WorldWideScience

Sample records for assessment study pts

  1. Overcooling transient selection and thermal hydraulic analyses of the Loviisa PTS assessments

    Energy Technology Data Exchange (ETDEWEB)

    Tuomisto, H [IVO Power Engineering Ltd, Vantaa (Finland)

    1997-09-01

    This paper describes transients selection and thermal hydraulic analyses of various PTS assessment studies performed for the pressure vessels of the Loviisa WWER-reactors. Deterministic analyses have been performed in various stages of the PTS studies and they have always made the formal basis for design and licensing of the reactor pressure vessel. The integrated, probabilistic PTS study was carried out to give an overview of the severity of all different PTS sequences, and give a quantitative estimate of the importance of the PTS issues in relation to the overall safety of the plant. Later, the sequences including external flooding of the pressure vessels were added to the PTS assessment. Thermal recovery annealing of the Loviisa 1 reactor pressure vessel took place during refuelling outage in 1996. (author). 10 refs, 4 figs, 3 tabs.

  2. WWER 440 integrity assessment with respect to PTS events

    International Nuclear Information System (INIS)

    Hrazsky, M.; Mikua, M.; Hermansky, P.

    1997-01-01

    The present state of art in WWER 440 RPV integrity assessment with respect to PTS events utilized in Slovakia is reviewed briefly in this paper. Recent results of some PTS's (very severe) analyses, shortly described in our paper, have confirmed the necessity of elaboration of new more sophisticated procedures again. Such methodology should be based on prepared IAEA Guidance. (author). 13 refs, 1 fig

  3. WWER 440 integrity assessment with respect to PTS events

    Energy Technology Data Exchange (ETDEWEB)

    Hrazsky, M; Mikua, M; Hermansky, P [Nuclear Power Plant Research Inst. Trnava Inc., Trnava (Slovakia)

    1997-09-01

    The present state of art in WWER 440 RPV integrity assessment with respect to PTS events utilized in Slovakia is reviewed briefly in this paper. Recent results of some PTS`s (very severe) analyses, shortly described in our paper, have confirmed the necessity of elaboration of new more sophisticated procedures again. Such methodology should be based on prepared IAEA Guidance. (author). 13 refs, 1 fig.

  4. Russian practice of RPV integrity assessment under PTS conditions

    International Nuclear Information System (INIS)

    Piminov, V.; Dragunov, Yu.; Kostyrkin, S.; Akbachev, I.

    1997-01-01

    In this paper the approach used by Gidopress (main designer of Russian WWER reactors) for RPV integrity assessment is presented. Recently performed calculations for RPVs of Novoronezh NPP, units 3 and 4, are used as an example of practical application of this approach. The calculations have been performed on the base of Russian regulatory requirements, at the same time the recommendations of IAEA Guidelines for PTS assessment was also taken into account. The scope of the work includes: Analysis of real state of NPP systems and PTS selection; analysis of material behavior including results of templets investigation; thermal hydraulic calculations; structural analyses for the leading transients; development of supplementary measures to reduce the risk of RPV fracture. 5 refs, 9 figs, 1 tab

  5. Russian practice of RPV integrity assessment under PTS conditions

    Energy Technology Data Exchange (ETDEWEB)

    Piminov, V; Dragunov, Yu; Kostyrkin, S; Akbachev, I

    1997-09-01

    In this paper the approach used by Gidopress (main designer of Russian WWER reactors) for RPV integrity assessment is presented. Recently performed calculations for RPVs of Novoronezh NPP, units 3 and 4, are used as an example of practical application of this approach. The calculations have been performed on the base of Russian regulatory requirements, at the same time the recommendations of IAEA Guidelines for PTS assessment was also taken into account. The scope of the work includes: Analysis of real state of NPP systems and PTS selection; analysis of material behavior including results of templets investigation; thermal hydraulic calculations; structural analyses for the leading transients; development of supplementary measures to reduce the risk of RPV fracture. 5 refs, 9 figs, 1 tab.

  6. Elaboration and verification of a PTS model

    Energy Technology Data Exchange (ETDEWEB)

    Martins, G.P. de; Terra, J L; Di Lorenzo, R; Mansur, T R [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN), Belo Horizonte, MG (Brazil); Prifo, S B [Atomic Energy Research Inst. AEKI/KFKI (Hungary)

    1997-09-01

    This work concerns to pressurize the thermal shock (PTS) phenomena, it is rapid cooldown of the primary system by low temperature water injection from the emergency core cooling system (ECCS). To assess the effect of a PTS event calculations and experimental work are equally necessary. The purpose of the present was to prepare the PTS analysis of Angra II RPV located near to Rio de Janeiro. This paper presents the method and the results of the calculations used to design an optimal RPV model. (author). 4 refs, 7 figs, 6 tabs.

  7. OECD Nuclear Energy Agency activities on PTS evaluation

    International Nuclear Information System (INIS)

    Miller, A.

    1997-01-01

    The Safety Division of the OECD Nuclear Energy Agency provides the secretariat for the Committee on the Safety of Nuclear Installations (CSNI), which deals with technological aspects, and for the Committee for Nuclear Regulatory Activities (CNRA) dealing with regulatory aspects. Under these committees, activities are carried out through five Principal Working Groups (PWGs). The relevant group for PTS is PWG-3 on the integrity of structures and components. There is also PWG-2 on coolant system behavior, but the thermal hydraulic aspects of PTS have not been considered by PWG-2. PWG-3 carries out it work in a similar manner to the IAEA IWG LMNPP, by preparing reports and organizing round robins, Specialists Meetings and Workshops. The general context of RPV PTS has been considered in several workshops: on the 'Complementary roles of Fracture Mechanics and Non-Destructive Examination in the Safety Assessment of Components' in Wuerenlingen in 1988; on the 'Safety Assessment of RPVs' in Espoo in 1990; and on 'Fracture Mechanics Verification by Large Scale Testing' (joint with IAEA) at Oak Ridge in 1992. Activities specific to PTS have been an international survey on regulatory practices on PTS carried out in 1991, and a series of fracture round robins addressing PTS conditions organized by GRS in Germany and ORNL in the USA. 3 refs, 5 tabs

  8. OECD Nuclear Energy Agency activities on PTS evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Miller, A [NEA Nuclear Safety Div., Issy-les-Moulineaux (France)

    1997-09-01

    The Safety Division of the OECD Nuclear Energy Agency provides the secretariat for the Committee on the Safety of Nuclear Installations (CSNI), which deals with technological aspects, and for the Committee for Nuclear Regulatory Activities (CNRA) dealing with regulatory aspects. Under these committees, activities are carried out through five Principal Working Groups (PWGs). The relevant group for PTS is PWG-3 on the integrity of structures and components. There is also PWG-2 on coolant system behavior, but the thermal hydraulic aspects of PTS have not been considered by PWG-2. PWG-3 carries out it work in a similar manner to the IAEA IWG LMNPP, by preparing reports and organizing round robins, Specialists Meetings and Workshops. The general context of RPV PTS has been considered in several workshops: on the `Complementary roles of Fracture Mechanics and Non-Destructive Examination in the Safety Assessment of Components` in Wuerenlingen in 1988; on the `Safety Assessment of RPVs` in Espoo in 1990; and on `Fracture Mechanics Verification by Large Scale Testing` (joint with IAEA) at Oak Ridge in 1992. Activities specific to PTS have been an international survey on regulatory practices on PTS carried out in 1991, and a series of fracture round robins addressing PTS conditions organized by GRS in Germany and ORNL in the USA. 3 refs, 5 tabs.

  9. RELAP5 analyses and support of Oconee-1 PTS studies

    International Nuclear Information System (INIS)

    Charlton, T.R.

    1983-01-01

    The integrity of a reactor vessel during a severe overcooling transient with primary system pressurization is a current safety concern and has been identified as an Unresolved Safety Issue(USI) A-49 by the US Nuclear Regulatory Commission (NRC). Resolution of USI A-49, denoted as Pressurized Thermal Shock (PTS), is being examined by the US NRC sponsored PTS integration study. In support of this study, the Idaho National Engineering Laboratory (INEL) has performed RELAP5/MOD1.5 thermal-hydraulic analyses of selected overcooling transients. These transient analyses were performed for the Oconee-1 pressurized water reactor (PWR), which is Babcock and Wilcox designed nuclear steam supply system

  10. PTS assessment - The basis of life time evaluation at NPP Paks

    International Nuclear Information System (INIS)

    Elter, J.; Oszwald, F.; Ratkay, S.; Fekete, T.; Gillemot, F.; Marothy, L.

    1997-01-01

    Plant specific PTS analysis at NPP Paks was performed in the frame of the AGNES (Advanced General New Evaluation of Safety) project. NPP Paks belongs to the second generation of the WWER-440/213 NPP-s. To verify the safety during transient events and predict the lifetime of the RPV-s several transient cases have been analyzed. The paper summarizes: The general scheme elaborated for the assessment; the safety philosophy used; the applied and available codes and methods; the ongoing and planned developments. (author). 8 refs, 3 figs, 1 tab

  11. PTS assessment - The basis of life time evaluation at NPP Paks

    Energy Technology Data Exchange (ETDEWEB)

    Elter, J; Oszwald, F; Ratkay, S [NPP Paks (Hungary); Fekete, T; Gillemot, F; Marothy, L [Atomic Energy Research Inst., Budapest (Hungary)

    1997-09-01

    Plant specific PTS analysis at NPP Paks was performed in the frame of the AGNES (Advanced General New Evaluation of Safety) project. NPP Paks belongs to the second generation of the WWER-440/213 NPP-s. To verify the safety during transient events and predict the lifetime of the RPV-s several transient cases have been analyzed. The paper summarizes: The general scheme elaborated for the assessment; the safety philosophy used; the applied and available codes and methods; the ongoing and planned developments. (author). 8 refs, 3 figs, 1 tab.

  12. Predictive value of markers of inflammation in the postthrombotic syndrome: a systematic review: inflammatory biomarkers and PTS.

    Science.gov (United States)

    Rabinovich, A; Cohen, J M; Kahn, S R

    2015-08-01

    The postthrombotic syndrome (PTS) is a chronic complication of deep vein thrombosis (DVT). Inflammation may contribute to its pathophysiology. We conducted a systematic review of studies that analyzed the association between biomarkers of inflammation and PTS in DVT patients. The electronic databases PubMed, EMBASE, Medline, Scopus and Web of Science were searched for studies published until March 2015 that measured blood inflammation biomarker levels in adult DVT patients and reported their association with PTS development. Two reviewers independently performed full text assessment and data extraction. Ten studies were included. Nine reported on the association between C-reactive protein and PTS; Interleukin (IL)-6 was measured in six studies; IL-8 in four studies; Intracellular adhesion molecule (ICAM)-1 in three studies; IL-10 and vascular cell adhesion molecule-1 in two studies; and monocyte chemotactic protein-1, matrix metalloprotease-9, P-Selectin, tumor necrosis factor α and erythrocyte sedimentation rate were measured in one study. Studies differed in terms of populations included, exclusion criteria, methods used for biomarker measurement and statistical measures of association between biomarkers and PTS. We were able to metaanalyze results only for IL-6 and found no significant association. Descriptively, ICAM-1 was significantly associated with PTS in two out of three studies that measured it. Other biomarkers did not demonstrate a significant association with PTS. Our systematic review found conflicting results regarding the role of inflammatory biomarkers as predictors of PTS. ICAM -1 appears to be a promising marker for further investigation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Plant specific PTS analysis of Kori Unit 1

    Energy Technology Data Exchange (ETDEWEB)

    Sung-Yull, Hong; Changheui, Jang; Ill-Seok, Jeong [Korea Eletric Power Research Inst., Daejon (Korea, Republic of); Tae-Eun, Jin [Korea Power Engineering Company, Yonging (Korea, Republic of)

    1997-09-01

    Currently, a nuclear PLIM (Plant Lifetime Management) program is underway in Korea to extend the operation life of Kori-1 which was originally licensed for 30 years. For the life extension of nuclear power plants, the residual lives of major components should be evaluated for the extended operation period. According to the residual life evaluation of reactor pressure vessel, which was classified as one of the major components crucial to life extension, it was found by screening analysis that reference PTS temperature would exceed screening criteria before the target extended operation years. In order to deal with this problem, a plant-specific PTS analysis for Kori-1 RPV has been initiated. In this paper, the relationship between PTS analysis and Kori-1 PLIM program is briefly described. The plant-specific PTS analysis covers system transient analysis, downcomer mixing analysis, and probabilistic fracture mechanics analysis to check the integrity or RPV during various PTS transients. The step-by-step procedure of the analysis will be described in detail. Finally, various issues regarding RPV materials and its integrity will be briefly mentioned, and their implications on Kori-1 PTS analysis will be discussed. Despite of the screening analysis result concern, it is now expected that Kori-1 PTS issues can be handled through the plant-specific PTS analysis. (author). 14 refs, 4 figs, 2 tabs.

  14. Description of code system PLES/PTS for evaluation of pressure vessel integrity during PTS events

    International Nuclear Information System (INIS)

    Hirano, Masashi; Kohsaka, Atsuo.

    1992-02-01

    A code system PLES/PTS has been developed at the Japan Atomic Energy Research Institute (JAERI) to evaluate the integrity of the pressure vessel during plant thermal-hydraulic transients related to pressurized thermal shock (PTS) in a pressurized water reactor (PWR). The code system consists of several member codes to analyse the thermal-mixing behavior of emergency core cooling (ECC) water and primary coolant, transient stress distribution within the vessel wall, and crack growth behavior at the inner surface of the vessel. The crack growth behavior is evaluated by comparing the stress intensity factor (k I ) with the crack initiation toughness (k Ic ) and crack arrest toughness (k Ic ), taking into account the fast neutron irradiation embrittlement. This report describes the methods and models applied in PLES/PTS and the input data requirements. (author)

  15. Comparison report of RPV pressurised thermal shock - international comparative assessment study (PTS ICAS)

    International Nuclear Information System (INIS)

    1999-01-01

    A summary of the recently completed International Comparative Assessment Study of Pressurized- Thermal-Shock in Reactor Pressure Vessels (RPV PTS ICAS) is presented here to record the results in actual and comparative fashions. The ICAS Project brought together an international group of experts from research, utility and regulatory organizations to perform a comparative evaluation of analysis methodologies employed in the assessment of RPV integrity under PTS loading conditions. The Project was sponsored jointly by Gesellschaft fuer Anlagen- und Reaktorsicherheit (GRS), Koeln, Germany, and Oak Ridge National Laboratory (ORNL), USA, with assistance from the Organization for Economic Co-operation and Development (OECD)/Nuclear Energy Agency (NEA)/Committee on the Safety of Nuclear Installations (CSNI)/Principal Working Group (PWG) No. 3 (Integrity of Components and Structures). The ICAS Project grew out of a strong interest expressed by participants in the previous FALSIRE II Project to proceed with further evaluations of analysis methods used in RPV integrity assessment. A Launch Meeting for the ICAS Project was held at GRS-Koeln, during June 1996, where an emphasis was placed on identifying the different approaches to RPV integrity assessment being employed within the international nuclear technology community. Also a Problem Statement was drafted that defined a Western type four-loop RPV with cladding on the inner surface. Also, a detailed task matrix was defined that included a set of transient thermal-mechanical loading conditions postulated to result from loss-of-coolant accidents. The primary focus of the analyses was on the behaviour of relatively shallow cracks under these conditions. The assessment activities based on the Problem Statement were divided under three tasks: deterministic fracture mechanics (DFM), probabilistic fracture mechanics (PFM) and thermal-hydraulic mixing (THM). An Intermediate Workshop was held at OECD/NEA-Paris during June 1997, to

  16. Thermal mixing characteritics during a postulated PTS event

    International Nuclear Information System (INIS)

    Jung, Jae Won; Bang, Young Seok; Seul, Kwang Won; Kim, Hho Jung

    1998-01-01

    The present study aims to investigate the characteristics of thermal fluid mixing during a postulated loss of coolant accident (LOCA) under two-phase flow condition using RELAP5 code. The RELAP5 code has been widely used in estimating global system thermal-hydraulic behaviors. However, the RELAP5 is not fully verified for the prediction of thermal mixing phenomena due to its limitation to the multi-dimensional behavior. Therefore, supplementary analysis is required, which can address the performance and limitation of the current RELAP5 code in predicting the thermal mixing. Another objective of this study is to compare the applicable empirical correlation (Theofanous') and the calculation of simple mixing code (REMIX) with one predicted by RELAP5. By those comparisons the capability on PTS thermal mixing of the current RELAP5 can be evaluated. In this study, thermal mixing behavior is analyzed for the task of the international comparative assessment study on PTS (PTS-ICAS) which was proposed by OECD-NEA. Through some preliminary calculations using RELAP5, the boundary conditions relevant to the problem constraints are appropriately specified with some artificial assumptions. As a calculation results, system pressure, downcomer water level, wall heat transfer coefficient, etc., are predicted as suitable for given problem constraints. From the predicted thermal hydraulic behavior, it is shown that the thermal stratification begins to start around 200 seconds after high pressure safety injection. At 400 seconds, the maximum difference in azimuthal temperature distribution at the downcomer due to thermal mixing is predicted about 150 K. Based on the comparison of the current RELAP5 prediction with the Theofanous' correlation and the REMIX calculation, it is found that thermal stratification characteristics predicted by RELAP5 is agreed in qualitative manner to the empirical correlation

  17. Modified PTS-based PAPR Reduction for FBMC-OQAM Systems

    Science.gov (United States)

    Deng, Honggui; Ren, Shuang; Liu, Yan; Tang, Chengying

    2017-10-01

    The filter bank multicarrier with offset quadrature amplitude modulation (FBMC-OQAM) has been raised great concern in the 5G communication research. However FBMC-OQAM has also the inherent drawback of high peak-to-average power ratio (PAPR) that should be addressed. Due to the overlapping structure of FBMC-OQAM signals, it is proven that directly employing conventional partial transmit sequence (PTS) scheme proposed for OFDM to FBMC-OQAM is ineffective. In this paper, we propose a modified PTS-based scheme by employing phase rotation factors to optimize only the phase of the sparse peak signals, called as sparse PTS (S-PTS) scheme. Theoretical analysis and simulation results show that the proposed S-PTS scheme provides a significant PAPR reduction performance with lower computational complexity.

  18. The Rhizobium etli rpoN locus: DNA sequence analysis and phenotypical characterization of rpoN, ptsN, and ptsA mutants.

    Science.gov (United States)

    Michiels, J; Van Soom, T; D'hooghe, I; Dombrecht, B; Benhassine, T; de Wilde, P; Vanderleyden, J

    1998-04-01

    The rpoN region of Rhizobium etli was isolated by using the Bradyrhizobium japonicum rpoN1 gene as a probe. Nucleotide sequence analysis of a 5,600-bp DNA fragment of this region revealed the presence of four complete open reading frames (ORFs), ORF258, rpoN, ORF191, and ptsN, coding for proteins of 258, 520, 191, and 154 amino acids, respectively. The gene product of ORF258 is homologous to members of the ATP-binding cassette-type permeases. ORF191 and ptsN are homologous to conserved ORFs found downstream from rpoN genes in other bacterial species. Unlike in most other microorganisms, rpoN and ORF191 are separated by approximately 1.6 kb. The R. etli rpoN gene was shown to control in free-living conditions the production of melanin, the activation of nifH, and the metabolism of C4-dicarboxylic acids and several nitrogen sources (ammonium, nitrate, alanine, and serine). Expression of the rpoN gene was negatively autoregulated and occurred independently of the nitrogen source. Inactivation of the ptsN gene resulted in a decrease of melanin synthesis and nifH expression. In a search for additional genes controlling the synthesis of melanin, an R. etli mutant carrying a Tn5 insertion in ptsA, a gene homologous to the Escherichia coli gene coding for enzyme I of the phosphoenolpyruvate:sugar phosphotransferase system, was obtained. The R. etli ptsA mutant also displayed reduced expression of nifH. The ptsN and ptsA mutants also displayed increased sensitivity to the toxic effects of malate and succinate. Growth of both mutants was inhibited by these C4-dicarboxylates at 20 mM at pH 7.0, while wild-type cells grow normally under these conditions. The effect of malate occurred independently of the nitrogen source used. Growth inhibition was decreased by lowering the pH of the growth medium. These results suggest that ptsN and ptsA are part of the same regulatory cascade, the inactivation of which renders the cells sensitive to toxic effects of elevated concentrations of

  19. Current pulse shaping of the load current on PTS

    Directory of Open Access Journals (Sweden)

    Minghe Xia

    2016-02-01

    Full Text Available The typical rise time of PTS machine is ∼110 ns with about 10 MA peak current under short pulse mode when all 24 modules discharge simultaneously. By distributing the trigger times of 12 laser beams logically and adjusting the statues of the pulse output switches, longer rise-time pulse can be obtained on the PTS facility. Based on the required pulse shape, whole circuit simulations will be used to calculate the trigger times of each laser triggering gas switch and the status of the pulse output switches. The rise time of the current is determined by the time difference between the first and last trigged laser triggering gas switches. In order to trigger the laser triggering gas switch, sufficient laser power is needed to be sent into the gap of the gas switches. The gas pressure and voltage difference on the two electrodes of the gas switches also affect the triggering of the gas switches, and the voltage added on the gas switch is determined by its transition time. Traditionally the trigger time difference should be less than the transition time of the two neighboring modules. A new simulation model of PTS shows one can break this transition time limits. Series of current pulse shaping experiments have been investigated on the PTS (Primary Test Stand. As results, more than 5 MA peak current were successfully achieved on the load with a rise time of 600 ns. This study and experiments of the pulse shaping on PTS demonstrate the adaptable ability of the PTS for offering different waveform of mega ampere current pulse for different research purpose.

  20. Pressurized thermal shock (PTS)

    International Nuclear Information System (INIS)

    Rosso, Ricardo D.; Ventura, Mirta A.

    2006-01-01

    In the present work, a description of Thermal Shock in Pressurized conditions (PTS), and its influence in the treatment of the integrity of the pressure vessel (RPV) of a Pressurized Water Reactor (PWR) and/or of a Heavy water Pressurized water Reactor (PHWR) is made. Generally, the analysis of PTS involves a process of three stages: a-) Modeling with a System Code of relevant thermohydraulics transients in reference with the thermal shock; b-) The local distribution of temperatures in the downcomer and the heat transference coefficients from the RPV wall to the fluid, are determined; c-) The fracture mechanical analysis. These three stages are included in this work: Results with the thermohydraulics code Relap5/mod.3, are obtained, for a LOCA scenario in the hot leg of the cooling System of the Primary System of the CAN-I reactor. The method used in obtaining results is described. A study on the basis of lumped parameters of the local evolutions of the temperature of the flow is made, in the downcomer of the reactor pressure vessel. The purpose of this study is to determine how the intensification of the stress coefficient, varies in function of the emergency injected water during the thermohydraulic transients that take place under the imposed conditions in the postulated scene. Specially, it is considered a 50 cm 2 break, located in the neighborhoods of the pressurized with the corresponding hot leg connection. This size is considered like the most critical. The method used to obtain the results is described. The fracture mechanical analysis is made. From the obtained results we confirmed that we have a simple tool of easy application in order to analyze phenomena of the type PTS in the postulated scenes by break in the cold and hot legs of the primary system. This methodology of calculus is completely independent of the used ones by the Nucleoelectrica Argentina S.A. (NASA) in the analysis of the PTS phenomena in the CAN-I. The results obtained with the adopted

  1. Summary of flow and heat transfer in RPV under PTS

    International Nuclear Information System (INIS)

    Lu Donghua; Wang Haijun; Chen Tingkuan; Luo Yushan

    2003-01-01

    PTS under loss of coolant accident (LOCA) has great effect on the safety of RPV. Many research works focusing on flow and heat transfer in RPV under PTS have been done in developed countries for many years, and a lot of results have been got both on experiment and numerical simulation. The safety of nuclear power plant is enhanced greatly by these research works. With the developing of nuclear power technology in China, RPV integration under PTS has been studied. The author summarizes research works at home and abroad in recent years. The problems existed in present work and research direction in the future are discussed

  2. Pressurized Thermal Shock, Pts

    International Nuclear Information System (INIS)

    Boyd, C.

    2008-01-01

    Pressurized Thermal Shock (Pts) refers to a condition that challenges the integrity of the reactor pressure vessel. The root cause of this problem is the radiation embrittlement of the reactor vessel. This embrittlement leads to an increase in the reference temperature for nil ductility transition (RTNDT). RTNDT can increase to the point where the reactor vessel material can loose fracture toughness during overcooling events. The analysis of the risk of having a Pts for a specific plant is a multi-disciplinary problem involving probabilistic risk analysis (PRA), thermal-hydraulic analysis, and ultimately a structural and fracture analysis of the vessel wall. The PRA effort involves the postulation of overcooling events and ultimately leads to an integrated risk analysis. The thermal-hydraulic effort involves the difficult task of predicting the system behavior during a postulated overcooling scenario with a special emphasis on predicting the thermal and mechanic loadings on the reactor pressure vessel wall. The structural and fracture analysis of the reactor vessel wall relies on the thermal-hydraulic conditions as boundary conditions. The US experience has indicated that medium and large diameter primary system breaks dominate the risk of Pts along with scenarios that involve a stuck open valve (and associated system cooldown) that recloses resulting in system re-pressurization while the vessel wall is cool.

  3. Procurement Tracking System (PTS)

    Data.gov (United States)

    Office of Personnel Management — The Procurement Tracking System (PTS) is used solely by the procurement staff of the Office of the Inspector General (OIG) at the U.S. Office of Personnel Management...

  4. Transferability of results of PTS experiments to the integrity assessment of reactor pressure vessels

    International Nuclear Information System (INIS)

    Roos, E.; Eisele, U.; Stumpfrock, L.

    1997-01-01

    The integrity assessment of the reactor pressure vessel (RPV) is based on the fracture mechanics concept as provided in the code. However this concept covers only the linear-elastic fracture mechanics regime on the basis of the reference temperature RT NDT as derived from charpy impact and drop-weight test. The conservatism of this concept was demonstrated for a variety of different materials covering optimized and lower bound material states with regard to unirradiated and irradiated conditions. For the elastic-plastic regime, methodologies have been developed to describe ductile crack initiation and stable crack growth. The transferability of both, the linear-elastic and elastic-plastic fracture mechanics concept was investigated with the help of large scale specimens focusing on complex loading situations as they result from postulated thermal shock events for the RPV. A series of pressurized thermal shock (PTS) experiments were performed in which the applicability of the fracture mechanics parameters derived from small scale specimen testing could be demonstrated. This includes brittle (static and dynamic) crack initiation and crack arrest in the low charpy energy regime as well as stable crack initiation, stable crack growth and crack arrest in the upper shelf toughness regime. The paper provides the basic material data, the load paths, representative for large complex components as well as experimental and theoretical results of PTS experiments. From these data it can be concluded that the available fracture mechanics concepts can be used to describe the component behavior under transient loading conditions. (author). 26 refs, 12 figs, 1 tab

  5. Transferability of results of PTS experiments to the integrity assessment of reactor pressure vessels

    Energy Technology Data Exchange (ETDEWEB)

    Roos, E; Eisele, U; Stumpfrock, L [MPA Stuttgart (Germany)

    1997-09-01

    The integrity assessment of the reactor pressure vessel (RPV) is based on the fracture mechanics concept as provided in the code. However this concept covers only the linear-elastic fracture mechanics regime on the basis of the reference temperature RT{sub NDT} as derived from charpy impact and drop-weight test. The conservatism of this concept was demonstrated for a variety of different materials covering optimized and lower bound material states with regard to unirradiated and irradiated conditions. For the elastic-plastic regime, methodologies have been developed to describe ductile crack initiation and stable crack growth. The transferability of both, the linear-elastic and elastic-plastic fracture mechanics concept was investigated with the help of large scale specimens focusing on complex loading situations as they result from postulated thermal shock events for the RPV. A series of pressurized thermal shock (PTS) experiments were performed in which the applicability of the fracture mechanics parameters derived from small scale specimen testing could be demonstrated. This includes brittle (static and dynamic) crack initiation and crack arrest in the low charpy energy regime as well as stable crack initiation, stable crack growth and crack arrest in the upper shelf toughness regime. The paper provides the basic material data, the load paths, representative for large complex components as well as experimental and theoretical results of PTS experiments. From these data it can be concluded that the available fracture mechanics concepts can be used to describe the component behavior under transient loading conditions. (author). 26 refs, 12 figs, 1 tab.

