December 2006, 68 patients with ?4 multiple brain metastases were included and reviewed retrospectively. Twenty-nine patientsreceived SRS and 39 patientsreceived whole brain radiotherapy (WBRT). Patients with small cell lung cancers and melanomas were excluded. The primary lesions were non-small cell lung cancer (69.0%) and breast cancer (13.8%) in the SRS group and non-small cell lung cancer (64.1%), breast cancer (15.4%), colorectal cancer (12.8%), esophageal cancer (5.1%) in the WBRT group. SRS involved gamma-knife radiosurgery and delivered 10?20 Gy (median, 16 Gy) in a single fraction with a 50% marginal dose. WBRT was delivered daily in 3 Gy ...
Energy consumption is a perennial issue in the design of wireless sensor networks (WSNs) which typically rely on portable sources like batteries for power. Recent advances in ambient energy harvesting technology have made it a potential and promising alternative source of energy for powering WSNs. By using energy harvesters with supercapacitors, WSNs are able to operate perpetually until hardware failure and in places where batteries are hard or impossible to replace. In this paper, we study the performance of different medium access control (MAC) schemes based on CSMA and polling techniques for WSNs which are solely powered by ambient energy harvesting using energy harvesters. We base the study on (i) network throughput (S), which is the rate of sensor data received by the sink, (ii) fair...
Known since ancient times, the phenomenon of allelopathy has recently received greater attention from researchers and farmers worldwide. Crop failures and low yields caused by the reseeding, overseeding, crop rotation and replanting of fruit trees in orchards are believed to be caused by allelopathic activity. Moreover, the expensive and environmentally impacting herbicides for weed control have motivated studies directed at developing cheaper, environmentally-friendly alternatives. Despite the difficulties in separating chemical interference from other mechanisms, more modern approaches have produced consistent and conclusive data on this topic. The release and dynamics of allelochemicals in the soil are discussed herein. Examples of allelopathic crops, the allelochemicals produced and th...
Abstract Aims To determine, in the context of a trial in which counseling did not improve smoking cessation outcomes, whether this was due to a failure of the conceptual theory identifying treatment targets or the action theory specifying interventions. Design Data from a randomized clinical trial of smoking cessation counseling and bupropion SR were submitted to multi level modeling to test whether counseling influenced real time reports of cognitions, emotions and behaviors, and whether these targets predicted abstinence. Setting Center for Tobacco Research and Intervention, Madison, WI. Participants A total of 403 adult, daily smokers without contraindications to bupropion SR use. Participants were assigned randomly to receive individual counseling or no counseling and a 9 week course o...
To determine the demographics, imaging findings, clinical symptoms, and prognosis of primary vertebral Ewing's sarcoma (PVES). A retrospective review of medical records and radiological studies of patients diagnosed with PVES from 1936 through 2001 in our institution and Department of Pathology consultation files was undertaken. Metastatic and soft tissue Ewing's sarcoma cases were excluded. From a total of 1,277 cases of Ewing's sarcoma, 125 (9.8%) had a primary vertebral origin. There were 48 females and 76 males. Patient ages ranged from 4 to 54 (mean 19.3, standard deviation 10.7, median 16) years. Vertebral column distribution was four cervical (3.2%), 13 thoracic (10.5%), 31 lumbar (25%), and 67 sacrum (53.2%). More than one vertebral segment was involved in ten cases (8%). Satisfactory imaging studies were available in 51 patients: 49 radiographs, 27 computerized tomography (CT), and 23 magnetic resonance imaging ...
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 ...
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 ...
Iodixanol is a new nonionic dimer, isotonic with blood at all clinically relevant concentrations. Iodixanol (270 mg I/ml) was compared in a double-blind, randomized, parallel-group, phase-III study to the monomeric nonionic iohexol (300 mg I/ml) for evaluation of safety, tolerability and radiographic efficacy during cerebral CT. One hundred adult patients scheduled to undergo contrast-enhanced cerebral CT were randomly allocated to receive either iodixanol or iohexol. All completed the trial. Safety was evaluated by recording discomfort and other adverse events, tolerance by assessing intensity and incidence of discomfort. Radiographic efficacy was assessed from the diagnostic information and the radiographic density. No serious adverse events occurred. One patient (2 %) in the iodixanol group and one patient (2 %) in the iohexol group experienced a transient reddening at the neck and lower neck-line, ...
Twenty-seven histologically confirmed cases of localised Ewing's sarcoma were treated by two different regimes. Radiotherapy alone was used in 13 cases and a combination of chemotherapy and radiotherapy in 14. Single agent chemotherapy (cyclophosphamide) was given sequentially in nine patients and cyclophosphamide and actinomycin-D in five. There is a significant difference in the response to these different regimes. Only 69.2% of patients treated by radiotherapy alone were disease-free, for a median period of 10.4 months and metastases were noticed in 53.8% of cases. The disease-free survival in patients treated by combination therapy (radiotherapy and chemotherapy) was 18.4 months and metastases were seen in only 42.9%. However, no metastases were seen in patients who received cyclophosphamide and actinomycin-D, during a period of 14 months and only one ...
Aim: To systematically review the currently available high quality evidence evaluating treatments for moist desquamation in radiotherapy patients. Design: Systematic literature review. Methods: Electronic databases, websites, reference lists, key journals and conference proceedings were searched. Attempts were also made to uncover unpublished material. Relevant studies proceeded to data extraction and quality assessment. Results: Twenty studies were found; 10 were eligible for inclusion. Although many studies were small, none had unacceptably poor quality. No meta-analysis was undertaken as the studies were not homogenous in their interventions or methods. No convincing evidence for any intervention was found. Conclusion: Despite being recommended by many guidelines (College of Radiographers Summary of Intervention for Acute Radiotherapy Induced Skin Reactions in Cancer Patients (London, 2001); NHS Quality Improvement Scotland Best Practice ...
Purpose: To conduct a retrospective analysis within a large university teaching hospital, comparing outcomes between patientsreceiving either radical surgery or radiotherapy as curative treatment for bladder cancer. Patients and Methods: Between March 1996 and December 2000, 169 patients were treated radically for muscle-invasive bladder cancer. Data were collected from patient notes. Statistical analyses were performed using Kaplan-Meier methods and Cox proportional hazards regression analysis to compare radiotherapy and surgical outcome data. Results: There was no difference in overall, cause-specific, and distant recurrence-free survival at 5 years between the two groups, despite the radiotherapy group being older (median age, 75.3 years vs. 68.2 years). There were 31 local bladder recurrences in the radiotherapy group (24 solitary), but there was no significant difference in ...
The purpose of this study was to evaluate the safety and efficacy of TACE with microspheres preloaded with doxorubicin in unresectable intrahepatic cholangiocarcinoma (UCH). Twenty patients with UCH were observed; 9 refused, preferring other palliative care or chemotherapy, and 11 agreed to be treated with one or more cycles of DC beads loaded with doxorubicin (100-150 mg) in a TACE procedure between February 2006 and September 2007. A total of 29 individual TACE procedures were performed. Follow-up imaging was performed on all patients before, immediately after, and 4 weeks after each TACE procedure to evaluate the response and need for further treatment. Each patientreceived i.v hydration, antibiotics, and medications against nausea and pain before TACE. Survival rate was calculated using Kaplan-Meier survival curve. A response rate of 100% followed RECIST criteria was observed. Eight of eleven ...
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 ...
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 ...
Since artificial organs are intended to replicate chemical processes, knowledge of chemical engineering is essential in their design so that they will function with the maximum efficiency. The most commonly used artificial organ is the artificial kidney, a machine that performs a treatment known as hemodialysis. This process cleanses the bodies of renal failurepatients by dialysis and filtration which are simple physiochemical processes. Hemodialysis membranes act to remove accumulated uremia toxins, excess ions and water from the patient via the dialysate, and to supply from the dialysate those ions that are insufficient. This paper describes dialysis membranes and dialyzers for blood purification, the solute transport mechanism of the membrane, and a technical evaluation of the dialysis membrane. Lastly, the next generation of artificial kidney is reviewed. 71 refs., 12 figs., 7 tabs.
Background: The outcome of acute myocardial infarction (AMI) complicated with cardiogenic shock is poor. The aim of this study was to analyse, whether upfront abciximab administration could improve the outcomes of cardiogenic shock. Methods: This multicentre open trial randomized 80 patients with AMI complicated by cardiogenic shock expected to undergo primary PCI into group A (routine upfront-pre-procedural-abciximab bolus followed by 12-h abciximab infusion) and group B (standard therapy). The study primary objective was 30-day combined outcome (death/reinfarction/stroke/new severe renal failure). Results: PCI was technically successful in 90% (A) versus 87.5% (B) patients. Abciximab was used in 100% (A) versus 35% (B). The primary endpoint occurred in 17 group A patients (42.5%) and 11 ...
Background and Purpose: In an earlier phase II study, irradiation together with razoxane was shown to improve local control in recurrent rectal cancer. Therefore, the Austrian Society of Radiooncology (OeGRO) initiated a randomized controlled trial in 1992 to compare this combined treatment versus radiation therapy alone. Patients and Methods: Between 1992 and 1999, 36 patients with localized recurrences of rectal cancer were randomized to receive radiotherapy without (group A) or with razoxane (group B). The prognostic variables of the two groups were similar except for a longer median latency period from initial surgery to local recurrence in group A. High-energy photons with daily fractions between 170 and 200 cGy were used. The median total radiation dose was 60 Gy in each group. The patients in group B received a median razoxane dose of 9.6 g (range, 5-12 g). Main outcome ...
Total 125 patients with primary and metastatic Ewing's sarcoma were treated in various ways between 1963 to 1977. Patients were divided into 3 groups according to the treatment methods. Group 1 was nonprotocol patients with or without chemotherapy. Total 58 patients were entered. Group 1 was divided into 2 subgroups. 33 patients were treated locally without chemotherapy and 25 patients were treated with local therapy and nonprotocol chemotherapy. Group 2 was treated with local therapy and plus T-2 regimen multiagent chemotherapy. 29 patients were entered. Group 3 was treated with local therapy and T-6 regimen multiagent chemotherapy. 38 patients were entered. Local treatments for primary tumor were surgery and/or radiation therapy. Radiation dose ranged between 2,000 and 8,000 rad. Patients with ...
To determine if barbiturates would protect brain at high doses of radiation, survival rates in rats that received whole-brain x-irradiation during pentobarbital- or lidocaine-induced anesthesia were compared with those of control animals that received no medication and of animals anesthetized with ketamine. The animals were shielded so that respiratory and digestive tissues would not be damaged by the radiation. Survival rates in rats that received whole-brain irradiation as a single 7500-rad dose under pentobarbital- or lidocaine-induced anesthesia was increased from between from 0% and 20% to between 45% and 69% over the 40 days of observation compared with the other two groups (p less than 0.007). Ketamine anesthesia provided no protection. There were no notable differential effects upon non-neural tissues, suggesting that pentobarbital afforded protection through modulation of ambient neural activity during radiation ...
Gonadal function was studied in two groups of children previously treated for medulloblastoma with surgery followed by postoperative craniospinal irradiation. In group 1 but not in group 2, the children also received adjuvant chemotherapy for one to two years. All children in group 1 received a nitrosourea (BCNU or CCNU), plus vincristine in four and procarbazine in three patients. The nine children in group 1 showed clinical and biochemical evidence of gonadal damage with elevated serum FSH concentrations and, in the boys, small testes for their stage of pubertal development. In group 2 (n . 8), each child had completed pubertal development normally, the boys had adult sized testes and the girls regular menses. Gonadotropin values were normal in all eight children. We conclude that nitrosoureas were responsible for the gonadal damage in the children in group 1, with procarbazine also contributing to the damage in the three ...
In the Harghita volcanic range (Romania) there are many occurrences of dry CO{sub 2} emanations, called mofettes. The emanating gas with high carbon dioxide content has a proved curative effect. The gas also contains important quantities of radon. Since the mofettes are used in curative purposes in several illnesses, in most of the cases without medical supervising, has been proposed to determine the radon activity concentration in some of the most frequented mofettes from Romania. The seasonal variations have also been monitored and were calculated the effective doses received by the patients during a cure. The radon activity concentrations' levels above the mofettes indoor air range between 548 and 10 717 Bq/m{sup 3} while within the gas pools' values between 3210 and 32 781 Bq/m{sup 3} have been measured. The effective dose received by the patients during a cure is between 0.0086 ...
In the Harghita volcanic range (Romania) there are many occurrences of dry CO2 emanations, called mofettes. The emanating gas with high carbon dioxide content has a proved curative effect. The gas also contains important quantities of radon. Since the mofettes are used in curative purposes in several illnesses, in most of the cases without medical supervising, has been proposed to determine the radon activity concentration in some of the most frequented mofettes from Romania. The seasonal variations have also been monitored and were calculated the effective doses received by the patients during a cure. The radon activity concentrations' levels above the mofettes indoor air range between 548 and 10 717 Bq/m3 while within the gas pools' values between 3210 and 32 781 Bq/m3 have been measured. The effective dose received by the patients during a cure is between 0.0086 and 0.16 mSv. No major seasonal ...
In a previous survey we revealed uncertainty among responders about (a) whether or not to perform hemodialysis in patients with severely reduced renal function who had received contrast medium; and (b) when to perform hemodialysis in patients on regular treatment with hemodialysis or continuous ambulatory dialysis who received contrast medium. Therefore, the Contrast Media Safety Committee of The European Society of Urogenital Radiology decided to review the literature and to issue guidelines. The committee performed a Medline search. Based on this, a report and guidelines were prepared. The report was discussed at the Ninth European Symposium on Urogenital Radiology in Genoa, Italy. Hemodialysis and peritoneal dialysis safely remove both iodinated and gadolinium-based contrast media. The effectiveness of hemodialysis depends on many factors including blood and dialysate flow rate, permeability of ...
Full text: Many factors including drug efficacy, compliance and antibiotic resistance may influence HP eradication rates. The "1"4C urea breath test is a sensitive method of confirming HP colonisation and eradication. The aim was to study the relationships between the peak "1"4CO_2 counts on the breath test prior to treatment, smoking and HP eradication, and to assess if persistent or recurrent symptoms implied failure of eradication. 117 patients with DU and HP colonisation proved on biopsy or rapid urease test who underwent "1"4C urea breath tests at least one month after eradication treatment was ceased were studied (69 male, 48 female, mean age 41, range 26-87 y). Questionnaire assessment of treatment regimen, smoking history and dyspeptic symptoms was made at the time of the breath test. A sub-group of 43 patients who had pre- and post-treatment breath tests was studied to assess if high peak "1"4CO_2 counts on the ...
To determine the presence, prevalence, and clinical importance of /sup 99m/Tc pertechnetate uterine uptake, this retrospective analysis of 71 Meckel's scans was undertaken. Specifically, each study was evaluated for the presence of a focal accumulation of radiotracer cephalad to the bladder. Patientsreceived an intravenous dose of 150 microCi/kg of /sup 99m/Tc pertechnetate. Each study consisted of 15 one minute anterior serial gamma camera images, and a 15, 30, and 60 minute anterior, right lateral and posterior scintiscan. Menstrual histories were obtained from all patients except two. No males (33/33), nor premenstrual (13/13), menopausal (4/4) or posthysterectomy (2/2) patients revealed a uterine blush. Eleven of 15 patients (73%) with regular menses demonstrated a uterine blush. They were in the menstrual or secretory phases of their cycle. Four demonstrated no ...
In a prior study, we demonstrated that certain disposable coils are contaminated with zinc and release substantial quantities of Zn during hemodialysis, producing high post-dialysis plasma Zn concentrations. The present investigation was designed to monitor plasma and dialysis fluid Zn and copper throughout dialysis and to estimate patient Zn and Cu uptake. Venous plasma, arterial plasma and coil chamber fluid were sampled periodically throughout dialysis; trace metal concentrations were determined by flame atomic absorption spectrophotometry. Release of considerable quantities of Zn from the coils into the dialysis fluid, with uptake into the patient's plasma, was found. Approximately one-half of the plasma Zn uptake occurred in the first 45 minutes. Coils from different lots released significantly different quantities of Zn. Patient uptake of Zn ranged from 3.2 mg-23.0 mg, with a mean of 15.0 +- 6.1 mg. Copper ...
Summary Background Systematic screening for liver fibrosis in heavy-drinking patients is a challenge. Aims To assess Fibroscan for non-invasive diagnosis of asymptomatic liver fibrosis in alcohol abuse patients, to determine diagnostic liver stiffness cut-off values and to compare performance of Fibroscan with seven non-invasive laboratory tests. Methods One hundred and three alcoholic patients were studied. Liver fibrosis was staged by METAVIR system. Fibroscan, Fibrotest, Fibrometer, Hepascore, APRI, PGA, PGAA and hyaluronic acid tests were performed. Liver stiffness cut-offs were determined using receiver-operating characteristic (ROC) curves. Results Liver stiffness was correlated with fibrosis (r = 0.72, P < 0.014), with median at 5.7, 6.3, 8.4, 15 and 47.3 kPa for F0 (n = 8), F1 (n =...
OBJECTIVE:- Tumor necrosis factor (TNF) inhibitors can be used to treat inflammatory bowel disease (IBD) but may lead to anti-nuclear antibody (ANA) positivity and lupus-like reactions. Because of its unique structure, certolizumab has lower rates of these complications. We sought to investigate whether patients who have had lupus-like reactions to infliximab or adalimumab would be able to tolerate certolizumab. METHODS:- We performed a retrospective analysis on the 23 patients at the Roberts Inflammatory Bowel Disease Center who received certolizumab for the treatment of Crohn's disease from March 2008 to June 2009. We identified 6 patients who were switched to this drug because of lupus-like reactions from prior anti-TNF therapy and had documented ANA after the reaction and prior to cert...
