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The diagnostic value of the portable chest radiography obtained with Fuji computed radiography (FCR) was evaluated in comparison with conventional images in 23 patients who were admitted to ICU in Yokohama City University Hospital. On the whole , FCR produced more exellent images than conventional screen-film radiographs. Especially the evaluation for the demonstration of the catheters, the endotracheal tubes and the tracheal shadows obtained high score. We discuss the clinically utility of FCR for the portable chest radiographs in ICU. (author).

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Introduction Gastrointestinal bleeding is a common life-threatening problem, causing significant mortality, costs and resource allocation. Its management requires a dynamic multidisciplinary approach that directs diagnostic and therapeutic priorities appropriately. Materials and methods Articles published within the past 15 years, related to gastrointestinal bleeding, were reviewed through MEDLINE search, in addition to current guidelines and standards. Results Decisions of ICU admission and blood transfusion must be individualized based on the extent of bleeding, hemodynamic profile and comorbidities of the patient and the risk of rebleeding. A secure airway may be required to optimize oxygenation and to prevent aspiration. Doses of induction agents must be reduced due to the changes in v...

International Nuclear Information System (INIS)

To evaluate the usefulness of portable chest radiographs by Fuji computed radiography (FCR) in ICU, FCR radiographs of 56 patients who were admitted to General Intensive Care Unit of Keio University Hospital were compared with the conventional portable images. Because FCR could show two differently processed images in one film and allowed a wide range of image reproduction, visualization of the trachea, bone soft tissues and catheters by FCR was easier than that by the conventional radiography. Repeated radiographs by FCR had similar optical densities and limited exposure errors. Furthermore, radiation was reduced than that of the conventional radiography. In conclusion, FCR is thought to be a useful technique for portable chest radiography in ICU patients. (author).

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Clinical-HINTS (Health Intelligence System) is a horizontally integrated decision support system (DSS) designed to meet the requirements for intelligent real-time clinical information management in critical care medical environments and to lay the foundation for the development of the next generation of intelligent medical instrumentation. The system presented was developed to refine and complement the information yielded by clinical laboratory investigations, thereby benefiting the management of the intensive care unit (ICU) patient. More specifically, Clinical-HINTS was developed to provide computer-based assistance with the acquisition, organisation and display, storage and retrieval, communication and generation of real-time patient-specific clinical information in an ICU. Clinical-HINTS is an object-oriented system developed in C+2 to run under Microsoft Windows as an embryo intelligent agent. ...

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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...

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Therapeutic hypothermia is a promising method for controlling intracranial pressure (ICP) in severely brain-injured patients. However, clinical data regarding the effect of brain hypothermia on overall outcome of these patients is limited. This may be because there are specific pitfalls associated with the clinical management of induced hypothermia in patients with severe traumatic brain injury (TBI). These pitfalls may be avoided by preventing specific risk factors when cooling is induced and with rewarming. However, these risk factors have not been well systematically discussed in the literature. In this paper, three categories of clinical issues regarding the management of brain hypothermia are discussed: (1) stress-induced secondary brain injury mechanisms; (2) technical aspects of intensive care unit (ICU) cooling management; and (3) rewarming rates and methods. For patients ...

UK PubMed Central (United Kingdom)

Background and objectives: Patients receiving dialysis have a high burden of cardiovascular disease. Some receive coronary artery revascularization but the optimal method is controversial.Design,...Full Text Available

International Nuclear Information System (INIS)

To optimize the emergency care of patients with multiple injuries, a special emergency room with integrated radiological equipment has been developed. It consists of a linear array of a computed tomography system, a mobile C-arm with an integrated scattered radiation grid for conventional films and a C-arm fluorographic system. The intent is to avoid delay caused by transport and repositioning of the patient. It enables all necessary diagnostic procedures to be performed within a minimal amount of time. (orig./MG).

UK PubMed Central (United Kingdom)

BackgroundHealthcare professionals can play a crucial role in optimizing the health status of patients with cardiovascular risk factors (abdominal obesity, high blood pressure, low...Full Text Available

UK PubMed Central (United Kingdom)

Objectives To evaluate the extent to which intensive care units participating in the initial Keystone ICU project sustained reductions in rates of catheter related bloodstream infections.Design...Full Text Available

UK PubMed Central (United Kingdom)

Quality research, requiring large numbers of participants, in the intensive care unit (ICU) population requires multicentre collaboration. Although logistically challenging, this methodology reduces...Full Text Available

International Nuclear Information System (INIS)

Results are presented applying an enteral nutrition by means of probes with Cosilat in complex therapy of patients with radiotherapeutic late effects of the colon. This nutrition was prescribed with the intention to gave the colon a functional recovery and to guarantee optimal conditions for repair of radiation injuries. Good results were seen in 27 of 28 patients (96.7%), the situation of one patient (3.3%) continued without any change. Cosilat has a high nutritive value, good organoleptic qualities and is well digested without any complications. (author).

UK PubMed Central (United Kingdom)

Wiskott-Aldrich syndrome protein (WASp) is essential for optimal T cell activation. Patients with WAS exhibit both immunodeficiency and a marked susceptibility to systemic autoimmunity. We investigated...Full Text Available

UK PubMed Central (United Kingdom)

Currently, the outcome of patients with intermediate-and poor-risk germ cell tumors at diagnosis is optimized by the use of risk-appropriate chemotherapy and post-chemotherapy surgical resection of...Full Text Available

UK PubMed Central (United Kingdom)

IntroductionThe optimal dialysis dose for the treatment of acute kidney injury (AKI) is controversial. We sought to evaluate the relationship between renal replacement therapy (RRT)...Full Text Available

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Abstract Lyme neuroborreliosis (LNB) is a serious but treatable disease. The diagnosis of LNB poses a challenge to clinicians, and improved tests are needed. The C6-peptide ELISA is frequently used on serum but not on cerebrospinal fluid (CSF). Data on the sensitivity of the C6-peptide ELISA in CSF in patients suffering from LNB have been conflicting. Serum-CSF pairs from 59 LNB patients, 36 Lyme non-neuroborreliosis cases, 69 infectious meningitis/encephalitis controls and 74 neurological controls were tested in a C6-peptide ELISA. With the optimal cut-off of 1.1, the sensitivity of the C6-peptide ELISA for LNB patients in CSF was 95%, and the specificity was 83% in the Lyme non-neuroborreliosis patients, 96% in the infectious controls, and 97% in the neurological controls. These results ...

International Nuclear Information System (INIS)

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 of 31). Factors ...

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A new leaf-sequencing approach has been developed that is designed to reduce the number of required beam segments for step-and-shoot intensity modulated radiation therapy (IMRT). This approach to leaf sequencing is called continuous-intensity-map-optimization (CIMO). Using a simulated annealing algorithm, CIMO seeks to minimize differences between the optimized and sequenced intensity maps. Two distinguishing features of the CIMO algorithm are (1) CIMO does not require that each optimized intensity map be clustered into discrete levels and (2) CIMO is not rule-based but rather simultaneously optimizes both the aperture shapes and weights. To test the CIMO algorithm, ten IMRT patient cases were selected (four head-and-neck, two pancreas, two prostate, one brain, and one pelvis). For each case, the optimized intensity maps were extracted from the Pinnacle"3 ...

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A simple dose-saving procedure for the diagnosis of congenital hip dysplasia employing a diaphragm in nearfocus position is presented. Doses to the skin and the gonads were measured with a phantom for the new and other techniques. With optimal techniques the skin dose is smaller than 2 mR and the gonadal doses lie around 0.1 mR for both male and female patients. An estimate of the dose burden from undesired radiation is appended. (orig.).