  6. Alflutop clinical efficacy assessment in osteoarthritis (two-years study

    Directory of Open Access Journals (Sweden)

    V. N. Chodyrev

    2003-01-01

    Full Text Available Objective. To assess alflutop clinical efficacy and safety during long-term course treatment of knee osteoarthritis. Methods. 51 pts with definite knee osteoarthritis of I-III stage according to Kellgren-Lawrence classification were included in an open controlled study. 20 pts received 6 intra-articular injections of alflutop 2 ml with subsequent intramuscular treatment during 3 months. Such courses were repeated 6 months apart for 2 years. 31 pts of control group received nonsteroidal anti-inflammatory drugs (NSAID only. Pain on visual analog scale, Leken functional score, changes of NSAID treatment and radiological picture were used for assessment of efficacy. Clinical examination was performed before and after every treatment course and 3 months after the last course. Results. Every alflutop treatment course provided significant stepwise decrease of pain with improvement of mobility, reduction of NSAID requirement and absence of osteoarthritis radiological progression. Doctor and pts clinical efficacy and safety assessment coincided. Conclusion. Alflutop is an effective drug for knee osteoarthritis treatment. It has anti-inflammatory and probably chondroprotective activity with good safety.

  7. Experimental validation of plant peroxisomal targeting prediction algorithms by systematic comparison of in vivo import efficiency and in vitro PTS1 binding affinity.

    Science.gov (United States)

    Skoulding, Nicola S; Chowdhary, Gopal; Deus, Mara J; Baker, Alison; Reumann, Sigrun; Warriner, Stuart L

    2015-03-13

    Most peroxisomal matrix proteins possess a C-terminal targeting signal type 1 (PTS1). Accurate prediction of functional PTS1 sequences and their relative strength by computational methods is essential for determination of peroxisomal proteomes in silico but has proved challenging due to high levels of sequence variability of non-canonical targeting signals, particularly in higher plants, and low levels of availability of experimentally validated non-canonical examples. In this study, in silico predictions were compared with in vivo targeting analyses and in vitro thermodynamic binding of mutated variants within the context of one model targeting sequence. There was broad agreement between the methods for entire PTS1 domains and position-specific single amino acid residues, including residues upstream of the PTS1 tripeptide. The hierarchy Leu>Met>Ile>Val at the C-terminal position was determined for all methods but both experimental approaches suggest that Tyr is underweighted in the prediction algorithm due to the absence of this residue in the positive training dataset. A combination of methods better defines the score range that discriminates a functional PTS1. In vitro binding to the PEX5 receptor could discriminate among strong targeting signals while in vivo targeting assays were more sensitive, allowing detection of weak functional import signals that were below the limit of detection in the binding assay. Together, the data provide a comprehensive assessment of the factors driving PTS1 efficacy and provide a framework for the more quantitative assessment of the protein import pathway in higher plants. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. PTS and the IAEA database

    International Nuclear Information System (INIS)

    Davies, L.M.; Gillemot, F.; Lyssakov, V.

    1997-01-01

    The International Atomic Energy Agency Data Base has been described previously at this meeting. It is the purpose of this paper to briefly describe PTS and to draw attention to the relevance of the International data base in the area of irradiation effects. 6 refs, 1 fig

  9. PTS and the IAEA database

    Energy Technology Data Exchange (ETDEWEB)

    Davies, L M [LMD Consultants, Oxford (United Kingdom); Gillemot, F [Atomic Energy Research Inst., Budapest (Hungary); Lyssakov, V [International Atomic Energy Agency, Vienna (Austria). Div. of Nuclear Power and the Fuel Cycle

    1997-09-01

    The International Atomic Energy Agency Data Base has been described previously at this meeting. It is the purpose of this paper to briefly describe PTS and to draw attention to the relevance of the International data base in the area of irradiation effects. 6 refs, 1 fig.

  10. Quality assurance of PTS thermal hydraulic calculations at BNL

    International Nuclear Information System (INIS)

    Rohatgi, U.S.; Pu, J.; Jo, J.; Saha, P.

    1983-01-01

    Rapid cooling of the reactor pressure vessel at high pressure has a potential of challenging the vessel integrity. This phenomenon is called overcooling or Pressurized Thermal Shock (PTS). The Nuclear Regulatory Commission (NRC) has selected three plants representing three types of PWRs in use for detailed PTS study. Oconee-1 (B and W), Calvert Cliffs (C.E.), and H.B. Robinson (Westinghouse). The Brookhaven National Laboratory (BNL) has been requested by NRC to review and compare the input decks developed at LANL and INEL, and to compare and explain the differences between the common calculations performed at these two laboratories. However, for the transients that will be computed by only one laboratory, a consistency check will be performed. So far only Oconee-1 calculations have been reviewed at BNL, and the results are presented here

  11. Final report on the reactor pressure vessel pressurized-thermal-shock. International comparative assessment study (RPV PTS ICAS)

    International Nuclear Information System (INIS)

    Sievers, J.; Schulz, H.; Bass, R.; Pugh, C.

    1999-10-01

    A summary of the recently completed International Comparative Assessment Study of Pressurized-Thermal-Shock in Reactor Pressure Vessels (RPV PTS ICAS) is presented here to record the results in actual and comparative fashions. Within the DFM task, where account was taken of material properties and boundary conditions, reasonable agreement was obtained in linear-elastic and elastic-plastic analysis results. Linear elastic analyses and J-estimation schemes were shown to provide conservative estimates of peak crack driving force when compared with those obtained using complex three-dimensional (3D) finite element analyses. Predictions of RT NDT generally showed less scatter than that observed in crack driving force calculations due to the fracture toughness curve used for fracture assessment in the transition temperature region. Observed scatter in some analytical results could be traced mainly to a misinterpretation of the thermal expansion coefficient data given for the cladding and base metal. Also, differences in some results could be due to a quality assurance problem related to procedures for approximating the loading data given in the Problem Statement. For the PFM task, linear-elastic solutions were again shown to be conservative with respect to elastic-plastic solutions (by a factor of 2 to 4). Scatter in solutions obtained using the same computer code was generally attributable to differences in input parameters, e.g. standard deviations for the initial value of RT NDT , as well as for nickel and copper content. In the THM task, while there was a high degree of scatter during the early part of the transient, reasonable agreement in results was obtained during the latter part of the transient. Generally, the scatter was due to differences in analytical approaches used by participants, which included correlation-based engineering methods, system codes and three-dimensional computational fluids dynamics codes. Some of the models used to simulate condensation

  12. The relevance of the non-canonical PTS1 of peroxisomal catalase

    NARCIS (Netherlands)

    Williams, Chris; Aksam, Eda Bener; Gunkel, Katja; Veenhuis, Marten; van der Klei, Ida J.

    Catalase is sorted to peroxisomes via a C-terminal peroxisomal targeting signal 1 (PTS1), which binds to the receptor protein Pex5. Analysis of the C-terminal sequences of peroxisomal catalases from various species indicated that catalase never contains the typical C-terminal PTS1 tripeptide-SKL,

  13. The plant PTS1 receptor : similarities and differences to its human and yeast counterparts

    NARCIS (Netherlands)

    Wimmer, C; Schmid, Markus; Veenhuis, M; Gietl, C

    1998-01-01

    Two targeting signals, PTS1 and PTS2, mediate import of proteins into the peroxisomal matrix. We have cloned and sequenced the watermelon (Citrullus vulgaris) cDNA homologue to the PTS1 receptor gene (PEX5). Its gene product, CvPex5p, belongs to the family of tetratricopeptide repeat (TPR)

  14. The “In-House Agency Work” in the PTS and the Union Movement of Agency Workers

    Directory of Open Access Journals (Sweden)

    Chang-De Liu

    2016-07-01

    Full Text Available The number of agency workers in the PTS had increased rapidly since 2008, while a total of around 200 agency workers represented 20% of the PTS employees during recent years. However, most of agency works in the PTS were “long-term core jobs” rather than “temporary peripheral jobs,” and the recruitment, remuneration and benefits of agency workers were actually decided by the user enterprise, the PTS, rather than the employment agency. The agency employment in the PTS, therefore, had become the “in-house agency work” which broke the rules of related employment laws. According to the findings based on the questionnaire survey and in-depth interviews, the PTS agency workers were relatively young and high-educated, but most of them suffered from job insecurity and wage discrimination. Most interviewees were discontent with poor working conditions while highly evaluated and identified with the public interests that the PTS pursued. In 2013, the PTS agency employees established a union and urged the management for a transition to standard employment. Nevertheless, the standard employees and their union (the PTS union spoke out against the “total transition plan,” and forced the employer laid off 6 agency workers while a total of 130 agency workers were successfully transited. The union movement of the PTS agency workers is unique for its two characteristics, including the internalization of public interests among the PTS members, and the young generation’s disobedience to the capitalism under the crisis of pauperization of work.

  15. Structural characterization of the PTS IIA and IIB proteins associated with pneumococcal fucose utilization.

    Science.gov (United States)

    Higgins, Melanie A; Hamilton, Aileen M; Boraston, Alisdair B

    2017-05-01

    Streptococcus pneumoniae harbors a significant number of transporters, including phosphotransferase (PTS) systems, allowing the bacterium to utilize a number of different carbohydrates for metabolic and other purposes. The genes encoding for one PTS transport system in particular (EII fuc ) are found within a fucose utilization operon in S. pneumoniae TIGR4. Here, we report the three-dimensional structures of IIA fuc and IIB fuc providing evidence that this PTS system belongs to the EII man family. Additionally, the predicted metabolic pathway for this distinctive fucose utilization system suggests that EII fuc transports the H-disaccharide blood group antigen, which would represent a novel PTS transporter specificity. Proteins 2017; 85:963-968. © 2016 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  16. No hypothyroidism after I-131 therapy in pts with toxic nodular goiter, treated under combined thyreostatic, thyreomimetic medication

    International Nuclear Information System (INIS)

    Giubbini, R.; Panarotto, M.B.; Paghera, B.; Pagliaini, R.; Pajoro, U.; Pizzocaro, C.; Rossini, P.L.; Terzi, A.; Maira, G.

    2002-01-01

    Background. Treatment of toxic nodular goiter with 131-I is generally satisfactory and will cause a reversion of hyperthyroidism. To avoid the risk of thyrotoxic storm I-131 therapy is usually performed after pre-treatment with antithyroid drugs, which causes a TSH increase and functional recruitment of previously inhibited normal thyroid tissue. In this functional state both autonomous nodule(s) and normal tissue are irradiated after I-131 administration. This may be the reason of late hypothyroidism occurring in 15-25% of Pts. Aim of the study was the evaluation of a different pre-treatment modality with combined methimazole (10-20 mg) and Triiodo-thyronine (T3 - 60 μg) in order to treat pts in euthyroid state with suppressed TSH. Study protocol. After diagnosis of hyperthyroidism with autonomous functioning tissue the pts were put under thyreostatic medication. Two months later TSH was checked and if >0.5% U.I the T3 treatment was associated. After two more months, the TSH level was checked again and, if suppressed, the pt received I-131 therapy. Study population. 93 pts (74f, 19m - age 75±10) were consecutively enrolled. 24 pts had a toxic nodular goiter and 69 a multi nodular one, respectively; they were evaluated at diagnosis, at pre-treatment, two months after therapy and at late follow-up (3.1 ± 3.5 yrs). Methods: 557±225 MBq of I-131 (according to uptake determinations and gland weight) were administered. Methymazole was discontinued 3 days before treatment whereas T3 was maintained during I-131 therapy. Results: Euthyroidism was achieved after the first treatment in 71% of pts. At late follow-up TSH values over the normal range were observed in only 4 pts (4.3% - however all 4 pts had TSH level below 6 I.U.). Summaries of FT3 and FT4 values are presented. Conclusions: The treatment of toxic nodular goiter under combined thyreostatic-thyreomimetic treatment is a safe, well tolerated and effective procedure allowing a 71% success at the first treatment

  17. Androgen deprivation does predict bNED survival in unfavorable prostate cancer PTS treated with external beam radiation therapy

    International Nuclear Information System (INIS)

    Anderson, Penny R.; Hanlon, Alexandra L.; Hanks, Gerald E.

    1996-01-01

    Purpose: Cooperative groups have investigated the outcome of androgen deprivation therapy combined with radiation therapy in prostate cancer pts with variable prerx prognostic indicators. This report describes an objective means of selecting pts for adjuvant hormonal therapy by examining bNED survival for groups of pts with specific prognostic indicators treated with adjuvant hormones (RT+H) vs matched controls treated with radiation therapy alone (RT). In addition, this report shows the 5-yr bNED survival for pts selected by this method for RT+H vs RT alone. Further, bNED survival is assessed multivariately according to treatment (RT+H vs RT) and predetermined prognostic treatment and prerx covariates. Materials and Methods: From (10(88)) to (12(94)), 684 T1-T3 NXM0 pts with known prerx PSA level were treated at Fox Chase Cancer Center. 568 of those pts were treated with RT alone while 116 were treated with RT+H. Table 1 lists the patient distributions for each of the putative prognostic factors indicative of bNED survival. We compare actuarial bNED survival rates according to treatment group within each of the prognostic groups. bNED survival is also compared for the two treatment groups using 107 RT+H pts and 107 matched (by stage, grade, and prerx PSA) controls randomly selected from the RT alone group. bNED survival for the 214 pts is then analyzed multivariately using stepwise Cox regression to determine independent predictors of outcome. Covariates considered for entry into the model included stage, grade, prerx PSA, treatment (RT vs RT+H), and center of prostate dose. bNED failure is defined as PSA ≥1.5 ngm/ml and rising on two consective determinations. The median follow-up is 30 mos (2 to 90 mos). Results: Table 1 presents three-year bNED actuarial survival rates according to treatment group for prerx PSA, gleason score, and stage groups. It is apparent that the T2C/T3, gleason 7-10, and the prerx PSA > 15 ngm/ml groups of pts benefit from hormonal

  18. Mechanism of phosphoryl transfer and protein-protein interaction in the PTS system-an NMR study

    Energy Technology Data Exchange (ETDEWEB)

    Rajagopal, P.; Klevit, R.E. [Univ. of Washington, Seattle, WA (United States)

    1994-12-01

    HPr and Enzyme IIA{sup Glc} are two of the components of the bacterial PTS (phosphoenolpyruvate: sugar phosphotranferase system) and are involved in the phosphorylation and concomitant translocation of sugars across the membrane. These PTS protein complexes also regulate sugar transport. HPr, phosphorylated at a histidine N1 site by Enzyme I and phosphoenol pyruvate, transfers the phosphoryl group to a histidine N3 position in Enzyme IIA{sup Glc}. HPrs from Gram-positive bacteria undergo regulatory phosphorylation at Ser{sup 46}, whereby phosphorylation of the histidine residue is inhibited. Conversely, histidine phosphorylation inhibits phosphorylation at Ser{sup 46}. HPrs from Gram-negative bacteria possess a serine residue at position 46, but do not undergo regulatory phosphorylation. HPr forms an open-faced sandwich structure with a four-strand S-sheet and 2 to 3 helices lying on top of the sheet. The active-site histidine and Ser{sup 46} occur in conformationally flexible regions. P-His-HPr from the Gram-positive bacterium Bacillus subtilus has been investigated by both homonuclear and heteronuclear two-dimensional and three-dimensional NMR experiments using an in-situ enzymatic regeneration system to maintain a constant level of P-His-HPr. The results show that localized conformational changes occur in the vicinity of the active-site histidine and also near Ser{sup 46}. HPr-Enzyme IIA{sup Glc} complexes from both Bacillus subtilis and Gram-negative Escherichia coli were also studied by a variety of {sup 15}N-edited two-dimensional NMR experiments, which were performed on uniformly {sup 15}N-labeled HPr complexed to unlabeled Enzyme IIA{sup Glc}. The complex is in fast exchange with a molecular weight of about 27 kDa. The focus of our work is to assess the changes undergone by HPr (the smaller of the two components), and so all the experiments were performed with excess Enzyme IIA present in the system.

  19. Review of thermal-hydraulic calculations for Calvert Cliffs and H.B. Robinson PTS study

    International Nuclear Information System (INIS)

    Jo, J.H.; Yuelys-Miksis, C.; Rohatgi, U.S.

    1984-01-01

    Thermal-hydraulic transient calculations performed by LANL using the TRAC-PF1 code and by INEL using the RELAP5 code for the USNRC pressurized thermal shock (PTS) study of the Calvert Cliffs and H.B. Robinson Nuclear Power Plants have been reviewed at BNL including the input decks and steady state calculations. Furthermore, six transients for each plant have been selected for the in-depth review. Simple hand calculations based on the mass and energy balances of the entire reactor system, have been performed to predict the temperature and pressure of the reactor system, and the results have been compared with those obtained by the code calculation. In general, the temperatures and pressures of the primary system calculated by the codes have been very reasonable. The secondary pressures calculated by TRAC appear to indicate that the codes have some difficulty with the condensation model and further work is needed to assess the code calculation of the U-tube steam generator pressure when the cold auxiliary feedwater is introduced to the steam generator. However, it is not expected that this uncertainty would affect the transient calculations significantly

  20. PAPR Reduction of OFDM Signals by Novel Global Harmony Search in PTS Scheme

    Directory of Open Access Journals (Sweden)

    Hojjat Salehinejad

    2012-01-01

    Full Text Available The orthogonal frequency division multiplexing (OFDM modulation technique is one of the key strategies for multiuser signal transmission especially in smart grids and wind farms. This paper introduces an approach for peak-to-average power ratio (PAPR reduction of such signals based on novel global harmony search (NGHS and partial transmit sequence (PTS schemes. In PTS technique, the data block to be transmitted is partitioned into disjoint subblocks, which are combined using phase factors to minimize PAPR. The PTS requires an exhaustive search over all combinations of allowed phase factors. Therefore, with respect to the fast implementation and simplicity of NGHS technique, we could achieve significant reduction of PAPR.

  1. Implementasi dan Analisis Teknik Reduksi PAPR OFDM Menggunakan Metode PTS pada WARP

    Directory of Open Access Journals (Sweden)

    Rizkha Ajeng Rochmatika

    2017-01-01

    Full Text Available Sistem OFDM cocok digunakan sebagai solusi yang dapat memenuhi layanan komunikasi data kecepatan tinggi karena memiliki efisiensi bandwidth dengan performansi terbaik. Namun dalam implementasinya, sistem OFDM memiliki kelemahan yang disebabkan oleh tingginya nilai Peak to Average Power Ratio (PAPR sehingga sinyal OFDM rentan terkena distorsi nonlinear yang disebabkan oleh adanya komponen RF power amplifier yang menyebabkan kompleksitas komponen Analog to Digital Converter (ADC yang terdapat pada Wireless Open Access Research Platform (WARP. Nilai PAPR yang besar pada OFDM membutuhkan power amplifier dengan dynamic range yang lebar untuk mengakomodasi sinyal, apabila hal tersebut tidak terpenuhi maka menyebabkan distorsi nonlinear dan pada akhirnya menurunkan performansi OFDM. Oleh karena itu, untuk mengatasinya dibutuhkan suatu metode yang dapat mereduksi nilai PAPR salah satunya menggunakan metode PTS. Guna melihat unjuk kerja teknik PTS, maka pada penelitian ini dibandingkan dua skema antara sistem OFDM tanpa dan dengan teknik PTS menggunakan analisa pada bit error rate dan nilai CCDF. Dari hasil pengukuran menunjukkan bahwa implementasi kinerja teknik PTS mampu meningkatkan kinerja sistem OFDM saat terkena distorsi nonlinear, terlihat pada pengukuran dengan modulasi 16-QAM untuk gain 56 didapatkan peningkatan BER sebesar 95.98%. Sedangkan pada grafik CCDF terjadi penurunan nilai PAPR sebesar 34.17% untuk M=4.

  2. Diagnostics for Z-pinch implosion experiments on PTS

    Energy Technology Data Exchange (ETDEWEB)

    Ren, X. D., E-mail: amosrxd@163.com; Huang, X. B., E-mail: amosrxd@163.com; Zhou, S. T., E-mail: amosrxd@163.com; Zhang, S. Q., E-mail: amosrxd@163.com; Dan, J. K., E-mail: amosrxd@163.com; Li, J., E-mail: amosrxd@163.com; Cai, H. C., E-mail: amosrxd@163.com; Wang, K. L., E-mail: amosrxd@163.com; Ouyang, K., E-mail: amosrxd@163.com; Xu, Q., E-mail: amosrxd@163.com; Duan, S. C., E-mail: amosrxd@163.com; Chen, G. H., E-mail: amosrxd@163.com; Wang, M., E-mail: amosrxd@163.com; Feng, S. P., E-mail: amosrxd@163.com; Yang, L. B., E-mail: amosrxd@163.com; Xie, W. P., E-mail: amosrxd@163.com; Deng, J. J., E-mail: amosrxd@163.com [Key Lab of Pulsed Power, Institute of Fluid Physics, CAEP, P.O. Box 919-108, Mianyang, Sichuan 621999 (China)

    2014-12-15

    The preliminary experiments of wire array implosion were performed on PTS, a 10 MA z-pinch driver with a 70 ns rise time. A set of diagnostics have been developed and fielded on PTS to study pinch physics and implosion dynamics of wire array. Radiated power measurement for soft x-rays was performed by multichannel filtered x-ray diode array, and flat spectral responses x-ray diode detector. Total x-ray yield was measured by a calibrated, unfiltered nickel bolometer which was also used to obtain pinch power. Multiple time-gated pinhole cameras were used to produce spatial-resolved images of x-ray self-emission from plasmas. Two time-integrated pinhole cameras were used respectively with 20-μm Be filter and with multilayer mirrors to record images produced by >1-keV and 277±5 eV self-emission. An optical streak camera was used to produce radial implosion trajectories, and an x-ray streak camera paired with a horizontal slit was used to record a continuous time-history of emission with one-dimensional spatial resolution. A frequency-doubled Nd:YAG laser (532 nm) was used to produce four frame laser shadowgraph images with 6 ns time interval. We will briefly describe each of these diagnostics and present some typical results from them.

  3. The influence of finite-length flaw effects on PTS analyses

    International Nuclear Information System (INIS)

    Keeney-Walker, J.; Dickson, T.L.

    1993-01-01

    Current licensing issues within the nuclear industry dictate a need to investigate the effects of cladding on the extension of small finite-length cracks near the inside surface of a vessel. Because flaws having depths of the order of the combined clad and heat affected zone thickness dominate the frequency distribution of flaws, their initiation probabilities can govern calculated vessel failure probabilities. Current pressurized-thermal-shock (PTS) analysis computer programs recognize the influence of the inner-surface cladding layer in the heat transfer and stress analysis models, but assume the cladding fracture toughness is the same as that for the base material. The programs do not recognize the influence cladding may have in inhibiting crack initiation and propagation of shallow finite-length surface flaws. Limited experimental data and analyses indicate the cladding can inhibit the propagation of certain shallow flaws. This paper describes an analytical study which was carried out to determine (1) the minimum flaw depth for crack initiation under PTS loading for semicircular surface flaws in a clad reactor pressure vessel and (2) the impact, in terms of the conditional probability of vessel failure, of using a semicircular surface flaw as the initial flaw and assuming that the flaw cannot propagate in the cladding. The analytical results indicate that for initiation a much deeper critical crack depth is required for the finite-length flaw than for the infinite-length flaw, except for the least severe transient. The minimum flaw depths required for crack initiation from the finite-length flaw analyses were incorporated into a modified version of the OCA-P code. The modified code was applied to the analysis of selected PTS transients, and the results produced a substantial decrease in the conditional probability of failure. This initial study indicates a significant effect on probabilistic fracture analyses by incorporating finite-length flaw results

  4. Influence of military sexual assault and other military stressors on substance use disorder and PTS symptomology in female military veterans.

    Science.gov (United States)

    Yalch, Matthew M; Hebenstreit, Claire L; Maguen, Shira

    2018-05-01

    Servicewomen exposed to traumatic stressors over the course of their military service are at increased risk of developing symptoms of substance use disorder (SUD) and posttraumatic stress (PTS). They are also at risk for exposure to military sexual assault (MSA), which is also associated with SUD and PTS symptomology. Research is unclear about the incremental contributions of different forms of traumatic stressors on co-occurring SUD and PTS symptomology. In this study we examined the independent and combined effects of MSA and other military stressors on SUD and PTS symptomology in a sample of female veterans (N=407). Results indicate that MSA and other military stressors exhibit incremental effects on SUD and PTS symptomology. Results further suggest that women exposed to both MSA and other military stressors are at increased risk for developing co-occurring SUD and PTSD. These findings extend previous research on comorbid SUD and PTSD, highlighting the cumulative effects of traumatic stressors on posttraumatic psychopathology, and have implications for future research and clinical practice with female veterans. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Verification of WPS effect under a PTS event

    International Nuclear Information System (INIS)

    Okamura, Hiroyuki; Yagawa, Genki; Urabe, Yoshio; Satoh, Masanobu; Tomimatsu, Minoru; Iida, Masato

    1993-01-01

    In WPS A1 test, K, was monotonically increased with thermal shock and constant tensile load by control of bending load. The specimen broke within the scatter band of K IC data. In WPS A2 test, initial specimen temperature was kept same as that of WPS A1 test and another PTS load was applied. No crack initiation took place when K I was within the scatter band of K IC at the decreasing stage. After that, bending load was increased up to brittle fracture at the temperature where WPS A1 test specimen broke. K I value at fracture for WPS A2 test specimen was beyond the upper bound of K IC data. That is, WPS effect was confirmed even for the low toughness steel like RPV wall under irradiation. Also K I value at fracture can be predicted by Chell's theory. By introducing WPS effect into PTS integrity analysis, much more temperature margin can be expected

  6. Defect assessment benchmark studies

    International Nuclear Information System (INIS)

    Hooton, D.G.; Sharples, J.K.