Summary Background Treatment of localised renal cell carcinoma consists of partial or radical nephrectomy. A substantial proportion of patients are at risk for recurrence because no effective adjuvant therapy exists. We investigated the use of an autologous, tumour-derived heat-shock protein (glycoprotein 96)-peptide complex (HSPPC-96; vitespen) as adjuvant treatment in patients at high risk of recurrence after resection of locally advanced renal cell carcinoma. Methods In this open-label trial, patients were randomly assigned to receive either vitespen (n=409) or observation alone (n=409) after nephrectomy. Randomisation was done in a one to one ratio by a computer-generated pseudo-random number generator, with a block size of four, and was stratified by performance score, lymph node stat...
This double-blind, multicenter, randomized placebo-controlled study evaluated the antihypertensive efficacy and safety of nebivolol, a selective beta1-adrenoreceptor blocker with vasodilating effects, in patients with mild to moderate hypertension (sitting diastolic blood pressure [SiDBP] > or =95 mm Hg and < or =109 mm Hg). A total of 909 patients were randomized to receive placebo or nebivolol 1.25, 2.5, 5, 10, 20, or 40 mg once daily for up to 84 days. The primary end point was the change in trough SiDBP from baseline to study end. Nebivolol significantly reduced trough SiDBP (8.0-11.2 mm Hg compared with 2.9 mm Hg with placebo; P<.001) and trough sitting systolic blood pressure (a 4.4-9.5-mm Hg decrease compared with a 2.2-mm Hg increase [corrected] with placebo; P< or =.002). The overall adverse event experience was similar in the nebivolol (46.1%) and placebo (40.7%) groups (P=.273). Once-daily nebivolol ...
The literature is littered with reports presenting the proportion of patients admitted with ischaemic stroke receiving thrombolysis. This gives some measure of activity and the efficiency of prehospital and hospital triage. Some stroke centres have reported rates of thrombolysis as high as 20%, but without knowing the population that such services serve, these proportions do not indicate how well or equitably the treatment is being delivered. Here, we explore various metrics to monitor our efforts to provide equitable access to stroke thrombolysis in Lothian, a region in the South East of Scotland. PMID:21086712
Snapping or grating scapula is a condition of the shoulder girdle in which the patient complains of pain and an audible snapping sound which may be associated with pain. We evaluated the diagnostic value of the computed tomography (CT) scans using the clinical diagnosis of a grating scapula as the gold standard. This retrospective study reports the sensitivity, specificity, likelihood ratio and receiver operator characteristic curve for the CT scans and the k value as a measure of the interobserver agreement. None of the parameters validated the examination. We therefore concluded that CT scans are inappropriate for differentiation between a grating scapula and a normally functioning shoulder except in cases where bony abnormalities are present. (orig.)
sup(99m)Tc-MDP bone scintigraphy was performed on patients who received muscle-pedicle bone graft. In each of the bone head and the bone graft, a time-activity curve was obtained. In this muscle-pedicle bone graft, active revascularization and marked osteogenesis, which suggested rapid bone repairing, were observed. The bone scintigraphy was considered to be useful in observing the result of bone grafts, blood circulation, and time of bone fusion, and of value for early detection of secondary changes.
PurposeThe behavior of trigeminocardiac reflex (TCR) during maxillofacial surgeries has not yet been sufficiently studied and knowledge of its behavior is limited to some case reports. The present study aimed to assess the occurrence of TCR in bilateral sagittal split ramus osteotomy and to determine the possible effect of Gow-Gates block on its incidence. Materials and MethodsTwenty candidates for bilateral sagittal split ramus osteotomy (included were American Society of Anesthesiologists I Class III patients with a prognathism of 3 to 5 mm) were given routine general anesthesia after at least 12 hours of fasting. All patientsreceived Gow-Gates mandibular nerve block on 1 random side (case ramus; the other side was used as the control) after induction of general anesthesia before surger...
In this paper the measurements of radon-222 concentration in the air of Kowary Radon Inhalatorium in the vicinity of Jelenia Gora, Lower Silesia, Poland, performed by Radiation Protection and Radiobiology Department of National Institute of Hygiene in Warsaw, have been presented. For the measurements the integration method with the application of charcoal canisters have been used. The radon concentration was found within the very broad ranges from about 4 to 420 kBq m"-"3 depending of the season of the year. Basing on the radon concentration measurements during the inhalation therapy session and taking into account the equilibrium factor of 0.8 the doses to the bronchi of the patients in range from 1.2 to about 204 mSv (0.12-20.4 rem) have been assessed. The majority of patients (ca. 76%) received the doses between 115 and 204 mSv. (author)
Subcutaneous involvement frequently occurs in maxillary sinus carcinoma. Radical resection does not include removal of the skin at risk. In standard postoperative wedge-pair treatment plans, the surface dose is dependent upon beam weighting, beam energy, and patient contour. Thermoluminescent dosimetry (TLD) measurements were performed to evaluate the surface dose of patients undergoing postoperative irradiation of maxillary sinus carcinoma following primary resection. When 60 Gy was delivered to isocenter with a 45 degrees wedge pair and 6 MV photons with 1 cm bolus, the subcutaneous tissues at risk received {approximately} 30 Gy. Based upon presented TLD measurements, supplemental electron beam therapy to the subcutaneous tissues if primarily involved should be considered.
Between 1964 and 1977, 94 patients with Ewing's sarcoma of bone were treated at the National Cancer Institute. They received 5000 rad to the whole bone and progressively more aggressive chemotherapy protocols. The patients were divided according to site of primary lesion into central, proximal and distal lesions, with 19%, 33% and 57%, respectively, alive and well. The local control rate is high (93%), with good functional results in the distal lesions, and no changes are needed in radiation therapy dose or volume. Control is not as satisfactory for central and proximal lesions and efforts need to be made to increase control at these sites. We are at present attempting to define more accurately the extent of soft tissue disease, increasing the dose to 6000 rad for central lesions, and using a more aggressive chemotherapy program, in the hope of increasing the local control in these more aggressive tumors.
Iopentol (350 mg I/ml) has been compared with iohixol (350 mg I/ml) in a double-blind randomized parallel group trial with 32 and 35 patientsreceiving iopentol and iohexol, respectively. Coronary angiography and left ventriculography were performed, and the mean total volume injected was 124 ml of iopentol and 135 ml of iohexol . There were no statistically significant differences regarding changes in heart rate and frequency of adverse advents, which were the primary parameters, between the two groups of patients. Blood pressure and ECG parameters revealed only minor fluctuations which were of no clinical relevance. The visualization of the coronary arteries and the left ventricle were the same with both contrast media, as was the diagnostic quality. The results support the use of iopentol in cardioangiography. (author). 1 ref.; 5 tabs.
Background: High satisfaction rates have been reported after autologous breast reconstruction. Yet, most mastectomy patientsreceive implant reconstructions (ImBR). Independent and active decision makers have shown mainly to choose for autologous reconstructions, such as the Deep inferior epigastric perforator (DIEP) flap (DiepBR). To further explore the decision making to opt for either ImBR or DiepBR, we investigated patient knowledge, informational resources used, effect of plastic surgeons' advice, coping style and personal independence. Methods: A total of 153 women, who were planned for DiepBR or ImBR preoperatively, completed a study-specific and standardised validated psychological questionnaire. Analyses were aimed at information-seeking behaviour, personal independence and coping...
Introduction: Haploidentical transplantation, with extensive T cell depletion to prevent GvHD, is associated with a high incidence of infection-related deaths. The key challenge is to improve immune recovery with allogeneic donor T cells without triggering GvHD. As T regulatory cells (Tregs) controlled GvHD in pre-clinical studies, the present study evaluated the impact of an infusion of donor CD4/CD25 + Tregs, followed by an inoculum of donor mature T cells (Tcons) and positively immunoselected CD34 + cells in the setting of haploidentical stem cell transplantation. Patients and methods: Twenty-eight patients were enrolled in this study (22 AML; 5 ALL; 1 NHL). All received immunoselected Tregs (CliniMACS, Miltenyi Biotec) followed by positively immunoselected CD34 + cells together with Tc...
Abstract Hepatitis B (HBV) and C (HCV) viruses are the most important infections transmitted by the parenteral route in patientsreceiving maintenance dialysis. The prevalence varies markedly from country to country. The aim of this study is to review the efficacy of the strategies to reduce the incidence of these infections and the trend of results in Iran. As a routine, all hemodialysis patients in Iran have biannual blood samples for assessment of serum HBSAg, HBS Abs, and HCV Abs. The data are collected in the Ministry of Health. For statistical analysis, prevalence, and incidence were calculated. There is an increasing prevalence/incidence of end-stage renal disease (ESRD) in Iran, from 238/49.9 pmp in 2000 to 357/63.8 pmp in 2006. The prevalence of positive HBSAg and HCV Abs decrease...
Atrial fibrillation (AF) is common after coronary artery bypass grafting (CABG) and increases the morbidity and cost. Amiodarone reduces AF after CABG. Ranolazine, an antianginal agent, also prolongs atrial refractoriness and inhibits after depolarizations and triggered activity; effects that could decrease AF after CABG. The present study compared amiodarone versus ranolazine for the prevention of AF after CABG. A retrospective cohort study of patients undergoing CABG at Aspirus Hospital from June 2008 to April 2010. The patientsreceived either amiodarone (400 mg preoperatively followed by 200 mg twice daily for 10 to 14 days) or ranolazine (1,500 mg preoperatively followed by 1,000 mg twice daily for 10 to 14 days). The primary end point was any identified AF after CABG. A total of 393 ...
Iron overload has been described in patients undergoing chronic hemodialysis. The present study was undertaken to evaluate a rapid, noninvasive method for determination of skin iron by the technique of diagnostic x-ray spectrometry (DXS). Thirty-five patientsreceiving chronic hemodialysis treatment entered the study and were compared with 25 normal controls. Since pathological skin iron deposition occurs mainly at the dermal-epidermal junction in the basal cells of the epidermis, measurements were made in the thenar eminence representing mainly epidermal tissue (FeE), and in the forearm representative mainly of dermis (FeD). The mean +/- SD FeE iron concentrations were equivalent to 14.5 +/- 8.8 and 18.2 +/- 10.2 parts per million wet weight tissue (ppm) and both were significantly higher than in normal controls in which they averaged 9.2 +/- 2.5 ppm (P less than 0.005) and 10.2 +/- 3.2 ppm (P less than 0.001), ...
The interaction between acidic fluoride solution and beta titanium alloy was investigated to explore the changes that occur in beta titanium alloy by fluoride-containing acetic acid solutions. For this, alloy crystal structure, tensile strength, and elements released from the alloy wires were determined using four solutions (0.05%/pH 6, 0.05%/pH 4, 0.2%/pH 6, and 0.2%/pH 4) for 1 or 3 days. The immersed wire did not form any identifiable new crystal structure compared with the as-received wire. The tensile strength of the immersed wires was significantly reduced compared to the as-received wires in the test solutions if the period of immersion increased from as-received to 3 days. The fractured area of the immersed wire was reduced compared to the as-received one. The dimple pattern at the inner part and a cup-cone morphology at the outer part of the fractured wires were similar in both ...
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 ...
The long-term survival of serologically incompatible red cell units was measured in five patients with antibodies to high-frequency antigens. Initially, the survival of 1 ml of "5"1Cr-labeled incompatible red cells was measured over 1 hour. After demonstrating that the 1-hour survival times were successful (greater than 70%), each patient then received 5 ml of the same "5"1Cr-labeled red cells followed by the transfusion of the remainder of the red cell unit. The long-term T 1/2Cr survival for each case was patient 1 (anti-McCa), 15 days; patient 2 (anti-JMH), 12 days; patient 3 (anti-Kna), 31 days; patient 4 (anti-McCa), 12 days; and patient 5 (anti-Hya), 14 days. Each antibody tested in an in vitro homologous macrophage assay showed less than 5 percent phagocytosis. Anti-JMH was the only antibody to react with IgG ...
SummaryStudy Objectives: To compare the effect of noninvasive mechanical ventilation (NIV) in severely acidotic with mildly acidotic patients with acute hypercapnic chronic obstructive lung disease (COPD).Design: Comparison of NIV in consecutively enrolled patients with acute hypercapnic COPD with mild (pH 7.25-7.35) or severe (pHPaCO2, duration of NIV treatment, length of stay in hospital and survival.Results (meadian (IQR)): Twenty-nine patients had 36 episodes of acute hypercapnic respiratory failure: Seventeen with pHPaCO2 improve (12 (6-34) vs 12 (4-28)h, respectively, Formula Not Shown ), with similar duration of NIV treatment (60 (35-96) vs 68 (36-48)h, respectively, Formula Not Shown ) and hospital length of stay (8 (7-18) vs 9 (5-17) days, respectively, Formula Not Shown ). Overal...
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 ...
To evaluate the effectiveness of percutaneous transluminal angioplasty(PTA) and to determine the factors affecting the long-term patency rate in the management of insufficient hemodialytic arteriovenous fistula(AVF). Forty-nine cases of insufficient hemodialytic AVF were treated in 44 patients(native AVF:20, graft AVF:29, M:17, F:27, Age:22-70 years). In 28 thrombus patients, thrombolysis was performed with urokinase, and was followed by PTA. The initial success rate and complications of PTA were evaluated. According to the site and length of the stenosis, type and age of the AVF, the presence or abscence of thrombus, a history of diabetic mellitus, the patient's age, and the duration of renal failure, patency rates were compared within each subgroup using the Kaplan-Meier logrank test. The initial success rate of PTA for insufficient hemodialytic AVF was 88%(43/49), the patency rate of PTA was ...
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 ...
The family of natriuretic peptides consists of the atria natriuretic peptide (ANP), the cerebral natriuretic peptide (BNP), the type C natriuretic peptide (CNP) and the peptide isolated from the dendroaspis snakes' poison (DNP), whose presence in humans has not been confirmed. The physiological function of ANP is in the control of arterial blood pressure by regulation of systemic vascular resistance of blood vessels. BNP is produced as one of the factors in the acute response to inflammatory tissue damage, mainly in coronary vessels. Increased serum concentrations of natriuretic peptides have been found in stress situations, such as trauma or major surgery, systemic hypotension, and in intrinsic myocardial dysfunction. High concentrations of natriuretic peptides were observed in severe sepsis, septic shock and in multiple organ failure, probably due to increased secretion by mediators of the inflammatory process.The highest concentrations of ANP and BNP were found ...
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, ...
Purpose: To evaluate the results of radiotherapy in cholangiocarcinoma patients managed with various combinations of chemotherapy and surgical resection with selective liver transplantation. Methods and Materials: From January 1990 to December 1995, 61 patients with histologically confirmed biliary duct adenocarcinoma were seen in the Radiation Oncology Department of the University of Pittsburgh. Median follow-up was 22 months (1 to 91 months). The extent of surgery was complete resection in 23 patients (including 17 with orthotopic liver transplant), partial resection in 4, and biopsy in 34. All patients had radiotherapy; median dose was 49.5 Gy. Thirty patientsreceived chemotherapy: 5-fluorouracil (5-FU)-leucovorin with interferon alpha (IFN#alpha#) in 27, and taxol in 3. Results: The median survival was 20 months (95% CI 15-25 months). The 5-year actuarial ...
Purpose: To analyze p53, bcl-2, c-myc, and cyclooxygenase-2 protein expression changes and examine their relationship with various antioxidant enzymes in esophageal carcinoma patients. Methods and Materials: Patients in Group 1 underwent transhiatal esophagectomy and those in Group 2 were administered chemoradiotherapy followed by surgery after 4 weeks of neoadjuvant therapy. Results: The relationship analysis among the various protein markers and antioxidant enzymes showed an inverse correlation between bcl-2 and superoxide dismutase/catalase in tumor tissues, irrespective of the treatment arm followed. An important positive association was observed between bcl-2 and reduced glutathione levels in the tumor tissue of patientsreceiving neoadjuvant therapy. Another apoptosis-modulating marker, c-myc, in the tumor tissue of Group 2 patients showed similar pattern levels (high and low) ...
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, ...
Renal osteodystrophy is a metabolic bone disease and a common complication of end-stage chronic renal failure and maintenance dialysis treatment. In this study, we examined the correlation between quantifying bone scintigraphy and serum biochemical markers in hemodialysis patients. Bone scintigraphy with technetium-99m-hydroxy-methylene-diphosphonate ("9"9"mTc-HMDP) was performed on 28 patients on maintenance hemodialysis. Bone scintigraphy was performed using a standard protocol and was quantified by setting regions of interest (ROIs) over selected regions. The bone-to-soft-tissue ratio (B/ST ratio) at each region was calculated in all patients. The B/ST ratios were then compared with serum biochemical markers. The B/ST ratio for the skull correlated well with serum bone-specific alkaline phosphatase (BAP) (r=0.735, p<0.001), serum deoxypyridinoline (DPD) (r=0.806, p<0.001) and intact parathyroid ...
Objective. The aim of this study was to assess the capability of high-resolution images obtained with a commercially available pelvic phased-array surface coil to demonstrate normal hip anatomy. Design. We retrospectively analyzed the oblique coronal magnetic resonance (MR) images of hips of 36 consecutive patients acquired on a 1.5-T clinical imager using a pelvic phased-array coil as a receiver, a 16-20 cm field of view, and 5 mm slice thickness. Patients. Thirty-six patients were studied, age 15-81 years. There were 20 males and 16 females. Results and conclusions. The articular cartilage, cortex, superior labrum, and iliofemoral ligament were well visualized on proton density weighted fat saturation (PDF) images. The femoral and obturator vessels, obturator nerve, and various muscles were easily seen on T1-weighted images. High-resolution imaging of the hip is achievable in a reasonable amount of ...