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Intravenous digital subtraction angiography using Fuji computed radiography system (FCR-DSA) was used to evaluate 57 preoperative patients with clinical manifestations of peripheral vascular disease of lower extremity. With its high contrast resolution and good special resolution, image of FCR-DSA could offer optimal information of vascular abnormality in lower extremity distal to midfoot for the diagnosis and the choice of management. (orig.).

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Effect of Abdominal Active Can on DFTs. Introduction: Many patients with implantable cardioverter defibrillators (ICDs) have older lead systems, which are usually not replaced at the time of pulse generator replacement unless a malfunction is noted. Therefore, optimization of defibrillation with these lead systems is clinically important. The objective of this prospective study was to determine if an active abdominal pulse generator (Can) affects chronic defibrillation thresholds (DFTs) with a dual-coil, transvenous ICD lead system. Methods and Results: The study population consisted of 39 patients who presented for routine abdominal pulse generator replacement. Each patient underwent two assessments of DFT using a step-down protocol, with the order of testing randomized. The distal right ...

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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 ...

International Nuclear Information System (INIS)

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 patients received 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 the incidence of pulmonary metastasis. ...

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Abstracts are presented of 63 papers on the following topics: large-scale optimization, interior-point methods, algorithms for optimization, problems in control, network optimization methods, and parallel algorithms for optimization problems.

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The purpose of this study was to determine the optimal technique for delivering postoperative radiotherapy for vulvar cancer and other tumors requiring treatment of the inguinal nodes. This project compared tumor coverage and normal tissue sparing for the 5 main radiotherapy techniques that are used to treat vulvar cancer. The intensity-modulated radiation therapy (IMRT) plan was undesirable because it resulted in an excessive dose to portions of the central pelvic structures. The photon thunderbird with skin match was unacceptable because it underdosed a portion of the groin region. The electron thunderbird was ideal for thin patients but was not applicable for most patients because of excessive dose to the skin and subcutaneous tissues. The photon through-and-through and the photon thunderbird with deep match were acceptable in most situations. In thin patients, where the depth of the inguinal vessels ...

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Much progress has been made in the clinical, biological and technical aspects of the T-cell-depleted haploidentical hematopoietic stem cell transplantation (HSCT). Our experience demonstrates that infusing a megadose of extensively T-cell-depleted hematopoietic peripheral blood stem cells after an immuno-myeloablative conditioning regimen in acute leukemia patients ensures sustained engraftment with minimal GvHD without the need of any post-transplant immunosuppressive treatment. Since our first successful pilot study, our efforts have concentrated on developing new conditioning regimens, optimizing the graft processing and improving the post-transplant immunological recovery. The results we have so far achieved in high risk acute leukemia patients show that haploidentical transplantation ...

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Adenosine triphosphate (ATP) is an alternative to dipyridamole or adenosine in thallium-201 myocardial scintigraphy. However, the optimal dose of ATP has not been determined. A Doppler guide wire study showed the coronary flow velocity at a dose of 0.15 mg/kg of ATP was equal or higher than that at 0.14 mg/kg of adenosine or 0.56 mg/kg of dipyridamole. ATP was given intravenously to 67 patients with coronary artery disease at 0.15 mg/kg/min for 6 min. Thallium-201 was injected at 3 min, followed by immediate and delayed (3 hrs) tomographic imaging. There was no serious side effect during examination, although chest pain (26%), dyspnea (17%), and flushing (33%) were common. The sensitivity and specificity to detect coronary artery disease were 98 and 100%, respectively. The sensitivity to detect left anterior descending artery, left circumflex artery, and right coronary artery lesions was 94, 59 and 77%, respectively. ATP loading thallium-201 ...

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The current role of magnetic resonance imaging (MRI) in different organ systems is discussed and compared to nuclear medicine and to other available clinical diagnostic modalities. The value of optimizing radiofrequency pulse sequence selection to provide additional tissue characterization is also described. The results of nuclear medicine and MRI studies in 56 patients are compared to evaluate the clinical diagnostic contribution of each imaging modality for various pathological processes. In addition, the state-of-the-art MRI systems and future development in MRI technology with its potential contribution is defined.

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Asymptomatic cholelithiasis is increasingly diagnosed today, mainly as a result of the widespread use of abdominal ultrasonography for the evaluation of patients for unrelated or vague abdominal complaints. About 10-20% of people in most western countries have gallstones, and among them 50-70% are asymptomatic at the time of diagnosis. Asymptomatic gallstone disease has a benign natural course; the progression of asymptomatic to symptomatic disease is relatively low, ranging from 10-25%. The majority of patients rarely develop gallstone-related complications without first having at least one episode of biliary pain ("colic"). In the prelaparoscopy era, (open) cholecystectomy was generally performed for symptomatic disease. The minimally invasive laparoscopic cholecystectomy refueled the discussion about the optimal management of asymptomatic cholelithiasis. Despite some controversy, most authors agree that the vast majority ...

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Purpose: calculation of conversion coefficients for the reconstruction of organ doses from entrance doses for abdomen radiographs of 0, 1, 5, 10, 15, and 30-year-old patients in conventional pediatric radiology for the radiographic settings recommended by the German and European guidelines for quality management in diagnostic radiology. Materials und method: using the commercially available personal computer program PCXMC developed by the Finnish Center for Radiation and Nuclear Safety (Saeteilyturvakeskus STUK), conversion coefficients for conventional abdomen radiographs were calculated performing Monte Carlo simulations in mathematical hermaphrodite phantom models describing patients of different ages. The possible clinical variation of beam collimation was taken into consideration by defining optimal and suboptimal radiation fields on the phantoms' surfaces. Results: conversion coefficients for the ...

International Nuclear Information System (INIS)

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 changing can provide ...

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Background: In an effort to standardise radiological practices in the Republic of Ireland, current legislation states that 'written protocols for every type of standard radiological practice shall be established'. In order to fulfil this requirement the Irish Medical Council recommends the protocols issued by the Commission of European Communitees (CEC) for adoption in the country. Whilst this document does provide good guidance with regard to various radiographic factors, patient shielding instructions are notably ambiguous. The aim of this study was to remove some of this ambiguity by defining the optimal method of positioning patient shielding in antero-posterior (AP) and lateral lumbar spine radiographic examinations. These projections were chosen on the basis of their area of coverage being in close to and in some cases including the reproductive organs. They also represent the highest source of collective population ...

International Nuclear Information System (INIS)

Objective: To characterize the protocols with low-dose radiation in survey CT scans for localization. Methods: Eighty standard adult patients, head and body phantoms were recruited. Default protocols provided by operator's manual setting were that all the tube voltage for head, chest, abdomen and lumbar was 120 kV; the tube currents were 20,10,20 and 40 mA, respectively. Values of kV and mA in the low-dose experiments were optimized according to the device options. For chest and abdomen, the tube position were compared between default (0 degree) and 180 degree. Phantoms were scanned with above protocols, and the radiation doses were measured respectively. Paired t-test were used for comparisons of standard deviation in CT value, noise and exposure surface dose (ESD) between group with default protocols and group with optimized protocols. Results: The optimized protocols in low-dose CT survey scans were ...

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A novel compact CT-guided intensity modulated proton radiotherapy (IMPT) system is described. The system is being designed to deliver fast IMPT so that larger target volumes and motion management can be accomplished. The system will be ideal for large and complex target volumes in young patients. The basis of the design is the dielectric wall accelerator (DWA) system being developed at the Lawrence Livermore National Laboratory (LLNL). The DWA uses fast switched high voltage transmission lines to generate pulsed electric fields on the inside of a high gradient insulating (HGI) acceleration tube. High electric field gradients are achieved by the use of alternating insulators and conductors and short pulse times. The system will produce individual pulses that can be varied in intensity, energy and spot width. The IMPT planning system will optimize delivery characteristics. The system will be capable of being sited in a conventional linac vault ...