    1995-01-01

    Assessments of the resistance to fast fracture of the beltline region of a PWR vessel subjected to a pressurized thermal shock (PTS) transient have been carried out using the procedures of French (RCC-M) and German (KTA) design codes, and comparisons made with results obtained using the R6 procedure as applied for Sizewell B. The example chosen for these comparisons is of a generic nature, and is taken as the PTS identified by the Hirsch addendum to the Second Marshall report (1987) as the most severe transient with regard to vessel integrity. All assessment methods show the beltline region of the vessel to be safe from the risk of fast fracture, but by varying factors of safety. These factors are discussed in terms of margins between limiting and reference defect sizes, fracture toughness and stress intensity factor, and material temperature and temperature at the onset of upper-shelf materials behaviour. Based on these studies, consideration is given to issues involved in the harmonization of those sections of the design codes which are concerned with methods for the demonstration of the avoidance of the risk of failure by fast fracture. (author)

  7. Influence of combined therapy with prospidin and methotrexate on radiological progression, functional status and quality of life in pts with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    O. V. Simonova

    2004-01-01

    Full Text Available Objective. To evaluate influence of combination therapy with prospidin (P and methotrexate (MTX on X-ray progression, functional status (FS and quality of life (QL in patients with rheumatoid arthritis (RA in comparison with MTX monotherapy. Material and methods. 143 RA pts (129 female and 14 male were studied. Of them, there were. Mean age was 45.5±5.l years. Average duration of the disease was 4.5 years. 20 pts had II and 123 - 111 degree of RA activity. The second X-ray stage according to Steinbroker dominated. 72 pts of group I received P+MTX combination therapy. The therapy included intravenous drip-feed of P 200-300 mg per week in 200ml of 5% glucose and MTX 10 mg per week 1M. The maintaining therapy included P 100-200 mg per week IM and MTX 10 mg per week. 71 patients of group II received MTX monotherapy 10 mg per week. X-ray progression assessment was performed according to Sharp method. FS was evaluated with the HAQ questionnaire, Lee test. QL was evaluated with SF-36 scale. Pts were examined before and after I, 2, 3, 6 and 12 months of treatment. Results. There was no increase of X-ray progression of the disease in case of P+MTX therapy as compared with MTX monotherapy. Both methods resulted in improvement of FS parameters and physical health. Combination therapy significantly improved psychological health as well.

  8. Service framework for Internet of People, Things and Services (IoPTS)

    DEFF Research Database (Denmark)

    Shinde, Gitanjali; Olesen, Henning

    2016-01-01

    Internet of Things (IoT) is a revolutionary technology, where devices around us will be capable of sensing, reacting, responding and working autonomously to provide services to the users e.g. within smart homes, enterprises, utilities and e-Health. In the IoT paradigm, every device...... will be connected to the Internet to provide services to the user. Bringing this together makes it relevant to talk about the "Internet of People, Things and Services (IoPTS)". However, providing the appropriate services to the users depending on their requirements is a major challenge for IoPTS. After reviewing...

  9. Strongly bound excitons in monolayer PtS2 and PtSe2

    KAUST Repository

    Sajjad, M.

    2018-01-22

    Based on first-principles calculations, the structural, electronic, and optical properties of monolayers PtS2 and PtSe2 are investigated. The bond stiffnesses and elastic moduli are determined by means of the spring constants and strain-energy relations, respectively. Dynamic stability is confirmed by calculating the phonon spectra, which shows excellent agreement with experimental reports for the frequencies of the Raman-active modes. The Heyd-Scuseria-Ernzerhof functional results in electronic bandgaps of 2.66 eV for monolayer PtS2 and 1.74 eV for monolayer PtSe2. G0W0 calculations combined with the Bethe-Salpeter equation are used to predict the optical spectra and exciton binding energies (0.78 eV for monolayer PtS2 and 0.60 eV for monolayer PtSe2). It turns out that the excitons are strongly bound and therefore very stable against external perturbations.

  10. TRAC analysis and support of Oconee-1 PTS studies

    International Nuclear Information System (INIS)

    Ireland, J.R.

    1983-01-01

    This paper describes the overall pressurized thermal shock (PTS) program at Los Alamos with emphasis on TRAC-PF1 calculations of severe overcooling transients for the Oconee-1 pressurized water reactor (PWR). A summary of results for several calculations are presented for the Oconee-1 PWR along with detailed discussions of two of the most severe overcooling transients predicted [main steam-line break and turbine-bypass valve (TBV) failures]. The calculations performed were plant specific in that details of both the primary and secondary sides were modeled in addition to a detailed model of the plant Integrated Control System (ICS). For the Oconee-1 main steam-line break transient, a minimum downcomer fluid temperature of approx. 405 K was predicted. For the TBV transient involving the failure of one bank of TBVs to close after initially opening following reactor and turbine trips, an extrapolated downcomer fluid temperature of approx. 365 K was estimated. The latter temperature is at the nil-ductility temperature (NDT) limit (approx. 365 K) for Oconee-1

  11. Molecular Recognition of PTS-1 Cargo Proteins by Pex5p: Implications for Protein Mistargeting in Primary Hyperoxaluria

    Directory of Open Access Journals (Sweden)

    Noel Mesa-Torres

    2015-02-01

    Full Text Available Peroxisomal biogenesis and function critically depends on the import of cytosolic proteins carrying a PTS1 sequence into this organelle upon interaction with the peroxin Pex5p. Recent structural studies have provided important insights into the molecular recognition of cargo proteins by Pex5p. Peroxisomal import is a key feature in the pathogenesis of primary hyperoxaluria type 1 (PH1, where alanine:glyoxylate aminotransferase (AGT undergoes mitochondrial mistargeting in about a third of patients. Here, we study the molecular recognition of PTS1 cargo proteins by Pex5p using oligopeptides and AGT variants bearing different natural PTS1 sequences, and employing an array of biophysical, computational and cell biology techniques. Changes in affinity for Pex5p (spanning over 3–4 orders of magnitude reflect different thermodynamic signatures, but overall bury similar amounts of molecular surface. Structure/energetic analyses provide information on the contribution of ancillary regions and the conformational changes induced in Pex5p and the PTS1 cargo upon complex formation. Pex5p stability in vitro is enhanced upon cargo binding according to their binding affinities. Moreover, we provide evidence that the rational modulation of the AGT: Pex5p binding affinity might be useful tools to investigate mistargeting and misfolding in PH1 by pulling the folding equilibria towards the native and peroxisomal import competent state.

  12. The relation of appraisal, coping efforts, and acuteness of trauma to PTS symptoms among former political prisoners.

    Science.gov (United States)

    Kanninen, Katri; Punamäki, Raija-Leena; Qouta, Samir

    2002-06-01

    We examined how trauma-specific appraisals and coping efforts mediate between traumatic experiences, acuteness of trauma, and length of imprisonment and posttraumatic stress symptoms (PTS) among 103 Palestinian former political prisoners. The findings provide support for both direct and mediated models of trauma. The acuteness of trauma (time since release), appraisal of prison experience as harmful and involving loss, and use of both emotion- and problem-focused coping efforts were associated with high levels of PTS symptoms. Torture and ill-treatment had a direct association with intrusion, and recent release from prison with avoidance symptoms. Acuteness of trauma turned out to be important in the coping and symptom association: emotion-focused coping was associated with a low level of PTS symptoms in the long run, whereas problem-focused coping was associated with a low level of PTS symptoms in the short run.

  13. Does Maternal Parenting Stress Mediate the Association between Postpartum PTS Symptoms and Children's Internalizing and Externalizing Problems? A Longitudinal Perspective

    Science.gov (United States)

    Di Blasio, Paola; Camisasca, Elena; Miragoli, Sarah; Ionio, Chiara; Milani, Luca

    2017-01-01

    Background: The research carried out in the last years outlined that childbirth could be considered as a sufficient stressor for the insurgence of posttraumatic stress (PTS) symptoms with important consequences for the child care. Objectives: In a longitudinal perspective, this study focused on PTS symptoms after childbirth to understand their…

  14. Tysnd1 deficiency in mice interferes with the peroxisomal localization of PTS2 enzymes, causing lipid metabolic abnormalities and male infertility.

    Directory of Open Access Journals (Sweden)

    Yumi Mizuno

    Full Text Available Peroxisomes are subcellular organelles involved in lipid metabolic processes, including those of very-long-chain fatty acids and branched-chain fatty acids, among others. Peroxisome matrix proteins are synthesized in the cytoplasm. Targeting signals (PTS or peroxisomal targeting signal at the C-terminus (PTS1 or N-terminus (PTS2 of peroxisomal matrix proteins mediate their import into the organelle. In the case of PTS2-containing proteins, the PTS2 signal is cleaved from the protein when transported into peroxisomes. The functional mechanism of PTS2 processing, however, is poorly understood. Previously we identified Tysnd1 (Trypsin domain containing 1 and biochemically characterized it as a peroxisomal cysteine endopeptidase that directly processes PTS2-containing prethiolase Acaa1 and PTS1-containing Acox1, Hsd17b4, and ScpX. The latter three enzymes are crucial components of the very-long-chain fatty acids β-oxidation pathway. To clarify the in vivo functions and physiological role of Tysnd1, we analyzed the phenotype of Tysnd1(-/- mice. Male Tysnd1(-/- mice are infertile, and the epididymal sperms lack the acrosomal cap. These phenotypic features are most likely the result of changes in the molecular species composition of choline and ethanolamine plasmalogens. Tysnd1(-/- mice also developed liver dysfunctions when the phytanic acid precursor phytol was orally administered. Phyh and Agps are known PTS2-containing proteins, but were identified as novel Tysnd1 substrates. Loss of Tysnd1 interferes with the peroxisomal localization of Acaa1, Phyh, and Agps, which might cause the mild Zellweger syndrome spectrum-resembling phenotypes. Our data established that peroxisomal processing protease Tysnd1 is necessary to mediate the physiological functions of PTS2-containing substrates.

  15. Methods used for immunization coverage assessment in Canada, a Canadian Immunization Research Network (CIRN) study.

    Science.gov (United States)

    Wilson, Sarah E; Quach, Susan; MacDonald, Shannon E; Naus, Monika; Deeks, Shelley L; Crowcroft, Natasha S; Mahmud, Salaheddin M; Tran, Dat; Kwong, Jeff; Tu, Karen; Gilbert, Nicolas L; Johnson, Caitlin; Desai, Shalini

    2017-08-03

    Accurate and complete immunization data are necessary to assess vaccine coverage, safety and effectiveness. Across Canada, different methods and data sources are used to assess vaccine coverage, but these have not been systematically described. Our primary objective was to examine and describe the methods used to determine immunization coverage in Canada. The secondary objective was to compare routine infant and childhood coverage estimates derived from the Canadian 2013 Childhood National Immunization Coverage Survey (cNICS) with estimates collected from provinces and territories (P/Ts). We collected information from key informants regarding their provincial, territorial or federal methods for assessing immunization coverage. We also collected P/T coverage estimates for select antigens and birth cohorts to determine absolute differences between these and estimates from cNICS. Twenty-six individuals across 16 public health organizations participated between April and August 2015. Coverage surveys are conducted regularly for toddlers in Quebec and in one health authority in British Columbia. Across P/Ts, different methodologies for measuring coverage are used (e.g., valid doses, grace periods). Most P/Ts, except Ontario, measure up-to-date (UTD) coverage and 4 P/Ts also assess on-time coverage. The degree of concordance between P/T and cNICS coverage estimates varied by jurisdiction, antigen and age group. In addition to differences in the data sources and processes used for coverage assessment, there are also differences between Canadian P/Ts in the methods used for calculating immunization coverage. Comparisons between P/T and cNICS estimates leave remaining questions about the proportion of children fully vaccinated in Canada.

  16. The methylotrophic yeast Hansenula polymorpha contains an inducible import pathway for peroxisomal matrix proteins with an N-terminal targeting signal (PTS2 proteins)

    NARCIS (Netherlands)

    Faber, Klaas Nico; Haima, Pieter; Gietl, Christine; Harder, Willem; Ab, Geert; Veenhuis, Marten

    1994-01-01

    Two main types of peroxisomal targeting signals have been identified that reside either at the extreme C terminus (PTS1) or the N terminus (PTS2) of the protein. In the methylotrophic yeast Hansenula polymorpha the majority of peroxisomal matrix proteins are of the PTS1 type. Thus far, for H.

  17. Strongly bound excitons in monolayer PtS2 and PtSe2

    KAUST Repository

    Sajjad, M.; Singh, Nirpendra; Schwingenschlö gl, Udo

    2018-01-01

    Based on first-principles calculations, the structural, electronic, and optical properties of monolayers PtS2 and PtSe2 are investigated. The bond stiffnesses and elastic moduli are determined by means of the spring constants and strain

  18. Fracture mechanics analysis and evaluation for the RPV of the Chinese Qinshan 300 MW NPP and PTS

    International Nuclear Information System (INIS)

    He Yinbiao; Isozaki, Toshikuni

    2000-03-01

    One of the most severe accident conditions of a reactor pressure vessel (RPV) in service is the loss of coolant accident (LOCA). Cold safety injection water is pumped into the downcomer of the RPV through inlet nozzles, while the internal pressure may remain at high level. Such an accident is called pressurized thermal shock (PTS) transient according to 10 CFR 50.61 definition. This paper illustrates the fracture mechanics analysis for the existing RPV of the Chinese Qinshan 300 MW nuclear power plant (NPP) under the postulated PTS transients that include SB-LOCA, LB-LOCA of Qinshan NPP and Rancho Seco transients. 3-D models with the flaw depth range a/w=0.05∼0.9 (a: flaw depth; w: wall thickness) were used to probe what kind of flaw and what kind of transient are most dangerous for the RPV in the end of life (EOF). Both the elastic and elastic-plastic material models were used in the stress analysis and fracture mechanics analysis. The different types of flaw and the influence of the stainless steel cladding on the fracture analysis were investigated for different PTS transients. comparing with the material initiation crack toughness K IC , the fracture evaluation for the RPV in question under PTS transients are performed in this paper. (author)

  19. Primary experimental results of wire-array Z-pinches on PTS

    Energy Technology Data Exchange (ETDEWEB)

    Huang, X. B., E-mail: caephxb2003@aliyun.com; Zhou, S. T., E-mail: caephxb2003@aliyun.com; Ren, X. D., E-mail: caephxb2003@aliyun.com; Dan, J. K., E-mail: caephxb2003@aliyun.com; Wang, K. L., E-mail: caephxb2003@aliyun.com; Zhang, S. Q., E-mail: caephxb2003@aliyun.com; Li, J., E-mail: caephxb2003@aliyun.com; Xu, Q., E-mail: caephxb2003@aliyun.com; Cai, H. C., E-mail: caephxb2003@aliyun.com; Duan, S. C., E-mail: caephxb2003@aliyun.com; Ouyang, K., E-mail: caephxb2003@aliyun.com; Chen, G. H., E-mail: caephxb2003@aliyun.com; Ji, C., E-mail: caephxb2003@aliyun.com; Wang, M., E-mail: caephxb2003@aliyun.com; Feng, S. P., E-mail: caephxb2003@aliyun.com; Yang, L. B., E-mail: caephxb2003@aliyun.com; Xie, W. P., E-mail: caephxb2003@aliyun.com; Deng, J. J., E-mail: caephxb2003@aliyun.com [Key Lab of Pulsed Power, Institute of Fluid Physics, CAEP, P.O. Box 919-108, Mianyang, Sichuan 621999 (China)

    2014-12-15

    The Primary Test Stand (PTS) developed at the China Academy of Engineering Physics is a multiterawatt pulsed power driver, which can deliver a ∼10 MA, 70 ns rise-time (10%-90%) current to a short circuit load and has important applications in Z-pinch driven inertial confinement fusion and high energy density physics. In this paper, primary results of tungsten wire-array Z-pinch experiments on PTS are presented. The load geometries investigated include 15-mm-tall cylindrical single and nested arrays with diameter ranging from 14.4-26.4 mm, and consisting of 132∼276 tungsten wires with 5∼10 μm in diameter. Multiple diagnostics were fielded to determine the characteristics of x-ray radiations and to obtain self-emitting images of imploding plasmas. X-ray power up to 80 TW with ∼3 ns FWMH is achieved by using nested wire arrays. The total x-ray energy exceeds 500 kJ and the peak radiation temperature is about 150 eV. Typical velocity of imploding plasmas goes around 3∼5×10{sup 7} cm/s and the radial convergence ratio is between 10 and 20.

  20. Symmetrical metallic and magnetic edge states of nanoribbon from semiconductive monolayer PtS2

    Science.gov (United States)

    Liu, Shan; Zhu, Heyu; Liu, Ziran; Zhou, Guanghui

    2018-03-01

    Transition metal dichalcogenides (TMD) MoS2 or graphene could be designed to metallic nanoribbons, which always have only one edge show metallic properties due to symmetric protection. In present work, a nanoribbon with two parallel metallic and magnetic edges was designed from a noble TMD PtS2 by employing first-principles calculations based on density functional theory (DFT). Edge energy, bonding charge density, band structure, density of states (DOS) and simulated scanning tunneling microscopy (STM) of four possible edge states of monolayer semiconductive PtS2 were systematically studied. Detailed calculations show that only Pt-terminated edge state among four edge states was relatively stable, metallic and magnetic. Those metallic and magnetic properties mainly contributed from 5d orbits of Pt atoms located at edges. What's more, two of those central symmetric edges coexist in one zigzag nanoribbon, which providing two atomic metallic wires thus may have promising application for the realization of quantum effects, such as Aharanov-Bohm effect and atomic power transmission lines in single nanoribbon.

  1. A hybrid peptide PTS that facilitates transmembrane delivery and its application for the rapid in vivo imaging via near-infrared fluorescence imaging

    Directory of Open Access Journals (Sweden)

    Xuejiao eYan

    2016-03-01

    Full Text Available Background and purpose: Intravital imaging provides invaluable readouts for clinical diagnoses and therapies and shows great potential in the design of individualized drug dosage regimes. Ts is a mammalian free cell membrane-penetrating peptide. This study aimed to introduce a novel approach to the design of a cancer-selective peptide on the basis of a membrane-penetrating peptide and to explore its potential as a carrier of medical substances. Experimental approach: Ts was linked with a αvβ3-binding peptide P1c to create a hybrid referred to as PTS. The hybrid was labeled with an FITC or Cy5.5 as an imaging indicator to evaluate its in vitro and in vivo bioactivity. Key results: Hemolysis tests proved that in comparison with Ts, PTS caused similar or even less leakage of human erythrocytes at concentrations of up to 1 mmol/L. Flow cytometry assay and confocal microscopy demonstrated the following. 1 P1c alone could target and mostly halt at the cancer cell membrane. 2 Ts alone could not bind to the membrane sufficiently. 3 P1c greatly enhanced the binding affinity of PTS with MDA-MB-231 breast cancer cells that upregulated αvβ3. 4 Ts conferred PTS with the ability to traverse a cell membrane and thus facilitate the transmembrane delivery of imaging probes. In vivo near-infrared fluorescence (NIRF imaging demonstrated that the imaging probes were rapidly concentrated in a MDA-MB-231 tumor tissue within 1 h after intravenous injection. Conclusions and implications: PTS exhibited the capability of targeting specific tumors and greatly facilitating the transmembrane delivery of imaging probes.

  2. Thermal hydraulic evaluation for an experimental facility to investigate pressurized thermal shock (PTS) in CDTN/CNEN

    International Nuclear Information System (INIS)

    Palmieri, Elcio T.; Navarro, Moyses A.; Aronne, Ivam D.; Terra, Jose L.

    2002-01-01

    The goal of the work presented in this paper is to provide necessary thermal hydraulics information to the design of an experimental installation to investigate the Pressurized Thermal Shock (PTS) to be implemented at Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN). The envisaged installation has a test section that represents, in a small scale, a pressure vessel of a nuclear reactor. This test section will be heated and then exposed to a PTS in order to evaluate the appearance and development of cracks. To verify the behavior of the temperatures of the pressure vessel after a sudden flood through the annulus, calculations were made using the RELAP5/MOD 3.2.2 gamma code. Different outer radiuses were studied for the annular region. The results showed that the smaller annulus spacing (20 mm) anticipates the wetting of the surface and produces a higher cooling of the external surface, which stays completely wet for a longer time. (author)

  3. A probabilistic approach to the evaluation of the PTS issue

    International Nuclear Information System (INIS)

    Cheverton, R.D.; Selby, D.L.

    1991-01-01

    An integrated probabilistic approach for the evaluation of the pressurized-thermal-shock (PTS) issue was developed at the Oak Ridge National Laboratory (ORNL) at the request of the Nuclear Regulatory Commission (NRC). The purpose was to provide a method for identifying dominant plant design and operating features, evaluating possible remedial measures and the validity of the NRC PTS screening criteria, and to provide an additional tool for estimating vessel life expectancy. The approach was to be integrated in the sense that it would include the postulation of transients; estimates of their frequencies of occurrence; systems analyses to obtain the corresponding primary-system pressure, down-comer coolant temperature, and fluid-film heat-transfer coefficient adjacent to the vessel wall; and a probabilistic fracture-mechanics analysis, using the latter data as input. A summation of the products of frequency of transient and conditional probability of failure for all postulated transients provides an estimate of frequency of vessel failure. In the process of developing the integrated pressurized-thermal-shock (IPTS) methodology, three specific plant analyses were conducted. The results indicate that the NRC screening criteria may not be appropriate for all US pressurized water reactor (PWR) plants; that is, for some PWRs, the calculated mean frequency of vessel failure corresponding to the screening criteria may be greater than the maximum permissible value in Regulatory Guide 1.154. A recent view of the ORNL IPTS study, which was completed in 1985, indicates that there are a number of areas in which the methodology can and should be updated, but it is not clear whether the update will increase or decrease the calculated probabilities. 31 refs., 2 tabs

  4. Validation of the Large Interface Method of NEPTUNE{sub C}FD 1.0.8 for Pressurized Thermal Shock (PTS) applications

    Energy Technology Data Exchange (ETDEWEB)

    Coste, P., E-mail: pierre.coste@cea.fr [CEA, DEN, DER/SSTH, F-38054 Grenoble (France); Lavieville, J. [Electricite de France, Chatou (France); Pouvreau, J. [CEA, DEN, DER/SSTH, F-38054 Grenoble (France); Baudry, C.; Guingo, M.; Douce, A. [Electricite de France, Chatou (France)

    2012-12-15

    Highlights: Black-Right-Pointing-Pointer The two-phase Pressurized Thermal Shock (PTS) is a key thermohydraulics issue for PWR safety. Black-Right-Pointing-Pointer The dynamic and condensation models are firstly validated separately. Black-Right-Pointing-Pointer Then the global validation is done with the COSI experiment. Black-Right-Pointing-Pointer All the calculations performed with the same set of models both in the Large Interface Method and in the k-{epsilon} approach for turbulence substantiate the application of the tool to PTS. - Abstract: NEPTUNE{sub C}FD is a code based on a 3D transient Eulerian two-fluid model. One of the main application targets is the two-phase Pressurized Thermal Shock (PTS), which is related to PWR Reactor Pressure Vessel (RPV) lifetime safety studies, when sub-cooled water from Emergency Core Cooling (ECC) system is injected into the possibly uncovered cold leg and penetrates into the RPV downcomer. Five experiments were selected for the validation, a selection reviewed by a panel of European experts. The dynamic models are validated with a co-current smooth and wavy air-water stratified flow in a rectangular channel with detailed measurements of turbulence and velocities. The condensation models are validated with a co-current smooth and wavy steam-water stratified flow in a rectangular channel with measurements of the steam flow rates. The dynamic models are validated in the situation of a jet impinging a pool free surface with two experiments dealing with a water jet impingement on a water pool free surface in air environment. Finally, all the models involved in the reactor conditions are validated with the COSI experiment. The calculations are done with the same set of Large Interface Method models and a RANS (k-{epsilon}) approach for turbulence. They substantiate the application of the tool to PTS studies.

  5. Development of Pneumatic Transfer Irradiation Facility (PTS no.3) for Neutron Activation Analysis at HANARO Research Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Y. S.; Moon, J. H.; Kim, S. H.; Sun, G. M.; Baek, S. Y.; Kim, H. R.; Kim, Y. J

    2008-04-15

    A pneumatic transfer system (PTS) is one of the most important facilities used during neutron irradiation of a target material for instrumental neutron activation analysis (INAA) in a research reactor. In particular, a fast pneumatic transfer system is essential for the measurement of a short half-life nuclide. The pneumatic transfer irradiation system (PTS no.3) involving a manual system and an semi-automatic system were reconstructed with new designs of a functional improvement at the HANARO research reactor and NAA laboratory of RI building in 2006. In this technical report, the design, operation and control of these system (PTS no.3) was described. Also the experimental results and the characteristic parameters measured from a functional operation test and an irradiation test of these systems, such as the transfer time of irradiation capsule, the different neutron flux, the temperature of the irradiation position with an irradiation time, the radiation dose rate when the rabbit is returned, etc. are reported to provide a user information as well as a reactor's management and safety.

  6. Development of Pneumatic Transfer Irradiation Facility (PTS no.1) for Neutron Activation Analysis at HANARO Research Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Y. S.; Moon, J. H.; Kim, S. H.; Sun, G. M.; Baek, S. Y.; Kim, H. R.; Kim, Y. J

    2008-03-15

    A pneumatic transfer system (PTS) is one of the most important facilities used during neutron irradiation of a target material for instrumental neutron activation analysis (INAA) in a research reactor. In particular, a fast pneumatic transfer system is essential for the measurement of a short half-life nuclide and a delayed neutron counting system. The pneumatic transfer system (PTS no.1) involving a manual system and an semiautomatic system were reconstructed with new designs of a functional improvement at the HANARO research reactor in 2006. In this technical report, the conception, design, operation and control of these system (PTS no.1) was described. Also the experimental results and the characteristic parameters measured by a mock-up test, a functional operation test and an irradiation test of these systems, such as the transfer time of irradiation capsule, the different neutron flux, the temperature of the irradiation position with an irradiation time, the radiation dose rate when the rabbit is returned, etc. are reported to provide a user information as well as a reactor's management and safety.

  7. Design and development of fast pneumatic transfer system (PTS) for instrumental neutron activation analysis at Jordan research reactor

    International Nuclear Information System (INIS)

    Chung, Yongsam; Kim, Sunha; Moon, Jonghwa; Choi, Jinbok; Lee, Jongmin; Ryu, Jungsu

    2013-01-01

    A pneumatic transfer system (PTS) is one of the important equipment used for an neutron irradiation of a target material for an instrumental neutron activation analysis (INAA) in a research reactor. In particular, a rapid pneumatic transportation of irradiation capsule is essential for an accurate measurement of a short half-life nuclide. Three types of PTS for NAA facility at the Jordan Research and Training Reactor (JRTR) were newly developed for a functional improvement involving a manual and an automatic system which is equipped with programmable logic controller, software, and 13 devices to facilitate optimal operation of the system. In this paper, the designs and construction of these PTS, the operation and control of the system are described. In addition, a functional and operational test of the system were carried out as one of the basic requirement and characteristic parameters, and the results were reported to provide a user information as well as for the management and safety of the reactor

  8. SISTEM PENDUKUNG KEPUTUSAN PEMILIHAN PTS DI LHOKSEUMAWE MENGGUNAKAN METODE FUZZY AHP BERBASIS WEB

    Directory of Open Access Journals (Sweden)

    - Nurdin

    2015-07-01

    Full Text Available Sistem Pendukung Keputusan pemilihan PTS ini bertujuan untuk memberikan dukungan pengambilan keputusan untuk pemilihan sebuah PTS di Lhokseumawe. Pada sistem ini terdapat 11 alternatif perguruan tinggi swasta dan ada 6 kriteria yang digunakan oleh sistem. Sistem ini menggunakan metode fuzzy untuk kriteriayang bobot nilainya tidak tetap, kriteria tersebut diantaranya jumlah lulusan, Jarak dengan kota, Biaya pendidikan, jumlah dosen dan pendidikan dosen serta menggunakan metode Analytic Hierarchy Process (AHP  yaitu untuk perangkingan Perguruan Tinggi yang dipilih oleh user. Pemberian nilai fuzzy berlaku untuk setiap kriteria yang ada. Pada sistem ini juga terdapat 2 proses yakni proses pemilihan perguruan tinggi swasta dan proses membandingkan tingkat kepentingan antar kriteria. Perhitungan fuzzy pada sistem ini tidak dilakukan di dalam sistem melainkan di input oleh admin sistem yang telah dicari terlebih dahulu nilai fuzzy kriteria untuk tiap alternatif yang ada. Hasil dari proses fuzzy dan AHP dalam aplikasi ini akan menghasilkan perangkingan untuk alternatif yang dipilih oleh user.Kata kunci : Fuzzy, AHP, SPK, Pemilihan

  9. Two-phase CFD PTS validation in an extended range of thermohydraulics conditions covered by the COSI experiment

    International Nuclear Information System (INIS)

    Coste, P.; Ortolan, A.