Rectum reference dose points have a direct impact on the morbidity seen in gynecological intracavitaty radiotherapy. The aim of this study is to obtain less morbidity by marking rectum with radio opaque solution. Fourteen patients with gynecological cancer who underwent external radiotherapy received 15 Gray (Gy) intracavitary radiotherapy. During the internal radiotherapy planning, radio opaque solution has been administered into the rectum to observe it on lateral radiogram. Thus rectum reference dose point and five points were marked at sites nearest to the sources. Nucletron Planning system was used for obtaining three-dimensional planning. After therapy patients were followed at every three months. Median follow-up was 18 months. Most frequently observed morbidities were grade 1-2 rectitis and cystitis in six patients. As a result, more accurate rectum dose values and less factors causing dose ...
A bioartificial kidney, which is composed of a membrane cartridge with renal epithelial cells, can substitute important kidney functions in patients with renal failure. A particular challenge is the maintenance of monolayer integrity and specialized renal epithelial cell functions ex vivo. We hypothesized that this can be improved by electro-spun, supramolecular polymer membranes which show clear benefits in ease of processability. We found that after 7?d, in comparison to conventional microporous membranes, renal tubular cells cultured on top of our fibrous supramolecular membranes formed polarized monolayers, which is prerequisite for a well-functioning bioartificial kidney. In future, these supramolecular membranes allow for incorporation of peptides that may increase cell function even further. PMID:20715132
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...
Theoretical and experimental results of investigating a cylindrical heat receiver with secondary reflectors are presented. One important element of solar thermal power plants (STPP) is the heat receiver. Several forms of heat receiver exist; the main form is the heat receiver of cavity form (including cylindrical, rectangular, and cubic heat receivers with a noncircular aperture). The linear dimension of such heat receivers is equal to, or larger than, the theoretical diameter of the concentrator focal spot.
We conducted a retrospective review of the North American Renal Transplant Cooperative Study (NAPRTCS) Registry transplant and dialysis arms to assess anemia and growth patterns in children who returned to dialysis after a failed renal transplant from January 1, 1992 to February 3, 2004. Of the 1807 potential study subjects, 1451 had transplant removal data (TxIn vs. TxOut) available for analysis. Four hundred and twenty-one of 1451 patients (29%) had a transplant nephrectomy at the time of entry into the NAPRTCS Registry Dialysis arm. Anemia rates steadily decreased from 72.2% at 30 days after dialysis initiation to 59.5% at 12 months after dialysis initiation. Factors associated with anemia at 30 days after dialysis initiation included hemodialysis, lack of Epo use, and patients who comprised earlier study era cohorts. At one yr after return to dialysis, earlier study cohort era was the only factor associated with anemia status. ...
A large proportion of patients may develop chronic pain following cancer treatments such as surgery, radiotherapy, or chemotherapy. These patients can experience significant levels of physical and psychological morbidity. Our aim was to investigate a cognitive-behavioral pain management program (PMP) for cancer patients with chronic treatment-related pain. Thirteen patients (1 man, 12 women; mean age 52 yrs) completed the study, 9 of whom had a history of breast cancer and had received extensive medical treatment, including surgery. A combination of physical and psychological techniques were adapted from previous work in chronic benign pain and implemented by two therapists. Interventions included education, relaxation, exercise training, and goal setting. A variety of outcomes were examined to assess general fitness, psychological distress, coping success, activities of daily ...
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 ...
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 ...
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 ...
We report the radiation exposure dose received by the anesthesiologist and nurse in the orthopaedic operating room, when a fluoroscopic image intensifier is in use. This study was done in 12 femoral neck fracture operations performed from January to May 1995. Radiation was monitored with the MYDOSE MINIX PDM 107 made by Aloka Co. which were attached in front and behind the nurse's lead apron, in front of the lead apron of the anesthesiologist. The average imaging time was 9.78 min. The average radiation dose in front of the anesthesiologist is lead apron was 2.08#mu#SV, and in front and behind the nurse's lead apron were 5.67#mu#SV, 0.08#mu#SV respectively. This study and review of the literature indicate that the operating room anesthesiologist and nurse receive a lower exposure than the orthopaedist. We can disregard the problem of radiation exposure to the anesthesiologist and nurse during an orthopaedic operation when they wear lead aprons ...
Over 300 cases of femoral neck fractures following radiotherapy for intrapelvic malignant tumor have been reported in various countries since Baensch reported this disease in 1927. In Japan, 40 cases or so have been reported, and cases of bilateral femoral neck fractures have not reached to ten cases. The authors experienced a case of 75 year-old female who received radiotherapy for cancer of the uterus, and suffered from right femoral neck fracture 3 months after and left femoral neck fracture one year and half after. As clinical symptoms, she had not previous history of trauma in bilateral femurs, but she complained of a pain in a hip joint and of gait disturbance. The pain in left femoral neck continued for about one month before fracture was recognized with roentgenogram. As histopathological findings, increase of fat marrow, decrease of bone trabeculae, and its marked degeneration were recognized. Proliferation of some blood vessels was found out, but ...
In August 1982, a 44-year-old man was diagnosed as having rectal cancer, histologically diagnosed as well differentiated adenocarcinoma, and abdominoperineal resection and colostomy were performed. Postoperatively, he received chemotherapy with mitomycin C up to a total dose of 100 mg. In September 1986, lung metastasis occurred and he was treated with a combination chemotherapy consisting of cisplatin, pirarubicin and 5-fluorouracil. In the following year, radiation treatment (total: 6900 rad) was given for a recurrent pelvic lesion. Peripheral blood on April 30, 1988, showed anemia, thrombocytopenia and appearance of myeloblasts, and a diagnosis of acute myelogenous leukemia (FAB: M1) was made. Combination chemotherapy (including aclarubicin, vincristine, behenoyl ara-C, daunorubicin, 6-mercaptopurine, cytarabine, etoposide and prednisolone) failed to induce remission and the patient died in June 1988. This case was thought to be one of ...
Twenty-four patients were studied with both /sup 201/Tl-thallus chloride and /sup 99m/Tc-TBI scintigraphy following exercise. Comparison of the two agents in detecting segmental myocardial ischemia and scar was made in 18 patients with evidence of coronary artery disease on /sup 201/Tl-thallous chloride scintigraphy. Agreement between the two studies was observed in 77% (125 of 162) of left ventricular segments, suggesting that /sup 99m/Tc-TBI can be used as a myocardial perfusion agent. Limitations were related to early high background activity from lungs and liver. The high lung activity and early myocardial redistribution within the 1st hour contributed to the failure of /sup 99m/Tc-TBI to detect 16 segmental defects seen in the immediate post-exercise thallous chloride scan. Persistently high liver activity additionally affected accurate interpretation in the left ventricular segments close to the diaphragm. Improvement ...
During the past year, an experiment has been underway to test use of reliable multicast capabilities for transmission of continuous data in the Global Communication Infrastructure. For the experiment a version of the CD-1 protocol was multicast enabled. The experiment has demonstrated the feasibility of transmitting data in a multicast mode over the GCI. In the case of the Comprehensive Nuclear Test-Ban Treaty the sender could be the station and the receivers the International Data Center (IDC) and one or more National Data Centers (NDC). The potential advantages of multicasting include (a) the timely receipt of the data by the IDC and the host NDC and (b) the simultaneous availability of the raw station data at, at least, two locations. The latter, by introducing redundant data paths, decreases the probability of loss of station data due to a potential failure of a single data receiver. This experiment is only one element ...
Data communication in a computer network environment is facing serious security threats from numerous sources such as viruses, worms, Zombies etc. These threats can be broadly characterized as internal or external security threats. Internal threats are mainly attributed to sneaker-nets, utility modems and unauthorized users, which can be minimized by skillful network administration, password management and optimum usage policy definition. The external threats need more serious attention as these attacks are mostly coming from public networks such as Internet. Frequency and complexity of such attacks is much higher as compared to internal attacks. This paper presents a host based network layer screening of external and internal IP packets for logging, analyzing and real-time detection of possible IP spoofing and Denial of Service attacks. This work can also be used in tuning security rules definition for gateway firewalls. Software has been developed which intercepts IP traffic and ...
Ten children receiving maintenance dialysis were immunized with the standard dose of measles-mumps-rubella vaccine between 15 and 33 months of age. Immune responses to vaccination were determined using commercially available enzyme-linked immunosorbent assays for measles, mumps, and rubella viruses. Eight children responded to measles vaccine, 5 to mumps vaccine, 8 to rubella vaccine, and only 3 children to all three vaccines, compared with a seroconversion rate of over 90% to all three vaccines in healthy children (P less than 0.0001). We contend that the relatively poor immunocompetence of our dialysis patients explains their less than optimal vaccine response and suggest that children vaccinated while undergoing dialysis be tested to confirm serological evidence of immunity. PMID:1571219
Abstract Aim- Conventional outcomes such as survival, tumour recurrence and complication rates after surgery for rectal cancer have been rigorously assessed, but the importance of maintaining quality of life (QOL) after surgery for rectal cancer has received less attention. The aim of the current study was to analyse QOL and the occurrence of pelvic dysfunction after the surgical treatment of rectal cancer. Method- Between May 2005 and May 2008, 150 patients with rectal cancer underwent abdominoperineal resection (APR) or anterior resection (AR). Seventy-four answered two preoperative questionnaires. At a follow up of 1-year, 65 were alive without sign of recurrence and answered the same questionnaires: (a) validated RAND 36-item health survey QOL questionnaire; and (b) self-administered d...
Introduction: Restrictions in prescribing broad spectrum antimicrobials have been part of a strategy to reduce Clostridium difficile cases in the UK in recent years. However, there has been little work on assessing the safety of alternative antimicrobial agents. Methods: We performed an uncontrolled prospective observational survey over a 1-year period to determine the effectiveness and safety of a new antimicrobial stewardship programme in a district hospital in the UK. Results: In total, 227 Gram-negative bacteraemias (203 episodes) occurred in the study period. Guidelines were adequate in 194 of 203 (95%) episodes and 163 episodes (80.2%) received adequate therapy. Patients in the inadequate therapy group had >2-fold increased likelihood of death [odds ratio (OR) = 2.63, 95% confidence ...
Summary Background There is a need for new artemisinin-based combination therapies that are convenient, effective, and safe. We compared the efficacy and safety of pyronaridine-artesunate with that of artemether-lumefantrine for treatment of uncomplicated P falciparum malaria. Methods This phase 3, parallel-group, double-blind, randomised, non-inferiority trial was undertaken in seven sites in Africa and three sites in southeast Asia. In a double-dummy design, patients aged 3-60 years with uncomplicated P falciparum malaria were randomly assigned in a 2:1 ratio to receive pyronaridine-artesunate once a day or artemether-lumefantrine twice a day, orally for 3 days, plus respective placebo. Randomisation was done by computer-generated randomisation sequence in blocks of nine by study centre....
Young children are at increased risk for valproic acid (VPA) hepatotoxicity. Urinary organic acid profiles, as a surrogate of mitochondrial function, were obtained in children 1.9 to 17.3 years of age (n = 52) who were undergoing treatment with VPA for seizure disorders. Age-matched patientsreceiving treatment with carbamazepine (CBZ; n = 50) and healthy children not undergoing treatment (n = 22) served as controls. Age-related changes in organic acid profiles were observed in all three groups. Although the untreated and CBZ control groups were indistinguishable from each other with respect to the principal-component analysis (PCA) score plots of the subjects, a distinct boundary was apparent between the VPA and each of the control groups. Interindividual variability was observed in the V...
A 33-year-old male of proven fertility suffered six attacks of malaria while resident in an African country. For this he received anti-malarial drugs. Semen analysis performed after the fourth attack, and repeated during the following 2 years after his return to Israel, revealed severe oligozoospermia, necrozoospermia and occasionally even azoospermia. Immunological examination of the patient revealed an inverse ratio of T-cell subsets and mast cell degranulation in response to palludrin. Twenty-five months after the last attack of malaria a significant improvement was found in semen quality and there was an increase in the ratio of T-helper to T-suppressor cytotoxic cells. These observations indicate that although malaria and its treatment may affect spermatogenesis, recovery may be expected eventually. PMID:3500921
Driving is a complex task that can be a significant challenge for individuals with attention-deficit/hyperactivity disorder (ADHD). A slight lapse in attention or inhibition while driving (not uncommon in individuals with ADHD) can result in hazardous consequences for these individuals and their families. This is also an interesting clinical scenario for the treating physician, who is always trying to optimize the various treatment options for the patient. Despite such potentially perilous consequences for society, this subject only recently has received researchers? attention. This review paper highlights the psychological differences between drivers with and without ADHD and examines differences between these groups in various driving simulation models. Research updates involving pharmac...
The aim of this study was to observe both the clinical signs and symptoms of wounds at risk of infection, that is critically colonised (biofilm infected) and antimicrobial-performance of an ionic silver alginate/carboxymethylcellulose (SACMC) dressing, in comparison with a non silver calcium alginate fibre (AF) dressing, on chronic venous leg and pressure ulcers. Thirty-six patients with venous or pressure ulcers, considered clinically to be critically colonised (biofilm infected), were randomly chosen to receive either an SACMC dressing or a non silver calcium AF dressing. The efficacy of each wound dressing was evaluated over a 4-week period. The primary study endpoints were prevention of infection and progression to wound healing. The SACMC group showed a statistically significant (P = ...
Iodixanol is a new nonionic dimer, isotonic with blood at all clinically relevant concentrations. Iodixanol (270 mg I/ml) was compared in a double-blind, randomized, parallel-group, phase-III study to the monomeric nonionic iohexol (300 mg I/ml) for evaluation of safety, tolerability and radiographic efficacy during cerebral CT. One hundred adult patients scheduled to undergo contrast-enhanced cerebral CT were randomly allocated to receive either iodixanol or iohexol. All completed the trial. Safety was evaluated by recording discomfort and other adverse events, tolerance by assessing intensity and incidence of discomfort. Radiographic efficacy was assessed from the diagnostic information and the radiographic density. No serious adverse events occurred. One patient (2 %) in the iodixanol group and one patient (2 %) in the iohexol group experienced a transient reddening at the neck and lower neck-line, ...
Radiotherapy recent development in cancer treatment needs strong procedures and quality assessment to improve safety both for patients and professionals. In Ile de France territory, a coordinated action between ASN inspectors and medical doctors specialized in public health (MISP), working as civil servants in health administration, was initiated at the end of 2007. An inspection guideline was implemented in a workshop between ASN and Regional Hospital Agency (ARH). The MISP as health administrator has to verify if care organisation responds to treatment cancer regulatory framework: as a doctor he is authorized to access to patient records to know which treatment was chosen. He has to assure if the therapeutic guidelines are respected. His comprehensive approach is essentially patient-oriented. The MISP inspection coordinated with ASN inspectors is a very pertinent pluri-disciplinary approach, undeniably necessary in such a ...
Radiotherapy recent development in cancer treatment needs strong procedures and quality assessment to improve safety both for patients and professionals. In Ile de France territory, a coordinated action between ASN inspectors and medical doctors specialized in public health (MISP), working as civil servants in health administration, was initiated at the end of 2007. An inspection guideline was implemented in a workshop between ASN and Regional Hospital Agency (ARH). The MISP as health administrator has to verify if care organisation responds to treatment cancer regulatory framework: as a doctor he is authorized to access to patient records to know which treatment was chosen. He has to assure if the therapeutic guidelines are respected. His comprehensive approach is essentially patient-oriented. The MISP inspection coordinated with ASN inspectors is a very pertinent pluri-disciplinary approach, undeniably necessary in such a ...
Background and purpose: We evaluate the feasibility of concomitant and adjuvant docetaxel combined with three-dimensional conformal radiotherapy (3D-CRT) and androgen deprivation in high-risk prostate carcinomas. Methods: Fifty men with high-risk localized prostate cancer (16), locally advanced (28) or very high-risk prostate cancer (6) were included. Seventy Gy were delivered on prostate and seminal vesicles in 35 fractions, concurrently with weekly docetaxel (20 mg/m"2). Three weeks after the completion of 3D-CRT, docetaxel was given for 3 cycles (60 mg/m"2), every 3 weeks. Patients had to receive LHRH agonist during 3 years. Results: The intent to treat analysis shows that four patients out of 15 stopped prematurely the chemotherapy due to grade 3-4 acute toxicity. In the per protocol analysis, 46 patients completed a full-dose chemoradiation regimen representing 413 cycles: five ...
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 ...
Individuals with male factor infertility resulting from idiopathic oligo-, astheno- or teratozoospermia are frequently offered IVF in an attempt to increase their chances of having a child. A concern remains whether these infertile males have an elevated risk of transmitting chromosomal abnormalities to their offspring. Sperm chromosomal complements from these men were assayed using the human sperm/hamster oocyte fusion system and fluorescence in situ hybridization (FISH) on sperm nuclei. For each of 5 infertile patients, 100 sperm karyotypes were analyzed and multicolour FISH analysis was performed on a minimum of 10,000 sperm nuclei for each chromosome-specific DNA probe for chromosomes 1 (pUC1.77), 12 (D12Z3), X (XC) and Y (DYZ3). As a group, the infertile patients showed increased frequencies of both numerical ({chi}{sup 2}=17.26, {proportional_to} <0.001) and total abnormalities ({chi}{sup 2}=7.78, {proportional_to} <0.01) relative ...
BackgroundMetastases to the stomach from an extra-gastric neoplasm are an unusual event, identified in less than 2% of cancer patients at autopsy. The stomach may be involved by hematogenous spread from a distant primary (most commonly breast, melanoma or lung), or by contiguous spread from an adjacent malignancy, such as the pancreas, esophagus and gallbladder. These latter sites may also involve the stomach via lymphatic or haematogenous spread. We present three cases of secondary gastric malignancy.Methods/ResultsThe first is a 19-year-old male who received a diagnosis of testicular choriocarcinoma in September 2004. Metastatic malignancy was demonstrated in the stomach after partial gastrectomy was performed to control gastric hemorrhage.The second is a 75-year-old male, generally well, who was diagnosed with adenocarcinoma of the lung in September 2005. Poorly differentiated adenocarcinoma of the lung was demonstrated in a subsequent ...