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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

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Allogeneic stem-cell transplantation (SCT) is potentially curative therapy in AML by providing both dose-intensive chemo-radiotherapy and induction of graft-versus-leukemia (GvL) effect. Historically, more emphasis was given to the intensity of conditioning. Over the last decade the pendulum turned more towards induction of GvL as the primary goal. A plethora of non-myeloablative (NMA) and reduced-intensity conditioning regimens (RIC) were introduced trying to reduce transplant-related toxicities and allow SCT in elderly and medically infirm patients. In addition, reduced-toxicity myeloablative regimens (RTC) based on fludarabine and myeloablative alkylating-agent doses were designed to allow safer administration of dose-intensive therapy. Conditioning dose-intensity is highly correlated w...

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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...

International Nuclear Information System (INIS)

The introduction of positron emission tomography (PET)/magnetic resonance (MR) systems into medical practice in the foreseeable future may not only lead to a gain in clinical diagnosis compared to PET/computed tomography (CT) imaging due to the superior soft-tissue contrast of the MR technology but can also substantially reduce exposure of patients to ionizing radiation. On the other hand, there are also risks and health effects associated with the use of diagnostic MR devices that have to be considered carefully. This review article summarizes biophysical and biological aspects, which are of relevance for the assessment of health effects related to the exposure of patients to both ionizing radiation in PET and magnetic and electromagnetic fields in MR. On this basis, some considerations concerning the justification and optimization of PET/MR examinations are presented - as far as this is possible at this very early stage. ...

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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 ...

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Background: The effective-dose method which was proposed by the ICRP (International Commission of Radiation Protection) for the estimation of risk to the general population from occupational or environmental, low-dose radiation exposure is not adequate for estimating the risk of cancer induction by radiotherapy of malignant or nonmalignant diseases. Methods:The risk of cancer induction by radiotherapy of benign diseases should be based on epidemiologic data directly derived from follow-up studies of patients who had been given radiotherapy for nonmalignant diseases in the past. Results: Risk factors were derived from epidemiologic studies of patients treated with irradiation for nonmalignant diseases to be used for selecting treatment options and optimizing treatment procedures. Conclusion: In most cases, cancer risks estimated by the effective-dose method may overestimate the true risks by one order of magnitude, yet in ...

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To evaluate the usefulness of three-dimensional (3D) rotational angiography, cervical carotid or cerebral angiography was done without catheterizing the branches of the thoracic aorta. A 5-Fr pig-tail type catheter was passed into the ascending aorta via the radial artery or the femoral artery. Optimal carotid angiogram views were obtained using approximately 45 ml of contrast medium at a flow rate of 15 ml/sec. Optimal cerebral angiogram views were obtained using approximately 70 ml of contrast medium at a flow rate of 20 ml/sec. The contrast medium concentration was 300 to 350 mgI/ml. A satisfactory view could be obtained in 5 of 8 (63%) cases on cervical carotid 3D angiography and in 8 of 14 (57%) cases on cerebral 3D angiography. In all cases, no complications were noted. This method offers the advantages of requiring a relatively short procedure time and a decrease in radiation exposure. Further studies are needed to determine the ...

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T{sub 2} weighted ultra-short turbo spin echo sequences were used in five individuals with variations in echo times, delayed triggering and echo intervals. To reduce movement artifacts all examinations were carried out with ECG and respiratory triggering. The sequences giving optimal image quality were then employed in 19 patients having various pulmonary abnormalities. Image resolutions, artifacts, image contrasts and diagnostic value were then judged by two observers and compared with CT. In the first study, a diastole-triggered UTSE sequence with the shortest echo proved optimal (T{sub E}=90 ms, T{sub R}=2-4 s, echo=9 ms, turbo factor=19). In the patient series studied, MRT was inferior to CT with regard to resolution and number of artifacts, but better in respect of contrast and diagnostic value. Using UTSE of the lung, MRT can produce images of good quality. Compared with CT, contrast is better ...

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... Accession Number : ADD321199. Title : OPTIMIZATION OF EDDY CURRENT PROBES FOR NDT OF CARBON FIBER COMPOSITES. ...

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PMID:9410608

International Nuclear Information System (INIS)

Purpose. To validate a protocol for creating virtual models to be used in the construction of solid prototypes useful for the planning-simulation of maxillo-facial surgery, in particular for very complex anatomical and pathologic problems. To optimize communications between the radiology, engineering and surgical laboratories. Methods and materials. We studied 16 patients with different clinical problems of the maxillo-facial district. Exams were performed with multidetector computed tomography (MDCT) and single slice computed tomography (SDCT) with axial scans and collimation of 0.5-2 mm, and reconstruction interval of 1 mm. Subsequently we performed 2D multiplanar reconstructions and 3D volume-rendering reconstructions. We exported the DICOM images to the engineering laboratory, to recognize and isolate the bony structures by software. With these data the solid prototypes were generated using stereolitography. To date, surgery has been ...

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PURPOSE We wanted to examine how coordinated care is implemented in primary care practices to address patients' health behavior change needs. METHODS Site visit notes, documents, interviews, and online implementation diaries were collected from July 2005 to September 2007 from practice-based research networks (PBRNs) participating in Prescription for Health: Promoting Healthy Behaviors in Primary Care Research Networks (P4H). An iterative group process was used to conduct a cross-case comparative analysis of 9 interventions. Published patient outcomes reports from P4H interventions were referenced to provide information on intervention effectiveness. RESULTS In-practice health risk assessment (HRA) and brief counseling, coupled with referral and outreach to a valued and known counseling resource, emerged as the best way to consistently coordinate and encourage follow-through for health behavior counseling. Findings from published P4H outcomes ...

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Xenotropic murine leukemia virus-related virus (XMRV) was discovered in human prostate tumors and later in some chronic fatigue syndrome (CFS) patients. However, subsequent studies have identified various sources of potential contamination with XMRV and other murine leukemia virus (MLV)-related sequences in test samples. Biological and nucleotide sequence analysis indicates that XMRV is distinct from known xenotropic MLVs and has a broad host range and cell tropism including human cells. Therefore, it is prudent to minimize the risk of human exposure to infection by evaluating XMRV contamination in cell lines handled in laboratory research and particularly those used in the manufacture of biological products. Nested DNA PCR assays were optimized for investigating XMRV gag and env sequences in various cell lines, which included MRC-5, Vero, HEK-293, MDCK, HeLa, and A549, that may be used in the development of some vaccines and other cell lines ...

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The objective of this study was to develop a method for 3D subtraction CT angiography and to optimize the visualization after semiautomatic segmentation. Ten patients with aneurysms of the abdominal aorta were examined using spiral CT. To reconstruct the vessels, as well as adjacent organs such as the liver and kidneys, one image data volume was acquired before and after injection of the contrast agent. The CT scans were obtained with a Siemens Somatom Plus 4. To improve the results of automatic segmentation, as well as visualization by maximum intensity projection (i.e. removal of bony structures), subtraction of both image volumes is necessary. However, small translation shifts disturb the subtraction process and produce artificial contours. To calculate the disparities along the three coordinate axes of two corresponding image volumes, a cepstrum filter is applied to a pair of image volumes. After detection of the disparities, which manifest ...