    2014-01-01

    Highlights: • Models for large interfaces in two-phase CFD were developed for PTS. • The COSI experiment is used for NEPTUNE C FD integral validation. • COSI is a PWR cold leg scaled 1/100 for volume. • Fifty runs are calculated, covering a large range of flow configurations. • The CFD predicting capability is analysed using global and local measurements. - Abstract: In the context of the Pressurized Water Reactors (PWR) life duration safety studies, some models were developed to address the Pressurized Thermal Shock (PTS) from the two-phase CFD angle, dealing with interfaces much larger than cells size and with direct contact condensation. Such models were implemented in NEPTUNE C FD, a 3D transient Eulerian two-fluid model. The COSI experiment is used for its integral validation. It represents a cold leg scaled 1/100 for volume and power from a 900 MW PWR under a large range of LOCA PTS conditions. In this study, the CFD is evaluated in the whole range of parameters and flow configurations covered by the experiment. In a first step, a single choice of mesh and CFD models parameters is fixed and justified. In a second step, fifty runs are calculated. The CFD predicting capability is analysed, comparing the liquid temperature and the total condensation rate with the experiment, discussing their dependency on the inlet cold liquid rate, on the liquid level in the cold leg and on the difference between co-current and counter-current runs. It is shown that NEPTUNE C FD 1.0.8 calculates with a fair agreement a large range of flow configurations related to ECCS injection and steam condensation

  10. Development of Pneumatic Transfer Irradiation Facility (PTS no.2) for Neutron Activation Analysis at HANARO Research Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Y. S.; Moon, J. H.; Kim, S. H.; Sun, G. M.; Baek, S. Y.; Kim, H. R.; Kim, Y. J

    2008-03-15

    A pneumatic transfer irradiation system (PTS) is one of the most important facilities used during neutron irradiation of a target material for instrumental neutron activation analysis (INAA) in a research reactor. In particular, a fast pneumatic transfer system is essential for the measurement of a short half-life nuclide and a delayed neutron counting system. The pneumatic transfer irradiation system (PTS no.2) involving a manual system and an automatic system for delayed neutron activation analysis (DNAA) were reconstructed with new designs of a functional improvement at the HANARO research reactor in 2006. In this technical report, the conception, design, operation and control of PTS no.2 was described. Also the experimental results and the characteristic parameters measured by a mock-up test, a functional operation test and an irradiation test of these systems, such as the transfer time of irradiation capsule, automatic operation control by personal computer, delayed neutron counting system, the different neutron flux, the temperature of the irradiation position with an irradiation time, the radiation dose rate when the rabbit is returned, etc. are reported to provide a user information as well as a reactor's management and safety.

  11. Class IIa bacteriocin resistance in Enterococcus faecalis V583: The mannose PTS operon mediates global transcriptional responses

    Directory of Open Access Journals (Sweden)

    Opsata Mona

    2010-08-01

    Full Text Available Abstract Background The class IIa bacteriocin, pediocin PA-1, has clear potential as food preservative and in the medical field to be used against Gram negative pathogen species as Enterococcus faecalis and Listeria monocytogenes. Resistance towards class IIa bacteriocins appear in laboratory and characterization of these phenotypes is important for their application. To gain insight into bacteriocin resistance we studied mutants of E. faecalis V583 resistant to pediocin PA-1 by use of transcriptomic analyses. Results Mutants of E. faecalis V583 resistant to pediocin PA-1 were isolated, and their gene expression profiles were analyzed and compared to the wild type using whole-genome microarray. Significantly altered transcription was detected from about 200 genes; most of them encoding proteins involved in energy metabolism and transport. Glycolytic genes were down-regulated in the mutants, but most of the genes showing differential expression were up-regulated. The data indicate that the mutants were relieved from glucose repression and putative catabolic responsive elements (cre could be identified in the upstream regions of 70% of the differentially expressed genes. Bacteriocin resistance was caused by reduced expression of the mpt operon encoding the mannose-specific phosphoenolpyruvate:carbohydrate phosphotransferase system (PTS, and the same transcriptional changes were seen in a mptD-inactivated mutant. This mutant also had decreased transcription of the whole mpt operon, showing that the PTS is involved in its own transcriptional regulation. Conclusion Our data confirm the important role of mannose PTS in class IIa bacteriocin sensitivity and we demonstrate its importance involving global carbon catabolite control.

  12. Transesophageal echocardiography in the assessment of coronary arteries

    International Nuclear Information System (INIS)

    Adamek-Kosmider, A.; Kasprzak, J.; Kosmider, M.; Krzeminska-Pakula, M.

    1993-01-01

    The study was undertaken to assess the usefulness of TEE for evaluation of morphology and flow in coronary arteries. TEE (2D, spectral and color Doppler imaging) and coronary angiography were performed in 75 patients - 41 with valvular heart disease and 34 with ischemic heart disease. Proximal coronary artery stenosis was detected by coronarography in 11 pts (9-left main coronary artery, 2-right coronary artery). TEE visualization of proximal coronary arteries was possible in all pts. Echocardiographic features of artery stenosis were: the narrowing of the vessel in 2D image (9 pts), high flow velocity spectral Doppler (4 pts, mean 135 cm/s vs 55 cm/s in normal arteries) and mosaic, turbulent flow in color Doppler (10 pts). Sensitivity and specificity of TEE for coronary artery stenosis detection was respectively 81%/98% for 2D imaging and 90%/100% for color Doppler. TEE is a new, noninvasive and safe method for the evaluation of proximal coronary arteries. Detection of LMCA stenosis prior to atheterization may enhance the safety of coronary angiography. (author)

  13. Variable length adjacent partitioning for PTS based PAPR reduction of OFDM signal

    International Nuclear Information System (INIS)

    Ibraheem, Zeyid T.; Rahman, Md. Mijanur; Yaakob, S. N.; Razalli, Mohammad Shahrazel; Kadhim, Rasim A.

    2015-01-01

    Peak-to-Average power ratio (PAPR) is a major drawback in OFDM communication. It leads the power amplifier into nonlinear region operation resulting into loss of data integrity. As such, there is a strong motivation to find techniques to reduce PAPR. Partial Transmit Sequence (PTS) is an attractive scheme for this purpose. Judicious partitioning the OFDM data frame into disjoint subsets is a pivotal component of any PTS scheme. Out of the existing partitioning techniques, adjacent partitioning is characterized by an attractive trade-off between cost and performance. With an aim of determining effects of length variability of adjacent partitions, we performed an investigation into the performances of a variable length adjacent partitioning (VL-AP) and fixed length adjacent partitioning in comparison with other partitioning schemes such as pseudorandom partitioning. Simulation results with different modulation and partitioning scenarios showed that fixed length adjacent partition had better performance compared to variable length adjacent partitioning. As expected, simulation results showed a slightly better performance of pseudorandom partitioning technique compared to fixed and variable adjacent partitioning schemes. However, as the pseudorandom technique incurs high computational complexities, adjacent partitioning schemes were still seen as favorable candidates for PAPR reduction

  14. Variable length adjacent partitioning for PTS based PAPR reduction of OFDM signal

    Energy Technology Data Exchange (ETDEWEB)

    Ibraheem, Zeyid T.; Rahman, Md. Mijanur; Yaakob, S. N.; Razalli, Mohammad Shahrazel; Kadhim, Rasim A. [School of Computer and Communication Engineering, Universiti Malaysia Perlis, 02600 Arau, Perlis (Malaysia)

    2015-05-15

    Peak-to-Average power ratio (PAPR) is a major drawback in OFDM communication. It leads the power amplifier into nonlinear region operation resulting into loss of data integrity. As such, there is a strong motivation to find techniques to reduce PAPR. Partial Transmit Sequence (PTS) is an attractive scheme for this purpose. Judicious partitioning the OFDM data frame into disjoint subsets is a pivotal component of any PTS scheme. Out of the existing partitioning techniques, adjacent partitioning is characterized by an attractive trade-off between cost and performance. With an aim of determining effects of length variability of adjacent partitions, we performed an investigation into the performances of a variable length adjacent partitioning (VL-AP) and fixed length adjacent partitioning in comparison with other partitioning schemes such as pseudorandom partitioning. Simulation results with different modulation and partitioning scenarios showed that fixed length adjacent partition had better performance compared to variable length adjacent partitioning. As expected, simulation results showed a slightly better performance of pseudorandom partitioning technique compared to fixed and variable adjacent partitioning schemes. However, as the pseudorandom technique incurs high computational complexities, adjacent partitioning schemes were still seen as favorable candidates for PAPR reduction.

  15. A Suboptimal PTS Algorithm Based on Particle Swarm Optimization Technique for PAPR Reduction in OFDM Systems

    Directory of Open Access Journals (Sweden)

    Ho-Lung Hung

    2008-08-01

    Full Text Available A suboptimal partial transmit sequence (PTS based on particle swarm optimization (PSO algorithm is presented for the low computation complexity and the reduction of the peak-to-average power ratio (PAPR of an orthogonal frequency division multiplexing (OFDM system. In general, PTS technique can improve the PAPR statistics of an OFDM system. However, it will come with an exhaustive search over all combinations of allowed phase weighting factors and the search complexity increasing exponentially with the number of subblocks. In this paper, we work around potentially computational intractability; the proposed PSO scheme exploits heuristics to search the optimal combination of phase factors with low complexity. Simulation results show that the new technique can effectively reduce the computation complexity and PAPR reduction.

  16. A Suboptimal PTS Algorithm Based on Particle Swarm Optimization Technique for PAPR Reduction in OFDM Systems

    Directory of Open Access Journals (Sweden)

    Lee Shu-Hong

    2008-01-01

    Full Text Available Abstract A suboptimal partial transmit sequence (PTS based on particle swarm optimization (PSO algorithm is presented for the low computation complexity and the reduction of the peak-to-average power ratio (PAPR of an orthogonal frequency division multiplexing (OFDM system. In general, PTS technique can improve the PAPR statistics of an OFDM system. However, it will come with an exhaustive search over all combinations of allowed phase weighting factors and the search complexity increasing exponentially with the number of subblocks. In this paper, we work around potentially computational intractability; the proposed PSO scheme exploits heuristics to search the optimal combination of phase factors with low complexity. Simulation results show that the new technique can effectively reduce the computation complexity and PAPR reduction.

  17. An evaluation of analysis methodologies for predicting cleavage arrest of a deep crack in an RPV subjected to PTS loading conditions

    International Nuclear Information System (INIS)

    Keeney-Walker, J.; Bass, B.R.

    1992-01-01

    Several calculational procedures are compared for predicting cleavage arrest of a deep crack in the wall of a prototypical reactor pressure vessel (RPV) subjected to pressurized-thermal-shock (PTS) types of loading conditions. Three procedures examined in this study utilized the following models: (1) a static finite-element model (full bending); (2) a radially constrained static model; and (3) a thermoelastic dynamic finite-element model. A PTS transient loading condition was selected that produced a deep arrest of an axially-oriented initially shallow crack according to calculational results obtained from the static (full-bending) model. Results from the two static models were compared with those generated from the detailed thermoelastic dynamic finite-element analysis. The dynamic analyses modeled cleavage-crack propagation using node-release technique and an application-mode methodology based on dynamic fracture toughness curves generated from measured data. Comparisons presented here indicate that the degree to which dynamic solutions can be approximated by static models is highly dependent on several factors, including the material dynamic fracture curves and the propensity for cleavage reinitiation of the arrested crack under PTS loading conditions. Additional work is required to develop and validate a satisfactory dynamic fracture toughness model applicable to postcleavage arrest conditions in an RPV

  18. A PhD abstract presentation on Cluster Framework for Internet of People, Things and Services (IoPTS)

    DEFF Research Database (Denmark)

    Shinde, Gitanjali; Olesen, Henning

    2014-01-01

    The Internet of Things (IoT) is a revolutionary technology, where devices around us are capable of sensing, reacting, responding and working autonomously to provide services to the users /people, e.g. smart homes, enterprise, utilities and e-Health. In the IoT paradigm, every device will be conne......The Internet of Things (IoT) is a revolutionary technology, where devices around us are capable of sensing, reacting, responding and working autonomously to provide services to the users /people, e.g. smart homes, enterprise, utilities and e-Health. In the IoT paradigm, every device...... will be connected to the Internet to provide services to the user. Bringing this together makes it relevant to talk about the "Internet of People, Things and Services (IoPTS)."However, managing such a huge number of devices is a major challenge for IoPTS. In any given context, a number of devices will work together...... announce their services to those who need them. Users can access these services with the help of widely interconnected devices. To access the services user has to provide some personal data. In IoPTS services are large in numbers, and to protect the user data there is a need to ensure that these services...

  19. Shear-wave elastography contributes to accurate tumour size estimation when assessing small breast cancers

    International Nuclear Information System (INIS)

    Mullen, R.; Thompson, J.M.; Moussa, O.; Vinnicombe, S.; Evans, A.

    2014-01-01

    Aim: To assess whether the size of peritumoural stiffness (PTS) on shear-wave elastography (SWE) for small primary breast cancers (≤15 mm) was associated with size discrepancies between grey-scale ultrasound (GSUS) and final histological size and whether the addition of PTS size to GSUS size might result in more accurate tumour size estimation when compared to final histological size. Materials and methods: A retrospective analysis of 86 consecutive patients between August 2011 and February 2013 who underwent breast-conserving surgery for tumours of size ≤15 mm at ultrasound was carried out. The size of PTS stiffness was compared to mean GSUS size, mean histological size, and the extent of size discrepancy between GSUS and histology. PTS size and GSUS were combined and compared to the final histological size. Results: PTS of >3 mm was associated with a larger mean final histological size (16 versus 11.3 mm, p < 0.001). PTS size of >3 mm was associated with a higher frequency of underestimation of final histological size by GSUS of >5 mm (63% versus 18%, p < 0.001). The combination of PTS and GSUS size led to accurate estimation of the final histological size (p = 0.03). The size of PTS was not associated with margin involvement (p = 0.27). Conclusion: PTS extending beyond 3 mm from the grey-scale abnormality is significantly associated with underestimation of tumour size of >5 mm for small invasive breast cancers. Taking into account the size of PTS also led to accurate estimation of the final histological size. Further studies are required to assess the relationship of the extent of SWE stiffness and margin status. - Highlights: • Peritumoural stiffness of greater than 3 mm was associated with larger tumour size. • Underestimation of tumour size by ultrasound was associated with peri-tumoural stiffness size. • Combining peri-tumoural stiffness size to ultrasound produced accurate tumour size estimation

  20. Family and Individual Factors Associated with Substance Involvement and PTS Symptoms among Adolescents in Greater New Orleans after Hurricane Katrina

    Science.gov (United States)

    Rowe, Cynthia L.; La Greca, Annette M.; Alexandersson, Anders

    2010-01-01

    Objective: This study examined the influence of hurricane impact as well as family and individual risk factors on posttraumatic stress (PTS) symptoms and substance involvement among clinically referred adolescents affected by Hurricane Katrina. Method: A total of 80 adolescents (87% male; 13-17 years old; mean age = 15.6 years; 38% minorities) and…

  1. Effect of the dilution factor on 18FDG and Na18F samples for bacterial endotoxin test using PTS (portable test system)

    International Nuclear Information System (INIS)

    Silveira, Marina B.; Costa, Flavia M.; Ferreira, Soraya Z.

    2011-01-01

    18 FDG and Na 18 F are radiopharmaceuticals produced as sterile solutions suitable for intravenous administration, which must contain no more than 175 EV/V. The most commonly used approach to detect endotoxins is the gelclot technique that requires 60 minutes for results. For radiopharmaceuticals containing short-life radionuclides, such as 18 F, there is an increasing interest for faster quality control methods. FDA licensed the Endosafe, PTS, a kinetic chromogenic endotoxin detection system that takes about 15 minutes for results. As other techniques, PTS test is susceptible to interferences which can be solved by product dilution. The aim of this study was to establish the best dilution of 18 FDG and Na 18 F for PTS analysis. Two different dilution factors for 18 FDG and 1:10 for Na 18 F were essayed: 1:10 and 1:100. 18 FDG and Na 18 solutions were prepared by the addition of LAL reagent water. Considering the assay acceptance criteria, the best dilution factor was 1:100 for 18 FDG and 1:10 for Na 18 F. The recovery of the product positive control was 98-12% for 18 FDG 1:100 and 104-120% for Na 18 F 1:10, which were, in both cases, within the specification (50-200%) and very close to 100%. Results obtained with these dilution studies were important to establish the most appropriate and non-interfering dilution factor for 18 FDG and Na 18 F routine endotoxin test. (author)

  2. Values of functional indexes in assessment of efficacy of osteoarthritis treatment with Chondrolon and Zel T in polyclinic

    Directory of Open Access Journals (Sweden)

    O Y Maiko

    2009-01-01

    Full Text Available Objective. To study change of knee joints functional disability in pts with predominantly I-II stage of knee osteoarthritis (OA with clinical tests and WOMAC index for assessment of efficacy of treatment with Chondrolon and Zel T in polyclinic. Material and methods. 70 pts with I and II stage of OA according to Kellgren-Lawrence aged from 40 to 67 years were included. They were divided in 2 groups (30 pts in group I and40 pts in group II. Group I pts were treated with Chondrolon and group II pts – with Zel T. Treatment efficacy was assessed with WOMAC index, functional Lequesne index, pain on VAS at rest and at movement, knee mobility, time of walking for 30 m and walking stairs. Results. Positive changes of all parameters were revealed in both groups: significant improvement of pain on VAS, functional tests, Lequesne index, WOMAC scales was achieved. During treatment with Zel T improvement of the efficacy measures increased slower, mainly after 12 weeks of treatment (during treatment with Chondrolon – after8 weeks. Both drugs provided functional improvement assessed by WOMAC index butChondrolon was more effective. Conclusion. Chondrolon and Zel T can be used for treatment of OA at I or II stage with moderate knee joints functional disability. Course of treatment with Zel T should be continued not less than 3 months and with Chondrolon – 2 months.

  3. Alflutop efficacy in chronic vertebrogenous lumbar ischialgia. A double blind placebo controlled study

    Directory of Open Access Journals (Sweden)

    O S Levin

    2004-01-01

    Full Text Available Objective. To assess efficacy and safety of intramuscular (im and paravertebral (pv alflutop injections in pts with chronic vertebrogenous lumbar ischialgia. Material and methods. 83 pts with lumbar ischialgia syndrome (44 male, 39 female aged 31 to 56 years (mean 43,1 ±5,2 years were included. Disease duration varied from I to 7 years (mean 3,5± 1,9 years, duration of the present exacerbation - from 1 to 4 months (mean 2.4±0,8 months. Vertebroneurologic diagnosis was made according to H. Hall criteria. Pts were randomized into 4 groups. 32 pts of group Al received im, 23 pts of group A2 - pv alflutop injections. 14 pts of group Bl and 14 pts of group B2 received im and pv placebo injections respectively. Treatment results were scored by the doctor. Pts assessed spine pain changes on visual analog scale. Quantitative assessment of verbal syndrome was performed with Waddle scale. Results. Im alflutop injections provided good or fair effect in 61%, pv - in 69% of pts (significantly better than placebo. Effect was evident during the first 2 weeks of treatment and persisted for 3 months after its termination. The best results were achieved in pts with facet syndrome, the worst - in spinal stenosis. Drug tolerability was good in both modes of administration.

  4. SMILE: experimental results of the WP4 PTS large scale test performed on a component in terms of cracked cylinder involving warm pre-stress

    International Nuclear Information System (INIS)

    Kerkhof, K.; Bezdikian, G.; Moinereau, D.; Dahl, A; Wadier, Y.; Gilles, P.; Keim, E.; Chapuliot, S.; Taylor, N.; Lidbury, D.; Sharples, J.; Budden, P.; Siegele, D.; Nagel, G.; Bass, R.; Emond, D.

    2005-01-01

    The Reactor Pressure Vessel (RPV) is an essential component, which is liable to limit the lifetime duration of PWR plants. The assessment of defects in RPV subjected to pressurized thermal shock (PTS) transients made at an European level generally does not necessarily consider the beneficial effect of the load history (Warm Pre-stress, WPS). The SMILE project - Structural Margin Improvements in aged embrittled RPV with Load history Effects-aims to give sufficient elements to demonstrate, to model and to validate the beneficial WPS effect. It also aims to harmonize the different approaches in the national codes and standards regarding the inclusion of the WPS effect in a RPV structural integrity assessment. The project includes significant experimental work on WPS type experiments with C(T) specimens and a PTS type transient experiment on a large component. This paper deals with the results of the PTS type transient experiment on a component-like specimen subjected to WPS- loading, the so called Validation Test, carried out within the framework of work package WP4. The test specimen consists of a cylindrical thick walled specimen with a thickness of 40 mm and an outer diameter of 160 mm, provided with an internal fully circumferential crack with a depth of about 15 mm. The specified load path type is Load-Cool-Unload-Fracture (LCUF). No crack initiation occurred during cooling (thermal shock loading) although the loading path crossed the fracture toughness curve in the transition region. The benefit of the WPS-effect by final re-loading up to fracture in the lower shelf region, was shown clearly. The corresponding fracture load during reloading in the lower shelf region was significantly higher than the crack initiation values of the original material in the lower shelf region. The post test fractographic evaluation showed that the fracture mode was predominantly cleavage fracture also with some secondary cracks emanating from major crack. (authors)

  5. CFD use in PTS safety analysis state of art and challenges for industrial applications

    International Nuclear Information System (INIS)

    Martin, Alain; Cornille, Sebastien; Lestang, Frederic; Bellet, Serge; Barbier, Anthony; Vit, Carole; Huvelin, Fabien

    2009-01-01

    For the Reactor Pressure Vessel (RPV) assessment and lifetime evaluation of the nuclear plants, French Utility applies a series of calculations including thermal-hydraulic, thermo mechanical and fracture mechanics studies in order to study the Pressurized Thermal Shock (PTS) in the downcomer caused by the safety injection. Within the frame of the plant life time project, integrity assessments of the French 900 MWe (3-loops) series RPV have been performed. We found that the modeling of thermal-hydraulics loads is a source of gain. Considering the length of local 3D calculation and the large number of cases, EDF and AREVA-NP decided to share the effort. From a physical phenomena point of view, the results of the system code analysis (CATHARE computation) of the PTS transient induce two kinds of scenarios: single phase and two-phase flows in the cold leg. For single phase flow, the two chains of software differ: EDF uses Code Saturne (coupled with the thermal solid code SYRTHES) and AREVA-NP uses STAR CD for thermal hydraulic computation. According to this approach, comparison between the two chains of tools has been performed. Moreover this action contributes to the verification and the validation of each code in accordance with the OECD Best Practice Guidelines (BPG). The study has been achieved by two independent teams from EDF and AREVA-NP. It should be emphasized that this benchmark helped to strengthen the accuracy of CFD and the adapted methodology (working progress). The good agreement observed between the different results and their accordance with the validation computations confirms the validity of the approach. In the case where the cold legs are partially filled with steam, it becomes a two-phase problem and new important effects occur. Thus, an advanced prediction of RPV thermal loading during these transients requires sophisticated two-phase, local scale, 3D codes. In that purpose, a program has been set up to extend the capabilities of the NEPTUNE CFD

  6. Attitudes and diagnostic practice in low back pain: A qualitative study amongst Greek and British physiotherapists.

    Science.gov (United States)

    Billis, Evdokia; McCarthy, Christopher J; Gliatis, John; Matzaroglou, Charalampos; Oldham, Jacqueline A

    2016-09-18

    To explore current diagnostic practice and attitudes of Greek and United Kingdom physiotherapists (PTs) on assessing low back pain (LBP) patients. Three focus groups were undertaken, followed by a structured questionnaire-type survey comprising 23 health professionals and a random stratified sample of 150 PTs, respectively. Twenty-nine themes relating to LBP diagnostic practice emerged. These were then given to 30 British PTs assessing their level of agreement with their Greek counterparts. Analysis was performed by percentage agreements and χ (2) tests. The survey was divided into three subsections; PTs' attitudes on LBP assessment, patients' attitudes and diagnostic/healthcare issues, each constituting 14, 7 and 8 statements, respectively. Over half of the statements fell within the 30%-80% agreement between Greece and United Kingdom whereas, 5 statements reported low ( 90%) PT percentage agreement. Similarities across British and Greek PTs were detected in history taking methods and in the way PTs feel patients perceive physiotherapy practice whereas, re-assessment was undertaken less frequently in Greece. Diagnosis according to 91% of the Greek PTs is considered a "privilege" which is exclusive for doctors in Greece (only 17% British PTs agreed) and is accompanied with a great overuse of medical investigations. Forty percent of Greek PTs (compared to 0% of British) consider themselves as "executers", being unable to interfere with treatment plan, possibly implying lack of autonomy. Although similarities on history taking methods and on patients' attitudes were detected across both groups, gross differences were found in re-assessment procedures and diagnostic issues between Greek and British physiotherapists, highlighting differences in service delivery and professional autonomy.

  7. Transesophageal echocardiography in the assessment of coronary arteries; Echokardiografia przezprzelykowa w ocenie proksymalnych odcinkow naczyn wiencowych

    Energy Technology Data Exchange (ETDEWEB)

    Adamek-Kosmider, A.; Kasprzak, J.; Kosmider, M.; Krzeminska-Pakula, M. [Akademia Medyczna, Lodz (Poland)

    1993-12-31

    The study was undertaken to assess the usefulness of TEE for evaluation of morphology and flow in coronary arteries. TEE (2D, spectral and color Doppler imaging) and coronary angiography were performed in 75 patients - 41 with valvular heart disease and 34 with ischemic heart disease. Proximal coronary artery stenosis was detected by coronarography in 11 pts (9-left main coronary artery, 2-right coronary artery). TEE visualization of proximal coronary arteries was possible in all pts. Echocardiographic features of artery stenosis were: the narrowing of the vessel in 2D image (9 pts), high flow velocity spectral Doppler (4 pts, mean 135 cm/s vs 55 cm/s in normal arteries) and mosaic, turbulent flow in color Doppler (10 pts). Sensitivity and specificity of TEE for coronary artery stenosis detection was respectively 81%/98% for 2D imaging and 90%/100% for color Doppler. TEE is a new, noninvasive and safe method for the evaluation of proximal coronary arteries. Detection of LMCA stenosis prior to atheterization may enhance the safety of coronary angiography. (author) 21 refs, 8 figs

  8. Effect of the dilution factor on {sup 18}FDG and Na{sup 18}F samples for bacterial endotoxin test using PTS (portable test system)

    Energy Technology Data Exchange (ETDEWEB)

    Silveira, Marina B.; Costa, Flavia M.; Ferreira, Soraya Z., E-mail: mbs@cdtn.b [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil). Unidade de Pesquisa e Producao de Radiofarmacos

    2011-07-01

    {sup 18}FDG and Na{sup 18}F are radiopharmaceuticals produced as sterile solutions suitable for intravenous administration, which must contain no more than 175 EV/V. The most commonly used approach to detect endotoxins is the gelclot technique that requires 60 minutes for results. For radiopharmaceuticals containing short-life radionuclides, such as {sup 18}F, there is an increasing interest for faster quality control methods. FDA licensed the Endosafe, PTS, a kinetic chromogenic endotoxin detection system that takes about 15 minutes for results. As other techniques, PTS test is susceptible to interferences which can be solved by product dilution. The aim of this study was to establish the best dilution of {sup 18}FDG and Na{sup 18}F for PTS analysis. Two different dilution factors for {sup 18}FDG and 1:10 for Na{sup 18}F were essayed: 1:10 and 1:100. {sup 18}FDG and Na{sup 18} solutions were prepared by the addition of LAL reagent water. Considering the assay acceptance criteria, the best dilution factor was 1:100 for {sup 18}FDG and 1:10 for Na{sup 18}F. The recovery of the product positive control was 98-12% for {sup 18}FDG 1:100 and 104-120% for Na{sup 18}F 1:10, which were, in both cases, within the specification (50-200%) and very close to 100%. Results obtained with these dilution studies were important to establish the most appropriate and non-interfering dilution factor for {sup 18}FDG and Na{sup 18}F routine endotoxin test. (author)

  9. Development of Pneumatic Transport System (PTS) for safe handling of uranium oxide powder in UMP/UED

    International Nuclear Information System (INIS)

    Manna, S.; Satpati, S.K.; Roy, S.B.