The aim of this pilot study was to evaluate the feasibility of long-term subcutaneous application of low-dose IL-2 in children with malignancies at very high risk of relapse who underwent highly T cell and B cell depleted HLA-identical (MUD) or full haplotype mismatched related hematopoetic stem cell transplantation. We studied 11 patients with acute leukemias/myelodysplastic syndrome and juvenile myelomonocytic leukemia (active disease and/or second stem cell transplantation, n = 8; >=CR 2, n = 2) and relapsed or progressive Ewings sarcoma (n = 2) who received prophylactic IL-2 treatment for a high probability of disease recurrence after allo-HSCT. Toxicities from IL-2 were transient fever, fatigue and local inflammation. In one patient GvHD grade III with no clear association to IL-2 adm...
We report a patient who developed occlusion of the intracranial major arteries induced by radiation therapy for craniopharyngioma. The patient, a 9-year-old boy, presented with deterioration of vision, nausea and vomiting. He underwent a right ventriculo-peritoneal shunt operation, and the tumor was partially removed. Postoperatively, he received focal radiation therapy with total of 60 Gy. Preoperative cerebral angiography, cerebral vessels had no sigh of occlusive lesion or stenosis. One year after irradiation, he started to have repeated cerebral ischemic attacks. But no regrowth of the tumor was detected on CT scans. Two years and 8 months after irradiation, he suddenly had right hemiparesis. Cerebral angiography revealed severe stenosis of the right anterior cerebral artery (precommunicating segment), middle cerebral artery (horizontal portion) and terminal portion of the right carotid artery. Left carotid angiography ...
We report a patient who developed occlusion of the intracranial major arteries induced by radiation therapy for craniopharyngioma. The patient, a 9-year-old boy, presented with deterioration of vision, nausea and vomiting. He underwent a right ventriculo-peritoneal shunt operation, and the tumor was partially removed. Postoperatively, he received focal radiation therapy with total of 60 Gy. Preoperative cerebral angiography, cerebral vessels had no sigh of occlusive lesion or stenosis. One year after irradiation, he started to have repeated cerebral ischemic attacks. But no regrowth of the tumor was detected on CT scans. Two years and 8 months after irradiation, he suddenly had right hemiparesis. Cerebral angiography revealed severe stenosis of the right anterior cerebral artery (precommunicating segment), middle cerebral artery (horizontal portion) and terminal portion of the right carotid artery. Left carotid angiography ...
Purpose. To evaluate injection-associated pain, safety, and efficacy with the isotonic contrast medium iodixanol (Visipaque 270 mg I/ml) compared with iopromide (Ultravist 300 mg I/ml) in femoral arteriography. Methods. A multicenter, double-blind, randomized, parallel-group clinical investigation was carried out in 54 hospitals in Europe. Of the patients evaluated, 1225 received iodixanol and 1227 iopromide in conventional and/or digital subtraction angiography. Results. The iodixanol group reported statistically significantly less injection-associated pain (0.9%) than the iopromide group (9.5%) (p<0.001). Further, 4.1% in the iodixanol group experienced pain and/or severe heat sensation vs 19.8% in the iopromide group (p<0.001). In the iodixanol group, 1.8% of the patients experienced contrast-related adverse events vs 2.4% in the iopromide group (p=NS). Overall diagnostic information was optimal for 94.1% in the ...
Selective alveolo-bronchography (SAB) has been routinely used to evaluate anatomical changes in the bronchiole and its distal air spaces. A narrowing of the bronchiole and abnormal pooling of contrast medium in the destroyed air space are the prime findings. Since the object of radiography is extremely thin, direct magnification radiography is mandatory to obtain radiologic details. However, the problem with this technique is that radiographic quality varies depending upon the size of the patient and the concentration of contrast medium to be introduced in the lung. This study had two goals. One was to improve the image quality of SAB by Fuji Computed Radiography (FCR). FCR provides radiographs with a good contrast and stable density throughout a wide range of exposure factors which occur in the use of SAB. The other goal was to separately evaluate morphological abnormalities in the outer and inner zones of the lung using X-ray CT. This idea was derived from our ...
Objective To determine whether a centralised telephone intervention reduces the incidence of death or admission for worsening heart failure in outpatients with chronic heart failure.Design...Full Text Available
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.
The accuracy of dose computation within the lungs depends strongly on the performance of the calculation algorithm in regions of electronic disequilibrium that arise near tissue inhomogeneities with large density variations. There is a lack of data evaluating the performance of highly developed analytical dose calculation algorithms compared to Monte Carlo computations in a clinical setting. We compared full Monte Carlo calculations (performed by our Monte Carlo dose engine MCDE) with two different commercial convolution/superposition (CS) implementations (Pinnacle-CS and Helax-TMS's collapsed cone model Helax-CC) and one pencil beam algorithm (Helax-TMS's pencil beam model Helax-PB) for 10 intensity modulated radiation therapy (IMRT) lung cancer patients. Treatment plans were created for two photon beam qualities (6 and 18 MV). For each dose calculation algorithm, patient, and beam quality, the following set of clinically relevant dose-volume ...
Objective: To investigate the predictive value of ADC value in grading of neuroepithelial tumors. Methods: The clinical data and images of 70 patients with neuroepithelial tumors pathologically proven were collected and analyzed retrospectively. All the patients were classified into low (WHO I or II) and high (WHO III or IV) grade groups which included 40 and 30 cases respectively according to the 2007 WHO classification of tumours of the central nervous system. All the patients underwent plain and contrast-enhanced MR scan and DWI before surgery. The minimum ADC (MinADC) value was measured postoperatively on ADC maps. The Ki-67 labeling index (Ki-67 LI) of tumor tissue was determined by immunohistochemistry. MinADC values for two groups were analyzed using student t test, while the age and Ki-67 LI for the two groups was analyzed using Mann-Whitney test (P<0.05 considered to be significant). Also the MinADC value and ...
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
Ultimate compressive strength and failure modes were studied using 24- ... to 81 % of the average ultimate compressive strength (UCS). Figure 1 (a) is the failure ...
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
We compared the efficacy of timolol maleate ophthalmic gel-forming solution 0.5% QD with that of levobunolol hydrochloride 0.5% BID, as measured by change in intraocular pressure (IOP), effect on heart rate, and ocular tolerability. The study had a positive-controlled, double-masked, randomized, multicenter, 12-week, two-period (6 weeks each), crossover design. One hundred fifty-two patients with open-angle glaucoma or ocular hypertension were randomized to receive either timolol maleate gel-forming solution QD or levobunolol BID for 6 weeks, followed by a crossover to the alternate treatment. IOP and heart rate were measured at morning trough and peak during weeks 3, 6, 9, and 12. Timolol maleate gel-forming solution QD was comparable to levobunolol BID in reducing IOP at peak and trough. Although the effects on peak heart rate were similar between the two medications, the effect on trough heart rate of timolol maleate gel-forming solution QD ...
We investigated the descriminative ability of total body bone-mineral expressed as the total body bone-density (TBBD) measured by dual photon absorptiometry (DPA) in 79 healthy premenopausal women, 27 healthy postmenopausal women, and 120 female osteoporotic fracture patients presenting with either Colles' fracture, vertebral fracture or femoral neck-fracture. TBBD was compared to the bone-mineral density of the lumbar spine (BMD{sub spine}) also measured by DPA, and to the bone-mineral content of the forearms (BMC{sub forearm}) measured by single photon absorptiometry (SPA). TBBD, BMD{sub spine} and BMC{sub forearm} showed that all the fracture patient groups had significantly reduced bone-mass. Using receiver operating characteristic (ROC) analysis, we found that TBBD had a tendency towards better discriminative ability than BMD{sub spine} or BMC{sub forearm} with regard to the discrimination between healthy ...
Apparatus for minimizing thermal loss in a windowless, open cavity solar receiver due to airflow at the receiver aperture includes means for deflecting wind away from the cavity opening such that flow stream reattachment occurs away from the receiver aperture to provide a dead air zone at the cavity opening. This prevents turbulent-mixing airflow exchange between ambient air and heated air within the solar receiver. The wind deflector apparatus includes either a passive annular deflection foil at the receiver aperture, or an active device for producing an outwardly projected air jet at the receiver aperture.
Purpose Cisplatin plus gemcitabine is a standard regimen for first-line treatment of advanced non-small-cell lung cancer (NSCLC). Phase II studies of pemetrexed plus platinum compounds have also shown activity in this setting. Patients and Methods This noninferiority, phase III, randomized study compared the overall survival between treatment arms using a fixed margin method (hazard ratio [HR] < 1.176) in 1,725 chemotherapy-naive patients with stage IIIB or IV NSCLC and an Eastern Cooperative Oncology Group performance status of 0 to 1. Patientsreceived cisplatin 75 mg/m(2) on day 1 and gemcitabine 1,250 mg/m(2) on days 1 and 8 (n = 863) or cisplatin 75 mg/m(2) and pemetrexed 500 mg/m(2) on day 1 (n = 862) every 3 weeks for up to six cycles. Results Overall survival for cisplatin/pemetrexed was noninferior to cisplatin/ gemcitabine (median survival, 10.3 v 10.3 months, respectively; HR = 0.94; 95% ...
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 ...
Four major natriuretic peptides have been isolated: atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), C-type natriuretic peptide (CNP), and Dendroaspis-type natriuretic peptide (DNP). Natriuretic peptides play an important role in the regulation of cardiovascular homeostasis maintaining blood pressure and extracellular fluid volume. The classical endocrine effects of natriuretic peptides to modulate fluid and electrolyte balance and vascular smooth muscle tone are complemented by autocrine and paracrine actions that include regulation of coronary blood flow and, therefore, myocardial perfusion; modulation of proliferative responses during myocardial and vascular remodeling; and cytoprotective anti-ischemic effects. The actions of natriuretic peptides are mediated by the specific binding of these peptides to three cell surface receptors: type A natriuretic peptide receptor (NPR-A), type B natriuretic peptide receptor (NPR-B), and type C natriuretic peptide receptor ...
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.
A survey was conducted of experience with steam generator tubes at nuclear power stations during 1976. Failures were reported at 25 out of 68 water-cooled reactors. The causes of these failures and the repair and inspection procedures designed to cope with them are summarized. Examination of the data indicates that corrosion was the major cause of steam generator tube failures. Improvements are needed in steam generator design, condenser integrity and secondary water chemistry control. (author).
This report documents the investigation regarding the failure of CPVC piping that was used to connect a solar hot water system to standard plumbing in a home. Details of the failure are described along with numerous pictures and diagrams. A potential failure mechanism is described and recommendations are outlined to prevent such a failure.
Severe damage to the pelvic viscera is a complication of irradiation therapy that, unfortunately, cannot always be avoided. Resulting rectal and rectocolonic strictures, rectovaginal fistulas, and shortening and stenosis of the vagina present very difficult problems that frequently require a colostomy for relief and may permanently impair sexual function. The authors present a new approach to correction of these unfortunate lesions based on the use of proximal nonirradiated colon which serves as a vascular pedicle graft to correct the defect without a complicated and massive resection. Twenty-two such operations have been done with 19 satisfactory to excellent results and two total failures (one death from small bowel complications). All patterns and combinations of irradiation injury have been found amenable to this technique of repair. These have included both web and linear strictures with and without fistulas. In half of the patients, it ...
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 ...
Objective: Traditional nasolacrimal duct stenting possesses some shortcoming including difficulty of pulling ball head guide wire from the nasal cavity with turbinate hypertrophy and nasal septal deviation. The new method of nose-oral tube track establishment can overcome the forementioned and increase the successful rate. Methods: 5 F catheter and arterial sheath were modified to be nasolacrimal duct stent delivery device respectively. Antegrade dacryocystography was taken firstly to display the obstructed site and followed by the modified protocol of inserting the guide wire through nasolacrimal duct and nasal cavity, and establishing the stent delivery track for retrograde stent placement. Results: 5 epiphora patients with failure implantation by traditional method were all succeeded through the modified stenting (100%). During 6-mouth follow-up, no serious complications and reocclusion occurred. Conclusion: The establishment of ...
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....
An advanced ceramic dome cavity receiver is discussed which heats pressurized gas to temperatures above 1800/sup 0/F (1000/sup 0/C) for use in solar Brayton power systems of the dispersed receiver/dish or central receiver type. Optical, heat transfer, structural, and ceramic material design aspects of the receiver are reported and the development and experimental demonstration of a high-temperature seal between the pressurized gas and the high-temperature silicon carbide dome material is described.
Extensive investigations and detailed analysis of the failure reason of 9DVN002ZV fan in Daya Bay Nuclear Power Station showed that the fan destroy was caused by the failure of non-drive end bear. The direct cause of this bearing' failure was its improper assembly caused by improper maintenance procedure, and the root cause was too small internal radial clearance after mounting. The factor affecting bearing internal radial clearance, the relationship between clearance and operating life time and fan failure process were discussed. (authors)
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.)
Full text: Introduction. Children, especially premature infants and neonates, are at a much higher risk to obtain an X ray induced disturbance of life - particularly cancer. On the one hand this is due to their longer life expectancy and on the other hand it is due to their higher cell proliferation rate. The paediatric radiology unit of the Inselspital Bern recently installed some of the most advanced X ray equipment nowadays available. It is based on the two latest digital technologies: double read computed radiography (CR) and direct digital radiography (DR). Only the implementation of these digital radiography systems permits the digital acquisition and additionally the analysis of acquired data. The systematic analysis of large amounts of biometric data and exposition data is the basis for further dose reduction and a systematic quality control (QC). Patients are increasingly critical concerning radiation exposure - especially parents regarding their children. ...
Purpose: During recent years, more intensified systemic and local treatment regimens have increased the 5-year survival figures in localized Ewing's sarcoma to more than 60%. There is, however, concern about the risk of second malignancies (SM) in long-term survivors. We have analyzed the second malignancies in patients treated in the German Ewing's Sarcoma Studies CESS 81 and CESS 86. Materials and Methods: From January 1981 through June 1991, 674 patients were registered in the two sequential multicentric Ewing's sarcoma trials CESS 81 (recruitment period 1981-1985) and CESS 86 (1986-1991). The systemic treatment in both studies consisted of a four-drug-regimen (VACA = vincristine, actinomycin D, cyclophosphamide, and adriamycin; or VAIA = vincristine, actinomycin D, ifosfamide, and adriamycin) and a total number of four courses, each lasting nine weeks, was recommended by the protocol. Local therapy in curative patients ...
2 ...Amount received and number years supported Project Duration: 2 years Funding received from APN in Year1: US$...00 Funding received from APN in Year 2: US$40,000.00
Two children with cutaneous lymphoma and leukemia who were treated with total skin electron beam therapy (TSEB) are described here. Patient 1. A 7-year-old boy was admitted because of a mass over the bilateral parotis and anemia. The white blood cell count on admission was 5,000/ul. Bone marrow examination revealed 70 per cent monoblasts (M5a type by FAB classification). Complete remission was obtained following the regimen of daunomycin, cytosine arabinoside, 6-mercaptopurine and prednisolone. He was again admitted because of a skin nodule on the left thigh 19 months after initial diagnosis. A biopsy of the skin nodule demonstrated monoblastic infiltration. He received 20 Grays (Gy) to the left thigh and this led to resolution of the skin nodule. At that time, other skin nodules appeared on the right upper and lower extremities. He was treated with TSEB. Daily doses of 1 Gy were given twice a week with a 4 MeV electron beam and a total dose of ...
In this study the distribution of sup(99m)Tc-diphosphonate and tetracycline and histological examination were also investigated in femoral heads obtained during replacement surgery. One hundred patientsreceived scintigraphic examinations immediately after the occurrence of injury and every month thereafter. Ten mCi of sup(99m)Tc-diphosphonate was injected intravenously. Three hours later, detailed scintigrams of the bilateral hip areas were made with a scintillation camera connected to a computer. The uptake of sup(99m)Tc-diphosphonate in the fracture was expressed as a ratio of the counts recorded in one area to those recorded in the other area. A peak value in count ratio was recorded in all patients 4 to 6 weeks after fractures. One hundred patients were classified into a normal healing group and a delayed or non-union group. Namely, sup(99m)Tc-diphosphonate uptake was significantly higher in the ...
In this study the distribution of sup(99m)Tc-diphosphonate and tetracycline and histological examination were also investigated in femoral heads obtained during replacement surgery. One hundred patientsreceived scintigraphic examinations immediately after the occurrence of injury and every month thereafter. Ten mCi of sup(99m)Tc-diphosphonate was injected intravenously. Three hours later, detailed scintigrams of the bilateral hips areas were made with a scintillation camera connected to a computer. The uptake of sup(99m)Tc-diphosphonate in the fracture was expressed as a ratio of the counts recorded in one area to those recorded in the other area. A peak value in count ratio was recorded in all patients 4 to 6 weeks after fractures. One hundred patients were classified into a normal healing group and a delayed or non-union group. Namely, sup(99m)Tc-diphosphonate uptake was significantly higher in the ...
A prospective pilot trial was performed in 20 patients randomised to receive either {sup 131}I-Lipiodol therapy alone (n=10) or {sup 131}I-Lipiodol combined with a short low-dose cisplatin infusion (n=10), the aim being to evaluate the possible positive influence of a radiosensitiser on toxicity and tumour response. An activity of 1,354-2,128 MBq (mean 1,824 MBq) [36.6-57.5 mCi (mean 49.3 mCi)] {sup 131}I-labelled Lipiodol was administered by selective instillation in the hepatic artery. Cisplatin was given in a dose of 30 mg/m{sup 2} at day -1 and day +6 (day 0: {sup 131}I-Lipiodol). The primary endpoint of this trial was toxicity of therapy; points of secondary interest were tumour response and survival at 6 months. With the use of cisplatin we found a higher percentage of stable or diminished tumour size (90%, vs 40% without). A benefit in group survival at 6 months was not evident. Low-grade stomatitis in one patient ...