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In this work a study of simulation of the gamma graphic studies that are carried out in human esophagus in the Dept. of Nuclear Medicine of the 'Celestino Hernandez Robau Hospital of Santa Clara is presented. For the investigation tubular reactors were used and sting-response techniques with radioactive tracer of Technetium 99 metastable to a concentration of 1 mCi and several flows were applied. The distribution curves of residences times were obtained, those that respond to an equation of the type: Y = A + B exp (- exp((x-C)/D)) - ((x-C/D)+1). They were also carried out, optimizations studies of the doses of the radioactive to give to the patients from 1 mCi (that is the one used in studies) up to 0,5 mCi, and the influences on the obtained distributions of residence time were analyzed. It was confirmed the possibility to lower the doses with clear information of the signal. It was also carried out a simulation of the attenuation of ...

International Nuclear Information System (INIS)

The implementation of a three-dimensional conformal radiotherapy facility in the radiotherapy department of the Heinrich Heine University is described. Complex radiotherapy techniques with commercially available networked systems are introduced to improve clinical work. Over 18 month we have gained clinical experience with a PHILIPS Multileaf Collimator (MLC) mounted on a SL 25 linear accelerator. For a limited period the MLC was used as a conventional blocking device. The standard MLC-shapes are controlled with a stand-alone computer system. In addition, a three-dimensional treatment planning system (3-D-TPS / TMS-Radix, Helax AB) based on convolution/superposition algorithms was recently installed. Treatment optimization is achieved using static field arrangements with complete volumetric computerized tomographic patient data for 3-D-TPS. Conformal adaptation of the 95%-isodose to the Planning Target Volume (PTV, ICRU 50) results in ...

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Little clinical evidence has been provided to show the minimization of radiation resistance of tumors using high linear energy transfer radiation. We therefore investigated the radiobiological and molecular pathological aspects of carbon beam therapy. A total of 27 patients with squamous cell carcinoma (SCC) of the cervix were treated using a carbon beam and 50 control patients with SCC of the cervix using a photon beam. The expression of Ki-67, p53, and p27 proteins before radiotherapy and 5 and 15 days after therapy initiation were investigated using immunohistochemistry. Similar changes were observed in Ki-67 labeling index (LI) and p53 LI during carbon and photon beam therapies. However, for carbon beam therapy, the mean p27 LI significantly decreased from 25.2% before treatment to 18.6% on the 5th day after treatment initiation, followed by a significant increase to 36.1% on the 15th day. In contrast, for photon beam therapy, the p27 LI ...

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In most previous studies of topology optimization, commercial programs, such as Optistruct, ANSYS, and MSC Patran, usually were used during implementation. Such commercial programs are not easy to use and entail time and cost. In addition, it is difficult to confirm results with reference to individual stages of optimization. For addressing this disadvantage, a topology optimization program, which is based on the C language, is developed in this study. This is a very convenient and powerful program for users to conduct topology optimization by using all density methods and homogenization methods in compliance with the methodology. For verifying the developed program, first of all, topology optimization was implemented by using density methods to evaluate the strain energy density of a cant...

UK PubMed Central (United Kingdom)

BackgroundPrior research links optimism to physical health, but the strength of the association has not been systematically evaluated.PurposeFull Text Available

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Sep 18, 2009 ... It is proposed to develop desensitized optimal filtering ... in robust and/or adaptive generalized Kalman and Sigma-Point filters for ...

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PMID:19955450

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UK PubMed Central (United Kingdom)

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

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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...

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An irradiation head with sample holders is described and measurement geometry is reported. Measurements were made for optimizing the distance between the source and the sample and for optimizing the sample diameter. The optimal distance between the source and the sample does not depend on the collimator diameter. The sample diameter should not exceed 30 - 35 mm. Sensitivity and detection limits were determined for Zn, Pb and Br and calibration curves were plotted. (M.D.) 6 figs., 2 tabs., 4 refs.

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Udgivelsesdato: MAR

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No abstract prepared.

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... been possible to prove the existence and uniqueness of a classical solution which tends to the well-known solution of the Stefan problem as the ...

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... Note that the terminal ... Probability and Statistics with Reliability, Queueing, and Computer ... Weiss, G., "Stochastic Bounds on Distributions of Optimal ...

CERN Document Server

Nature-inspired algorithms are among the most powerful algorithms for optimization. This paper intends to provide a detailed description of a new Firefly Algorithm (FA) for multimodal optimization applications. We will compare the proposed firefly algorithm with other metaheuristic algorithms such as particle swarm optimization (PSO). Simulations and results indicate that the proposed firefly algorithm is superior to existing metaheuristic algorithms. Finally we will discuss its applications and implications for further research.

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A systematic optimization method of choosing the weighting matrix in linear optimal control system design, under the conditions of prespecified closed-loop dominant eigenvalue locations and feedback gain limit constraints, is presented in this paper. Studies show that with the proposed method one can obtain the desired weighting matrix very quickly and conveniently without the heavy burden of choosing a suitable weighting matrix by trail and error. This method can also easily achieve a reduced-order feedback control system. The linear optimal power system stabilizer designed by using the proposed method produces very good performance.

International Nuclear Information System (INIS)

An important unresolved issue in outcomes analysis for lung complications is the effect of poor or completely lacking heterogeneity corrections in previously archived treatment plans. To estimate this effect, we developed a novel method based on Monte Carlo (MC) dose calculations which can be applied retrospectively to RTOG/AAPM-style archived treatment plans (ATP). We applied this method to 218 archived nonsmall cell lung cancer lung treatment plans that were originally calculated either without heterogeneity corrections or with primitive corrections. To retrospectively specify beam weights and wedges, beams were broken into Monte Carlo-generated beamlets, simulated using the VMC++ code, and mathematical optimization was used to match the archived water-based dose distributions. The derived beam weights (and any wedge effects) were then applied to Monte Carlo beamlets regenerated based on the patient computed tomography densities. Validation ...

International Nuclear Information System (INIS)

Objective: To determine the optimal contrast injection protocol for 64-MDCT coronary angiography. Materials and methods: One hundred and fifty consecutive patients scheduled to undergo retrospectively electrocardiographically gated 64-MDCT. Each 30 patients were assigned to use a different contrast protocol: group 1: uniphasic protocol (contrast injection without saline flush); group 2: biphasic protocol (contrast injection with saline flush); group 3A, 3B and 3C: triphasic protocol (contrast media + different saline diluted contrast media + saline flush). Image quality scores and artifacts were compared and evaluated on both transaxial and three-dimensional coronary artery images among each contrast protocol. Results: Among the triphasic protocol groups, group 3A (30%:70% contrast media-saline mixture was used in second phase) used the least contrast media and had the least frequency of streak artifacts, but there were no ...

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60 patients between 17 and 72 years of age were investigated. First, an enteroclysis was performed in typical manner. The applicated methylcellulosis was blended with positive oral MR contrast media (Magnevist oral, Schering). After enteroclysis, MRI of the abdomen was performed using T1- and T2-weighted breathhold sequences (Flash 2D pre- and postcontrast and TSE) in axial and coronal planes. The length of the affected bowel and the stenosis seen with enteroclysis correlated well with the visible thickening of the small bowel wall and the stenosis seen in MRI. Using MRI, additional findings could be obtained in 28 patients, such as fistulas, abscesses or a hydronephrosis, or a better assessment of the stenosis was possible with MRI, because of the avoidance of overshadowing of the affected bowel loop with MRI. A brilliant MR-tomographic imaging of the small bowel is possible under the condition, that the small bowel contrast is ...

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The main purpose of this work is to evaluate the role of CT in identifying other morphological signs of met static lymph node involvement from non small cell bronchogenic carcinoma. This is done to improve N staging, a critical step in this disease. In fact, since diameter is the only criterion used to distinguish normal form abnormal lymph nodes, mediastinal CT only has 80% diagnostic accuracy. 137 patients with known or suspected lung cancer were examined with Helical CT during early and late arterial phases (2 min. delay, 3 mm thickness, 5 mm inter slice gap) to depict node characteristics. Mediastinal lymph nodes, located according to the American Thoracic Society mapping, were considered normal when they were not visible or, if visible, less than 1 cm in diameter and of homogeneous density; lymph nodes over 1 cm in diameter and homogenous density were considered reactive. A lymph node was considered metastatic when, independent of size, the following signs ...