    2009-01-01

    Tonnage quantity radioactive uranium oxide powder of particle size sub micron to 100 micron is handled in Uranium Metal Plant (UMP), UED/BARC for production of nuclear grade uranium metal, required for fuelling research reactors - Dhruva and Cirus. A Pneumatic Transfer System (PTS) using vacuum has been introduced and is being used for handling radioactive powder to improve radiation protection

  10. Expression of the agmatine deiminase pathway in Enterococcus faecalis is activated by the AguR regulator and repressed by CcpA and PTS(Man systems.

    Directory of Open Access Journals (Sweden)

    Cristian Suárez

    Full Text Available Although the agmatine deiminase system (AgDI has been investigated in Enterococcus faecalis, little information is available with respect to its gene regulation. In this study we demonstrate that the presence of exogenous agmatine induces the expression of agu genes in this bacterium. In contrast to the homologous and extensively characterized AgDI system of S. mutants, the aguBDAC operon in E. faecalis is not induced in response to low pH. In spite of this, agmatine catabolism in this bacterium contributes by neutralizing the external medium while enhancing bacterial growth. Our results indicate that carbon catabolic repression (CCR operates on the AgDI system via a mechanism that involves interaction of CcpA and P-Ser-HPr with a cre site found in an unusual position considering the aguB promoter (55 nt upstream the +1 position. In addition, we found that components of the mannose phosphotransferase (PTS(Man system also contributed to CCR in E. faecalis since a complete relief of the PTS-sugars repressive effect was observed only in a PTS(Man and CcpA double defective strain. Our gene context analysis revealed that aguR is present in oral and gastrointestinal microorganisms. Thus, regulation of the aguBDAC operon in E. faecalis seems to have evolved to obtain energy and resist low pH conditions in order to persist and colonize gastrointestinal niches.

  11. Synbiotic impact of tagatose on viability of Lactobacillus rhamnosus strain GG mediated by the phosphotransferase system (PTS).

    Science.gov (United States)

    Koh, Ji Hoon; Choi, Seung Hye; Park, Seung Won; Choi, Nag-Jin; Kim, Younghoon; Kim, Sae Hun

    2013-10-01

    Synbiotics, the combination of prebiotics and probiotics, has been shown to produce synergistic effects that promote gastrointestinal well-being of host. Tagatose is a low calorie food ingredient with putative health-promoting benefits. Herein, we investigated its synbiotic impact on the viability of Lactobacillus casei 01 and Lactobacillus rhamnosus strain GG and the potential mechanism involved. Tagatose, as a synbiotic substrate, enhanced the growth of L. casei 01 and L. rhamnosus strain GG compared to other prebiotics. Other gut-indigenous such as Clostridium spp. readily utilized fructooligosaccharide (FOS), the most widely used functional prebiotics, but not tagatose. Additionally, tagatose enhanced probiotic functions of L. casei 01 and L. rhamnosus strain GG by reinforcing their attachment on HT-29 intestine epithelial cells and enhancing their cholesterol-lowering activities. Whole transcriptome study and quantitative real-time polymerase chain reaction (qRT-PCR) test showed that the presence of tagatose in L. rhamnosus strain GG caused induction of a large number of genes associated with carbohydrate metabolism including the phosphotransferase system (PTS). Collectively, these results indicate the tagatose enhanced the growth of L. casei 01 and L. rhamnosus strain GG and their probiotic activities by activating tagatose-associated PTS networks. Importantly, this study highlights the potential application of tagatose and L. casei 01 and/or L. rhamnosus strain GG as a synbiotic partner in functional dairy foods (i.e. yogurt and cheese) and therapeutic dietary supplements. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Role of ptsP, orfT, and sss recombinase genes in root colonization by Pseudomonas fluorescens Q8r1-96.

    Science.gov (United States)

    Mavrodi, Olga V; Mavrodi, Dmitri V; Weller, David M; Thomashow, Linda S

    2006-11-01

    Pseudomonas fluorescens Q8r1-96 produces 2,4-diacetylphloroglucinol (2,4-DAPG), a polyketide antibiotic that suppresses a wide variety of soilborne fungal pathogens, including Gaeumannomyces graminis var. tritici, which causes take-all disease of wheat. Strain Q8r1-96 is representative of the D-genotype of 2,4-DAPG producers, which are exceptional because of their ability to aggressively colonize and maintain large populations on the roots of host plants, including wheat, pea, and sugar beet. In this study, three genes, an sss recombinase gene, ptsP, and orfT, which are important in the interaction of Pseudomonas spp. with various hosts, were investigated to determine their contributions to the unusual colonization properties of strain Q8r1-96. The sss recombinase and ptsP genes influence global processes, including phenotypic plasticity and organic nitrogen utilization, respectively. The orfT gene contributes to the pathogenicity of Pseudomonas aeruginosa in plants and animals and is conserved among saprophytic rhizosphere pseudomonads, but its function is unknown. Clones containing these genes were identified in a Q8r1-96 genomic library, sequenced, and used to construct gene replacement mutants of Q8r1-96. Mutants were characterized to determine their 2,4-DAPG production, motility, fluorescence, colony morphology, exoprotease and hydrogen cyanide (HCN) production, carbon and nitrogen utilization, and ability to colonize the rhizosphere of wheat grown in natural soil. The ptsP mutant was impaired in wheat root colonization, whereas mutants with mutations in the sss recombinase gene and orfT were not. However, all three mutants were less competitive than wild-type P. fluorescens Q8r1-96 in the wheat rhizosphere when they were introduced into the soil by paired inoculation with the parental strain.

  13. [Study of prognostic factors and prevalence of post-thrombotic syndrome in patients with deep vein thrombosis in Spain].

    Science.gov (United States)

    Ordi, Josep; Salmerón, Luis; Acosta, Fernando; Camacho, Isabel; Marín, Núria

    2016-01-15

    The prevalence of post-thrombotic syndrome (PTS) in Spain is not known accurately at present. The main objective of this study was to determine the prevalence of PTS and the possible prognostic factors related to its development and impact on quality of life. This was an observational, multicenter, cross-sectional and retrospective study of patients who had suffered a deep vein thrombosis (DVT) between March 2010 and March 2011. The Villalta scale was applied as a standardized assessment of PTS at the enrollment visit. According to the score, distribution was: patients with PTS (score>4) and patients without PTS (score ≤4). Subsequently, DVT data and risk factors were collected retrospectively. The quality of life of patients was evaluated. In total 511 patients with DVT were enrolled, of which 7 patients were excluded as they did not meet the inclusion/exclusion criteria. The prevalence of PTS was 53%, with 56.2% having a mild character, 20.6% moderate, and 23.2% severe. The presence of risk factors for DVT including immobilization, hormonal therapy and obesity was significantly higher in patients with PTS than in patients without PTS. There were not significant differences in the location of the DVT. The perception of patients about their health was significantly worse in patients with DVT. The prevalence of PTS in patients with DVT is very high. The presence of risk factors for DVT clearly contributes to a greater predisposition to suffering PTS in an average time of 2 years. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  14. Fracture risk assessment for the pressurized water reactor pressure vessel under pressurized thermal shock events

    International Nuclear Information System (INIS)

    Chou, Hsoung-Wei; Huang, Chin-Cheng

    2016-01-01

    Highlight: • The PTS loading conditions consistent with the USNRC's new PTS rule are applied as the loading condition for a Taiwan domestic PWR. • The state-of-the-art PFM technique is employed to analyze a reactor pressure vessel. • Novel flaw model and embrittlement correlation are considered in the study. • The RT-based regression formula of NUREG-1874 was also utilized to evaluate the failure risks of RPV. • For slightly embrittled RPV, the SO-1 type PTSs play more important role than other types of PTS. - Abstract: The fracture risk of the pressurized water reactor pressure vessel of a Taiwan domestic nuclear power plant has been evaluated according to the technical basis of the U.S.NRC's new pressurized thermal shock (PTS) screening criteria. The ORNL's FAVOR code and the PNNL's flaw models were employed to perform the probabilistic fracture mechanics analysis associated with plant specific parameters of the domestic reactor pressure vessel. Meanwhile, the PTS thermal hydraulic and probabilistic risk assessment data analyzed from a similar nuclear power plant in the United States for establishing the new PTS rule were applied as the loading conditions. Besides, an RT-based regression formula derived by the U.S.NRC was also utilized to verify the through-wall cracking frequencies. It is found that the through-wall cracking of the analyzed reactor pressure vessel only occurs during the PTS events resulted from the stuck-open primary safety relief valves that later reclose, but with only an insignificant failure risk. The results indicate that the Taiwan domestic PWR pressure vessel has sufficient structural margin for the PTS attack until either the current license expiration dates or during the proposed extended operation periods.

  15. Experimental tests and validation of calculation criteria of acceptable Tk shift with respect to PTS at VVER

    International Nuclear Information System (INIS)

    Hosnedl, P.; Roubalova, M.; Sik, J.; Priban, M.; Hora, P.; Vales, F.

    2004-01-01

    The following topics were examined: (i) Methodology of fracture tests at temperature gradients and pressurized thermal shock (PTS) cooling tests on large specimens (1500x1200x140 mm) with a designed postulated crack and other smaller cracks in the cooled area (test performed on a ZZ 8000 (80MN) loading stand); (ii) simulation of radiation embrittlement of tested material near the end of the RPV designed life, the material is subjected to standard mechanical property tests and fracture tests of standard test specimens modelling the PTS regime of material loading; (iii) 100% NDT tests of a specimen before the beginning of tests and μTOFD before and after each particular test of a specimen; (iv) on-line monitoring of the test conditions based on instrumentation of a specimen with thermocouples, COD and strain gauges together with on-line monitoring of Acoustic Emission during the tests; (v) calculation of K l at the critical points of the crack front during the test, based on monitored boundary conditions; (vi) fractographic analysis after the fracture of a specimen and evaluation of the whole test. (P.A.)

  16. A Cross-Lagged Panel Study of Dissociation and Posttraumatic Stress in a Treatment-Seeking Sample of Survivors of Childhood Sexual Abuse

    DEFF Research Database (Denmark)

    Murphy, Siobhan; Elklit, Ask; Murphy, Jamie

    2017-01-01

    Objective: The current prospective study assessed the temporal relations between dissociation and posttraumatic stress (PTS) in a sample of treatment-seeking female survivors of childhood sexual abuse. PTS refers to symptoms associated with posttraumatic stress disorder (PTSD) in the absence...... clinical implications that may affect their treatment and trauma recovery....

  17. Association between thrombophilia and the post-thrombotic syndrome: a systematic review and meta-analysis.

    Science.gov (United States)

    Rabinovich, A; Cohen, J M; Prandoni, P; Kahn, S R

    2014-01-01

    The postthrombotic syndrome (PTS) is a frequent chronic complication of deep vein thrombosis (DVT), occurring in 20-40% of patients. Identifying risk factors for PTS may be useful to provide patients with prognostic information and target prevention strategies. To conduct a systematic review to assess whether, among patients with DVT, inherited and acquired thrombophilias are associated with a risk of PTS. We searched the electronic databases PubMed, EMBASE, Scopus, and Web of Science for studies published from 1990 to 2013 that assessed any thrombophilia in adult DVT patients and its association with the development of PTS. We calculated odds ratios and 95% confidence intervals for PTS according to the presence of thrombophilia. Meta-analysis was performed using the random-effects model. Sixteen studies were included: 13 assessed factor V Leiden (FVL), 10 assessed prothrombin mutation, five assessed protein S and C deficiencies, three assessed antithrombin deficiency, four assessed elevated FVIII levels, and six assessed antiphospholipid antibodies. None of the meta-analyses identified any thrombophilia to be predictive of PTS. Both FVL and prothrombin mutation appeared protective among studies including patients with both first and recurrent DVT and studies in which more than 50% of patients had an unprovoked DVT. Our meta-analysis did not demonstrate a significant association between any of the thrombophilias assessed and the risk of PTS in DVT patients. Other biomarkers in the pathophysiological pathway may be more predictive of PTS. © 2013 International Society on Thrombosis and Haemostasis.

  18. Evaluation of the PTS potential in a WWER-1000 following a steam line break

    International Nuclear Information System (INIS)

    Beghini, M.; D'Auria, F.; Galassi, G.M.; Vitale, E.

    1997-01-01

    A qualified nodalization for WWER-1000 is available at DCMN (Dipartimento di Costruzioni Meccaniche e Nucleari) of University of Pisa that is suitable for running with the thermohydraulic system code Relap5/mod3.2. The nodalization consists of about 1400 hydraulic nodes and more than 5000 mesh points for conduction heat transfer. The four loops of the NPP are separately modelled. Detailed information about the plant hardware has been gotten from contacts with Eastern Organizations in Bulgaria, Russia and Ukraine. The qualification of the nodalization has been achieved at a steady state level utilizing a procedure available at DCMN and at a transient level on the basis of operational (planned) transients performed in the Bulgarian Kozloduy-5 NPP and of the unplanned transient occurred at the Ukrainian Zaporosche NPP (April 1995). Data measured in steam generators have also been utilized. The nodalization has been widely applied to the analysis of accident scenarios in WWER-1000, including Large Break LOCA, Small Break LOCA, ATWS, Loss of Feedwater and Station Blackout. The present activity aims at evaluating the potential for PTS (Pressurized Thermal Shock) following a steam line break accident. The thermalhydraulic results were employed as input for a parametric Fracture Mechanics analysis based on conservative hypothesis of the shape and localization of a pre-existing defect. Stress analysis evidenced the effect of partial cooling of the vessel and gave some general indications of the risk for unstable crack propagation under the simulated PTS conditions. (author). 30 refs, 17 figs, 4 tabs

  19. Evaluation of the PTS potential in a WWER-1000 following a steam line break

    Energy Technology Data Exchange (ETDEWEB)

    Beghini, M; D` Auria, F; Galassi, G M; Vitale, E [Universita degli Studi di Pisa, Dipt. di Costruzioni Meccaniche e Nucleari, Pisa (Italy)

    1997-09-01

    A qualified nodalization for WWER-1000 is available at DCMN (Dipartimento di Costruzioni Meccaniche e Nucleari) of University of Pisa that is suitable for running with the thermohydraulic system code Relap5/mod3.2. The nodalization consists of about 1400 hydraulic nodes and more than 5000 mesh points for conduction heat transfer. The four loops of the NPP are separately modelled. Detailed information about the plant hardware has been gotten from contacts with Eastern Organizations in Bulgaria, Russia and Ukraine. The qualification of the nodalization has been achieved at a steady state level utilizing a procedure available at DCMN and at a transient level on the basis of operational (planned) transients performed in the Bulgarian Kozloduy-5 NPP and of the unplanned transient occurred at the Ukrainian Zaporosche NPP (April 1995). Data measured in steam generators have also been utilized. The nodalization has been widely applied to the analysis of accident scenarios in WWER-1000, including Large Break LOCA, Small Break LOCA, ATWS, Loss of Feedwater and Station Blackout. The present activity aims at evaluating the potential for PTS (Pressurized Thermal Shock) following a steam line break accident. The thermalhydraulic results were employed as input for a parametric Fracture Mechanics analysis based on conservative hypothesis of the shape and localization of a pre-existing defect. Stress analysis evidenced the effect of partial cooling of the vessel and gave some general indications of the risk for unstable crack propagation under the simulated PTS conditions. (author). 30 refs, 17 figs, 4 tabs.

  20. Contribution for the improvement of pressurized thermal shock assessment methodologies in PWR pressure vessels

    International Nuclear Information System (INIS)

    Gomes, Paulo de Tarso Vida

    2005-01-01

    The structural integrity assessment of nuclear reactor pressure vessel, concerned to Pressurized Thermal Shock (PTS) accidents, became a necessity and has been investigated since the eighty's. The recognition of the importance of PTS assessment has led the international nuclear technology community to devote a considerable research effort directed to the complete integrity assessment process of the Reactor Pressure Vessels (VPR). Researchers in Europe, Japan and U.S.A. have concentrated efforts in the VPR structural and fracture analysis, conducting experiments to best understand how specific factors act on the behavior of discontinuities, under PTS loading conditions. The main goal of this work is to study de structural behavior of an 'in scale' PWR nuclear reactor pressure vessel model, containing actual discontinuities, under loading conditions generated by a pressurized thermal shock. To construct the pressure vessel model utilized in this research, the approach developed by Barroso (1995) and based on likelihood studies, related to thermal-hydraulic behavior during the PTS was employed. To achieve the objective of this research, a new methodology to generate cracks, with known geometry and localization in the vessel model wall was developed. Additionally, an hydraulic circuit, able to flood the vessel model, heated to 300 deg C, with 10 m 3 of water at 8 deg C, in 170 seconds, was built. Thermo-hydraulic calculations using RELAP5/M0D 3.2.2γ computational code were done, to estimate the temperature profiles during the cooling time. The resulting data subsidized the thermo-structural calculations that were accomplished using ANSYS 7.01 computational code, for both 2D and 3D models. So, the stress profiles obtained with these calculations were associated with fracture mechanics concepts, to assess the crack growth behavior in the VPR model wall. After the PTS test, the VPR model was submitted to destructive and non-destructive inspections. The results

  1. [Age specific and individual psychological factors of post--traumatic stress (PTS) development of children with after-effects of physical damages indicating medical rehabilitation].

    Science.gov (United States)

    Пятакова, Галина В; Лебедева, Екатерина И; Потявина, Валерия В; Церфус, Диана Н

    children and teenagers having received hard physical damages face a difficult life situation which includes events accompanied by feeling of intensive fear and helplessness. Every child's individual psychological features play an important role in coping with negative psychological after-effects of his/her physical trauma. learning PTS manifestations among children and teenagers with hard physical damages indicating medical rehabilitation. patients of the traumatological department of children's surgery clinic took part in the research: 31 preadolescent children and their parents, 45 teengaers and their parents. Physical damages were received by children clinic's patients in accidents and out of negligence. A survey containing clinical and historical method elements, medical documents; semi-structured interviews for identification of signs of children's post-traumatic stress, a survey for parents for identification of children's traumatic experience, colour matrices and J. Raven black-and-white matrices, S. Rosenzweig frustration tolerance methods (children's and adult version) were used as certain research methods. it was shown that intellectual productivity showings and stable ways of emotional reaction can act as individual psychological factos of PTS development. Age specifics of embeddedness of intellectual features and stable ways of emotional reaction to PTS symptoms development among children and teenagers with hard physical damages. the received results can be used as a base for developing specific approaches for psychological support of children and teenagers having the experience of physical damage and difficult medical rehabilitation.

  2. Study of Ender’s Nailing in Shaft Femur Fractures of Older Children

    Directory of Open Access Journals (Sweden)

    Ladani HG

    2014-12-01

    Full Text Available Background: Fractures in shaft femur in children are relatively common. Various methods of treating these fractures starting from non operative to methods like closed intramedullary nailing are at our disposal. Traditionally non operative methods are acceptable and find wide acceptance even today in very young children. However in older children certain problems are encountered like failure to control angulation and shortening, prolonged immobilization which causes very much discomfort & the overgrowth phenomenon. In view of above difficulties, closed intramedullary nailing was attempted in older children and adolescents. I have tried to study 23 cases of shaft femur fractures in older children treated by Ender’s nails. Methodology: 22 pts., out of which one having bilateral # shaft femur (total 23 #s with age ranging from 7 to 16 yrs. were studied. 3 pts. having polio limbs studied separately. Fracture was in upper third shaft femur in 5 pts., middle third in 13 pts., lower third in 3pts. & involving more than one region in 2 pts. Fracture was transverse in 6 pts., spiral in 3 pts., oblique in 12 pts.& comminuted in 2 pts.. Results: Average union time was 10 weeks except in polio pts. where it was delayed. No nonunion, no infection. Excellent hip & knee movements in almost all pts. Out of 20 pts. ( except polio pts. limb length was equal in 17 pts., one pt. was having 1 cm. lengthening & 2 pts. were having shortening ( 1cm. & 2 cm.. Conclusion: Results of this study strongly favor the use of Ender’s nailing in shaft femur fractures in older children. Second surgery of implant removal is mandatory. Closed reduction can usually be achieved if surgery is performed earlier.

  3. Factors which influence quality of life in patients with non-small cell lung cancer (NSCLC): A radiation therapy oncology group study (RTOG 89-01)

    International Nuclear Information System (INIS)

    Scott, C.B.; Sause, W.T.; Johnson, D.; Dar, A.R.; Wasserman, T.H.; Rubin, P.; Khandekar, J.; Byhardt, R.B.; Taylor, S.; McDonald, A.

    1997-01-01

    Purpose: Prospectively evaluate the quality of life (QOL) of patients with NSCLC participating in a randomized phase III study conducted by the RTOG and Eastern Cooperative Oncology Group. Determine the factors which influence QOL during and post therapy. Materials and Methods: From (4(90)) to (4(94)) to 75 patients (pts) were randomized on RTOG 89-01 between a regimen containing radiation therapy (RT) versus a regimen containing surgery (S). All pts received induction vinblastine and cisplatin, followed by either S or RT and consolidation chemotherapy (CT). Pts were given the self-assessment QOL forms prior to the start of therapy, post induction CT, post RT or S, and periodically during follow-up. Two questionnaires were used: Functional Assessment of Cancer Therapy for lung cancer patients (FACT-L) and Functional Living Index-Cancer (FLIC). The FACT-L consists of 44 questions covering 6 domains (physical, social, and emotional well-being, relationship with physician, fulfilment, and lung cancer specific concerns), FLIC contains 22 questions summing to one total score. Results: 51 pts participated in the QOL endpoint, 24 were excluded: 3 pts refused, institution did not administer QOL questionnaires in 9 pts, 3 completed QOL after start of therapy, 1 institution refused to participate, 5 questionnaires were incomplete/unusable, 1 pt could not read English, and 2 were ineligible for treatment. Participation in QOL was not predicted by any pretreatment characteristic. Women had worse pretreatment QOL (p<0.005, by FLIC) and more problems with disease-related symptoms (p<0.005, by FACT) than men. Pts with KPS 90-100 had better pretreatment QOL than pts with KPS 60-80 (p<0.025, FLIC). Neither race, marital status, education level, age, prior weight loss, nor disease symptoms statistically significantly influenced pretreatment QOL. Initial QOL did not predict overall survival. FACT-L was reported on 25 pts post induction CT. Follow-up FACT-L was available on 12 pts

  4. Single-Crystalline cooperite (PtS): Crystal-Chemical characterization, ESR spectroscopy, and {sup 195}Pt NMR spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Rozhdestvina, V. I., E-mail: veronika@ascnet.ru; Ivanov, A. V.; Zaremba, M. A. [Far East Division, Russian Academy of Sciences, Institute of Geology and Nature Management (Russian Federation); Antsutkin, O. N.; Forsling, W. [Lulea University of Technology (Sweden)

    2008-05-15

    Single-crystalline cooperite (PtS) with a nearly stoichiometric composition was characterized in detail by X-ray diffraction, electron-probe X-ray microanalysis, and high-resolution scanning electron microscopy. For the first time it was demonstrated that {sup 195}Pt static and MAS NMR spectroscopy can be used for studying natural platinum minerals. The {sup 195}Pt chemical-shift tensor of cooperite was found to be consistent with the axial symmetry and is characterized by the following principal values: {delta}{sub xx} = -5920 ppm, {delta}{sub yy} = -3734 ppm, {delta}{sub zz} = +4023 ppm, and {delta}{sub iso} = -1850 ppm. According to the ESR data, the samples of cooperite contain copper(II), which is adsorbed on the surface during the layer-by-layer crystal growth and is not involved in the crystal lattice.

  5. A multi-institutional phase II study of hyperfractionated accelerated radiation therapy for unresectable non-small cell lung cancer: initial report of ECOG 4593

    International Nuclear Information System (INIS)

    Tannehill, Scott P.; Froseth, Carrie; Wagner, Henry; Petereit, Dan P.; Mehta, Minesh P.

    1996-01-01

    Purpose: To assess the feasibility, acute toxicity, response and survival in a trial of hyperfractionated accelerated radiation therapy for unresectable locally advanced non-small cell lung cancer (NSCLC) using a t.i.d. regimen 5 days a week in an 8 hour schedule. Materials and Methods: Thirty patients (pts) from 6 institutions were enrolled in this pilot trial. Pt characteristics: 24 male, 6 female; median age 67 yrs (range 47-84); ECOG PS 0 in 22 pts, 1 in 8 pts; weight loss >5% in 7 pts. Stage was II (inoperable) in 1 pt, IIIA in 12 pts, and IIIB in 17 pts. Radiation therapy (total 57.6 Gy/36 fx) encompassing gross disease and draining lymphatics to 36 Gy (1.5 Gy b.i.d., 8 hours apart) with daily off-cord concomitant boost to 21.6 Gy (1.8 Gy 4 hours after first fraction) was given over 12 treatment days (15 elapsed days). Results: (28(30)) (93%) pts completed radiation therapy on schedule without toxicity-related treatment interruptions. Two pts did not complete radiation therapy; 1 due to in-field progression and 1 due to fatal acute gastric bleed unrelated to therapy. Two additional pts died in the first 6 weeks: 1 due to a presumed acute cardiovascular event and another due to complications of pre-existing cardiovascular disease. The major treatment-related toxicities were esophagitis in 6 pts (18%: 5 Grade 3 and 1 Grade 4) scored using a study specific esophagitis grading tool and 2 grade 3 dermatitis, in a total of 6 pts. Only 1 pt (3%) required hospitalization for IV hydration (Grade 4 esophagitis). Median weight loss at 6 weeks was 3 kg. Response data are pending in 2 pts and unavailable in 2 due to early death. Of the remaining 26 pts, local response analysis showed CR in 4, PR in 14, stable in 7 and progressive disease in 1 for an overall response rate of (18(26)) (69%). With a median potential follow-up of 13 months, the median survival has not yet been reached. The 1-yr actuarial survival is 63%. Exclusion of the 3 pts experiencing early death (in

  6. Assessment of response to therapy with hydroxyurea in patients with functional asplenia

    International Nuclear Information System (INIS)

    Santos A, O.; Demange, M.N.; Severiche, F.A.; Bomediano, V.H.; Silva, V.R.; Anjos, A.C.; Brandalise, S.R.; Etchebehere, E.C.S.C.; Cunha, M.L.; Camargo, E.E.