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 using Somatom Siemens ...
A model for energy transport in a solid particle cavity receiver is developed and applied to the design and analysis of a receiver for the Central Receiver Test Facility (CRTF), Albuquerque, New Mexico. The model gives thermal performance results - including particle temperatures, cavity efficiencies, and wall temperatures - which directly affect the economic and technical feasibility of a solid particle receiver. In addition, design criteria relevant to the configuration of a solid particle cavity receiver are developed. Results for CRTF indicate that at design conditions particle temperatures will exceed 1200/sup 0/K with cavity efficiencies on the order of 75%.
The HT-28 and 29 irradiation capsules are part of a cooperative agreement between GA and ORNL designed to evaluate irradiation performance of unbonded BISO and TRISO coated ThO_2 fertile fuel particles. The capsules will contain a total of 44 different positions uniformly divided between each capsule. The positions in HT-29 are designated for operation at 900"0C over a fast fluence increment between 5.4 to 10.7 x 10"2"1 n/cm"2 (E > 0.18 MeV)/sub HFIR/. Positions in HT-28 are divided into two sections: 11 positions at 1250"0C to receive a fast fluence exposure between 7.8 and 8.6 x 10"2"1 n/cm"2 (E > 0.18 MeV)/sub HFIR/ and 11 positions at 900"0C designed for a 4.3 to 6.9 x 10"2"1 n/cm"2 (E > 0.18 MeV)/sub HFIR/ fast fluence exposure. Both capsuls are to serve as an evaluation test to characterize the performance of BISO OPyC coatings deposited from mixed-gas (acetylene-propylene). The OPyC variables tested will be density, coating rate, and thickness. A ...
The ability to mechanically reinforce an osteoporotic vertebral body could impede spinal compression fracture and the associated pain and complications. Previous studies have shown that reinforcement of fractured vertebrae with conventional acrylic cement can relieve symptoms and avoid further collapse. In this study, we explored the use of a carbonated apatite cement combined with a minimally invasive injection technique to improve the compressive mechanical properties of cadaveric vertebral bodies. After establishing the biomechanical characteristics of cement formulations intended to have appropriate viscosities, we evaluated the infiltration of the cements into thoracic vertebral bodies using a combined suction-injection technique. The energy-absorption capabilities of the reinforced vertebral bodies were then measured during axial compressive tests and compared with those of nonreinforced vertebrae. The ultimate compressive strength of the cement formulations averaged from 11.6 to ...
A 450 MeV Synchrotron Radiation Source, Indus-1 is being constructed at Centre for Advanced Technology at Indore in central India. This paper narrates our experience in construction and alignment of synchrotron machines which was first of its kind for most of us. Careful design, planning and execution of the work yielded modest results so that alignment accuracies between 0.1 to 0.3 mm could be achieved (in booster synchrotron) and, which have proved to be adequate up till now. The building of the SRS complex was constructed such that machine rings have their foundations isolated from rest of the building. A number of 100 x 150 mm size steel plates were embedded in the concrete of floor and walls to serve as base for reference surveying marks which were established later. The pre-injector and booster ring are enclosed in a radiation shielding zone with separate ventilation system. Dipoles, quadrupoles and a few sextupoles were fiducialised during their field mappings; on a CNC ...
May 16, 1995 ... She received an honorary doctorate of science from Northern Arizona University in 1990. With her husband, she received the Rittenhouse Medal ...
S>Hydrogen-induced delayed failure in an alpha-beta titanium alloy (4Al-- 4Mn) was sensitive to microstructure. A quenched structure was less susceptible to delayed failure than aged or annealed structures. The tendency for delayed failure was magnified in all structures by an increase in hydrogen content or an increase in strength level. Hydrogen-induced delayed failure occurred by a process of crack initiation and controlled crack growth. Delayed failures resulting from creep were also encountered. Plastic strain resulting from creep tended to retard crack initiation. Changes occurring in material under static load prior to formation of cracks were reversible, as long as no appreciable plastic strain occurred, indicating stress-induced diffusion of hydrogen. Hydrogen-induced delayed failure disappeared at both high and low ...
Portal verification images were generated from the photon contamination in electron beams produced by a linear accelerator during treatment of patientsreceiving high-energy electron radiation therapy (8-14 MeV). An experimental storage phosphor system was used to record the images and display them on laser-printed film. Images were obtained from four or more treatment fractions from 21 cases of head and neck cancer. Precision in field placement was estimated by determining the position of a selected anatomic landmark relative to the center of the field for each series of images. The average standard deviation in the field-position measurements was 3.8 mm. Several procedural problems were also detected and corrected after review of the verification images. The results indicate that the emphasis placed on monitoring and control of field-positioning error in high-energy electron treatments should be similar to the emphasis placed on this aspect ...
Purpose We assess the outcome in 46,XX men with congenital adrenal hyperplasia who were born with Prader 4 or 5 genitalia and assigned male gender at birth. Materials and Methods After receiving institutional review board approval and subject consent we reviewed the medical records of 12 men 35 to 69 years old with 46,XX congenital adrenal hyperplasia, of whom 6 completed social and gender issue questionnaires. Results All subjects were assigned male gender at birth, were diagnosed with virilizing congenital adrenal hyperplasia at age greater than 3 years and indicated a male gender identity with sexual orientation to females. Ten of the 12 subjects had always lived as male and 2 who were reassigned to female gender in childhood subsequently self-reassigned as male. Nine of the 12 men had ...
Objective: The aim of this study was to compare symptoms and anterior segment tolerability with short-term (3-day) administration of once-daily timolol hemihydrate 0.5%, timolol maleate in sorbate 0.5%, and generic timolol maleate gel-forming solution 0.5% in the treatment of glaucoma and/or ocular hypertension. Methods: In this prospective, randomized, double-masked, active-controlled, 3-period crossover pilot study, eligible patients had primary open-angle, pigmentdispersion, or exfoliation glaucoma, and/or ocular hypertension in >=1 eye; had a best corrected visual acuity of 1.0 or better in each eye, as measured using the Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity testing chart; were receiving 1 glaucoma medication; and had an untreated intraocular pressure (IOP) ...
Early diagnosis of hepatocellular carcinoma (hepatoma) along with surgical resection is the most appropriate therapeutic modality. For this purpose, there have been many reports concerning the diagnostic value of Lipiodol-CT scan. The authors selected 45 patients with hepatoma during the period of Feb.1986 to Jan. 1988 who received a conventional CT scan, hepatic angiography and a Lipiodol-CT scan. The results were as follows: 1. There was no statistical significant between serum AFP level and mass size, morphology and amount of necrosis. 2. Tumor necrosis was observed in a single massive and multinodular type when the tumor size exceeded 5 cm. 3. Pattern II on Lipiodol-CT, homogenous accumulation of Lipiodol except for the area of inner necrosis, was most frequently demonstrated, which means that a tumor mass with hypervascularity and increased blood flow will attract Lipiodol better. 4. Lipiodol-CT was superior to conventional CT in detecting ...
The study compares the doses absorbed by the dentomaxillary area in spiral CT and panoramic examinations. The dose measurements demonstrate that patientsreceive smaller doses with panoramic radiography than with spiral CT with Dentascan. After following for some variations from instrumental differences, they are in substantial agreement with literature data. Further investigations are needed considering the radiobiological risk related to the growing spread of Dentascan examinations. [Italian] Questo lavoro intende confrontare le dosi assorbite nel distretto dento-mascellare, con le due principali tecniche utilizzate in questo campo: TC spirale e ortopantomografia. Emerge come l'esame panoramico delle arcate dentarie eseguito con l'ortopantomografo comporti la'ssorbimento di dosi inferiori rispetto a quelle dell'esame TC spirale con programma Dentascan. Questi dati, pur essendo soggetti a ...
The aim of this study was to observe both the clinical signs and symptoms of wounds at risk of infection, that is critically colonised (biofilm infected) and antimicrobial-performance of an ionic silver alginate/carboxymethylcellulose (SACMC) dressing, in comparison with a non silver calcium alginate fibre (AF) dressing, on chronic venous leg and pressure ulcers. Thirty-six patients with venous or pressure ulcers, considered clinically to be critically colonised (biofilm infected), were randomly chosen to receive either an SACMC dressing or a non silver calcium AF dressing. The efficacy of each wound dressing was evaluated over a 4-week period. The primary study endpoints were prevention of infection and progression to wound healing. The SACMC group showed a statistically significant (P = 0.017) improvement to healing as indicated by a reduction in the surface area of the wound, over the 4-week study period, compared with AF controls. In ...
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 ...
Breaker failure relaying has been generally achieved through the use of a current monitoring relay to determine whether current continues to flow into a fault after a breaker has been instructed to interrupt the circuit. If current continues to flow after a predefined period of time, the circuit breaker is considered to have failed. Steps must then be taken to trip the next set of upstream breakers in the power system to remove the faulted circuit and prevent system damage. However, with industrial power systems, this may be the utility`s breakers on the feeding transmission line. Regardless, breaker failure schemes must be designed to isolate both the faulted circuit and the failed circuit breaker. This paper discusses a new and innovative method of protecting a circuit breaker from the failure described above, plus other failures that go unprotected with conventional schemes, this providing total ...
Objective: To evaluate the effect of PTBD in treating malignant biliary obstruction caused by hilar cholangiocarcinoma. Methods: We retrospectively analyzed the data of 103 patients(M:62,F:41)with malignant obstructive jaundice caused by hilar cholangiocarcinoma. After taking percutaneous transhepatic cholangiography, metallic stent or plastic external catheter or external-internal catheter for drainage was deployed and then followed up was undertaken with clinical and radiographic evaluation and laboratory. examination. Results: All patients went though PTBD successfully (100%). According to Bismuth classification, all 103 cases consisted of I type(N=30), II type (N=30), III type (N=26) and IV type (N=17). Thirty-nine cases were placed with 47 stents and 64 eases with drainage tubes. 4 cases installed two stems for bilateral drainage, 2 cases installed two stents because of long segmental strictures with stent in stent, 1 case was placed with ...
Thermal absorption with its combined thermal and mechanical loads in a solar receiver does depend significantly on the distribution of incident solar radiation. For a cavity receiver with paraboloid collectar a method is derived which enables the calculation of solar radiation distribution on the areas inside the receiver. The theoretical bases are presented first, and a subsequent example shows the influence of the most important geometric parameters on the distribution of solar radiation.
A preliminary study of two different kinds of solar receivers (a rotating cavity receiver and a volumetric receiver) suitable to operate in the 1 kW solar facility at the University of Rome is presented. Possible applications of solar energy in the aluminum extraction from leucite and chemical storage by the CuO/Cu[sub 2]O cycle are presented and discussed. (author).
The development and experimental demonstration of a high-temperature seal for the SHARE ceramic dome cavity receiver is reported. The mechanical contact seal which was tested on one-foot-diameter silicon-carbide ceramic-dome hardware at pressure differentials to four atmospheres and dome temperatures to 2200/sup 0/F (1200/sup 0/C) showed negligible leakage at expected receiver operating conditions. Potential solar receiver applications for the technology are illustrated.
Chronic heart failure (HF) is a cardiovascular disease of cardinal importance because of several factors: a) an increasing occurrence due to the aging of the population, primary and secondary prevention...Full Text Available
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
A mechanistic understanding of fracture in human bone is critical to predicting fracture risk associated with age and disease. Despite extensive work, a mechanistic framework for describing how the underlying microstructure affects the failure mode in bone is lacking.
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
Background:The cardiac sodium–calcium exchanger (NCX1) is a key sarcolemmal protein for the maintenance of calcium homeostasis in the heart. Since heart failure...Full Text Available
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
There is limited information about the true incidence of acute renal failure (ARF). Most studies could not quantify disease frequency in the general population as they are hospital-based and...Full Text Available
The design of a global steady-state thermal model of a 100kWt molten salt cavity receiver was developed as part of the key project of the Ministry of Science and Technology of People's Republic of China (MOST). In the design process, the following factors were analyzed: receiver area, heat loss (convective, emissive, reflective and conductive), number of tubes in the receiver panel, tube diameter and receiver surface temperature. The model was also used to calculate the receiver performance of the Sandia National Laboratories' molten salt electric experiment (MSEE). In addition, the thermal performance of the designed molten salt cavity receiver is presented for a fixed outlet flow rate and a fixed output temperature.
A thermal analysis of the Omnium-G receiver is presented and the technique is shown to be generally applicable to solar thermal receivers utilizing a directly heated thermal mass. The thermal loss coefficient, including reradiation losses, is calculated and shown to agree quite well with the experimentally measured thermal loss coefficient. The rate of heat transfer to the working fluid is also analyzed and the analysis is used to show that the Omnium-G receiver is well matched to the water/steam working fluid because the steam outlet temperature is almost the same as the receiver temperature. A general procedure for calculating receiver performance is presented. With this procedure, the energy delivery to any working fluid, the delivered temperature of the working fluid, and the pressure drop through the receiver can be determined. An example of the calculation ...
The authors investigate the optimisation of solar-heated cavity receivers in which solar energy collected by a paraboloid collector is converted into electrical energy. The focussed solar energy enters the receiver through an aperture to heat the working fluid, which flows inside the receiver tubes and is compressed by the compressor of a gas turbine system, to the highest process temperature. A method of calculating the distribution on the inner receiver surfaces of the solar radiation reflected by the paraboloid collector is presented to begin with. The interchange of radiant energy inside the receiver cavity can be calculated on this basis, including the radiation loads, the temperatures of the inner receiver walls, and the radiative and convective losses. The temperature fields in the tube walls must be known for determining the strength required of ...
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)
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.
... with the additional US funds supporting Islamic ... the FATA and NWFP, keeping Pakistan's government and ... Without these madrassas, the TTP is left ...
Aluminum electrolytic capacitors, with 1043 failures, are a good example. Also, categorization by size and voltage reveals such frequencies of occurrence as ...
... which extend beyond the upper airway. These include attention deficit hyperactivity disorder, learning disorders, failure to thrive, and enuresis. Tonsillectomies ...
Considerable potential exists for increasing the annual efficiency of line-focus collectors by reducing receiver heat losses. Five alternate receiver designs are compared with a standard design. The comparison is based on annual collector-field efficiency using optimized receiver designs. Of the receivers studied, the all-glass design and the cavity design provide the greatest increases in efficiency. Average fluid temperatures range from 200/sup 0/ to 450/sup 0/C. As a guide for further study, areas of uncertainty and potential problems are identified.
An improved hybrid solar/combustion powered receiver of the type having an insulated housing with a front end and a rear end, a heat exchanger positioned adjacent the rear housing end for extracting heat energy out of the receiver, the insulated housing surrounding the heat exchanger and forming a receiver cavity, the housing also including an aperature having an aperture axis, the aperture located in the front housing end for admitting solar radiation to the cavity to impinge upon the heat exchanger, and a plurality of gas burners to provide combustion gases within the receiver.
Numerical analysis of solar dish modified cavity receiver with Cone, CPC and Trumpet reflectors is presented. Three-dimensional modeling is carried out to estimate the convective and radiative heat loss from the receiver for different angles of inclination and operating temperatures. Incorporating reflectors in the modified cavity receiver for second stage concentration, the natural convection heat losses are reduced by 29.23, 19.81 and 19.16%, respectively. The receiver with the trumpet reflector has shown better performance as compared to other configurations. (orig.)
To determine a suitable combination of X-ray filter and tube kilovoltage for Fuji Computed Radiography (FCR), provide better detection of pulmonary nodules, and reduce patient exposure, we compared observer performance with different X-ray filters and tube voltages. Radiographs were obtained with a copper filter backed by aluminium, with a tungsten filter backed by yttrium and aluminium, and with a lead filter backed by yttrium and aluminium, at both 100 kVp and 135 kVp. Observer performance in detecting simulated lung nodules, which were placed on the posterior aspect of a chest phantom, was compared using receiver operating characteristic (ROC) techniques for each combination of the X-ray filter and tube voltage. The results of the study indicated that (1) nodule detection was superior for the images obtained with 135 kVq as compared with 100 kVp; (2) approximately equal detection rates were obtained for the three X-ray filter sets, although ...
To determine a suitable combination of X-ray filter and tube kilovoltage for Fuji Computed Radiography (FCR), provide better detection of pulmonary nodules, and reduce patient exposure, we compared observer performance with different X-ray filters and tube voltages. Radiographs were obtained with a copper filter backed by aluminium, with a tungsten filter backed by yttrium and aluminium, and with a lead filter backed by yttrium and aluminium, at both 100 kVp and 135 kVp. Observer performance in detecting simulated lung nodules, which were placed on the posterior aspect of a chest phantom, was compared using receiver operating characteristic (ROC) techniques for each combination of the X-ray filter and tube voltage. The results of the study indicated that 1) nodule detection was superior for the images obtained with 135 kVq as compared with 100 kVp; 2) approximately equal detection rates were obtained for the three X-ray filter sets, although ...
To compare the accuracy of MR imaging using an endorectal-pelvic and a pelvic phased-array coil for preoperative local staging of rectal carcinoma. To determine preoperative staging, 38 patients with rectal carcinoma underwent MR imaging. All patients were examined with both an endorectal-pelvic and a pelvic phased-array coil. All underwent surgery and staging was pathologically confirmed. Two radiologists blinded to pathologic stage analyzed perirectal invasion and perirectal node metastasis, and scored according to a four-point scale. Radiologic and pathologic findings were correlated. Receiver operating characteristic (ROC) analysis of Wilcoxon statistic (W values) was used to compare diagnostic accuracy between the two different MR methods. Interobserver variation was measured using {kappa} statistics. For perirectal invasion, T1WI endorectal-pelvic phased-array coil images (reader 1:0. 854, reader 2:0.818) showed ...