CERN Document Server

Reactive power plays an important role in supporting the real power transfer by maintaining voltage stability and system reliability. It is a critical element for a transmission operator to ensure the reliability of an electric system while minimizing the cost associated with it. The traditional objectives of reactive power dispatch are focused on the technical side of reactive support such as minimization of transmission losses. Reactive power cost compensation to a generator is based on the incurred cost of its reactive power contribution less the cost of its obligation to support the active power delivery. In this paper an efficient Particle Swarm Optimization (PSO) based reactive power optimization approach is presented. The optimal reactive power dispatch problem is a nonlinear optimization problem with several constraints. The objective of the proposed PSO is to minimize the total support cost ...

Science.gov (United States)

An optimal deployment pattern of flux mapping detectors for a Canada uranium-deuterium (CANDU)-600 pressurized heavy water reactor (PHWR) is determined by obtaining an optimal feedback relationship between flux measurements and zone controllers. The reactor core is modeled with a time-dependent two-group, two-dimensional diffusion equation, and flux perturbation are expressed by model expansions. The modal expansion coefficients are used as elements of the state vector representing the system dynamics. An optimal feedback matrix connecting the flux measurement vector to the control vector is derived by minimizing a quadratic performance index involving both the state and control vectors. We obtain the detector effectiveness in terms of the optimal feedback matrix and determine optimal detector locations for the Wolsung Unit 1 reactor in Korea. We have tested the methodology through ...

International Nuclear Information System (INIS)

In not infected knee prostheses bone scintigraphy is a possible method to diagnose mechanical loosening, and therefore, to affect treatment regimes in symptomatic patients. However, hitherto studies showed controversial results for the reliability of bone scintigraphy in diagnosing loosened knee prostheses by using asymptomatic control groups. Therefore, the aim of our study was to optimize the interpretation procedure and to evaluate the accuracy using results from revision surgery as standard. Methods: Retrospectively, we were able to examine the tibial component in 31 cemented prostheses. In this prostheses infection was excluded by histological or bacteriological examination during revision surgery. To quantify bone scintigraphy, we used medial and lateral tibial regions with a reference region from the contralateral femur. Results: to differentiate between loosened and intact prostheses we found a threshold of 5.0 for the maximum tibia to ...

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Background and Purpose: Total-body irradiation (TBI) is an important part of the conditioning regimen for hematopoietic stem cell transplantation (HSCT) in patients with hematologic malignancies. The results after treatment with various TBI regimes were compared, and dose-effect relationships for the endpoints relapse incidence, disease-free survival, treatment-related mortality, and overall survival were derived. The aim was to define requirements for an optimal treatment schedule with respect to leukemic cell kill and late normal-tissue morbidity. Material and Methods: A literature search was performed. Three randomized studies, four studies comparing results of two or three TBI regimens, and nine reports with results of one specific TBI regimen were identified. Biologically effective doses (BEDs) were calculated. The results of the randomized studies and the studies comparing results of two or three TBI regimens were pooled, and the pooled ...

UK PubMed Central (United Kingdom)

The brain maintains internal models of its environment to interpret sensory inputs and prepare actions. While behavioral studies demonstrated that these internal models are optimally adapted...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundThe aim of this study was to compare and to validate different dose calculation algorithms for the use in radiation therapy of small lung lesions and to optimize the treatment...Full Text Available

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Operation of an X-ray spectrometer based on a spherical variable-line-spacing (VLS) grating is analyzed using dedicated ray-tracing software allowing fast optimization of the grating parameters and...Full Text Available

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A dissipative particle swarm optimization is developed according to the self-organization of dissipative structure. The negative entropy is introduced to construct an opening dissipative system that is far-from-equilibrium so as to driving the irreversible evolution process with better fitness. The testing of two multimodal functions indicates it improves the performance effectively

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The conventional IMRT planning process involves two stages in which the first stage consists of fast but approximate idealized pencil beam dose calculations and dose optimization and the second...Full Text Available

UK PubMed Central (United Kingdom)

Patients who fail to attend initial appointments reduce clinic efficiency. To maximize attendance by newly referred outpatients, we introduced a mandatory group orientation clinic for all new patients...Full Text Available

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

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

UK PubMed Central (United Kingdom)

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

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

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

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

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BackgroundIn patients with Stage 5 Chronic Kidney Disease who require renal replacement therapy a major decision concerns modality choice. However, many patients defer the decision...Full Text Available

UK PubMed Central (United Kingdom)

The performance of the Lung Imaging Fluorescence Endoscope (LIFE) system was compared with conventional bronchoscopy in 158 patients: 68 patients with invasive cancer, 42 patients with abnormal sputum...Full Text Available

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In a combined clinical, radiological, and laboratory study of 77 patients throughout the leprosy spectrum, 10 patients had an enthesitis which has not been described previously as far as is known and...Full Text Available

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BackgroundThe effects of intervention programs on health-related quality of life (HRQOL) of patients with hip fracture have not been well studied. We hypothesized that older patients...Full Text Available

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BackgroundClassification systems may be useful to direct more aggressive treatment to cancer patients with a relatively poor prognosis. The definition of 'poor prognosis' often lacks...Full Text Available

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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)

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This paper presents a new algorithm for the optimal long-range generation planning for a thermal system with pumped-storage plants. The algorithm is based upon the analytical production costing model developed under the assumption of Gaussian probabilistic distribution of random load fluctuations and plant outages. The optimization problem consists of the master problem to determine the annual investment, and the pumped-storage subproblem to determine the optimal pumped-storage operation. The master problem is formulated as a Hamiltonian minimization problem, and the pumped-storage subproblem is solved using the concept of peak-shaving operation on the original load curve.

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... 1]. Results and Discussion A cross section of liquid feed direct borohydride fuel cell model was created and studied. The ...

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... populations ..... 63 34 Vertebral ultimate compressive strength for various populations ..... 64 35 ...

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... In this paper research aimed at creating a computer vision system to power such an optimal edging and ... ...

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The results for development of methods and computer programs for integrated optimization of parameters of perspective fast reactors are given. The possibilities of the program for the reactor campaign calculation are analysed. This program is based on utilisation of the Bubnov-Galerkin method and Wigner disturbance theory. The possibility of application of approximation methods for the optimization researches is discussed. The results of development of the programs for complex reactor computations with account of control rods system and change of physical parameters in the reactor campaign are discussed. (author).

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In the present paper the progress of optimization of soft magnetic properties have been studied by applying different experimental techniques (magnetic measurements, electric measurements, X-ray analysis, and high-resolution electron microscopy observation). It has been shown that an increase in magnetic permeability after optimization annealing can be mainly attributed to annealing out of microvoids. (author)

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This paper discusses, partially, the advantages and the disadvantages of the optimal power flow. It shows some of the difficulties of implementation and proposes solutions. An analysis is made comparing the power flow, BIGPOWER/CESP, and the optimal power flow, FPO/SEL, developed by the author, when applied to the CEPEL-ELETRONORTE and CESP systems. (author) 8 refs., 5 tabs.

Science.gov (United States)

One of the main goals in the operation of a cupola furnace is to keep the molten iron properties within prescribed bounds while maintaining the most economical operation for the cupola. In this paper the authors present a procedure to obtain the nominal values for the manipulated process variables. The nominal values are calculated by solving a constrained nonlinear programming optimization problem. Two different optimization problems are discussed and examples for using the procedure are presented.