    1997-01-01

    Full text: Functional asplenia is a chronic complication of sickle cell (SC) disease. As the concentration of fetal hemoglobin (hemoglobin F) increases in the re blood cells (RBCs), the polymerization of hemoglobin S declines. This makes it possible for a therapeutic approach with drugs that induce hemoglobin F synthesis, leading to improvement of the acute and chronic consequences of SC disease. Hydroxyurea is a chemotherapeutic agent capable of increasing the levels of hemoglobin F in RBCs. Its long term use as an anti-sicklemic agent has been proposed recently. The purpose of this investigation was to evaluate the long term effects of hydroxyurea on the recovery of splenic function in pts with SC disease. Six pts with the disease (5 males, 1 female; 4 to 22 yrs; 5 with SS hemoglobinopathy, , 1 with Sβ o hemoglobinopathy; 4 black, 2 white) were studied. All pts received an intravenous injection of 74-185 MBq of [Tc-99m] sulfur colloid and liver-spleen imaging was performed 10 minutes later in the anterior and posterior views, with and without hepatic shielding. Pts were studied before and immediately after 6 months of treatment with hydroxyurea. All studied were submitted to visual and semi-quantitative analysis. Liver/spleen ratios were obtained before and after 6 months of treatment. Baseline images showed functional asplenia both visually and semi-quantitatively in all 5 SS pts and severely impaired splenic function in the Sβ o pt. Follow-up images performed after 6 months of treatment demonstrated significant splenic function improvement in 4 pts while 2 pts did not show any improvement. It was to demonstrate, using liver/spleen scintigraphy, that hydroxyurea is capable of reversing functional asplenia in pts with SC disease. The best results were observed in the youngest pts and in the Sβ o pt, probably because the amount of splenic fibrosis was less significant

  7. Risk factors for post-thrombotic syndrome in patients with a first deep venous thrombosis

    NARCIS (Netherlands)

    Tick, L. W.; Kramer, M. H. H.; Rosendaal, F. R.; Faber, W. R.; Doggen, C. J. M.

    2008-01-01

    BACKGROUND: Post-thrombotic syndrome (PTS) is a chronic complication of deep venous thrombosis (DVT). OBJECTIVES: To determine the risk of PTS after DVT and to assess risk factors for PTS. METHODS: Patients were recruited from the Multiple Environmental and Genetic Assessment (MEGA) study of risk

  8. Synthesis and Physicochemical Characterization of D-Tagatose-1-phosphate: The Substrate of the Tagatose-1-Phosphate Kinase TagK in the PTS-mediated D-Tagatose Catabolic Pathway of Bacillus licheniformis

    Science.gov (United States)

    Van der Heiden, Edwige; Delmarcelle, Michaël; Simon, Patricia; Counson, Melody; Galleni, Moreno; Freedberg, Darón I.; Thompson, John; Joris, Bernard; Battistel, Marcos D.

    2015-01-01

    We report the first enzymatic synthesis of D-tagatose-1-phosphate (Tag-1P) by the multi-component PEP-dependent:tag-PTS present in tagatose-grown cells of Klebsiella pneumoniae. Physicochemical characterization by 31P and 1H NMR spectroscopy reveals that, in solution, this derivative is primarily in the pyranose form. Tag-1P was used to characterize the putative tagatose-1-phosphate kinase (TagK) of the Bacillus licheniformis PTS-mediated D-Tagatose catabolic Pathway (Bli-TagP). For this purpose, a soluble protein fusion was obtained with the 6 His-tagged trigger factor (TFHis6) of Escherichia coli. The active fusion enzyme was named TagK-TFHis6. Tag-1P and D-fructose-1-phosphate (Fru-1P) are substrates for the TagK-TFHis6 enzyme, whereas the isomeric derivatives D-tagatose-6-phosphate (Tag-6P) and D-fructose-6-phosphate (Fru-6P) are inhibitors. Studies of catalytic efficiency (kcat/Km) reveal that the enzyme specificity is markedly in favor of Tag-1P as substrate. Importantly, we show in vivo that the transfer of the phosphate moiety from PEP to the B. licheniformis tagatose-specific enzyme II (EIITag) in E.coli is inefficient. The capability of the PTS general cytoplasmic components of B. subtilis, HPr and EI, to restore the phosphate transfer is demonstrated. PMID:26159072

  9. Patient’s satisfaction after 2-piece inflatable penile prosthesis implantation: An Italian multicentric study

    Directory of Open Access Journals (Sweden)

    Giorgio Gentile

    2016-03-01

    Full Text Available Introduction: Penile prosthesis implant represents a valuable solution for pts with severe erectile dysfunction (ED, non-responders to medical management. The aim of our study was to evaluate the satisfaction of patients (pts after 2-pieces inflatable penile prosthesis (IPP. Aim of the study: to evaluate safety, reliability and post-operative patient’s satisfaction after implantation of two-pieces IPP. Materials and Methods: This retrospective multicentric analysis concerns a group of 42 patients undergone 2-pieces IPP implantation from November 2005 to November 2013, in four Centers of proven experience. As a first step, a detailed review of all clinical reports was performed. Secondly, every patient was asked to fill the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS specifically modified, in order to assess their own satisfaction after surgery and, its impact on patient’s quality of sexual life. Results: 42 pts were evaluated (AMS-Ambicor: 28; Coloplast- Excell: 14; mean age, at time of operation: 60,7 years; mean follow up: 27,6 months; etiology of ED: vascular 23,8%, diabetes 19%, La Peyronie D. 7,1%, consequence of radical prostatectomy 31%, consequence of other pelvic surgery 11,9%, spinal trauma 7%. Mean operative time: 117 ± 58 min, mean postoperative hospital stay 3 ± 1,6 days. Post operative short-term complications: 4 pts (9,5%. Post operative long-term complications: 4 pts (9,5%. Long-term functional results (Questionnaire: 71% of pts (30 reported regular use of the prosthesis, at least 1 time/week, the satisfaction was good in 42% of pts (18, quite good in 33,3% (14, quite bad in 2,4% (1, very bad in 7,1% (3, 6 pts (14,4% didn’t answer. Conclusions: 2 pieces IPP appears to be associated with a low complication rate and good satisfaction of pts especially in the elderly. It also assures satisfactory rates of aesthetics and functional results.

  10. Cardiovascular Magnetic Resonance Imaging—Incremental Value in a Series of 361 Patients Demonstrating Cost Savings and Clinical Benefits: An Outcome-Based Study

    Science.gov (United States)

    Hegde, Vinayak A; Biederman, Robert WW; Mikolich, J Ronald

    2017-01-01

    BACKGROUND This study was designed to assess the clinical impact and cost-benefit of cardiovascular magnetic resonance imaging (CMR). In the face of current health care cost concerns, cardiac imaging modalities have come under focused review. Data related to CMR clinical impact and cost-benefit are lacking. METHODS AND RESULTS Retrospective review of 361 consecutive patients (pts) who underwent CMR exams was conducted. Indications for CMR were tabulated for appropriateness criteria. Components of the CMR exam were identified along with evidence of clinical impact. The cost of each CMR exam was ascertained along with cost savings attributable to the CMR exam for calculation of an incremental cost-effectiveness ratio. A total of 354 of 361 pts (98%) had diagnostic quality studies. Of the 361 pts, 350 (97%) had at least 1 published Appropriateness Criterion for CMR. A significant clinical impact attributable to CMR exam results was observed in 256 of 361 pts (71%). The CMR exam resulted in a new diagnosis in 69 of 361 (27%) pts. Cardiovascular magnetic resonance imaging results avoided invasive procedures in 38 (11%) pts and prevented additional diagnostic testing in 26 (7%) pts. Comparison of health care savings using CMR as opposed to current standards of care showed a net cost savings of $833 037, ie, per patient cost savings of $2308. CONCLUSIONS Cardiovascular magnetic resonance imaging provides diagnostic image quality in >98% of cases. Cardiovascular magnetic resonance imaging findings have documentable clinical impact on patient management in 71% of pts undergoing the exam, in a cost beneficial manner. PMID:28579858

  11. Cardiovascular Magnetic Resonance Imaging-Incremental Value in a Series of 361 Patients Demonstrating Cost Savings and Clinical Benefits: An Outcome-Based Study.

    Science.gov (United States)

    Hegde, Vinayak A; Biederman, Robert Ww; Mikolich, J Ronald

    2017-01-01

    This study was designed to assess the clinical impact and cost-benefit of cardiovascular magnetic resonance imaging (CMR). In the face of current health care cost concerns, cardiac imaging modalities have come under focused review. Data related to CMR clinical impact and cost-benefit are lacking. Retrospective review of 361 consecutive patients (pts) who underwent CMR exams was conducted. Indications for CMR were tabulated for appropriateness criteria. Components of the CMR exam were identified along with evidence of clinical impact. The cost of each CMR exam was ascertained along with cost savings attributable to the CMR exam for calculation of an incremental cost-effectiveness ratio. A total of 354 of 361 pts (98%) had diagnostic quality studies. Of the 361 pts, 350 (97%) had at least 1 published Appropriateness Criterion for CMR. A significant clinical impact attributable to CMR exam results was observed in 256 of 361 pts (71%). The CMR exam resulted in a new diagnosis in 69 of 361 (27%) pts. Cardiovascular magnetic resonance imaging results avoided invasive procedures in 38 (11%) pts and prevented additional diagnostic testing in 26 (7%) pts. Comparison of health care savings using CMR as opposed to current standards of care showed a net cost savings of $833 037, ie, per patient cost savings of $2308. Cardiovascular magnetic resonance imaging provides diagnostic image quality in >98% of cases. Cardiovascular magnetic resonance imaging findings have documentable clinical impact on patient management in 71% of pts undergoing the exam, in a cost beneficial manner.

  12. Cardiovascular Magnetic Resonance Imaging—Incremental Value in a Series of 361 Patients Demonstrating Cost Savings and Clinical Benefits: An Outcome-Based Study

    Directory of Open Access Journals (Sweden)

    Vinayak A Hegde

    2017-05-01

    Full Text Available Background: This study was designed to assess the clinical impact and cost-benefit of cardiovascular magnetic resonance imaging (CMR. In the face of current health care cost concerns, cardiac imaging modalities have come under focused review. Data related to CMR clinical impact and cost-benefit are lacking. Methods and Results: Retrospective review of 361 consecutive patients (pts who underwent CMR exams was conducted. Indications for CMR were tabulated for appropriateness criteria. Components of the CMR exam were identified along with evidence of clinical impact. The cost of each CMR exam was ascertained along with cost savings attributable to the CMR exam for calculation of an incremental cost-effectiveness ratio. A total of 354 of 361 pts (98% had diagnostic quality studies. Of the 361 pts, 350 (97% had at least 1 published Appropriateness Criterion for CMR. A significant clinical impact attributable to CMR exam results was observed in 256 of 361 pts (71%. The CMR exam resulted in a new diagnosis in 69 of 361 (27% pts. Cardiovascular magnetic resonance imaging results avoided invasive procedures in 38 (11% pts and prevented additional diagnostic testing in 26 (7% pts. Comparison of health care savings using CMR as opposed to current standards of care showed a net cost savings of $833 037, ie, per patient cost savings of $2308. Conclusions: Cardiovascular magnetic resonance imaging provides diagnostic image quality in >98% of cases. Cardiovascular magnetic resonance imaging findings have documentable clinical impact on patient management in 71% of pts undergoing the exam, in a cost beneficial manner.

  13. Quality and Quantity of Rehabilitation Exercises Delivered By A 3-D Motion Controlled Camera: A Pilot Study.

    Science.gov (United States)

    Komatireddy, Ravi; Chokshi, Anang; Basnett, Jeanna; Casale, Michael; Goble, Daniel; Shubert, Tiffany

    2014-08-01

    Tele-rehabiliation technologies that track human motion could enable physical therapy in the home. To be effective, these systems need to collect critical metrics without PT supervision both in real time and in a store and forward capacity. The first step of this process is to determine if PTs (PTs) are able to accurately assess the quality and quantity of an exercise repetition captured by a tele-rehabilitation platform. The purpose of this pilot project was to determine the level of agreement of quality and quantity of an exercise delivered and assessed by the Virtual Exercise Rehabilitation Assistant (VERA), and seven PTs. Ten healthy subjects were instructed by a PT in how to perform four lower extremity exercises. Subjects then performed each exercises delivered by VERA which counted repetitions and quality. Seven PTs independently reviewed video of each subject's session and assessed repetitions quality. The percent difference in total repetitions and analysis of the distribution of rating repetition quality was assessed between the VERA and PTs. The VERA counted 426 repetitions across 10 subjects performing the four different exercises while the mean repetition count from the PT panel was 426.7 (SD = 0.8). The VERA underestimated the total repetitions performed by 0.16% (SD = 0.03%, 95% CI 0.12 - 0. 22). Chi square analysis across raters was χ 2 = 63.17 (df = 6, p<.001), suggesting significant variance in at least one rater. The VERA count of repetitions was accurate in comparison to a seven member panel of PTs. For exercise quality the VERA was able to rate 426 exercise repetitions across 10 patients and four different exercises in a manner consistent with five out of seven experienced PTs.

  14. A review on the conservatism embodied in the integrity assessment procedure of CANDU pressure tubes

    International Nuclear Information System (INIS)

    Chung, Han Sub; Kim, Hong Duk

    2009-01-01

    Excessive conservatism may be embodied in the integrity assessment procedure for PTs of CANDUs, as guided in the CSA N285.8-05 code. Four sources of conservatism are suggested as (1) the effect of thermal history on DHC, (2) the effect of manufacturing variables on properties of PTs, (3) poor definition or limited availability of databases regarding the aging degradation trends and probability density functions of important material properties, and (4) the simplified equations defining threshold condition for the initiation of DHC at the volumetric flaws. It is suggested that both extensive review of databases available and extensive calculation case studies are required to remove the potential excessive conservatism.

  15. A phase I study of paclitaxel as a radiation sensitizer for the treatment of non-small cell lung cancer and mesothelioma

    International Nuclear Information System (INIS)

    Herscher, L.; Hahn, S.; Pass, H.; Temeck, B.; Goldspiel, B.; Cook, J.; Mitchell, J.B.; Liebmann, J.

    1995-01-01

    Purpose/Objective Paclitaxel exposure of cancer cells in vitro results in a G 2 /M block in the cell cycle. Paclitaxel also has independent activity against a wide variety of tumors. We report here a phase I study of patients with non-small cell lung cancer and malignant pleural mesothelioma treated with radiation therapy and concurrent paclitaxel. Objectives were to determine the maximum tolerated dose (MTD) of paclitaxel when delivered as a 5-day continuous infusion with concurrent radiotherapy, to assess tumor response and toxicity, and to evaluate the biological effects of paclitaxel in tumor biopsy specimens. Materials and Methods 19 patients (pts.) were enrolled on study. 17 pts. were male and 2 were female. 18 pts. had mesothelioma and 1 had non-small cell lung cancer. Mean age was 59 yrs with a range of 47 to 72 years. One patient did not complete treatment due to progressive disease. Patients who completed treatment received from 5760 to 6300 cGy. Dose volume histography and multiple non-coplanar and non-coaxial fields were used. Patients received a continuous infusion of paclitaxel for 120 hours every three weeks during radiation therapy. The Results MTD of paclitaxel was determined to be 105 mg/m 2 delivered as a 120-hour continuous infusion. The dose-limiting toxicity of paclitaxel was neutropenia at 120 mg/m 2 given over 120 hrs. 13 patients were assessable for local control; 4 pts. are too early to evaluate and 2 pts. did not return for follow-up. (11(13)) pts. achieved local control. 3 of 13 patients are free of disease. 10 tumor biopsies were taken from 4 mesothelioma pts. Biopsies were taken prior to the paclitaxel infusion and then during the infusion. A modest G 2 /M block was observed in only 1 of the 5 specimens taken during the paclitaxel infusion. Conclusions This study demonstrates that paclitaxel can be safely delivered as a 120-hour continuous infusion at 105 mg/m 2 with concurrent thoracic radiotherapy. However, the biologic effect of

  16. The predictive value of markers of fibrinolysis and endothelial dysfunction in the post thrombotic syndrome. A systematic review.

    Science.gov (United States)

    Rabinovich, Anat; Cohen, Jacqueline M; Kahn, Susan R

    2014-06-01

    The post thrombotic syndrome (PTS) develops in 20-40% of deep venous thrombosis (DVT) patients. Risk factors for PTS have not been well elucidated. Identification of risk factors would facilitate individualised risk assessment for PTS. We conducted a systematic review to determine whether biomarkers of fibrinolysis or endothelial dysfunction can predict the risk for PTS among DVT patients. Studies were identified by searching the electronic databases PubMed, EMBASE, Scopus and Web of science. We included studies published between 1990 and 2013, measured biomarker levels in adult DVT patients, and reported rates of PTS development. Fourteen studies were included: 11 investigated the association between D-dimer and PTS; three examined fibrinogen; two measured von Willebrand factor; one measured plasminogen activator inhibitor-1; one assessed ADAMTS-13 (A Disintegrin and Metalloprotease with Thrombospondin type 1 repeats) and one measured factor XIII activity. Studies varied with regards to inclusion criteria, definition of PTS, time point and method of biomarker measurement. We were unable to meta-analyse results due to marked clinical heterogeneity. Descriptively, a significant association with PTS was found for D-dimer in four studies and factor XIII in one study. Further prospective research is needed to elucidate whether these markers might be useful to predict PTS development.

  17. Thermal hydraulic evaluation for an experimental facility to investigate pressurized thermal shock (PTS) in CDTN/CNEN; Avaliacao termo-hidraulica da montagem experimental de choque termico pressurizado do CDTN/CNEN

    Energy Technology Data Exchange (ETDEWEB)

    Palmieri, Elcio T.; Navarro, Moyses A.; Aronne, Ivam D.; Terra, Jose L. [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN), Belo Horizonte, MG (Brazil)

    2002-07-01

    The goal of the work presented in this paper is to provide necessary thermal hydraulics information to the design of an experimental installation to investigate the Pressurized Thermal Shock (PTS) to be implemented at Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN). The envisaged installation has a test section that represents, in a small scale, a pressure vessel of a nuclear reactor. This test section will be heated and then exposed to a PTS in order to evaluate the appearance and development of cracks. To verify the behavior of the temperatures of the pressure vessel after a sudden flood through the annulus, calculations were made using the RELAP5/MOD 3.2.2 gamma code. Different outer radiuses were studied for the annular region. The results showed that the smaller annulus spacing (20 mm) anticipates the wetting of the surface and produces a higher cooling of the external surface, which stays completely wet for a longer time. (author)

  18. Identifying and predicting subgroups of information needs among cancer patients: an initial study using latent class analysis.

    Science.gov (United States)

    Neumann, Melanie; Wirtz, Markus; Ernstmann, Nicole; Ommen, Oliver; Längler, Alfred; Edelhäuser, Friedrich; Scheffer, Christian; Tauschel, Diethard; Pfaff, Holger

    2011-08-01

    Understanding how the information needs of cancer patients (CaPts) vary is important because met information needs affect health outcomes and CaPts' satisfaction. The goals of the study were to identify subgroups of CaPts based on self-reported cancer- and treatment-related information needs and to determine whether subgroups could be predicted on the basis of selected sociodemographic, clinical and clinician-patient relationship variables. Three hundred twenty-three CaPts participated in a survey using the "Cancer Patients Information Needs" scale, which is a new tool for measuring cancer-related information needs. The number of information need subgroups and need profiles within each subgroup was identified using latent class analysis (LCA). Multinomial logistic regression was applied to predict class membership. LCA identified a model of five subgroups exhibiting differences in type and extent of CaPts' unmet information needs: a subgroup with "no unmet needs" (31.4% of the sample), two subgroups with "high level of psychosocial unmet information needs" (27.0% and 12.0%), a subgroup with "high level of purely medical unmet information needs" (16.0%) and a subgroup with "high level of medical and psychosocial unmet information needs" (13.6%). An assessment of sociodemographic and clinical characteristics revealed that younger CaPts and CaPts' requiring psychological support seem to belong to subgroups with a higher level of unmet information needs. However, the most significant predictor for the subgroups with unmet information needs is a good clinician-patient relationship, i.e. subjective perception of high level of trust in and caring attention from nurses together with high degree of physician empathy seems to be predictive for inclusion in the subgroup with no unmet information needs. The results of our study can be used by oncology nurses and physicians to increase their awareness of the complexity and heterogeneity of information needs among CaPts and of

  19. Thermal hydraulic analyses of accidents associated with coolant leak from the primary circuit through a hole 10 mm equivalent diameter for the needs of PTS

    International Nuclear Information System (INIS)

    Krhounkova, J.; Kral, P.; Parduba, Z.

    1999-10-01

    The conservative assumptions of the analyses were oriented towards a worsening of the process with respect to the pressurized thermal shock (PTS). Four variants were treated, viz. leaks from the cold or hot leg, each at the rated power or zero power. Since the temperature of water supplied to the primary circuit by the emergency core cooling system is an important parameter with respect to a PTS, the calculations were performed by the iterative procedure: the basic thermal hydraulic calculation was performed by the RELAP5/MOD3.2.1 code which calculates the behaviour of the primary and secondary circuits, whereas the MELCOR code was used to calculate the behaviour of the parameters in the hermetic rooms. The calculation by the RELAP code was then repeated using data from the MELCOR calculations. Interventions by the reactor operators were also considered. (P.A.)

  20. Evaluation of cerebral metabolism in patients with unilateral carotid stenosis by proton MR spectroscopy: a correlative study with cerebral hemodynamics by acetazolamide stress brain perfusion SPECT (acz-SPECT)

    International Nuclear Information System (INIS)

    Kim, Jae Seung; Kim, Geun Eun; Lee, Jeong Hee; Kim, Do Gyun; Kim, Sang Tae; Lee, Hee Kyung

    2001-01-01

    Carotid stenosis may lead not only to cerebral hemodynamic compromise but also cerebral metabolic changes without overt infarction. To investigate the brain metabolic changes as a result of hemodynamic compromise in pts with carotid stenosis, we compared the changes in metabolism of the gray and white matter detected by proton MRS with cortical hemodynamics measured by Acz-SPECT. We prospectively studied symptomatic 18 pts (M/F=15/3, mean ages: 64.4y) with unilateral carotid stenosis. All pts underwent Acz-SPECT and MRS with 3 days. rCBF and rCVR of MCA territory were assessed by Acz-SPECT. Hemodynamic compromise was graded as stage 0 (normal rCBF and rCVR), stage 1 (normal rCBF and reduced rCVR), and stage 2( reduced rCBF and rCVR). Brain metabolism was assessed by measuring the peaks of N-acetyl aspartate (NAA), choline (Cho), and the sum of creatine and phosphocreatine (Cr) from noninfarcted white matter in the both centrum semiovales and gray matter in both MCA territories. On Acz-SPECT, 7 pts showed stage 2 were significantly lower than in pts with stage 0 (p<0.01). The asymmetric ratio of NAA/Cr in pts with state 2 was also significantly lower than in pts with stage 1(p<0.05). The asymmetric ratio of Cho/Cr was increased as hemodynamic stage increased but the differences were not statistically significant among 3 stages. In cortical gray matter, the asymmetric ratios of NAA/Cho and NAA/Cr were decreased statistically significant among 3 stages. In cortical gray matter, the asymmetric ratios of NAA/Cho and NAA/Cr were decreased and that of Cho/Cr was increased as hemodynamic stage increased. However, these differences were not statistically significant among 3 stages. The asymmetric ratios of NAA/Cho of centrum semiovale in pts with reduced rCBF and/or reduced rCVR were lower than in pts with normal perfusion. Our results indicate the metabolic changes detected by proton MRS in patients with carotid stenosis reflect a hemodynamic compromised state

  1. The relationship between processing style, trauma memory processes, and the development of posttraumatic stress symptoms in children and adolescents.

    Science.gov (United States)

    McKinnon, Anna; Brewer, Neil; Cameron, Kate; Nixon, Reginald D V

    2017-12-01

    Data-driven processing, peri-event fear, and trauma memory characteristics are hypothesised to play a core role in the development of Posttraumatic Stress Disorder. We assessed the relationships between these characteristics and Posttraumatic Stress (PTS) symptoms in a sample of youth. Study 1 (N = 36, 7-16 years), involved a sample of children who had undergone a stressful orthopaedic procedure. One week later they answered a series of probed recall questions about the trauma (assessed for accuracy by comparison to a video) and reported on their PTS symptoms. They also rated confidence in their probed recall answers to assess meta-cognitive monitoring of their memory for the trauma. In Study 2, a sample of injured children (N = 57, 7-16 years) were assessed within 1-month of a visit to an Emergency Department, and then at 3-month follow-up. They answered probed recall questions, made confidence ratings, and completed measures of data-driven processing, peri-event fear, PTS and associated psychopathology. Memories were verified using witness accounts. Studies 1 and 2 did not find an association between PTS symptoms and trauma memory accuracy or confidence. In Studies 1 and 2 data-driven processing predicted PTS symptoms. The studies had modest samples sizes and there were ceiling effects for some accuracy and confidence items. Data-driven processing at the time of a trauma was associated with PTS symptoms after accounting for fear at the time of the trauma. Accuracy of recall for trauma memories was not significantly related to PTS symptoms. No decisive conclusion could be drawn regarding the relation between confidence in trauma memories and PTS symptoms. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Accumulation of chlorinated and brominated persistent toxic substances (PTS) and their relationship to testosterone suppression in Norway rats from Japan

    Energy Technology Data Exchange (ETDEWEB)

    Takasuga, T.; Senthilkumar, K. [Shimadzu Techno-Research Inc. (Japan); Ishizuka, M.; Fujita, S. [Graduate School of Veterinary Medicine, Hokkaido Univ. (Japan); Tanikawa, R. [Inst. of Tech., Ikari Corp. (Japan)

    2004-09-15

    Contamination of chlorinated/brominated persistent toxic substances (PTS) such as polychlorinated, -dibenzo-p-dioxins (PCDDs), -dibenzofurans (PCDFs), -biphenyls (PCBs), - organochlorine pesticides (OCPs) {l_brace}e.g., aldrin, dieldrin, endrin, chlordane compounds [cis/transchlordane, cis/trans-nonachlor, oxychlordane, heptachlor, heptachlor epoxide], hexachlorobenzene (HCB), 2,2-bis(p-chlorophenyl)-1,1,1-trichloroethane (DDTs) and its metabolities [o,p/p,p'-DDD and DDE] and hexachlorocyclohexane (HCHs){r_brace} and -brominated diphenyl ethers (PBDEs) are considered to important class of chemicals due to persistence in nature, bioaccumulation potential and adverse health effects in wildlife and humans. Among South East Asian countries, Japan reported to contaminated with aforesaid chemicals with considerable amounts. There is no document reports contamination of PTS in wild animals, which in-habit near humans. Norway rat (NR) inhabits not only near human environment but also distributed worldwide. Especially, NR feeds on human waste and shelter in and around human environment and thus exposure of toxic contaminants in this animal considered to similar with those in humans. In addition, rats have unique physiology that match with humans (e.g., they have similar pathogens as humans have). Therefore, analysis of toxic contaminants in NR considered as indirect measure in humans. Considering those facts, in this study, we analyzed NR collected from urban area, rural area, waste dumping or land fill site and isolated remote island from Japan. Particularly several chlorinated and brominated organic contaminants such as PCDDs, PCDFs, PCBs, DDTs, HCHs, chlordane compounds, heptachlor, heptachlor epoxide, HCB, aldrin, dieldrin, endrin and PBDEs were analyzed in rat livers by isotope dilution technique using HRGC-HRMS. In addition, laboratory Wistar rats (WR) were used as control.

  3. Physical properties and the Peierls instability of Li0.82[Pt(S2C2(CN)2)2] · 2H2O

    DEFF Research Database (Denmark)

    Ahmad, M. M.; Turner, D. J.; Underhill, A. E.