There is a continuing need to understand dose-response relationships for ionizing radiation in order to protect the health of the public and nuclear workers from undue exposures. However, relatively few human populations have been exposed to doses of radiation high enough to cause observable, long-term health effects from which to derive dose-response relationships. This is particularly true for internally deposited radionuclides, although much effort has been devoted to epidemiological studies of the few types of exposures available, including lung cancers in uranium miners form the inhalation of the radioactive decay products of Ra, liver cancers in patients injected with Thorotrast X-ray contrast medium containing Th, bone cancers in radium dial painters who ingested Ra, and bone cancers in patients who received therapeutic doses of Ra. These four types of exposures to internally deposited radionuclides provide a basis ...
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.
Heart failure goes beyond mechanical dysfunction and involves an interplay of multiple pathophysiologic mechanisms, including inflammation, tissue remodeling, neurohormonal and endocrine signaling, and interactions with the renal and nervous systems. This article highlights some novel biomarkers that may aid in diagnosis, treatment, and prognosis of acute heart failure, specifically focusing on ST2, endoglin, galectin-3, cystatin C, neutrophil gelatinase?associated lipocalin, midregional pro-adrenomedullin, chromogranin A, adiponectin, resistin, and leptin and their emerging clinical roles.
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.)
1 The decreased binding of drugs and dyes to plasma proteins from male and female rats with acute renal failure has been investigated using equilibrium dialysis at 37 degrees C. 2 Acute renal failure...Full Text Available
Purpose: Various published reports involving intensity-modulated radiotherapy (IMRT) plans developed using automated optimization (inverse planning) have demonstrated highly conformal plans. These reported conformal IMRT plans involve significant target dose inhomogeneity, including both overdosage and underdosage within the target volume. In this study, we demonstrate the development of optimized beamlet IMRT plans that satisfy rigorous dose homogeneity requirements for all target volumes (e.g., #+-#5%), while also sparing the parotids and other normal structures. Methods and Materials: The treatment plans of 15 patients with oropharyngeal cancer who were previously treated with forward-planned multisegmental IMRT were planned again using an automated optimization system developed in-house. The optimization system allows for variable sized beamlets computed using a three-dimensional convolution/superposition dose calculation and flexible cost functions derived ...
Most of previous study for creep rupture of RPV lower head under severe accident condition, have been focused on global failure of RPV lower head. In contract, the local failure of the RPV nozzle region has not been studied in detail. The existence and features of nozzle failure in LAVA-ICI specimen of KAERI and LHF-4 specimen of Sandia National Lab., are observed. It is confirmed that the nozzle failure of LHF-4 specimen is due to the hoop stress in the RPV. The tensile tests in various temperatures and the creep rupture tests in various temperatures and stresses, are accomplished. The finite element analysis for LAVA-ICI experiment was confirmed, and the stress and deformation analysis results are used in LAVA-ICI experiment. 17 refs., 34 figs., 3 tabs. (Author)
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...
Else of solar energy as substitute for conventional fuels at a competitive cost requires efficient conversion from solar radiation to usable forms of energy. In solar thermal or thermochemical applications, high efficiency usually re- quires high temperature and high concentration of incoming radiation. The main form of energy loss from high temperature solar central receivers is thermal emission ('re radiation'), at an effective temperature close to the maximum receiver temperature. This loss is reduced if the aperture is divided into segments, most of which are maintained at lower temperatures. A two-stage partitioned receiver demonstrating this concept is under construction at the Weizman Solar Tower. The high-temperature stage is the DIAPR (Directly Irradiated Annular Pressurized Receiver). The low-temperature stage is made of tubular cavity receivers of simpler design. ...
The purpose of this study was to correlate histopathological with CT findings in patients suffering from hepatocellular carcinoma (HCC) eligible for orthotopic liver transplantation (OLT), with a special focus on the antitumoral effect of transarterial chemoembolization (TACE) therapy. A total of 42 consecutive patients suffering from HCC had been treated prior to OLT by means of TACE. TACE was carried out with a mixture of Lipiodol (10-20 ml) and mitomycin C (max. dosage, 10 mg). TACE was performed at 6- to 8-week intervals. Follow-up investigation included contrast-enhanced multislice CT controls and laboratory control. Liver explants were evaluated macroscopically and microscopically to determine the number and size of the tumor lesions as well as the degree of tumor necrosis. Necrosis was investigated in H and E-stained sections. The degree of necrosis was classified as follows: 0-25%, 26-50%, 51-75%, 75-99%, and complete necrosis. Two ...
According to the California Earthquake Authority, only about 12% of current California residences are covered by any form of earthquake insurance, down from about 30% in 1996 following the 1994, M6.7 Northridge earthquake. Part of the reason for this decreasing rate of insurance uptake is the high deductible, either 10% or 15% of the value of the structure, and the relatively high cost of the premiums, as much as thousands of dollars per year. The earthquake insurance industry is composed of the CEA, a public-private partnership; modeling companies that produce damage and loss models similar to the FEMA HAZUS model; and financial companies such as the insurance, reinsurance, and investment banking companies in New York, London, the Cayman Islands, Zurich, Dubai, Singapore, and elsewhere. In setting earthquake insurance rates, financial companies rely on models like HAZUS, that calculate on risk and exposure. In California, the process begins with an official earthquake forecast by the ...
Microelectronic failure analysis (FA) has been an integral part of the development of state-of-the-art integrated circuits. FA of MicroElectroMechanical Systems (MEMS) is moving from its infancy stage to assume an important role in the successful design, fabrication, performance and reliability analysis for this new technology. In previous work, the authors focused on the application of several techniques developed for integrated circuit analysis to an earlier version of a surface micromachined microengine fabricated at Sandia. Recently, they have identified important new failure modes in binary counters that incorporate a newer design of the microengine, using a subset of integrated circuit failure analysis techniques including optical microscopy, focused ion beam (FIB) techniques, atomic force microscopy (AFM), and scanning electron microscopy (SEM). The primary failure mode they have identified is ...
Solar cavity receiver plays a dominant role in the light-heat conversion. Its performance can directly affect the efficiency of the whole power generation system. A combined calculation method for evaluating the thermal performance of the solar cavity receiver is raised in this paper. This method couples the Monte-Carlo method, the correlations of the flow boiling heat transfer, and the calculation of air flow field. And this method can ultimately figure out the surface heat flux inside the cavity, the wall temperature of the boiling tubes, and the heat loss of the solar receiver with an iterative solution. With this method, the thermal performance of a solar cavity receiver, a saturated steam receiver, is simulated under different wind environments. The highest wall temperature of the boi...
An energy transfer and conversion model for high-temperature solar cavity receivers has been developed using the transport behaviour of solar radiation as described by the spectral radiative exchange factors. A Monte-Carlo ray-tracing method coupled with optical properties was adopted, to predict radiation characteristics of the solar collector system by calculating radiative exchange factors. A cavity receiver with a plano-convexo quartz window was proposed, based upon the directional characteristics of the focal flux and the redistribution effect of the quartz window. Parametric studies on the windowed receiver provided a more uniform flux distribution, higher efficiency and lower loss than the windowless receivers. The predicted results serve as a design reference for the solar receiver...
The development of central receiver technology for the production of electricity is reasonably well established. One possible direction for future research and development efforts funded by the Department of Energy is high-temperature, high-performance systems. In this paper, the performance of central receiver systems is investigated for a range of heliostat sizes, field configurations, plant sizes, and receiver temperatures. The maximum plant efficiency achievable in a central receiver system that uses simple cavity geometry is shown for a range of receiver temperatures. The impact of changes in heliostat size, field packing density, and canting and focusing strategies on system efficiency are investigated over a range of plant sizes. The results of the study underscore the importance of accommodating high absorber plane fluxes in order to efficiently produce working temperatures ...
The present invention concerns a high thermal load heat receiving plate such as a divertor plate of a thermonuclear device. The high thermal load heat receiving plate of the present invention has a cooling performance capable of suppressing the temperature of an armour tile to less than a threshold value of the material against high thermal loads applied from plasmas. Spiral polygonal pipes are inserted in cooling pipes at a portion receiving high thermal loads in the high temperature load heat receiving plate of the present invention. Both ends of the polygonal pipes are sealed by lids. An area of the flow channel in the cooling pipes is thus reduced. Heat conductivity on the cooling surface of the cooling pipes is increased in the high thermal load heat receiving plate having such a structure. Accordingly, temperature elevation of the armour tile can be suppressed. (I.S.).
Results from a numerical model of axisymmetric solar cavity receivers are compared with experimental data for tests of a novel test bed receiver in the Saudi National Laboratories solar furnace. The computed energy transfer rates and temperatures are compared with the experimental data for different receiver geometries, aperture sizes, and operating conditions. In general, the agreement between the numerical model and the experimental data is better for the small-to-midsized apertures than for the large apertures. The analysis indicates that for the larger apertures, the convective heat losses are overpredicted. It also suggests that these losses could be better characterized. Sensitivity analyses show that both the total solar energy input rate and the convective heat-loss coefficient significantly affect the receiver thermal performance and that the distribution of the input solar flux significantly ...
A 2-D model has been proposed to investigate the approximate estimation of the natural convection heat loss from modified cavity receiver of without insulation (WOI) and with insulation (WI) at the bottom of the aperture plane in our previous article. In this paper, a 3-D numerical model is presented to investigate the accurate estimation of natural convection heat loss from modified cavity receiver (WOI) of fuzzy focal solar dish concentrator. A comparison of 2-D and 3-D natural convection heat loss from a modified cavity receiver is carried out. A parametric study is carried out to develop separate Nusselt number correlations for 2-D and 3-D geometries of modified cavity receiver for estimation of convective heat loss from the receiver. The results show that the 2-D and 3-D are comparabl...
Background and purpose: the recent RTOG guidelines for future clinical developments in gynecologic malignancies included the investigation of dose escalation in the paraaortic (PO) region which is, however, very difficult to target due to the presence of critical organs such as kidneys, liver, spinal cord, and digestive structures. The aim of this study was to investigate intensity-modulated radiotherapy's (IMRT) possibilities of either increasing, in a safe way, the dose to 50-60 Gy in case of macroscopic disease or decreasing the dose to organs at risk (OR) when treatment is given in an adjuvant setting. Material and methods: the dosimetric charts of 14 patients irradiated to the PO region at the department of radiation oncology, university hospital of Liege, Belgium, in 2000 were analyzed in order to compare six-field conformal external-beam radio-therapy (CEBR) and five-beam IMRT approaches. Both CEBR and IMRT investigations were planned to ...
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 ...
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 ...
This guide describes an acceptable method of complying with the Commission's regulations with regard to the quality assurance requirements for the packaging, shipping, receiving, storage, and handling of items for water-cooled nuclear power plants.
The United States and Russia have agreed to jointly develop a solar dynamic (SD) system for flight demonstration on the Russian Mir space station starting in late 1997. Two important components of this SD system are the solar concentrator and heat receiver provided by Russia and the US, respectively. This paper describes optical analysis of the concentrator and solar flux predictions on target receiver surfaces. The optical analysis is performed using the code CIRCE2. These analyses account for finite sun size with limb darkening, concentrator surface slope and position errors, concentrator petal thermal deformation, gaps between petals, and the shading effect of the receiver support struts. The receiver spatial flux distributions are then combined with concentrator shadowing predictions. Geometric shadowing patterns are traced from the concentrator to the target receiver surfaces. ...
A 2-D model has been proposed to investigate the approximate estimation of the natural convection heat loss from modified cavity receiver of without insulation (WOI) and with insulation (WI) at the bottom of the aperture plane in our previous article. In this paper, a 3-D numerical model is presented to investigate the accurate estimation of natural convection heat loss from modified cavity receiver (WOI) of fuzzy focal solar dish concentrator. A comparison of 2-D and 3-D natural convection heat loss from a modified cavity receiver is carried out. A parametric study is carried out to develop separate Nusselt number correlations for 2-D and 3-D geometries of modified cavity receiver for estimation of convective heat loss from the receiver. The results show that the 2-D and 3-D are comparable only at higher angle of inclinations (60 {<=} {beta} {<=} 90 ) of the ...
This report is a compilation of worksheets from the waste management units of Savannah River Plant. Information is presented on the following: Solid Waste Management Units having received hazardous waste or hazardous constituents with a known release to the environment; Solid Waste Management Units having received hazardous waste or hazardous constituents with no known release to the environment; Solid Waste Management Units having received no hazardous waste or hazardous constituents; Waste Management Units having received source; and special nuclear, or byproduct material only.
Solar heating of gas turbine plants steps back more and more into the focus of current research. The mainly instationary operation of solar turbine power plants can only be predicted with sufficient accuracy if the transient behaviour of the receiver for the solar radiation is known. Therefore the transient behaviour of cavity receivers of different design is investigated. The mathematical model used for the simulation of the heat transfer and energy storage processes is illustrated. Computed results for receivers with various inner lining are compared and evaluated concerning their use in practice.
Solar heating of gas turbine plants is moving back to the focus of current research. The mainly unsteady operation of solar turbine power plants can only be predicted with sufficient accuracy if the transient behavior of the solar radiation receiver is known. Therefore the transient behavior of cavity receivers of different designs is investigated. The mathematical model used to simulate heat transfer and energy storage is illustrated. Computed results for two receivers with different inner lining are compared and evaluated concerning their use in practice.
... mounted new operations against the TTP stronghold in ... was the fourth tranche of Pakistan's IMF-backed ... and brought the total funds received by ...
... losing unit should document reasons for rehabilitation in a counseling with a view ... of the reprimand and have received at least one OER or NCOER. ...
An electric power generating apparatus is described, including: a solar collector; a primary thermal loop including primary thermal fluid; a cavity receiver to receive reflected solar energy from the solar reflector, convert the solar energy into thermal energy, and transmit the thermal energy to the primary thermal fluid by heating the primary thermal fluid not to exceed a given temperature, the given temperature being substantially equal to 700 F; a Stirling engine receiving the primary thermal fluid heated by the cavity receiver, including means to generate mechanical power and means to generate electrical power from the means to generate mechanical power.
The theory for the general case of solar cells operating inside integrating cavity receivers is established. This is applied to the particular case of different configurations of silicon and GaAs cells. The results of the analysis show that a composite system of silicon and GaAs cells manufactured using relatively simple technology could reach an efficiency of 34%. The optimal configuration is that in which the GaAs cells are placed in the directly illuminated area of the receiver and the silicon cells are placed in the indirectly illuminated area of the receiver. (orig.).
The design of a solar heated cavity receiver transferring 60 MW of thermal energy to the working medium (air) for a closed-cycle gas turbine is described. The gas turbine plant with its cycle layout is presented. Then the tubes for the receiver are designed taking into account thermal and mechanical loads. It is shown how the occurring stresses are influenced by the destribution of the locally absorbed hat flux. Calculations for an existing coal fired air heater of a closed-cycle gas turbine give a first impression of the long-term behaviour to be expected of the receiver tubes.
The receiver whose convective heat loss test results are presented was designed to absorb 5 MW of solar energy, using a molten salt working fluid. During the tests, this receiver was brought to a temperature of about 343 C by a small group of heliostats. Total receiver heat loss due to emitted radiation, conduction and convection was first determined, and the convection loss was established by calculating the radiation and conduction losses analytically and subtracting their sum from the total. Losses due to convection are found to be 1.43 percent of the total heat input.
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
The conception of a solar receiver intended to equip a tower power-station has to combine multiple requirements: very highly concentrated solar flux, unsteady in time and space; necessity to obtain a high efficiency; respect of the physical limits of the materials and of the fluid. The description of Themis solar receiver and of its operation is preceded by considerations which have led to the choice of the cavity, of the fluid and of its circulation.
A solar unit is described which contains a cavity radiation receiver, parabolic-cylindrical concentrator, and reflector arranged between the radiation receiver and the concentrator symmetrically in relation to the optical plane of the latter. In order to expand the range of use, it contains a pair of flat mirrors with 2 working surfaces installed at an angle and symmetrically to the optical plane of the parabolic cylindrical concentrator between them and the reflector, while the latter is made in the form of 2 flat mirrors installed at an angle on the cavity radiation receiver.
This report uses experimental data to compare the performance of two sodium cooled solar central receivers operated at the International Energy Agency Small Solar Power Systems project near Almeria, Spain. Performance includes point-in-time steady state efficiency, average efficiency, start-up time, and operation time. Point-in-time steady state efficiency calculations were based on the statistical method of least squares using receiver incident and absorbed powers. One receiver, a cavity type, showed a peak steady state receiver efficiency of 87% +- 5% and an average efficiency of about 67%. The other receiver, an external ''billboard'' type, had a peak steady state receiver efficiency of 96% +- 4% and an average efficiency of about 79%. The original design peak steady state efficiency predictions for both ...
The concept of a multi-cavity volumetric solar receiver is very attractive for the profitability of certain of its characteristics such as high efficiency and economy. The absorber is based on a pack of small ceramic cavities which intercept and absorb the inherent high solar flux reflected from an array of mirrors. Atmospheric air acts as a coolant medium when it is drawn through the pack. A model for an overall heat transfer performance of the receiver is given and numerically solved.
In conveyor type irradiators, the movement of conveyor and the product boxes is not there until the source is fully in the irradiation position. In case the conveyor system fails the source must automatically be returned to its shielded storage vault. The dose received by the product during the movement of the source from or to the shield becomes significant if the total dose to be received by the product is small. A study has been carried out for evaluating the transient dose received by onions in the POTON irradiator. The results of the study are discussed in this paper. (author)
The mainly nonstationary operation of a solar-heated receiver can be simulated with sufficient accuracy only if data about the dynamic behavior are available. For this reason, the dynamic behavior of a solar cavity receiver with parabolic dish collector is investigated. The development of a mathematical simulation considering heat transfer and storage processes is presented and the procedure for a numerical solution is illustrated. The performance of the calculation method is finally demonstrated by simulating the passage of a cloud.