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The authors present a new concept: 'adaptive optimal reclosure' under transmission line faults by integrating the adaptive and optimal reclosure techniques. Simulation studies prove that the proposed technique is able to first detect the persistence time of fault path arc and then capture the optimal reclosure time, thereby enhancing system stability. (author)

CERN Document Server

Nature-inspired algorithms such as Particle Swarm Optimization and Firefly Algorithm are among the most powerful algorithms for optimization. In this paper, we intend to formulate a new metaheuristic algorithm by combining Levy flights with the search strategy via the Firefly Algorithm. Numerical studies and results suggest that the proposed Levy-flight firefly algorithm is superior to existing metaheuristic algorithms. Finally implications for further research and wider applications will be discussed.

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Forty-one patients were treated with epidural neurolysis using 50 % ethyl alcohol 2 ml. Thirty eight patients were suffering from cancer pain and three patients were complaining of chronic benign pain. Alcohol block was repeated 2.3 times (mean) in the same patient. Thirty patients were followed after the treatment. Forty-seven percent of the patients reported 70 % or greater pain relief and 20 % of the patients reported about 50 % pain relief. Duration of pain relief was from 9 days to 203 days with a mean duration of 54 days. Adverse effects were reported 43 % of the patients. There is no miserable adverse effect. Adverse effect reported most was pain with epidural injection of drugs after the alcohol block had been performed. PMID:8544293

UK PubMed Central (United Kingdom)

A patient with Cushing's syndrome due to a nonresectable chromophobe adenoma underwent external irradiation of the hypothalamic-pituitary area. The signs of Cushing's syndrome ameliorated subsequently...Full Text Available

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The ultrastructure of conjunctival melanocytic lesions in 49 patients was evaluated to find significant differences between benign and malignant cells. The patients studied included 9 with benign epithelial...Full Text Available

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ObjectivesTo determine the content and extent, design, and relative importance of patient assessment courses in the professional pharmacy curriculum.MethodsA...Full Text Available

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... their clothes set afire. One patient fell into a hot cupola furnace. Steam burns were observed for four patients. In the clinical ...

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Background/AimTo assess pathophysiology in irritable bowel syndrome (IBS).Methods122 IBS patients...Full Text Available

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PurposeTo identify the extent of persistence (period of time of continuous therapy with the drug prescribed) of glaucoma patients treated with prostaglandins (latanoprost, bimatoprost,...Full Text Available

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The Model for the Assessment of Psychosocial Problems (MAPP) can help family medicine residents effectively assess patients with psychosocial problems. Following a patient-centred clinical method, MAPP...Full Text Available

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A group of patients is described who developed the clinical features of foveomacular retinitis. No causative factors were isolated, and all patients strongly denied any type of sun gazing. It is possible...Full Text Available

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Determination of absorbed dose in a patient irradiated by beams of x or gamma rays in radiotherapy procedures

UK PubMed Central (United Kingdom)

This exploratory research paper investigated the coping strategies of families of hospitalized psychiatric patients and identified their positive and negative coping strategies. In this paper, the coping...Full Text Available

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Raltegravir is the first integrase inhibitor approved for treatment of HIV-infected patients harboring multiresistant viruses.

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Background Increasing numbers of cancer patients are using the Internet, but little is known about their attitudes toward online health care.Full Text Available

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The Systems Development Group and the Pharmacy Service of the Washington D.C. VAMC are involved in automating the administrative and clinical data requirements of a satellite out-patient pharmacy....Full Text Available

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BackgroundAdnexal masses are not uncommon in patients with breast cancer. Breast cancer and ovarian malignancies are known to be associated. In patients with breast cancer and co-existing...Full Text Available

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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 receiving ...

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Using a Markov Chain Monte Carlo optimization algorithm and a computer simulation, I find the passenger ordering which minimizes the time required to board the passengers onto an airplane. The model that I employ assumes that the time that a passenger requires to load his or her luggage is the dominant contribution to the time needed to completely fill the aircraft. The optimal boarding strategy may reduce the time required to board and airplane by over a factor of four and possibly more depending upon the dimensions of the aircraft. I explore some features of the optimal boarding method and discuss practical modifications to the optimal. Finally, I mention some of the benefits that could come from implementing an improved passenger boarding scheme.

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Incomplete convergence in numerical simulation such as computational physics simulations and/or Monte Carlo simulations can enter into the calculation of the objective function in an optimization problem, producing noise, bias, and topo- graphical inaccuracy in the objective function. These affect accuracy and convergence rate in the optimization problem. This paper is concerned with global searching of a diverse parameter space, graduating to accelerated local convergence to a (hopefully) global optimum, in a framework that acknowledges convergence uncertainty and manages model resolu- tion to efficiently reduce uncertainty in the final optimum. In its own right, the global-to-local optimization engine employed here (devised for noise tolerance) performs better than other classical and contemporary optimization approaches tried individually and in combination on the "industrial" test problem to be ...

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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 patients received 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. Fifty-one patients ...

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PMID:1461290

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PMID:12886534

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Short note.

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Short communication.

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Melanoma (Skin)

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Severe Crohn's Disease; Anxiety

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The purpose of this study is to evaluate the radiologic findings of the extraosseous Ewing's sarcoma. Six patients with pathologically confirmed extraosseous Ewing's sarcoma were retrospectively reviewed. Patients included two men and four women with an average age of 21.5 years (age range 9-48 years). Plain radiographs (six patients), magnetic resonance (MR) images (five patients), computed tomographic (CT) scans (three patients) and whole body scintigraphy (two patients) were reviewed and analyzed. Images were evaluated with regard to lesion location, size, margin, muscle or bone involvement and intrinsic imaging characteristics on CT and MRI. The tumors were located in the thigh (three patients), back (two patients) and upper arm (one patient). The tumors ranged in size from 2.3 cm to 7.5 cm ...

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... blood serum patients radioimmunoassay sampling tracer techniques isotope

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Two patients receiving 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 patients receiving maintenance dialysis with rheumatic manifestations should be aware of this potential complication. PMID:2185360

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... pathological changes patients radiation protection radiotherapy diseases

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Background Limited data is available for investigating the long-term safety and effects of intracoronary progenitor cell therapy in patients with acute myocardial infarction (AMI). Objective To assess the clinical course, NT-proBNP and MRI data as objective markers of cardiac function of the TOPCARE-AMI patients at 5-year follow-up. Design The TOPCARE-AMI trial was the first randomized study investigating the effects of intracoronary infusion of circulating (CPC) or bone marrow-derived progenitor cells (BMC) in 59 patients with successfully reperfused AMI. Results Five-year follow-up data were completed in 55 patients, 3 patients were lost to follow-up. None of the patients showed any signs of intramyocardial calcification or tumors at 5?years. One patient died during the initial hospitali...

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Purpose We retrospectively analyzed the results of percutaneous nephrolithotomy operations for treatment of staghorn kidney stone disease in elderly patients and compared surgical parameters and outcomes with a control group of young adult patients. Patients and method Between 2002 and 2010, 300 consecutive patients underwent percutaneous nephrolithotomy operation for treatment of staghorn kidney stone disease. Forty-five of the patients were older than 65?years and considered to be in elderly group. Thirty-seven of the patients were between the ages 18 and 36?years and considered to be the control group. Surgical parameters and outcomes were compared between groups. Results There were no significant differences between groups for stone area, operation time, difference in hemoglobin levels...