    1984-01-01

    The infrared reflectivity, the temperature-dependent conductivity, and thermopower of the one-dimensional conductor Li0.82[Pt(S2C2(CN)2)2] · 2H2O, LiPt(mnt), is presented. It undergoes a simple Peierls transition at Tc=215 K, which is not influenced by correlations or by cation ordering. The meta...

  4. Alflutop clinical efficacy in vertebral osteochondrosis (12-mohth study

    Directory of Open Access Journals (Sweden)

    V N Hodyrev

    2005-01-01

    Full Text Available Objective. To study clinical efficacy of aiflutop (A in lumbar osteochondrosis (LO with chronic back pain syndrome. Material and Methods. 32 pts with LO were included. 14 from them (group 1 during a year received 2 courses of A intramuscular injections (I ml/day, 30 ml total and nonsteroidal anti-inflammatory drugs (NSAIDs if necessary. 18 pts (group 2 received NSAIDs only. Clinical examination of pts was performed at the stert of the study, before and after each A course and in 3 months after the last course. Results. Pain in the spine at rest and forward bending significantly decreased in group 1 pts (p<0,05 after each A course. Full pain disappearance after the first A course was achieved in 7,1% and after the second course - in 35,7% of group I pts and was not shown in control group. Significant stepped decrease of Thomayer's test value (p<0,00l was also shown in group 1: 3,6 times decrease in comparison with baseline was achieved in 3 months after completion of treatment with A. During treatment period these pts showed 2-2,5 times increase of static and dynamic spine load (according to Vxdel chronic inability index. 42,9% of group I pts stopped NSAIDs after A treatment completion. Only 5,6% of control group pts stopped NSAIDs during follow up. A tolerability was good. It can be combined with any other medications the pts received due to comorbid diseases.

  5. Long-term screening for sleep apnoea in paced patients: preliminary assessment of a novel patient management flowchart by using automatic pacemaker indexes and sleep lab polygraphy.

    Science.gov (United States)

    Aimé, Ezio; Rovida, Marina; Contardi, Danilo; Ricci, Cristian; Gaeta, Maddalena; Innocenti, Ester; Cabral Tantchou-Tchoumi, Jacques

    2014-10-01

    The primary aim of this pilot study was to prospectively assess a flowchart to screen and diagnose paced patients (pts) affected by sleep apnoeas, by crosschecking indexes derived from pacemakers (minute ventilation sensor on-board) with Sleep-Lab Polygraphy (PG) outcomes. Secondarily, "smoothed" long-term pacemaker indexes (all the information between two consecutive follow-up visits) have been retrospectively compared vs. standard short-term pacemaker indexes (last 24h) at each follow-up (FU) visit, to test their correlation and diagnostic concordance. Data from long-term FU of 61 paced pts were collected. At each visit, the standard short-term apnoea+hypopnoea (PM_AHI) index was retrieved from the pacemaker memory. Patients showing PM_AHI ≥ 30 at least once during FU were proposed to undergo a PG for diagnostic confirmation. Smoothed pacemaker (PM_SAHI) indexes were calculated by averaging the overall number of apnoeas/hypopnoeas over the period between two FU visits, and retrospectively compared with standard PM_AHI. Data were available from 609 consecutive visits (overall 4.64 ± 1.78 years FU). PM_AHI indexes were positive during FU in 40/61 pts (65.6%); 26/40 pts (65%) accepted to undergo a PG recording; Sleep-Lab confirmed positivity in 22/26 pts (84.6% positive predictive value for PM_AHI). A strong correlation (r=0.73) and a high level of concordance were found between smoothed and standard indexes (multivariate analysis, Cohen's-k and Z-score tests). Pacemaker-derived indexes may help in screening paced pts potentially affected by sleep apnoeas. Long-term "smoothed" apnoea indexes could improve the accuracy of pacemaker screening capability, even though this hypothesis must be prospectively confirmed by larger studies. Copyright © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  6. Long-term adverse effects associated with isolated below-knee deep-vein thrombosis: a 10-year follow-up study

    International Nuclear Information System (INIS)

    Cowell, G.W.; King, S.C.; Reid, J.H.; Beek, E.J.R. van; Murchison, J.T.

    2016-01-01

    Aim: To assess the effect of the presence and locality of symptomatic lower-limb deep vein thrombosis (DVT) on mortality and morbidity following contrast venography (CV), the reference standard for diagnosing below-knee DVT, with a view to determining the prevalence of recurrent episodes of DVT and post-thrombotic syndrome (PTS). Materials and methods: Patients with clinical DVT undergoing investigation using CV were prospectively recorded. By retrospective case note examination and mortality data evaluation, 347 patients with DVT were matched with negative controls for mortality follow-up. Long-term complications were recorded. Results: Fifty-one (14.7%) of the DVT patients were diagnosed with PTS and 43 (12.4%) with possible PTS in the 10 years following presentation. The relative risk for developing definite PTS was 0.544 for below- versus above-knee DVT; 9.9% with below-knee DVT had PTS, and 9% had probable PTS. Recurrent DVT occurred in 23.3% of patients with proximal DVT as opposed to 12.6% of patients with isolated below-knee DVT. Conclusions: Morbidity is greater in patients with proximal DVT; however, a significant, albeit smaller, proportion of patients with isolated below-knee DVT develop recurrent DVT and PTS. Below-knee DVT carries sufficient morbidity and mortality to warrant vigilance in diagnosis and management of this condition. - Highlights: • We assessed the effect of symptomatic lower limb DVT on mortality and morbidity. • Morbidity is greater in patients with proximal DVT. • A small percentage of patients with distal DVT develop post thrombotic syndrome. • Distal DVT warrants vigilance in diagnosis and management of this condition.

  7. Quality of life of patients with low back pain and pharmacoeconomic aspects of the treatment

    Directory of Open Access Journals (Sweden)

    T V Chernyshova

    2005-01-01

    Full Text Available Objective. To define clinical efficacy of diclofenac and nise in pts with low back pain (LBP considering quality of life (QL and pharmacoeconomic aspects (PA Material and methods . 100 pts with chronic LBP due to vertebral osteochondrosis were included. Clinical examination was performed. QL was assessed with 4 questionnaires: Health Assessment Questionnaire (HAQ, WOMAC osteoarthritis index (Vfersion vas. 1, Osvestry Low Back Pain Disability Questionnaire and SF-36. 50 pts of the 1 group received diclofenac retard 100 mg twice a day during 10 days. Nise was administered to the 50 pts of the 2 group 100 mg twice a day. All pts received midocalm 450 mg/day. Results. The study showed high efficacy of nise in complex treatment of pts with chronic LBP considering its analgesic and anti-inflammatory properties, low adverse events frequency so as PA and QL improvement.

  8. The Management of Synchronous Bilateral Wilms Tumor: A Report from the National Wilms Tumor Study Group

    Science.gov (United States)

    Hamilton, Thomas E.; Ritchey, Michael L.; Haase, Gerald M.; Argani, Pedram; Peterson, Susan M.; Anderson, James R.; Green, Daniel M.; Shamberger, Robert C.

    2013-01-01

    Objective To provide guidelines for future trials, we reviewed the outcomes of children with synchronous bilateral Wilms tumors (BWT) treated on National Wilms Tumor Study-4 (NWTS-4). Methods NWTS-4 enrolled 3,335 patients (pts) including 188 pts with BWT (5.6%). Treatment and outcome data were collected. Results Among 188 BWT pts registered with NWTS-4, 195 kidneys in 123 patients had initial open biopsy, 44 kidneys in 31 pts had needle biopsies. Although pre-resection chemotherapy was recommended, 87 kidneys in 83 pts were managed with primary resection: Complete nephrectomy 48 in 48 pts, 31 partial/wedge nephrectomies in 27 pts, enucleations 8 in 8 pts. No initial surgery was performed in 45 kidneys in 43 pts, 5 kidneys in 3 pts not coded. Anaplasia was diagnosed after completion of the initial course of chemotherapy in 14 pts (initial surgical procedure: 9 open biopsies, 4 needle biopsies, 1 partial nephrectomy). The average number of days from the start of chemotherapy to diagnosis of anaplasia was 390 (range 44–1,925 days). Relapse or progression of disease occurred in 54 children. End stage renal failure occurred in 23 children, 6 of whom had bilateral nephrectomies. The 8 year event free survival (EFS) for BWT with favorable histology was 74%, and overall survival (OS) was 89%; while the EFS for BWT with unfavorable histology was 40%, OS was 45%. Conclusion The current analysis of patients with BWT treated on NWTS-4 shows that preservation of renal parenchyma is possible in many pts following initial preoperative chemotherapy. The incidence of end-stage renal disease remains significantly higher in children with BWT. Future studies are warranted to address the need for earlier biopsy in non-responsive tumors and earlier definitive surgery to recognize unfavorable histology in these high risk patients. PMID:21394016

  9. Interpenetrated Uranyl-Organic Frameworks with bor and pts Topology: Structure, Spectroscopy, and Computation.

    Science.gov (United States)

    Liu, Chao; Chen, Fang-Yuan; Tian, Hong-Rui; Ai, Jing; Yang, Weiting; Pan, Qing-Jiang; Sun, Zhong-Ming

    2017-11-20

    Two novel three-dimensional interpenetrated uranyl-organic frameworks, (NH 4 ) 4 [(UO 2 ) 4 (L 1 ) 3 ]·6H 2 O (1) and [(UO 2 ) 2 (H 2 O) 2 L 2 ]·2H 2 O (2), where L 1 = tetrakis(3-carboxyphenyl)silicon and L 2 = tetrakis(4-carboxyphenyl)silicon, were synthesized by a combination of two isomeric tetrahedral silicon-centered ligands with 3-connected triangular [(UO 2 )(COO) 3 ] - and 4-connected dinuclear [(UO 2 ) 2 (COO) 4 ] units, respectively. Structural analyses indicate that 1 possesses a 2-fold interpenetrating anion bor network, while 2 exhibits a 3-fold interpenetrated 4,4-connected neutral network with pts topology. Both compounds were characterized by thermogravimetric analysis and IR, UV-vis, and photoluminescence spectroscopy. A relativistic density functional theory (DFT) investigation on 10 model compounds of 1 and 2 shows good agreement of the structural parameters, stretching vibrational frequencies, and absorption with experimental results; the time-dependent DFT calculations unravel that low-energy absorption bands originate from ligand-to-uranium charge transfer.

  10. Application of the French codes to the pressurized thermal shocks assessment

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Mingya; Wang, Rong Shan; Yu, Weiwei; Lu, Feng; Zhang, Guo Dong; Xue, Fei; Chen, Zhilin [Suzhou Nuclear Power Research Institute, Life Management Center, Suzhou (China); Qian, Guian [Paul Scherrer Institute, Nuclear Energy and Safety Department, Villigen (Switzerland); Shi, Jinhua [Amec Foster Wheeler, Clean Energy Department, Gloucester (United Kingdom)

    2016-12-15

    The integrity of a reactor pressure vessel (RPV) related to pressurized thermal shocks (PTSs) has been extensively studied. This paper introduces an integrity assessment of an RPV subjected to a PTS transient based on the French codes. In the USA, the 'screening criterion' for maximum allowable embrittlement of RPV material is developed based on the probabilistic fracture mechanics. However, in the French RCC-M and RSE-M codes, which are developed based on the deterministic fracture mechanics, there is no 'screening criterion'. In this paper, the methodology in the RCC-M and RSE-M codes, which are used for PTS analysis, are firstly discussed. The bases of the French codes are compared with ASME and FAVOR codes. A case study is also presented. The results show that the method in the RCC-M code that accounts for the influence of cladding on the stress intensity factor (SIF) may be nonconservative. The SIF almost doubles if the weld residual stress is considered. The approaches included in the codes differ in many aspects, which may result in significant differences in the assessment results. Therefore, homogenization of the codes in the long time operation of nuclear power plants is needed.

  11. Application of the French Codes to the Pressurized Thermal Shocks Assessment

    Directory of Open Access Journals (Sweden)

    Mingya Chen

    2016-12-01

    Full Text Available The integrity of a reactor pressure vessel (RPV related to pressurized thermal shocks (PTSs has been extensively studied. This paper introduces an integrity assessment of an RPV subjected to a PTS transient based on the French codes. In the USA, the “screening criterion” for maximum allowable embrittlement of RPV material is developed based on the probabilistic fracture mechanics. However, in the French RCC-M and RSE-M codes, which are developed based on the deterministic fracture mechanics, there is no “screening criterion”. In this paper, the methodology in the RCC-M and RSE-M codes, which are used for PTS analysis, are firstly discussed. The bases of the French codes are compared with ASME and FAVOR codes. A case study is also presented. The results show that the method in the RCC-M code that accounts for the influence of cladding on the stress intensity factor (SIF may be nonconservative. The SIF almost doubles if the weld residual stress is considered. The approaches included in the codes differ in many aspects, which may result in significant differences in the assessment results. Therefore, homogenization of the codes in the long time operation of nuclear power plants is needed.

  12. Application of the French codes to the pressurized thermal shocks assessment

    International Nuclear Information System (INIS)

    Chen, Mingya; Wang, Rong Shan; Yu, Weiwei; Lu, Feng; Zhang, Guo Dong; Xue, Fei; Chen, Zhilin; Qian, Guian; Shi, Jinhua

    2016-01-01

    The integrity of a reactor pressure vessel (RPV) related to pressurized thermal shocks (PTSs) has been extensively studied. This paper introduces an integrity assessment of an RPV subjected to a PTS transient based on the French codes. In the USA, the 'screening criterion' for maximum allowable embrittlement of RPV material is developed based on the probabilistic fracture mechanics. However, in the French RCC-M and RSE-M codes, which are developed based on the deterministic fracture mechanics, there is no 'screening criterion'. In this paper, the methodology in the RCC-M and RSE-M codes, which are used for PTS analysis, are firstly discussed. The bases of the French codes are compared with ASME and FAVOR codes. A case study is also presented. The results show that the method in the RCC-M code that accounts for the influence of cladding on the stress intensity factor (SIF) may be nonconservative. The SIF almost doubles if the weld residual stress is considered. The approaches included in the codes differ in many aspects, which may result in significant differences in the assessment results. Therefore, homogenization of the codes in the long time operation of nuclear power plants is needed

  13. The clinical impact of perfusion scintigraphy with dipyridamole

    International Nuclear Information System (INIS)

    Schechtmann, N.; Dae, M.; Lanzer, P.; Sajardo, L.; Faulkner, D.; Botvinick, E.

    1984-01-01

    In order to assess their clinical impact, the authors analyzed perfusion scintigrams (PS) with dipyridamole (D) and the resultant clinical management in 41 consecutive patients (PTS). Population mean age was 67, with 22 males and represented 14% of those having PS. Fifteen PTS had rest chest pain of unknown cause and 26 PTS had pain typical or suggestive of angina but couldn't undergo dynamic stress due to claudication, arthritis, amputation, stroke, recent surgery or other disability. Four PTS were studies for surgical clearance, 3 following angiography to assess coronary pathophysiology and 9 had prior negative or equivocal stress PS at suboptimal levels. Among 18 PTS with reversible scintigraphic abnormalities, 10 underwent subsequent catheterization, with successful CABG in 7, PTCA in 1, aggressive medical treatment of ischemia in 11, and 2 had noncoronary surgery delayed. One PT with associated extensive fixed abnormalities underwent CABG and died late in heart failure. Among 23 PTS without significant scintigraphic reversibility, 8 with normal studies were discharged, 3 went on to uncomplicated noncardiac surgery and 11 PTS, 9 with dilated cardiomyopathy, were managed without therapeutic change. D infusion was uncomplicated and related findings on PS correlated well with coronary angiography, where available in 19 of 20 PTS. PS with D: 1) is safe; 2) correlates closely with coronary anatomy; and 3) adds unique, important pathophysiologic information to clinical evaluation and impacts strongly on the management of a large number of PTS with known or suspected coronary disease

  14. Gated-SPECT myocardial scintigraphy in left bundle branch block: A study in patients with and without coronary artery disease

    International Nuclear Information System (INIS)

    Falcao, A.M.; Moffa, P.J.; Chalela, W.A.; Soares, J.; Oliveira, C.G.; Kreling, J.C.; Ferreira, B.A.; Uchida, A.H.; Meneghetti, J.C.

    2002-01-01

    Introduction: Myocardial perfusion scintigraphy (MPS) is a non-invasive method helpful for evaluating coronary heart disease. In left bundle branch block (LBBB), the myocardial scintigraphy frequently reveals septal abnormalities in the absence of coronary artery disease (CAD) and gives rise to 'false-positive' results in patients (pts) with suspected CAD. The purpose of this study was to assess the diagnostic role of ECG-gated SPECT in pts with complete LBBB, with and without known CAD. Methods. This study included 46 pts, 29 women (63%), with mean age 63.8 ± 11.6yr, divided into two groups: Group 1 (n=21 pts) with LBBB and CAD angiographically confirmed and Group 2 (n=25 pts) with LBBB and normal coronangiography. All pts underwent MPS at rest and two stress tests - dipyridamole (DIP) and treadmill exercise test (ET) with Bruce protocol. Myocardial perfusion, wall motility and wall thickening were analyzed qualitatively by consensus of two observers in anterior, septal, inferior, lateral and apical myocardial segments. Scores were attributed to: perfusion as normal, reversible or fixed defects; motility as normal, hypokinesia, akinesia or dyskinesia and thickening if present or absent. The left ventricle ejection fraction (LVEF) was automatically calculated from the ECG-gated SPECT. Results: The comparative analysis between groups 1 and 2 for both stresses (DIP and ET) for the parameters analyzed in the myocardial segments are presented: LVEF at rest, ET and DIP show statistically significant differences between groups 1 and 2 (p<0.0001). Conclusion: In the anterior and septal segments, only septal thickening was capable of differentiating between LBBB with and without CAD, independent of the kind of stress. In the other segments there was no influence of disturbance conduction for the perfusion analysis

  15. [The influence of physical exercise on heart rate variability].

    Science.gov (United States)

    Gajek, Jacek; Zyśko, Dorota; Negrusz-Kawecka, Marta; Halawa, Bogumił

    2003-03-01

    Heart rate variability is controlled by the influence of autonomic nervous system, whereas one part of the system modulates the activity of the other. There is evidence of increased sympathetic activity in patients (pts) with essential hypertension. The aim of the study was to assess the persisting influence of increased sympathetic activity 30 min after moderate physical exercise on heart rate variability in patients with arterial hypertension. The study was performed in 19 patients (10 women, mean age 52.7 +/- 9.5 years and 9 men, mean age 37.7 +/- 8.8 years) with stage I (6 pts) and stage II (13 pts) arterial hypertension. All studied pts had sinus rhythm, were free of diabetes, coronary heart disease and congestive heart failure. 24-hour Holter monitoring was performed and for 30 min before the exercise test the pts stayed in supine rest. The exercise tests were performed between 10 and 11 a.m. Immediately after the exercise all pts stayed in supine position for 30 min. The heart rate variability parameters were studied using Holter monitoring system Medilog Optima Jet and were then analysed statistically. The mean energy expenditure during the exercise was 5.8 +/- 1.1 METs and the maximal heart rate was 148.1 +/- 20.3 bpm. All studied HRV parameters were significantly different in the assessed time period compared to the baseline values (p < 0.001). Significant correlation was found between the age of the studied patients and the mean RR interval, what can be considered as a hyperkinetic (hyperadrenergic) circulatory status and shorter RR interval in younger pts. Significant negative correlation between the age and SDNN parameter (r = -0.65, p < 0.001), 30 min after the exercise mirrors the prolonged adrenergic influence in older pts. The present study shows that the influence of moderate physical exercise on heart rate variability in pts with essential hypertension is extended over 30 min period after exercise and is more pronounced in older pts. The studies

  16. Juvenile idiopathic arthritis outcome and prognosis according to catamnesis evaluation

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    O V Semenova

    2005-01-01

    Full Text Available Objective. To study outcome and prognosis in pts with juvenile idiopathic arthritis (JIA. Material and methods. 239 JIA pts with disease duration of 10 years and more were analyzed. 80 children and adolescents before 18 years old (66 girls and 14 boys were included in group 1. Arthritis clinical and laboratory activity, radiological stage and functional status according to Steinbroker and CHAQ questionnaire were assessed. 159 grown up pts (109 female and 50 male suffering from JIA from childhood were included in group 2. They were examined using Stanford Health Assessment Questionnaire (HAQ and a specially developed social status questionnaire. Results. Half pts of group 1 had recurrence of the disease during examination but activity in most cases did not exceed stage I or 2 (54% and 31% respectively. Joint destructive changes were revealed in 50% of pts. 80% of pts had radiological signs of secondary osteoarthritis. Amyloidosis was revealed in 2 from 27 pts with systemic type of JIA. 68% of pts had 1 or 2 functional class. 1/3 of pts did not have functional limitations (CHAQ=0. 13% of pts had maximal disability with CHAQ ranging from 2,1 to 3,0 (pts with polyarticular and systemic types of JIA. Most grown up pts (59% considered their health as good. Substantial part of them worked or learned. 10 pts did not worked because of the disease (1,5%. 61% of pts did not have functional limitations (HAQ=0. 32% of pts were disabled. Most of them had 3 or 2 disability degree and had possibility to work. Conclusion. Substantial part of pts with longstanding JIA have stabilization of the disease or remission. Recurrent course of the disease was characterized by decrease of activity. Most children and grown ups with longstanding disease have relatively benign functional outcome. Pts with polyarticular and systemic types of JIA require especial attention because they have maximal risk of joint destruction with severe disability.

  17. A qualitative study of clinical reasoning in physiotherapy with preterm infants and their parents: Action and interaction.

    Science.gov (United States)

    Håkstad, Ragnhild B; Obstfelder, Aud; Øberg, Gunn Kristin

    2018-09-01

    Physiotherapists (PTs) in primary health care provide services to preterm infants and their parents after hospital discharge. The service should be collaborative and individualized to meet the family's needs. In this study, we analyze pediatric PTs' collaborative work in the clinical setting and investigate the PTs' emerging clinical reasoning (CR) in interaction with the infant and parent(s). The study is based on observations of 20 physical therapy sessions and 20 interviews with PTs. We performed a systematic content analysis informed by enactive theory regarding the interactions and co-creation of meaning. CR emerged in reciprocity with the PTs' interaction with the infant and parent(s). Based on the sensitivity to the infant's motor abilities and signs of engagement as well as the parents' need of support and education, the PTs individualized and reasoned about their therapeutic approach. This interactional CR was vulnerable: infant disengagement, parent expectations, and PT preoccupations could obfuscate interactions and hamper CR. Through mutuality and engagement with the infant and parent(s), the PTs allow the autonomy of interaction to emerge and shape the translation of CR into successful therapeutic actions and learning together with the infant and parent(s).

  18. Effects of defibrotide in patients with chronic deep insufficiency. The PROVEDIS study.

    Science.gov (United States)

    Coccheri, S; Andreozzi, G M; D'Addato, M; Gensini, G F

    2004-06-01

    In the present study the effect of defibrotide, an antithrombotic and profibrinolytic agent, was investigated in patients with chronic venous insufficiency (CVI) due to deep vein obstruction and/or reflux (chronic deep vein insufficiency, CDVI). The study was a multicenter, randomized, double blind placebo controlled trial in which only patients with CDVI confirmed by ultrasound were enrolled. All patients were treated with adequate elastic compression and randomized to receive either oral defibrotide (800 mg/die) or matching placebo for 1 year. Patients with active or previous leg ulcer were excluded. A total of 288 patients were randomized and 159 completed the study. At baseline ultrasound investigation, obstructive changes were found in 2/3 of all patients thus ascertaining a post-thrombotic syndrome (PTS). The primary endpoint, ankle circumference, was significantly reduced under defibrotide from day 120 throughout 360. Scores for pain and edema were improved. The number of episodes of superficial thrombophlebitis and deep vein thrombosis was significantly lower under defibrotide (n=2) than under placebo (n=10). The majority of these events occurred in the subset of patients with documented PTS. Treatment with defibrotide in addition to elastic compression in patients with objectively assessed CDVI, mostly due to PTS, resulted in clinical benefits and prevented thrombotic complications harmful to the limb conditions.

  19. Manual Torque Data Study

    Energy Technology Data Exchange (ETDEWEB)

    Mundt, Mark Osroe [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Martinez, Matthew Ronald [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Varela, Jeanette Judith [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Anderson-Cook, Christine Michaela [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Gilmore, Walter E. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Williams, Allie [Pantex Plant (PTX), Amarillo, TX (United States)

    2018-01-11

    At the Pantex Plant in Amarillo, TX, Production Technicians (PTs) build and disassemble nuclear weapon systems. The weapons are held in an integrated work stand for stability and to increase the safety environment for the workers and for the materials being processed. There are many occasions in which a knob must be turned to tighten an assembly part. This can help to secure or manipulate pieces of the system. As there are so many knobs to turn, the instructions given to the PTs are to twist the knob to a hand-tight setting, without the aid of a torque wrench. There are inherent risks in this procedure as the knobs can be tightened too loosely such that the apparatus falls apart or too tightly such that the force can crush or pinch components in the system that contain energetic materials. We want to study these operations at Pantex. Our goal is to collect torque data to assess the safety and reliability of humantooling interfaces.

  20. Parenteral nutrition support for patients with pancreatic cancer. Results of a phase II study

    Directory of Open Access Journals (Sweden)

    Riess Hanno

    2010-03-01

    Full Text Available Abstract Background Cachexia is a common problem in patients (pts suffering from upper gastrointestinal cancer. In addition, most of these patients suffer from malabsorption and stenosis of the gastrointestinal tract due to their illness. Various methods of supplementary nutrition (enteral, parenteral are practised. In patients with advanced pancreatic cancer (APC, phase angle, determined by bio-electrical impedance analysis (BIA, seems to be a survival predictor. The positive influence of BIA determinate predictors by additional nutrition is currently under discussion. Methods To examine the impact of additional parenteral nutrition (APN we assessed outpatients suffering from APC and progressive cachexia. The assessment based on the BIA method. Assessment parameters were phase angle, ECM/BCM index (ratio of extracellular mass to body cell mass, and BMI (body mass index. Patients suffering from progressive weight loss in spite of additional enteral nutritional support were eligible for the study. Results Median treatment duration in 32 pts was 18 [8-35] weeks. Response evaluation showed a benefit in 27 pts (84% in at least one parameter. 14 pts (43.7% improved or stabilised in all three parameters. The median ECM/BCM index was 1.7 [1.11-3.14] at start of APN and improved down to 1.5 [1.12-3.36] during therapy. The median BMI increased from 19.7 [14.4-25.9] to 20.5 [15.4-25.0]. The median phase angle improved by 10% from 3.6 [2.3-5.1] to 3.9 [2.2-5.1]. Conclusions We demonstrated the positive impact of APN on the assessed parameters, first of all the phase angle, and we observed at least a temporary benefit or stabilisation of the nutritional status in the majority of the investigated patients. Based on these findings we are currently investigating the impact of APN on survival in a larger patient cohort. Trial registration ClinicalTrials.gov Identifier: NCT00919659

  1. Inter-rater reliability of the evaluation of muscular chains associated with posture alterations in scoliosis

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    Fortin Carole

    2012-05-01

    Full Text Available Abstract Background In the Global postural re-education (GPR evaluation, posture alterations are associated with anterior or posterior muscular chain impairments. Our goal was to assess the reliability of the GPR muscular chain evaluation. Methods Design: Inter-rater reliability study. Fifty physical therapists (PTs and two experts trained in GPR assessed the standing posture from photographs of five youths with idiopathic scoliosis using a posture analysis grid with 23 posture indices (PI. The PTs and experts indicated the muscular chain associated with posture alterations. The PTs were also divided into three groups according to their experience in GPR. Experts’ results (after consensus were used to verify agreement between PTs and experts for muscular chain and posture assessments. We used Kappa coefficients (K and the percentage of agreement (%A to assess inter-rater reliability and intra-class coefficients (ICC for determining agreement between PTs and experts. Results For the muscular chain evaluation, reliability was moderate to substantial for 12 PI for the PTs (%A: 56 to 82; K: 0.42 to 0.76 and perfect for 19 PI for the experts. For posture assessment, reliability was moderate to substantial for 12 PI for the PTs (%A > 60%; K: 0.42 to 0.75 and moderate to perfect for 18 PI for the experts (%A: 80 to 100; K: 0.55 to 1.00. The agreement between PTs and experts was good for most muscular chain evaluations (18 PI; ICC: 0.82 to 0.99 and PI (19 PI; ICC: 0.78 to 1.00. Conclusions The GPR muscular chain evaluation has good reliability for most posture indices. GPR evaluation should help guide physical therapists in targeting affected muscles for treatment of abnormal posture patterns.