The mainly instationary operation of a solar heated receiver can be simulated with sufficient accuracy only if data about the dynamic behavior are available. For this reason, the dynamic behavior of a solar cavity receiver with parabolic dish collector is investigated. The development of a mathematical simulation considering heat transfer and storage processes is presented and the procedure for a numerical solution is illustrated. The performance of the calculation method is finally demonstrated by simulating the passage of a cloud.
Polyethylene gas piping is expected to be in service for times on the order of 50 years depending on service conditions. Therefore research research on piping materials and pipes has two principal objectives: (a) developing methods for predicting when a pipe will fail and (b) improving the material for piping. The prediction of long time failure hinges on the development of short time test methods which relate to long time failure. The improvement in the behavior of current materials also hinges on the use of test methods of short duration relative to the anticipated life time of the pipe in service. One of the primary criterion for an acceptable test method is that it produces the same type of failure as is observed after long time failure in service. It has been found that P.E. pipe material fails in a brittle mode after long periods of time. The failure mode is called brittle ...
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 ...
Airborne pollutants can cause failures in switching and computing equipment. This paper focuses on a subset of such pollutants - airborne fine particles (<2.5 [mu]m diameter). It begins by examining the extent to which different improvements in heating, ventilating and air conditioning (HVAC) systems reduce indoor concentrations of fine particles. For each modification, the consequent reduction in soiling rate is derived. The concomitant increase in operating costs is also calculated. These costs are then compared with the costs of failures in telephone switching offices, leading to estimates of failure rate reductions that would make improvements cost-effective. Finally, the reduction in failures required to offset the costs of the improvements are compared with documented differences in failure rates between unimproved and improved environments. This study suggests that, in ...
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 ...
This study describes the formulations to optimize the time interval of inspections and/or replacements of equipment/parts taking into account the probability density functions (PDF) for failure rates and parameters of failure distribution functions (FDF) and evaluates the optimized results of these time intervals using our formulations by comparing with those using only representative values of failure rates and the parameters of FDF instead of using these PDFs. The PDFs are obtained with Bayesian method and the representative values are obtained with likelihood estimation method. However, any significant difference is not observed between both optimized results within our preliminary calculations. (author)
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).
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(#+-#5)% and 90(#+-#5)% relative humidity levels, after being statistically analysed, showed that such a linear relationship was valid for up to 100% polymer impregnation. (author).
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.
The wind industry has experienced premature turbine component failures during the past years. With the increase in turbine size, these failures, especially those found in the major drivetrain components, i.e. main shaft, gearbox, and generator, have become extremely costly. Given that the gearbox is the most costly component in the drivetrain to fix, the National Renewable Energy Laboratory (NREL) initiated the Gearbox Reliability Collaborative (GRC) to determine the causes for premature gearbox failures and subsequently, recommend improvements to gearbox design, manufacture, and operational practices. The GRC has two identical test gearboxes, which are planned for a dynamometer and a field test, respectively.
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.
of the Intelligent Control System (ICS) for reusable rocket engines. .... the incoming measurements with corresponding estimates, a sensor failure can be ...
Mangroves are disappearing rapidly worldwide despite their well documented biodiversity and the ecosystem services they provide. Failure to link ecological processes and their societal benefits has...Full Text Available
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.
The coolant activity analysis to obtain the information about the fuel failure has been studied long before. And several codes have been developed to estimate the number of fuel failures through evaluating volatile and inert fission products release in coolant from the defective fuel. These codes use a fission product diffusion model coupled with a mass balance in the gap and coolant. But each code has a different model to assess fuel failure. In order to develop the model to estimate the number of fuel failures we analysis well-known code's models such as CHIRON, CADE, IODYNE, and CAAP and compare accuracy through Korean PWR activity data
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.
A general purpose Emergency Generator Set (EGS) is considered for a methodological study and related reliability behavior is analyzed. In particular in a procedure of reliability and availability analysis of a EGS, dependent failure events need a complex mathematical model as state-space model to be a accurately evaluated. Furthermore these dependent failure events are one of the most important reliability characteristic of EGS. This paper suggests a procedure for reliability calculations in presence of dependent failure based on the evaluation of a equivalent failure rate that can be fitted to a network reduction method by simple mathematical calculations. The simplified models analyzed show a good accuracy for a wide range of variation of main reliability characteristics of EGS and utility. The advantages obtained are very useful on reliability evaluation because the possibility of use of network ...
... position must not be penalized in their NCO Evaluation Report (NCOER). ... failure to perform MOS-, SQI-, or ASI-related duties after counseling. ...
Results are presented from a numerical model of the steady-state energy transfer in molten-salt-in-tube solar cavity receivers that includes convective energy transfer at a local (spatially resolved) level. Molten salt energy absorption and gray radiative transfer between all cavity surfaces are also included. This model is applied to the Molten Salt Subsystem Component Test Experiment (MSS/CTE) cavity receiver. Results for this receiver indicate the global (entire cavity) receiver thermal efficiency is invariant within a few percent to most parameters investigated, although front surface temperatures of the nonabsorbing walls vary considerably, and are particularly sensitive to the type of convective submodel used. Absorption efficiencies indicate the effects of the cavity enclosure environment. For all conditions investigated, tube inner wall temperatures remain under 855 K, ensuring that the salt ...
Properly quantified performance of a solar-thermal cavity receiver must not only account for the energy gains and losses as dictated by the First Law of thermodynamics, but it must also account for the quality of that energy. Energy quality can only be determined from the Second Law. In this paper, an equation developed for the Second-Law efficiency of a cavity receiver is presented as an evolution from the definition of available energy or ''availability'' (occasionally called exergy). The variables required are all either known or readily determined. The importance of considering the Second-Law is emphasized by a comparison of the First- and Second-Law efficiencies around an example of data collected from two receivers that were designed for different purposes, where the attempt was made to demonstrate that a Second-Law approach to quantifying the performance of a solarthermal cavity ...
Cavity solar receivers are generally believed to have higher thermal efficiencies than external receivers due to reduced losses. A simple analytical model was presented by the author which indicated that the ability to heat the air inside the cavity often controls the convective loss from cavity receivers. Thus, if the receiver contains a large amount of inactive hot wall area, it can experience a large convective loss. Excellent experimental data from a variety of cavity configurations and orientations have recently become available. These data provided a means of testing and refining the analytical model. In this manuscript, a brief description of the refined model is presented. Emphasis is placed on using available experimental evidence to substantiate the hypothesized mechanisms and assumptions. Detailed comparisons are given between analytical predictions and experimental results. Excellent ...
ObjectiveTo identify patient-care practices related to an increased prevalence of hepatitis C virus (HCV) infection among chronic hemodialysis patients.Full Text Available
The aim of this study was to document vascular complications that occurred following cadaveric and living donor kidney transplants in order to assess the overall incidence of these complications at our center as well as to identify possible risk factors. In a retrospective cohort study, 1500 consecutive renal transplant recipients who received a living or cadaveric donor kidney between December 1988 and July 2006 were evaluated. The study was performed at the Nemazee Hospital, Shiraz, Iran. The assessment of the anatomy and number of renal arteries as well as the incidence of vascular complications was made by color doppler ultrasonography, angiography, and/or surgical exploration. Clinically apparent vascular complications were seen in 8.86% of all study patients (n = 133) with the most frequent being hemorrhage (n = 91; 6.1%) followed by allograft renal artery stenosis (n = 26; 1.7%), renal artery thrombosis (n = 9; 0.6%), and renal vein ...
Sixty-three subjects, aged 6 months to 16 years, who were enrolled in a prospective, fully blinded, randomized parallel-group phase III clinical trial, received 0.1 mmol/kg doses of either Gd-BOPTA (n=29) or Gd-DTPA (n=34). The MR images were acquired before and within 10 min of contrast agent injection. The primary objective was to compare the difference from pre-dose to post-dose lesion visualization between Gd-BOPTA and Gd-DTPA. Lesion visualization was determined as the sum of individual scores for three criteria of lesion morphological characteristics (lesion border delineation, internal morphology, and contrast enhancement), each assessed qualitatively using 4-point scales. Quantitative evaluation compared changes in lesion-to-background (LBR) and contrast-to-noise (CNR) ratios and per cent enhancement. Monitoring for adverse events and evaluation of vital signs and laboratory values was performed. Pre-dose to post-dose changes in lesion visualization were ...
Background and purpose: the recent RTOG guidelines for future clinical developments in gynecologic malignancies included the investigation of dose escalation in the paraaortic (PO) region which is, however, very difficult to target due to the presence of critical organs such as kidneys, liver, spinal cord, and digestive structures. The aim of this study was to investigate intensity-modulated radiotherapy's (IMRT) possibilities of either increasing, in a safe way, the dose to 50-60 Gy in case of macroscopic disease or decreasing the dose to organs at risk (OR) when treatment is given in an adjuvant setting. Material and methods: the dosimetric charts of 14 patients irradiated to the PO region at the department of radiation oncology, university hospital of Liege, Belgium, in 2000 were analyzed in order to compare six-field conformal external-beam radio-therapy (CEBR) and five-beam IMRT approaches. Both CEBR and IMRT investigations were planned to theoretically ...
Quantitative evaluation of CRT and CR observations in indentification of malignancy using phantom and clinical data. A breast phantom and a total of 40 patients were imaged by Fuji computed radiography (FCR). The images were interpreted twice by six radiologists both on CR film (2510 x 2000 pixels x 10 bits, 0.1 mm spatial resolution) and on a CRT monitor (1568 x 1152 pixels x 10 bits, 0.1 mm pixel size with double expansion) with image processing parameters of a toutine (RN 1.0, RE 0.2), for a calcification (RN 9.0, RE 4.0) and for a mass (RN 7.0, RE 2.0). The forty clinical cases included breast diseases with calcifications, masses, and normal breasts. Two-tailed t-test was performed to analyze interpretation of simulated microcalcifications and masses in the phantom. The receiver operating characteristic (ROC) analysis was performed to evaluate clinical cases. In all interpretation studies using both breast phantom and clinical cases, there ...
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...
The present paper deals with the conversion of solar energy in a gas turbine plant with a parabolic dish collector. Particular consideration is devoted to the thermodynamic and mechanical design and partload behavior of the receiver. The incident sunlight is focussed by the parabolic dish and then beamed into the cavity receiver. Here the working medium of the gas turbine flows through tubes and is heated up to the receiver outlet temperature. The task of the receiver is to transfer the radiated energy as efficiently as possible to the working medium. Furthermore the required heating surface should be small as possible i.e. optimum use must be made of the tube material with respect to its state of stress. It is shown which geometric and thermodynamic plant parameters influence these two design criteria. An optimum receiver design is presented on the basis of the results thus ...
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 ...
The purpose of the Microelectronic Evaluation Laboratory at Sandia is to develop a program for evaluating CMOS LSI (complementary metal oxide silicon - large scale integrated) technology devices which are being used for the first time in a weapon system. These evaluations are based on accelerated aging studies and electrical tests to determine the reliability and life of the devices. In accelerated aging, specific, controlled stresses are applied to the device to accelerate time-to-failure. Data are used tin mathematical models to estimate life in acutal use. The stresses used for this technology are temperature and voltage. The devices are stored at temperatures with or without voltage applied (steady-state or cyclical) and periodically tested until at least 50% failures are encountered. Since most current technologies use epoxy-die-attachment, aging temperatures must be under 200/sup 0/C. This delays device failure, and a ...
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
This paper investigates the calculation of availability for parallel transmission lines (two or more) in the same tower or on the same right of way. As in many studies, the development of mathematical models is an important step. The models are justified using historical data and known characteristics of power system elements. A statistical method was used to generalize the failure rate and repair rate from real operating data. Application of the new model (which combines common-mode, simultaneous independent, and dependent outages) is discussed.
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.
The paper presents results of studies on the effect of heat treatment on strength and pattern of 40Kh steel impact failure. Loading levels corresponding to macroscopic spalling microdamage initiation in the material are determined for three initial states. Metallographic study on the spalling failure pattern for 40Kh steel in different initial states and data on microhardness measurement are presented.
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 ...
A historical overview of corrosion problems found in power plant condensers and mitigation procedures is presented. The paper is organized according to alloy type and failure mode. Alloys considered are copper-base alloys, stainless steels and titanium. Failure modes discussed include erosion-corrosion, sulfide attack, environmentally assisted cracking, galvanic corrosion, steam condensate corrosion, pitting corrosion, and dealloying. Mitigation procedures discussed include cathodic protection, ferrous ion injection, as well as tube cleaning and layup practices.
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).
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 ...
Reliability has an impact on wind energy project costs and benefits. Both life test data and field failure data can be used for reliability analysis. In wind energy industry, wind farm operators have greater interest in recording wind turbine operating data. However, field failure data may be tainted or incomplete, and therefore it needs a more general mathematical model and algorithms to solve the model. The aim of this paper is to provide a solution to this problem. A three-parameter Weibull failure rate function is discussed for wind turbines and the parameters are estimated by maximum likelihood and least squares. Two populations of German and Danish wind turbines are analyzed. The traditional Weibull failure rate function is also employed for comparison. Analysis shows that the three-parameter Weibull function can obtain more accuracy on reliability growth of wind turbines. This work will be ...
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 ...
A modified boundary element approach was used to analyze the response of offshore piles subjected to external soil movements. The computer model employed to solve the pile-soil problem was able to model pile head and tip loading, and loading caused by lateral movement of soil. A nonlinear pile-soil interface element with the ability to represent a hardening or softening plastic response prior to reaching an ultimate state was incorporated. With the program, 4 failure modes can be determined: flow of the soil slide past an intact stationary pile; rotation of the pile with the soil at failure along the full pile length; translation of the pile with the sliding soil, resulting in failure of the supporting soil; and the long-pile mode, in which the maximum bending moment in the pile reaches the yield moment of the pile before complete development of the other 3 modes. Theoretical solutions for a realistic hypothetical offshore ...
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 ...
A newly developed 220 Mbps free-space 4-ary pulse position modulation (PPM) direct detection optical communication system is described. High speed GaAs integrated circuits were used to construct the PPM encoder and receiver electronic circuits. Both PPM slot and word timing recovery were provided in the PPM receiver. The optical transmitter consisted of an AlGaAs laser diode (Mitsubishi ML5702A, lambda=821nm) and a high speed driver unit. The photodetector consisted of a silicon avalanche photodiode (APD) (RCA30902S) preceded by an optical interference filter (delta lambda=10nm). Preliminary tests showed that the self-synchronized PPM receiver could achieve a receiver bit error rate of less than 10(exp -6) at 25 nW average received optical signal power or 360 photons per transmitted information bit. The relatively poor receiver sensitivity was believed to be ...
The convection heat loss from cavity receiver in parabolic dish solar thermal power system can significantly reduce the efficiency and consequently the cost effectiveness of the system. It is important to assess this heat loss and subsequently improve the thermal performance of the receiver. This paper aims to present a comprehensive review and systematic summarization of the state of the art in the research and progress in this area. The efforts include the convection heat loss mechanism, experimental and numerical investigations on the cavity receivers with varied shapes that have been considered up to date, and the Nusselt number correlations developed for convection heat loss prediction as well as the wind effect. One of the most important features of this paper is that it has covered numerous cavity literatures encountered in various other engineering systems, such as those in electronic cooling devices and buildings. ...
Decreasing the aperture of a solar central receiver operating at high temperatures contributes significantly to the increase of the efficiency of energy absorption. However, decreasing the aperture also decreases the collection efficiency. A simple solution is using a 3D-CPC as secondary element for augmenting the energy collection, while the aperture can remain relatively small. Nevertheless, the receiver aperture as well as the secondary concentrator are usually rather large. For practical considerations an approximate solution may be chosen at times, designing the concentrator by a series of truncated cones. However, in particular cases, the solution of truncated cones remains expensive and unpractical and therefore the authors designed a CPC approximated by a series of trapezoidal planar facets. Under technical restrictions, there is an optimum for choosing the partition of the pure-CPC in truncated pyramids and the paper presents the ...
A schematic of the Bench cavity receiver system is given, and the primary objectives, schedule and research plan for each of four tests are discussed. The tests are: (1) cold flow testing to functionally check all valves and their response using high pressure nitrogen gas; (2) a hot checkout to simulate both steady state and transient flux inputs to the receiver which are expected at the French facility; (3) basic performance using solar energy at the French facility; and (4) ir radiant heat testing. (LEW)
The Conawapa-Winnipeg Power Transmission Complex includes five interrelated transmission and conversion facilities. This booklet describes work done on the upgrade of the southern receiver system, one component of the complex. The southern receiver system is composed of a network of high voltage transmission lines and station facilities. The booklet includes a description of the upgrade, the project setting, short and long-term effects and impact management, and the next steps to be taken in the process, including the regulatory process and public consultation.
Typical receiver processing, targeting always the best achievable bit error rate performance, can result in a waste of resources, especially, when the transmission conditions are such that the best performance is orders of magnitude better than the required. In this work, a processing framework is proposed which allows adjusting the processing requirements to the transmission conditions and the required bit error rate. It applies a-posteriori probability receivers operating over multiple-input multiple-output channels. It is demonstrated that significant complexity savings can be achieved both at the soft, sphere-decoder based detector and the channel decoder with only minor modifications.
Josephson effect heterodyne mixers with external local oscillators are very promising low noise mm-wave receivers for applications such as radio astronomy. Experiments at 36 GHz have shown that both the noise and the conversion efficiency of mixers made using Nb point contacts are in quantitative agreement with values calculated from the resistively shunted junction (RSJ) model. Preliminary measurements at 140 GHz suggest that this agreement extends to higher frequencies. In this paper the theoretical limits to the sensitivity of such receivers are explored as a function of the signal frequency. (Auth.).