British Library Electronic Table of Contents (United Kingdom)

BACKGROUND: Controversy exists as to whether patients with thick (Breslow depth >4 mm), clinically lymph node-negative melanoma require sentinel lymph node (SLN) biopsy. The authors examined the impact of SLN biopsy on prognosis and outcome in this patient population. METHODS: A review of the authors institutional review board-approved melanoma database identified 293 patients with T4 melanoma who underwent surgical excision between 1998 and 2007. Patient demographics, histologic features, and outcome were recorded and analyzed. RESULTS: Of 227 T4 patients who had an SLN biopsy, 107 (47%) were positive. The strongest predictors of a positive SLN included angiolymphatic invasion, satellitosis, or ulceration of the primary tumor. Patients with a T4 melanoma and a negative SLN had a significa...

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A destructive spondyloarthropathy is reported in four patients undergoing maintenance hemodialysis for chronic renal disease. In a separate investigation a controlled, prospective radiographic study of the cervical spine revealed this spondyloarthropathy in 4 (15%) of 26 long-term dialysis patients. A single disk level was involved in three patients, and two disc levels were involved in one patient. This spondyloarthropathy correlated with the duration of dialysis but not with the radiographic evidence of renal osteodystrophy or severity of laboratory abnormalities associated with hyperparathyroidism. Three of these four patients also had discovertebral erosions or destruction involving the lumbar spine. Cervical spine flexion views revealed evidence of ligamentous laxity or instability in three (12%) dialysis patients, all with vertebral resorption and disc ...

International Nuclear Information System (INIS)

Somatostatin receptor expression has been demonstrated on a number of plasma cell lines. Therefore, we questioned whether somatostatin receptor scintigraphy (SRS) can be used to demonstrate in vivo multiple myeloma (MM) activity. SRS was performed in newly diagnosed (n = 9) or relapsing (n = 18) MM patients or in patients with localized plasmacytoma (n = 2). The results were compared with radiographic findings. A positive SRS was demonstrated in 44% of the newly diagnosed patients, in 83% of the relapsed patients and in both patients with plasmacytoma. The SRS findings corresponded with radiographic abnormalities in 40% of the patients. However, in relapsed patients 60% demonstrated increased SRS uptake in areas without new radiographic abnormalities. The positive SRS corresponded with histologically proven disease activity and responded ...

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Background: In order to reconceptualize somatoform disorders (SFDs), the psychological characteristics of SFD patients are increasingly investigated. The cognitive style of magical thinking (MT) has not been studied so far in patients with SFDs. Sampling and Methods: In a cross-sectional study, 201 allergy workup patients were interviewed using the Structured Clinical Interview for DSM-IV; they answered a set of self-report questionnaires including the Schizotypal Personality Questionnaire subscale for MT and the Patient Health Questionnaire (PHQ). The expression of MT was explored in 61 patients with SFDs compared to 140 patients without SFDs. Results: Patients with SFDs reached higher scores of MT, also when controlled for gender, depression, and anxiety. In particular, they stated more frequently that they were believers in telepathy (64 ...

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Intraspinal synovial cysts were diagnosed in six patients during a 5-year period and retrospectively studied. Plain films of the lumbar spine showed degenerative changes in all patients. Lumbar myelography showed a posterior and lateral defect caused by extradural compression. Using CT without contrast enhancement established the diagnosis in five of the six patients. In four cases MRI was performed, three before and after injection of gadolinium diethyline-triamine penta-acetic acid (Gd-DTPA). Including the patient with a false-negative CT, MRI was positive in all patients. (orig.)

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CT-Expo is a novel MS Excel application for assessing the radiation doses delivered to patients undergoing CT examinations, based on computational methods that were used to analyze the data collected in the German survey on CT practice in 1999. The program enables the calculation of all dose quantities of practical value, such as axial dose free-in-air, weighted CTDI, dose-length product, effective dose and uterine dose. In contrast to existing programs for CT dose assessment, CT-Expo offers a number of unique features, such as gender-specific dose calculation for all age groups (adults, children, newborns), applicability to all existing scanner models including correction of scanner-specific influences, and the possibility of comparison with the results from the German CT survey on CT practice. Three different application modules offer free and standardized dose calculations as well as a comprehensive benchmarking section including guidance on dose ...

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We present an optimal control approach for the solidification process of a melt in a container. The process is described by a two phase Stefan problem with the free boundary (interface between the two phases) modelled as a graph. We control the evolution of the free boundary using the temperature on the container wall. The control goal consists in tracking a prescribed evolution of the free boundary. We achieve this goal by minimizing a appropriate cost functional. The resulting minimization problem is solved numerically by a steepest descent method with step size control, where the gradient of the cost functional is expressed in terms of the adjoint variables. Several numerical examples are presented which illustrate the performance of the method. The novelty of the approach presented consists in using a sharp interface model for the control of the free boundary. This guarantees direct access to the free boundary as optimization variable in ...

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Staggered arrays of dimples printed on opposite surfaces of a cooling channel is formulated numerically and optimized with hybrid multi-objective evolutionary algorithm and Pareto optimal front. As Pareto optimal front produces a set of optimal solutions, the trends of objective functions with design variables are predicted by hybrid multi-objective evolutionary algorithm. The problem is defined by three non-dimensional geometric design variables composed of dimpled channel height, dimple print diameter, dimple spacing, and dimple depth, to maximize heat transfer rate compromising with pressure drop. Twenty designs generated by Latin hypercube sampling were evaluated by Reynolds-averaged Navier-Stokes solver and the evaluated objectives were used to construct Pareto optimal front through hybrid multi-objective evolutionary algorithm. The optimum designs were grouped by k-means ...

International Nuclear Information System (INIS)

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 patients received 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 failure, hematoma and ...

Science.gov (United States)

Objective:? Primary hyperparathyroidism (HPT) is characterised by autonomous secretion of PTH from enlarged parathyroid glands leading, in most patients, to asymptomatic hypercalcaemia. Familial hypocalciuric hypercalcaemia (FHH) is an autosomal dominant disorder caused by inactivating mutations in the calcium sensing receptor (CaSR) gene; it is characterised by lifelong and usually asymptomatic hypercalcaemia. Establishing the correct diagnosis is important because surgery can be curative in HPT, but ineffective in FHH. There is overlap in the diagnostic criteria for the two disorders and some patients carrying inactivating mutations in the CaSR gene, which is suggestive of FHH, also have HPT with hyperplastic parathyroid glands or adenomas. Design and Patients:? CaSR gene mutations were analyzed and clinical and biochemical parameters evaluated in 139 consecutive out-patients presenting with ...

Energy Technology Data Exchange (ETDEWEB)

A method for cleaning timing optimization in a parallel steam generator system is described. The method is based on the minimization of a suitable objective function, and takes into account the load allocation on steam generators. In order to establish appropriate fouling growth models the mechanism of the particle deposition and removal on heat transfer surfaces is analyzed. The objective function is related to the short time management costs which are based on depreciation of steam generators, fuel costs and the costs of cleaning interventions. The optimization problem is described; a direct one level method is compared with a two level method. Some applications and their results are reported and discussed. (author)

British Library Electronic Table of Contents (United Kingdom)

Recent research developments in common-pool resource models emphasize the importance of links with ecological systems and the presence of non-linearities, thresholds and multiple steady states. In a recent paper Kossioris et al. (2008) develop a methodology for deriving feedback Nash equilibria for non-linear differential games and apply this methodology to a common-pool resource model of a lake where pollution corresponds to benefits and at the same time affects the ecosystem services. This paper studies the structure of optimal state-dependent taxes that steer the combined economic-ecological system towards the trajectory of optimal management, and provides an algorithm for calculating such taxes.