Asymmetrical solar concentrators may offer significant advantages over symmetrical ones by the higher yearly average energy input per unit aperture area and the wider range of flexibilities in the design and operation. This paper describes the design, construction and performance evaluation of a non-parabolic asymmetrical solar concentrator with an evacuated receiver. The concentrator has a concentration ratio of 3.25 and a theoretical optical efficiency of 0.67. Collector efficiency test results are presented and compared with another similar concentrator without an evacuated receiver.
In an ideal system the surface of the dish is perfectly parabolic (no contour flaws are present), and the sun rays fall on the dish surface parallel to the focal axis (no sun tracking flaws are present). These two conditions are not realizable in practice; in this case, the parabolic dish system is called real system. In this paper a procedure for analysing the flux distribution on the receiver internal surfaces is presented for a cavity receiver with a real parabolic dish collector. First, the theoretical principles are discussed. Then the effect of the inaccuracy in the collector and in the sun tracking on the insolation pattern is described using an example.
Solar energy can be economically converted into electrical energy for small and medium power outputs. A typical solar power plant consists of a parabolic dish, cavity receiver and gas turbine. To obtain high gas turbine efficiences, the working fluid used has to be heated to high temperatures. This necessitates the use of expensive high-quality materials for the tubes in the receiver. This expense must be kept to a minimum. The present paper demonstrates how this aim can be achieved by meeting the so-called Bammert Criterion.
Solar energy can be economically converted into electrical energy for small and medium power outputs. A typical solar power plant consists of a parabolic dish, cavity receiver and gas turbine. To obtain high gas turbine efficiencies, the working fluid used has to be heated to high temperatures. This necessitates the use of expensive high-quality materials for the tubes in the receiver. This expense must be kept to a minimum. The present paper demonstrates how this aim can be achieved by meeting the so-called Bammert Criterion.
An analytical model is presented which enables the estimation of convective losses from cavity receivers. Evidence from solar experiments is used to test the hypothesized mechanisms. The analytical results and experimental evidence indicate that the convective loss from cavity receivers is appreciable. The model indicates that the influences of the wind on the convective loss at normal operating conditions are minimal. It also shows that the internal thermal resistance, i.e. the ability to heat the air inside the cavity, are of importance. Buoyancy induced flows are, on the other hand, effective in transferring energy across the aperture. 8 refs.
A simple analytical model has been developed in order to provide a framework for designing experimental programs for convective loss determinations, for analyzing available experimental data from solar receiver test programs, and for estimating the convective loss at a relatively small cost. Analytical results and experimental evidence indicate that the convective loss from cavity receivers is appreciable, while the effects of wind on the convective loss under normal operating conditions are minimal. The proposed analytical model provides a means of determining the relative importance of the internal resistances and predicting the bulk air temperature within the convective zone inside the cavity.
Radioactive waste shipping and receiving facilities presently planned for commercial and defence high level nuclear waste will handle waste packages at frequencies far in excess of those in common practice today. If current limits for radiation levels at the cask surface and current handling methods are used, high cumulative personnel exposure to ionizing radiation is projected to occur. To reduce these exposure levels, alternate handling methods are being developed and demonstrated. The production nature of cask receiving operations suggests commercial robotics be incorporated into a remote handling system to reduce predicted worker exposure to acceptable levels while maintaining or increasing throughput. The first phase of cask handling system development culminated in a proof-of-principle test demonstrating the feasibility of performing cask receiving and unloading operations in a remote and partially automated manner. ...
Radioactive waste shipping and receiving facilities presently planned for commercial and defense high-level nuclear waste will handle waste packages at frequencies far in excess of those in common practice today. If current limits for radiation levels at the cask surface and current handling methods are used, high cumulative personnel exposure to ionizing radiation is projected to occur. To reduce these exposure levels, alternate handling methods are being developed and demonstrated. The production nature of cask receiving operations, suggests commercial robotics be incorporated into a remote handling system to reduce predicted worker exposure to acceptable levels while maintaining or increasing throughput. The first phase of cask handling system development culminated in a proof-of-principle test demonstrating the feasibility of performing cask receiving and unloading operations in a remote and partially automated manner.
Radioactive waste shipping and receiving facilities presently planned for commercial and defense nuclear waste will handle waste packages at frequencies far in excess of those in common practice today. Unacceptable personnel exposure to ionizing radiation is projected to occur if current limits for radiation levels at the cask surface and current handling methods are used. To reduce these exposure levels, alternate handling methods are being developed and demonstrated. The production nature of cask receiving operations suggests commercial robotics be incorporated into a remote handling system to reduce predicted worker exposure to acceptable levels, while maintaining or increasing throughput. The first phase of cask handling system development culminated in a proof-of-principle test demonstrating the feasibility of performing cask receiving and unloading operations in a remote and partially automated manner. 6 refs., 12 ...
BackgroundProfessionalism is a critical quality for physicians to possess. Physician professionalism has received increased attention in recent years, with many authorities suggesting...Full Text Available
... 4302, and to the Office of Management and Budget, Paper-work ... link coverage areas, so it is possible to receive your own ... mestic Ku-band satellite. ...
... Received: February 22, 2010; Accepted: August 17, 2010 Hygrophila polysperma (Roxb.) T. Anderson. (ACANTHACEAE) Berkeley County: central part ... This is the first report for South Carolina. Hygrophila...
A new kind of receiver-reactor for high-temperature solar furnaces is proposed. The main body of the receiver component is an ellipsoid of revolution with specularly reflecting inner walls. The reactor component, a crucible, is placed at one focal point and the aperture at the other. With this arrangement, substantially all of the incident radiation from the concentrator should reach the reactor directly or after one reflection from the cavity walls. An analysis of the radiative exchange among the surfaces is presented. The analysis provides a tool for a parametric study and optimization of the design. It is found that, in contrast to that of conventional well-insulated cavity receivers, its collection efficiency is not very sensitive to the size of its aperture.
A module is described with a receiver having a solar energy acceptance opening and supported by a mounting ring along the optic axis of a parabolic mirror in coaxial alignment for receiving solar energy from the mirror, and a solar flux modulator plate for varying the quantity of solar energy flux received by the acceptance opening of the module. The modulator plate is characterized by an annular, plate-like body, the internal diameter of which is equal to or slightly greater than the diameter of the solar energy acceptance opening of the receiver. Slave cylinders are connected to the modulator plate for supporting the plate for axial displacement along the axis of the mirror thereby shading the opening with respect to solar energy flux reflected from the surface of the mirror to the solar energy acceptance opening.
Rationale and ObjectivesSample-size estimation is an important consideration when planning a receiver operating characteristic (ROC) study. The aim of this work was...Full Text Available
This invention is an improved solar energy cavity receiver for exposing materials and components to high temperatures. The receiver includes a housing having an internal reflective surface defining a cavity and having an inlet for admitting solar radiation thereto. A photothermal absorber is positioned in the cavity to receive radiation from the inlet. A reflective baffle is positioned between the absorber and the inlet to severely restrict the re-radiation of energy through the inlet. The front surface of the baffle defines a narrow annulus with the internal reflective surface of the housing. The front surface of the baffle is contoured to reflect incoming radiation onto the internal surface of the housing, from which it is reflected through the annulus and onto the front surface of the absorber. The back surface of the baffle intercepts infrared radiation from the front of the absorber. With this arrangement, a high ...
This invention is an improved solar energy cavity receiver for exposing materials and components to high temperatures. The receiver includes a housing having an internal reflective surface defining a cavity and having an inlet for admitting solar radiation thereto. A photothermal absorber is positioned in the cavity to receive radiation from the inlet. A reflective baffle is positioned between the absorber and the inlet to severely restrict the re-radiation of energy through the inlet. The front surface of the baffle defines a narrow annulus with the internal reflective surface of the housing. The front surface of the baffle is contoured to reflect incoming radiation onto the internal surface of the housing, from which it is reflected through the annulus and onto the front surface of the absorber. The back surface of the baffle intercepts infrared radiation from the front of the absorber. With this arrangement, a high ...
The visual outcome, histopathology, and electrodiagnostic tests of a man with a malignant melanoma of the choroid who received foveal argon laser photocoagulation prior to enucleatiion are described....Full Text Available
When evaluating the risks of oncogenesis and cancer mortality following exposure to the radiations of the atomic bombs (A-bombs), the medical X-ray doses received by the A-bomb survivors must also be estimated and considered. Using a human phantom, dosimetry was performed to estimate the X-ray doses received by A-bomb survivors during medical examinations at the Radiation Effects Foundation (RERF) as part of the long-term follow-up on the Adult Health Study (AHS). These examinations have been estimated to represent nearly 45% of the survivors' cumulative medical irradiation dose. Doses to the salivary glands, thyroid gland, lung, breast, stomach and colon were measured using thermoluminescent dosemeters. The results, which are reported here, will aid in estimating organ doses received by individual AHS participants. (Author).
When evaluating the risks of oncogenesis and cancer mortality following exposure to the radiations of the atomic bombs (A-bombs), the medical X-ray doses received by the A-bomb survivors must also be estimated and considered. Using a human phantom, dosimetry was performed to estimate the X-ray doses received by A-bomb survivors during medical examinations at the Radiation Effects Foundation (RERF) as part of the long-term follow-up on the Adult Health Study (AHS). These examinations have been estimated to represent nearly 45% of the survivors' cumulative medical irradiation dose. Doses to the salivary glands, thyroid gland, lung, breast, stomach and colon were measured using thermoluminescent dosemeters. The results, which are reported here, will aid in estimating organ doses received by individual AHS participants. (Author).
This invention is an improved solar energy cavity receiver for exposing materials and components to high temperatures. The receiver includes a housing having an internal reflective surface defining a cavity and having an inlet for admitting solar radiation thereto. A photothermal absorber is positiond in the cavity to receive radiation from the inlet. A reflective baffle is positioned between the absorber and the inlet to severely restrict the re-radiation of energy through the inlet. The front surface of the baffle defines a narrow annulus with the internal reflective surface of the housing. The front surface of the baffle is contoured to reflect incoming radiation onto the internal surface of the housing, from which it is reflected through the annulus and onto the front surface of the absorber. The back surface of the baffle intercepts radiation from the front of the absorber. With this arrangement, a high percentage of ...
Our global impact is finally receiving the scientific attention it deserves. The outcome will largely determine the future course of evolution. Human-modified ecosystems are shaped by our activities...Full Text Available
Cavity type receivers are used extensively in concentrating solar thermal energy collecting systems. The Solar Total Energy Project (STEP) in Shenandoah, Georgia is a large scale field test for the collection of solar thermal energy. The STEP experiment consists of a large field array of solar collectors used to supplement the process steam, cooling and other electrical power requirements of an adjacent knitwear manufacturing facility. The purpose of the tests, conducted for this study, was to isolate and quantify the radiative, conductive, and convective components of total heat loss, and to determine the effects of operating temperature, receiver angle, and aperture size on cavity heat loss. An analytical model for radiative heat loss was developed and compared with two other methods used to determine radiative heat loss. A proposed convective heat loss correlation, including effects of aperture size, receiver operating ...
... s guides and "how-to" videos and other materials, and 7. Receive continuing support from GLOBE's ... and educational materials that result from international proposals in its materials and support ...
BackgroundGender is a critically important moderator of psychopathology. However, gender similarities and differences in body dysmorphic disorder (BDD) have received...Full Text Available
An elderly man receiving chlorambucil for chronic lymphatic leukaemia developed focal fits. The onset and frequency were dose related. There was no evidence of metabolic disturbance or of meningeal...Full Text Available
... If the MCAV is used in conjunction with a cooling system designed for the CVC air vest, the wearer would receive more cooling due entirely to the ...
In 1976 the design and fabrication began of an 1 MWt Bench Model Solar Receiver (BMSR) to demonstrate and further develop the ceramic tube central receiver concept. Although many of the properties of silicon carbide are well documented, this material has never been utilized in an application of this type and size. Further investigation was undertaken to confirm the choice of silicon carbide against available metals and other ceramic materials. The BMSR is configured for testing at the Department of Energy's Central Receiver Test Facility in Albuquerque, New Mexico. Design and fabrication of the BMSR are highlighted in this report. Completion and testing of the BMSR are planned for the next phase of the project.
Phytoremediation, a technology using plants to remediate or stabilize contaminants in soil, groundwater, or sediments, has recently received a great deal of attention from regulators, consultants, responsible parties, and stakeholders. phytoremediation ha...
The need to increase efficiency of volumetric receivers for use in solar power plants by reducing reradiation losses and increasing the ``volumetric effect`` has promoted the idea of a receiver with tapered ducts. These seems to be very promising since higher efficiency and considerable saving of material can be achieved, as compared to conventional receivers perforated with ducts of constant cross-section. A finite element program is being developed to calculate stationary heat transfer in the tapered ducts by free and forced convection in the gas flow, conduction in walls and in the gas, and solar and thermal radiation. Gas and wall temperatures are considered to be varying only in the flow direction. In order to perform the highly nonlinear calculations of radiative exchange, the exact knowledge of the view factors is necessary. The aim of the present work is to evaluate analytically the view factors in tapered ducts.
... earns money through receiving protection funds from embattled ... relationship between the TTP and LI ... relevant considering that Pakistan's military is ...
She completed Northern Arizona University's post-baccalaureate program, and received her M.E.d from Arizona State University with a focus in cognitive ...
... mounted new operations against the TTP stronghold in ... was the fourth tranche of Pakistan's IMF-backed ... and brought the total funds received by ...
Research in concentrated thermal solar power plants of all types and, in particular, those based on central receiver, namely solar tower plants, has experienced great impetus in the last decade, reaching full commercial operation with the PS10 plant in Spain. In spite of previous demonstration plants testing different receivers and power cycle layouts, this first commercial power plant adopted a cavity receiver generating saturated steam and therefore penalising cycle efficiency in order to gain plant reliability. According to the experience gained, if a competitive Levelised Cost of Electricity is to be reached, capital and maintenance costs must be reduced and efficiencies must be increased. To achieve these goals, modifying the power cycle is deemed essential, whether using superheated ...
Variations in thermal energy costs of single module solar central receiver systems using one, two, three, and four aperture cavity receivers at a location corresponding to Barstow, California are investigated for nominal power ratings ranging from 100 MWt to 900 MWt. Also considered are the effects on energy costs of changes in plant latitude, and the energy cost impact of the replacement of the single module design with multiple connected modules producing the same thermal power. The results, obtained with the aid of the DELSOL2 computer program, indicate that solar central receiver plant energy costs are insensitive functions of power level, latitude, and configuration. No clear cost of energy advantage between single and multiple modules is seen.
A cone concentrator combined with a solar cavity receiver is presented and its performance compared to a single cavity receiver. For both cases the available heat sink within the receiver is calculated. The cone concentrator suffers from a high amount of rejected rays if the exit aperture is made too small. A larger exit aperture on the other hand increases the thermal losses of the cavity. The optimum cone geometry therefore has to be found taking also into account a model of the cavity. Different operating temperatures and different values of absorption coefficients of the cavity walls are considered. A cone concentrator was built and tested at the solar furnace in Cologne. It transmits 97 percent of the rays entering the entrance aperture, which is in exact agreement with the theoretical predictions. (author)
The study presented in this thesis is a contribution about the analysis of failures modes of electrolytic capacitors and thyristors. The studied components are main elements of the protection system of the superconductive magnets of the LHC. The study of the ageing of the electrolytic capacitors has shown that their reliability is strongly related to their technological characteristic. Evolution of their principal indicator of ageing (ESR) can be modeled according to different laws chosen according to their running mode. It appears that the prediction of failure of these components other than that due to wear can be only statistical taking into account the many causes of failure involving various modes of failure. In order to be able to evaluate influence of the ageing of the electrolytic capacitors on a system, simple models taking into account this parameters as well as the effective temperature of ...
Background and purpose: The low density of lung tissue causes a reduced attenuation of photons and an increased range of secondary electrons, which is inaccurately predicted by the algorithms incorporated in some commonly available treatment planning systems (TPSs). This study evaluates the differences in dose in normal lung tissue computed using a simple and a more correct algorithm. We also studied the consequences of these differences on the dose-effect relations for radiation-induced lung injury. Materials and methods: The treatment plans of 68 lung cancer patients initially produced in a TPS using a calculation model that incorporates the equivalent-pathlength (EPL) inhomogeneity-correction algorithm, were recalculated in a TPS with the convolution-superposition (CS) algorithm. The higher accuracy of the CS algorithm is well-established. Dose distributions in lung were compared using isodoses, dose-volume histograms (DVHs), the mean lung dose (MLD) and the ...
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 ...
Design rules for robustness require insensitivity to local failure and the prevention of progressive collapse. This is often verified by applying the load case ''removal of a limited part of the structure''. This paper will evaluate typical structural systems for large-span timber roof structures against these requirements, comparing the results against typical reasons for damages and failures. Applying the finding that most failures of timber structures are not caused by random occurrences or local defects, but by global (repetitive) defects (e.g. from systematic mistakes), it is shown that the objective of load transfer-often mentioned as preferable-should be critically analysed for such structures. Based on these findings, proposals for structural systems and details towards a robust de...
This paper presents a probabilistic approach for structural robustness assessment for a timber structure built a few years ago. The robustness analysis is based on a structural reliability based framework for robustness and a simplified mechanical system modelling of a timber truss system. A complex timber structure with a large number of failure modes is modelled with only a few dominant failure modes. First, a component based robustness analysis is performed based on the reliability indices of the remaining elements after the removal of selected critical elements. The robustness is expressed and evaluated by a robustness index. Next, the robustness is assessed using system reliability indices where the probabilistic failure model is modelled by a series system of parallel systems.
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)