Energy Technology Data Exchange (ETDEWEB)

Fins serve as heat transfer augmentation features in solar air heaters; however, they increase pressure drop in flow channels. Pin fins are relatively good heat transfer augmentation features with superior aerodynamic performance, and as a result find application in some solar air heaters. The exergy optimization method is employed in sizing the pin fin. Results indicate that high efficiency of the optimized fin improves the heat absorption and dissipation potential of a solar air heater. With optimum fin efficiency and superior absorptive coating quality, useful energy losses can be minimized. Some important observations pertinent in design are made. (author)

CERN Document Server

In key management schemes that realize secure multicast communications encrypted by group keys on a public network, tree structures are often used to update the group keys efficiently. Selcuk and Sidhu have proposed an efficient scheme which updates dynamically the tree structures based on the withdrawal probabilities of members. In this paper, it is shown that Selcuk-Sidhu scheme is asymptotically optimal for the cost of withdrawal. Furthermore, a new key management scheme, which takes account of key update costs of joining in addition to withdrawal, is proposed. It is proved that the proposed scheme is also asymptotically optimal, and it is shown by simulation that it can attain good performance for nonasymptotic cases.

British Library Electronic Table of Contents (United Kingdom)

We investigate optimal horizons for targeting inflation in response to different shocks and their properties. Our analysis is based on a well specified macroeconometric model of Norway. We find that optimal horizons are highly shock-specific and do not increase with concern for output and/or interest rate fluctuations beyond some shock-specific levels. Optimal horizons increase with the degree of persistence in shocks while they are not affected by the size of a shock unless the central bank is averse to interest rate volatility. In the face of multiple shocks, however, sizes as well as signs of shocks become important for optimal horizons even when the central bank is not averse to interest rate volatility. This is because shocks of different signs and sizes may amplify or outweigh each o...

UK PubMed Central (United Kingdom)

The immediate early gene Arc is emerging as a versatile, finely tuned system capable of coupling changes in neuronal activity patterns to synaptic plasticity, thereby optimizing information...Full Text Available

British Library Electronic Table of Contents (United Kingdom)

This paper uses multi-pass iteration particle swarm optimization (MIPSO) to solve short term hydroelectric generation scheduling of a power system with wind turbine generators. MIPSO is a new algorithm for solving nonlinear optimal scheduling problems. A new index called iteration best (IB) is incorporated into particle swarm optimization (PSO) to improve solution quality. The concept of multi-pass dynamic programming is applied to modify PSO further and improve computation efficiency.The feasible operational regions of the hydro units and pumped storage plants over the whole scheduling time range must be determined before applying MIPSO to the problem. Wind turbine power generation then shaves the power system load curves. Next, MIPSO calculates hydroelectric generation scheduling. It beg...

UK PubMed Central (United Kingdom)

After fluid resuscitation, vasoactive drug treatment represents the major cornerstone for correcting any major impairment of the circulation. However, debate still rages as to the choice of agent, dose,...Full Text Available

UK PubMed Central (United Kingdom)

The polyene antibiotic Amphotericin B (AMB) is one of the first therapeutic agents to be marketed commercially as nanosized formulations in which the drug is associated with lipids as liposomes or complexes....Full Text Available

Science.gov (United States)

... Hydro- gen gas is fed through a temperature- controlled Pd-Ag leak 161 into a cylindrical double-walled Pyrex bulb, 15 cm long and 1.9 cm in ...

British Library Electronic Table of Contents (United Kingdom)

The management programs for invasive species have been proposed and implemented in many regions of the world. However, practitioners and scientists have not reached a consensus on how to control them yet. One reason is the presence of various uncertainties associated with the management. To give some guidance on this issue, we characterize the optimal strategy by developing a dynamic model of invasive species management under uncertainties. In particular, focusing on (i) growth uncertainty and (ii) measurement uncertainty, we identify how these uncertainties affect optimal strategies and value functions. Our results suggest that a rise in growth uncertainty causes the optimal strategy to involve more restrained removals and the corresponding value function to shift up. Furthermore, we also...

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... system size exhibit a stochastic decomposition property ... to manage congestion in the primary queue. ... video at individual computer network terminals. ...

UK PubMed Central (United Kingdom)

Here we describe the fabrication, optimization, and application of a microfluidic device that integrates microdialysis (MD) sampling, microchip electrophoresis (ME), and electrochemical detection...Full Text Available

Science.gov (United States)

... defense's weapons are Space-based kinetic-kill vehicles ... I ti I obtained by dividing the weapons as ... of the optimal weapon-arge assigntments and ...

Energy Technology Data Exchange (ETDEWEB)

An adaptive power system stabilizer (APSS) employing a new self-optimizing pole shifting control strategy and its application to a power system are described in this paper. Based on an identified model of the system, the control is computed by an algorithm which shifts the closed-loop poles of the system to some optimal locations inside the unit circle in the z-domain to minimize a given performance criterion. With the self-optimization property, outside intervention in the controller design procedure is minimized, thus simplifying the tuning procedure during commissioning. Also, a new method of calculating the variable forgetting factor in real-time parameter identification is discussed. Studies show that the proposed APSS can provide good damping of the power system over a wide operating range and significantly improve the dynamic performance of the system.

British Library Electronic Table of Contents (United Kingdom)

An appropriate mathematical model can help researchers to simulate, evaluate, and control a proton exchange membrane fuel cell (PEMFC) stack system. Because a PEMFC is a nonlinear and strongly coupled system, many assumptions and approximations are considered during modeling. Therefore, some differences are found between model results and the real performance of PEMFCs. To increase the precision of the models so that they can describe better the actual performance, optimization of PEMFC model parameters is essential. In this paper, an artificial bee swarm optimization algorithm, called ABSO, is proposed for optimizing the parameters of a steady-state PEMFC stack model suitable for electrical engineering applications. For studying the usefulness of the proposed algorithm, ABSO-based results...

British Library Electronic Table of Contents (United Kingdom)

A concept for the optimization of manufacturing processes of composite material components with regard to product's quality and cost is introduced and applied for the case of thermoplastic composite helicopter canopies produced by `Cold' Diaphragm Forming (CDF) process. The proposed methodology relies on the consideration of the processes thermal cycle as decisive for the component's quality and cost. Quality and cost sensitivity analyses were made to derive material dependent Quality Functions (QFs) and process dependent Cost Estimation Relationships (CERs). QFs and CERs are exploited to derive iteratively the optimal thermal cycle. The processes thermal cycle is numerically simulated to allow for its virtual application on the material. To perform the optimization procedure a new softwar...

CERN Document Server

In this paper, we propose a bid optimizer for sponsored keyword search auctions which leads to better retention of advertisers by yielding attractive utilities to the advertisers without decreasing the revenue to the search engine. The bid optimizer is positioned as a key value added tool the search engine provides to the advertisers. The proposed bid optimizer algorithm transforms the reported values of the advertisers for a keyword into a correlated bid profile using many ideas from cooperative game theory. The algorithm is based on a characteristic form game involving the search engine and the advertisers. Ideas from Nash bargaining theory are used in formulating the characteristic form game to provide for a fair share of surplus among the players involved. The algorithm then computes the nucleolus of the characteristic form game since we find that the nucleolus is an apt way of allocating the gains of cooperation among ...

Energy Technology Data Exchange (ETDEWEB)

The prospective study includes 25 patients without pathology of the femoral head for the evaluation of the normal femoral head perfusion. In addition 34 patients with femoral head necrosis underwent i.a. DSA preoperatively before pedicled pelvic bone grafting. 15 patients after pelvic bone graft operation and 7 patients with medial femoral head fracture were also examined via superselective DSA. In cases with femoral head necrosis a rarefaction or interruption of the rami nutricii proximales, or an occlusion of the medial circumflex femoral artery were observed. Patients with medial femoral neck fracture showed an interruption of the rami nutricii proximales of the femoral head. Postoperative DSA - after pedicled pelvic bone graft - revealed a regular arterial graft perfusion in 82%. (orig.).