  2. Gender Differences in Posttraumatic Stress Symptoms Among Participants of a Violence Intervention Program at a Pediatric Hospital: A Pilot Study.

    Science.gov (United States)

    Purtle, Jonathan; Adams-Harris, Erica; Frisby, Bianca; Rich, John A; Corbin, Theodore J

    2016-01-01

    Hospital-based violence intervention programs (HVIPs) have emerged as a strategy to address posttraumatic stress (PTS) symptoms among violently injured patients and their families. HVIP research, however, has focused on males and little guidance exists about how HVIPs could be tailored to meet gender-specific needs. We analyzed pediatric HVIP data to assess gender differences in prevalence and type of PTS symptoms. Girls reported more PTS symptoms than boys (6.96 vs 5.21, P = .027), particularly hyperarousal symptoms (4.00 vs 2.82, P = .002) such as feeling upset by reminders of the event (88.9% vs 48.3%, P = .005). Gender-focused research represents a priority area for HVIPs.

  3. Atherosclerotic vessel damage in systemic lupus erythematosus and antiphospholipid syndrome in men

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    A. I. Iljina

    2005-01-01

    Full Text Available Objective. To study prevalence of clinical and subclinical atherosclerosis signs in men with systemic lupus erythematosus (SLE and antiphospholipid syndrome, to assess relationship between atherosclerotic vessel damage, risk factors, CRP and anti-cardiolipin antibodies (АСА Material and methods. 62 pts were included. Mean age was 35,7+11,6 years, mean disease duration - 129,3± 102 months. Traditional and related to the disease risk factors were analyzed. To reveal atherosclerotic vessel damage carotid sonographic examination was performed. Serum CRP concentration was evaluated by high sensitivity nephelometric immunoassay. IgG and IgM АСА were assessed by solid-phase immuno-enzyme assay. Results. Sonographic signs of carotid damage was revealed in 58% of pts, clinical signs of atherosclerosis - in 42%. Pts were divided into two groups according to intima-media complex thickness (IMCT. Group I included 36 pts with atherosclerotic vessel damage signs (IMCT?0,9 mm. Group 2-26 pts with IMCT<0,9 mm. Mean age at the examination, age of disease onset, disease duration, smoking frequency damage index in group I pts were higher than in group 2 pts. Mean CRP concentration in atherosclerosis group was significantly higher than in group 2 (p=0,007. 19 pts had APS signs. 43 pts did not. CRP level significantly correlated with IMCT in SLE pts with and without APS (p<0,05. Pts with atherosclerosis had higher IgG АСА level though the differences were not statistically significant. Conclusion. Men with SLE with or without APS have high risk of atherosclerosis development. CRP elevation is associated with IMCT increase.

  4. Pressurized thermal shock re-evaluation studies for Korean PWR plant

    International Nuclear Information System (INIS)

    Jung, Sung Gyu; Kim, Hyun Su; Jin, Tae Eun; Jang, Chang Hee

    2001-01-01

    The PTS reference temperature of reactor pressure vessel for one of the Korean NPPs has been predicted to exceed the screening criteria before it reaches it's design life. To cope with this issue, a plant-specific PTS analysis had been performed in accordance with the Regulatory Guide 1.154 in 1999. As a result of that analysis, it was found that current methodology of RG. 1.154 was very conservative. The objective of this study is to examine the effects of changing various input parameters and to determine the amount of conservatism of the current PTS analysis method. To do this, based on the past PTS analysis experience, parametric study were performed for various models using modified VISA-II code. This paper discusses the analysis results and recommendations to reduce the conservatism of current analysis method

  5. Quantitative stress-redistribution planar T1-201 scintigraphy: Assessment of the extent of hypoperfused myocardium by relationship to angiographic findings

    International Nuclear Information System (INIS)

    Bassir, R.; Maddahi, J.; Garcia, E.

    1984-01-01

    The size of hypoperfused myocardium (HM) in coronary artery (CA) disease (D) potentially provides a prognostic index that may not be accurately assess by conventional angiographic classification. The authors studied 62 consecutive patients (pts) with planar stress-redistribution T1-201 scintigraphy (T1-201) and coronary arteriography who did not have prior myocardial infarction and achieved 85% predicted maximum heart rate on exercise. Of 62 pts, 42 had CAD (>50% stenosis). For T1-201 quantification of the size of HM, maximum count circumferential profiles of initial distribution and % washout were obtained and compared to previously established normal limits. The area enclosed between the normal limits and the abnormal portion of the pt's profiles represented a quantitative T1-201 jeopardy score (JS). Despite increasing T1-201 JS from 1 to 3 vessel (V) and left-main (LM) D, significant overlap between the different angiographic groups was observed; of 45 pts with mild JS (<300), 14 (31%) had 3VD and/or LMD. The angiographic extent of CAD was also analyzed using a method (CLASS) proposed by Gensini et al based on the CA territory, location and severity of stenosis, and collateral circulation. T1-201 JS correlated significantly with CLASS (r=.78, p<.01). Of the 45 pts with mild JS, only 5 (11%) had severe CLASS score. Thus, the size of the hypoperfused myocardium by quantitative stress- and redistribution T1-201 correlates better with a more complex angiographic estimate of myocardium at risk than conventional 1, 2, and 3 vessel disease classification

  6. Rheumatoid arthritis and bacterial infections

    Directory of Open Access Journals (Sweden)

    N L Prokopjeva

    2008-01-01

    Full Text Available To study features of bacterial infections course in pts with rheumatoid arthritis (RA and changes of laboratory measures after focus of infection sanation. Material and methods. 46 pts with definite rheumatoid arthritis were examined at the time of comorbid infection (Cl detection and after infection focus sanation. Bacteriological test with evaluation of flora sensitivity to antibiotics by disco-diffusion method was performed at baseline and after the course of antibacterial therapy to assess its efficacy. Hemogram, serum fibrinogen, rheumatoid factor, circulating immune complexes (CIC, C-reactive protein levels were assessed. Serum interleukin (IL 1(3, IL6 and neopterin concentrations were examined by immune-enzyme assay in a part of pts. Typical clinical features of Cl were present in only 28 (60,9% pts. 13 (28,3% pts had fever, 12 (26,0% — leukocytosis, 15 (32,6% — changes of leucocyte populations. Some laboratory measures (thrombocytes, fibrinogen, CIC, neopterin levels significantly decreased (p<0,05 after infection focus sanation without correction of disease modifying therapy. Cl quite often develop as asymptomatic processes most often in pts with high activity and can induce disturbances promoting appearance of endothelial dysfunction, atherothrombosis and reduction of life duration. So timely detection and proper sanation of infection focuses should be performed in pts with RA

  7. Development of a viscoplastic dynamic fracture mechanics treatment for crack arrest predictions in a PTS event

    International Nuclear Information System (INIS)

    Kanninen, M.F.; Hudak, S.J. Jr.; Reed, K.W.; Dexter, R.J.; Polch, E.Z.; Cardinal, J.W.; Achenbach, J.D.; Popelar, C.H.

    1986-01-01

    The objective of this research is to develop a fundamentally correct methodology for the prediction of crack arrest at the high upper shelf conditions occurring in a postulated pressurized thermal shock (PTS) event. The effort is aimed at the development of a versatile finite-element method for the solution of time-dependent boundary value problems that admit inertia effects, a prescribed spatial temperature distribution, and viscoplastic constitutive and fracture behavior. Supporting this development are (1) material characterization and fracture experimentation, (2) detailed mathematical analyses of the near-tip region, (3) elastodynamic fracture analysis, and (4) elastic-plastic tearing instability analyses. As a first step, dynamic-viscoplastic analyses are currently being made of the wide plate tests being performed by the National Bureau of Standards in a companion HSST program. Some preliminary conclusions drawn from this work and from the supporting research activities are offered in this paper. The outstanding critical issues that subsequent research must focus on are also described

  8. Alflutop in osteoarthritis therapy

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    G. V. Lukina

    2004-01-01

    Full Text Available Objective. To study efficacy and safety of different schemes of alflutop (AT administration in pts with osteoarthritis (OA. Material and methods 45 pts (40 womene and 5 men with knee or hip OA or nodular form of the disease were included. Mean age was 60,3± 10,0 years, mean disease duration - 8,0±6,0 years, mean duration of the last exacerbation - 5,6±5,4 months. Pts with 2 (27 pts and 3(15 pts X-ray OA stage and 2 functional class (30 pts prevailed. Pts were devided into 3 comparable groups, 15 pts in each. Pts of the group 1 received AT I ml/day intramuscularly (im during 3 weeks, group 2 pts received intra-articular (ia injections of AT 2 ml twice a week for 3 weeks and then im for 20 days. In group 3 ia (6 and im (20 injections were performed^simultaneously. During 12 months of follow up every pt received 2 appropriate courses. Results. 41 pts completed the study. AT significantly decreased joint pain at rest and at movement measured visual analog scale and WOMAC index in all groups. It also improved functional activity of pts (according to WOMAC index. Improvement according to doctor assessment was achieved after the second course in 78% of pts in group I, in 92% in group 2 and in 86% in group 3. Sonography of knee joints showed significant decrease of synovial membrane thickness (as a sign of synovitis as well as increase parts of intra-articular hyaline cartilage thickness in group 2 and 3 pts. There was no radiological progression year of follow up. Tolerability was good. The drug was stopped due to adverse events in only 3 pts (dermatitis at the site of injection-1, increase of joint pain after intra-articular injections- 2 . In 3 other pts side effects were mild, and treatmend was continued. Conclusion. Combined Im and AT administration provides anti-inflammatory, analgesic and possible chondroprotective effect in OA pts.

  9. [POL-PAVTI--Polish report on transcatheter pulmonary artery valve implantation of Melody-Medtronic prosthesis in the first 14 patients in Poland].

    Science.gov (United States)

    Ruzyłło, Witold; Demkow, Marcin; Włodarska, Elzbieta K; Kowalski, Mirosław; Spiewak, Mateusz; Siudalska, Hanna; Wolski, Piotr; Miśko, Jolanta; Hoffman, Piotr; Kusa, Jacek; Szkutnik, Małgorzata; Białkowski, Jacek; Fiszer, Roland; Urbańska, Ewa; Sondergaard, Lars

    2009-10-01

    To assess the early results of the pulmonary artery valve transcatheter implantation (PAVTI) in pts included into POL-PAVTI registry. Detailed medical and economic analyses were performed. Pulmonary artery valve implantation was performed in 14 pts (9 men), aged 16-31 (mean 24.6 +/- 4.8) years, with pulmonary homograft dysfunction after total repair of tetralogy of Fallot (4 pts), pulmonary atresia (2 pts), pulmonary stenosis (1 pt), common arterial trunk type I (1 pt), Ross procedure (3 pts) and TGA - Rastelli operation (3 pts). Eleven pts underwent in the past 2-5 surgical or/and catheter interventions. Indication for PAVTI was based on clinical evaluation and echocardiographic studies. Assessment of morphological and functional features of the right ventricle (RV) and homograft with the use of cardiac magnetic resonance (CMR) was performed in 10 cases. Pulmonary stenosis (max. pulmonary gradient 32-119, mean 72 +/- 28 mmHg) was observed in 13 pts and/or significant pulmonary regurgitation in 10 pts. The procedure was performed in general anesthesia. The deployment of a valved stent in the pulmonary valve position was preceded by a metal stent implantation. Results were evaluated by echocardiography two days after the procedure and one month later. Four patients were evaluated 6 months after procedure. Time of the procedure varied 60-190 (mean 127 +/- 35) min, time of fluoroscopy ranged 12-31 (mean 21 +/- 11) min. PAVTI was successfully performed in all pts without serious complications. Patients were discharged from the hospital 48-293 (mean 120 +/- 71) h after procedure. Significant reduction of pulmonary gradient after the procedure assessed by echocardiography was observed on the second day (20-60, mean 38 +/- 12 mmHg, p < 0.0001) and one month (19-52, mean 34 +/- 9 mmHg, p < 0.0001). Mild pulmonary regurgitation was observed in 2 pts. In 5 pts evaluated 6 months after procedure haemodynamic parameters were unchanged; no late complications were observed

  10. Some advances in fracture studies under the heavy-section steel technology program

    International Nuclear Information System (INIS)

    Pugh, C.E.; Corwin, W.R.; Bryan, R.H.; Bass, B.R.

    1985-01-01

    Recent results are summarized from HSST studies in three major areas that relate to assessing nuclear reactor pressure vessel integrity under pressurized-thermal-shock (PTS) conditions: irradiation effects on the fracture properties of stainless steel cladding, crack run-arrest behavior under nonisothermal conditions, and fracture behavior of a thick-wall vessel under combined thermal and pressure loadings

  11. Application of radionuclide techniques in evaluation of dilated cardiomyopathy and ischemic cardiomyopathy

    International Nuclear Information System (INIS)

    Tian Yueqin; Liu Xiujie; Shi Rongfang

    2000-01-01

    Objective: To assess the clinical significance of radionuclide techniques in differentiating dilated cardiomyopathy (DCM) from ischemic cardiomyopathy (CAD-CM). Methods: 28 patients (pts) with DCM and 55 pts with CAD-CM were studied. All pts underwent 99 Tc m -MIBI myocardial perfusion SPECT and 18 F-FDG myocardial metabolic PET. 73 pts had 99 Tc m -RBC radionuclide ventriculography and 68 pts had coronary angiography. Results: 23 pts (82%) with DCM showed perfusion abnormalities with mild and not segmental distribution. 52 pts (95%) with CAD-CM showed perfusion abnormalities that distributed along the coronary vessel territories. Perfusion defects were found in 4 pts (14%) with DCM and 45 pts (82%) with CAD-CM (P<0.01). The average perfusion score was 4.5 +- 2.6 in DCM and 9.5 +- 2.9 in CAD-CM, the area of perfusion diminished uptake was significantly smaller in DCM than in CAD-CM (P < 0.001). 2 pts with DCM and 18 pts with CAD-CM had metabolic defect. The patterns of perfusion/metabolic imaging showed mismatch in most pts with CAD-CM but match in pts with DCM. The LVEF in pts with DCM and CAD-CM was decreased but no significant difference between DCM and CAD-CM was observed. The RVEF in pts with DCM was significantly lower than that in pts with CAD-CM (32.4% +- 13.9% vs 40.9% +- 15.4%, P < 0.05). Conclusions: The radionuclide techniques showed to be helpful for distinguishing DCM from CAD-CM. The discriminate analysis revealed that segmental perfusion abnormality and RVEF were the most important factors for differentiation of DCM from CAD-CM

  12. Lethality of patients with rheumatoid arthritis depending on adalimumab administration: imitation modeling

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    D V Goryachev

    2009-01-01

    Full Text Available Lethality of pts with rheumatoid arthritis (RA exceeds mortality values in general population. Possibility of disease modifying anti-rheumatic drugs (DMARD influence on RA pts lethality has been widely discussed lately in scientific works. Objective. To determine possible lethality diminishment in Russian population of RA pts with one of biological drugs TNFα antagonist adalimumab. Material and methods. Model construction is based on the fact of lethality dependence on pt functional state assessed by HAQ. Model simulating progression of functional disability in pts with RA visiting medical institutions of Russia was made (RAISER study. 3 model variants for imitation of consecutive change of DMARDs including adalimumab were done. First consecution assessed DMARD change in the next chain: adalimumab-methotrexate-sulfasalazine-leflunomide-azathioprine-cyclosporine-palliative therapy. Second consecution: adalimumab administration after failure of first 3 DMARDs. Third consecution considered only change of synthetic DMARDs without adalimumab inclusion. Model imitated participation of 3000 pts in every consecution. Prognosis horizon was 12 years. Age of pts and initial HAQ distribution were get from results of epidemiological RAISER study. Calculation was done on the base of elevation of standardized lethality level (SLL in population of RA pts in average from 135% to 300%. SLL values from 80 to 320% were used depending on functional disability degree with converting to Russian values of age-specific lethality coefficient for 1999. Results. Lethality in treatment consecutions including adalimumab was significantly lower. To the end of 12th year in group not using adalimumab, using it at once and using it after 376 DMARDs respectively 65,1%, 71,6% and 71,1% of pts were still alive. Conclusion. Significant decrease of lethality with adalimumab inclusion in consecution of DMARD change during treatment of RA pts was demonstrated with imitation modeling

  13. Impact of new traumatic or stressful life events on pre-existing PTSD in traumatized refugees: results of a longitudinal study

    Directory of Open Access Journals (Sweden)

    Katrin Schock

    2016-11-01

    Full Text Available Background: A significant proportion of trauma survivors experience an additional critical life event in the aftermath. These renewed experiences of traumatic and stressful life events may lead to an increase in trauma-related mental health symptoms.Method: In a longitudinal study, the effects of renewed experiences of a trauma or stressful life event were examined. For this purpose, refugees seeking asylum in Germany were assessed for posttraumatic stress symptoms (PTS, Posttraumatic Stress Diagnostic Scale (PDS, anxiety, and depression (Hopkins Symptom Checklist [HSCL-25] before treatment start as well as after 6 and 12 months during treatment (N=46. Stressful life events and traumatic events were recorded monthly. If a new event happened, PDS and HSCL were additionally assessed directly afterwards. Mann–Whitney U-tests were performed to calculate the differences between the group that experienced an additional critical event (stressful vs. trauma during treatment (n=23 and the group that did not (n=23, as well as differences within the critical event group between the stressful life event group (n=13 and the trauma group (n=10.Results: Refugees improved significantly during the 12-month period of our study, but remained severely distressed. In a comparison of refugees with a new stressful life event or trauma, significant increases in PTS, anxiety, and depressive symptoms were found directly after the experience, compared to the group without a renewed event during the 12 months of treatment. With regard to the different critical life events (stressful vs. trauma, no significant differences were found regarding overall PTS, anxiety, and depression symptoms. Only avoidance symptoms increased significantly in the group experiencing a stressful life event.Conclusion: Although all clinicians should be aware of possible PTS symptom reactivation, especially those working with refugees and asylum seekers, who often experience new critical life

  14. Impact of new traumatic or stressful life events on pre-existing PTSD in traumatized refugees: results of a longitudinal study.

    Science.gov (United States)

    Schock, Katrin; Böttche, Maria; Rosner, Rita; Wenk-Ansohn, Mechthild; Knaevelsrud, Christine

    2016-01-01

    A significant proportion of trauma survivors experience an additional critical life event in the aftermath. These renewed experiences of traumatic and stressful life events may lead to an increase in trauma-related mental health symptoms. In a longitudinal study, the effects of renewed experiences of a trauma or stressful life event were examined. For this purpose, refugees seeking asylum in Germany were assessed for posttraumatic stress symptoms (PTS), Posttraumatic Stress Diagnostic Scale (PDS), anxiety, and depression (Hopkins Symptom Checklist [HSCL-25]) before treatment start as well as after 6 and 12 months during treatment ( N =46). Stressful life events and traumatic events were recorded monthly. If a new event happened, PDS and HSCL were additionally assessed directly afterwards. Mann-Whitney U -tests were performed to calculate the differences between the group that experienced an additional critical event (stressful vs. trauma) during treatment ( n =23) and the group that did not ( n =23), as well as differences within the critical event group between the stressful life event group ( n =13) and the trauma group ( n =10). Refugees improved significantly during the 12-month period of our study, but remained severely distressed. In a comparison of refugees with a new stressful life event or trauma, significant increases in PTS, anxiety, and depressive symptoms were found directly after the experience, compared to the group without a renewed event during the 12 months of treatment. With regard to the different critical life events (stressful vs. trauma), no significant differences were found regarding overall PTS, anxiety, and depression symptoms. Only avoidance symptoms increased significantly in the group experiencing a stressful life event. Although all clinicians should be aware of possible PTS symptom reactivation, especially those working with refugees and asylum seekers, who often experience new critical life events, should understand symptom

  15. Viscoplastic-dynamic analyses of small-scale fracture tests to obtain crack arrest toughness values for PTS conditions

    International Nuclear Information System (INIS)

    Kanninen, M.F.; Hudak, S.J. Jr; Dexter, R.J.; Couque, H.; O'Donoghue, P.E.; Polch, E.Z.

    1988-01-01

    Reliable predictions of crack arrest at the high upper shelf toughness conditions involved in postulated pressurized thermal shock (PTS) events require procedures beyond those utilized in conventional fracture mechanics treatments. To develop such a procedure, viscoplastic-dynamic fracture mechanics finite element analyses, viscoplastic material characterization testing, and small-scale crack propagation and arrest experimentation are being combines in this research. The approach couples SwRI's viscoplastic-dynamic fracture mechanics finite element code VISCRK with experiments using duplex 4340/A533B steel compact specimens. The experiments are simulated by VISCRK computations employing the Bodner-Partom viscoplastic constitutive relation and the nonlinear fracture mechanics parameter T. The goal is to develop temperature-dependent crack arrest toughness values for A533B steel. While only room temperature K Ia values have been obtained so far, these have been found to agree closely with those obtained from wide plate tests. (author)

  16. Gastroduodenal safety of Nimesulid (Nimesil, Berlin Chemie in rheumatic patients with history of ulcer

    Directory of Open Access Journals (Sweden)

    A. E. Karateyev

    2003-01-01

    Full Text Available Objective. To assess safety of nimesulid in rheumatic pts with history of ulcer or multiple erosions (ME of stomach and/or duodenal mucosa. Methods. 42 pts with rheumatic diseases aged 22-73 years were included. AH had gastric or duodenal ulcers or ME (n>10 connected with NSAID treatment and confirmed by endoscopy no more than 6 months before the beginning of the study. Pts were included after healing of ulcers and erosions. The pts were randomized to receive Nimesulid 200 mg/day (group 1 or Diclofenac suppositoria 100 mg/day + ranitidine 150 mg/day (group 2. Esophagogastroduodenoscopy was performed before and 12 weeks after the beginning of treatment. Results. Relapse of stomach ulcer was observed in I pts of group 1 (5,6%. Relapse of NSAID-induced ulcers and ME was noted in 6 pts of group 2 (33,3%: in 4 cases stomach ulcers, in 1 case stomach ME, in 1 case duodenal ulcer (p=0,0424. Presence of gastralgias and dyspepsia was noted in 36,8% pts of group 1 and in 20% pts of group 2 (p=0,0539. In 1 pts of group 2 gastralgias were the reason for premature endoscopy. Conclusion. Nimesil (Nimesulid can be considered as a more safe drug than classical NSAIDs with smaller risk of serious gastroduodenal complications development in rheumatic pts with ulcer history. The results of the study allow to recommend Nimesulid as a drug of choice for treatment of pts with history of NSAID-induced gastropathy.

  17. Preliminary assessment of the effects of biaxial loading on reactor pressure vessel structural-integrity-assessment technology

    International Nuclear Information System (INIS)

    Pennell, W.E.; Bass, B.R.; Bryson, J.W.; Dickson, T.L.; McAfee, W.J.; Merkle, J.G.

    1996-01-01

    Effects of biaxial loading on shallow-flaw fracture toughness were studied to determine potential impact on structural integrity assessment of a reactor pressure vessel (RPV) under pressurized thermal shock (PTS) transient loading and pressure-temperature (PT) loading produced by reactor heatup and cooldown transients. Biaxial shallow-flaw fracture-toughness tests results were also used to determine the parameter controlling fracture in the transition temperature range, and to develop a related dual-parameter fracture-toughness correlation. Shallow-flaw and biaxial loading effects were found to reduce the conditional probability of crack initiation by a factor of nine when the shallow-flaw fracture-toughness K Jc data set, with biaxial-loading effects adjustments, was substituted in place of ASME Code K Ic data set in PTS analyses. Biaxial loading was found to reduce the shallow-flaw fracture toughness of RPV steel such that the lower-bound curve was located between ASME K Ic and K IR curves. This is relevant to future development of P-T curve analysis procedures. Fracture in shallow-flaw biaxial samples tested in the lower transition temperature range was shown to be strain controlled. A strain-based dual-parameter fracture-toughness correlation was developed and shown to be capable of predicting the effect of crack-tip constraint on fracture toughness for strain-controlled fracture

  18. Myocardial perfusion assessed by contrast echocardiography and single photon emission computed tomography in the evaluation of patients with acute chest pain and normal electrocardiogram

    International Nuclear Information System (INIS)

    Soares, J. Jr.; Ferreira, S.M.A.; Matias, W. Jr.; Giorgi, M.C.P.; Izaki, M.; Luz, P.L.; Ramires, J.A.F.; Meneghetti, J.C.

    2002-01-01

    Aim : Evaluation of diagnostic accuracy of myocardial contrast echocardiography (MCE) in comparison with single-photon emission computed tomography (SPECT) for the detection of myocardial ischemia in patients with acute chest pain. Material and Methods : Eighteen patients (pts) with chest pain lasting ≥30 minutes, occurring within 6 hours of emergency room presentation and a normal or no diagnostic electrocardiogram were studied. Pts underwent rest MCE and SPECT. For both exams myocardial perfusion was assessed in the same 7 segments (apical, anterior, inferior, anteroseptal, inferoseptal, lateral and posterior) of left ventricle. A total of 126 segments were analyzed. Images were classified as positive for ischemia if they had a perfusion defect. Coronary angiography was performed if MCE or SPECT images were classified as positive for ischemia or by clinical indication. Otherwise the patients underwent stress SPECT. Significant coronary artery disease (CAD) was defined as ≥70% stenosis in a major coronary artery or its branches. Final diagnosis of an acute coronary event (ACE) was established in the presence of positive findings in MCE or SPECT in addition to significant CAD in the corresponding territory. Kappa statistics were calculated to evaluate the concordance between MCE and SPECT. κ values of ≤0.4, >0.4 and >0.7 indicate fair, good and excellent agreement, respectively. Results: Thirteen out of 18 pts underwent coronary angiography (seven pts had positive findings on SPECT, 2 on MCE, 2 on both exams and 1 had clinical indication). Significant CAD was detected on six. Five pts underwent stress SPECT and no perfusion defect was detected. Therefore, six pts (33.3%) had an ACE and 12 (66.6%) had not. There were no statistical differences between groups according to age, gender, duration of pain, free pain interval, presence of risk factors and antecedents. Concordance between MCE and SPECT for evaluation of perfusion defects showed a ? coefficient of 0

  19. Evaluating Referral, Screening, and Assessment Procedures for Middle School Trauma/Grief-Focused Treatment Groups

    Science.gov (United States)

    Grassetti, Stevie N.; Williamson, Ariel A.; Herres, Joanna; Kobak, Roger; Layne, Christopher M.; Kaplow, Julie B.; Pynoos, Robert S.

    2018-01-01

    There is a need to delineate best practices for referring, assessing, and retaining students suspected of posttraumatic stress (PTS) and maladaptive grief (MG) in school-based treatment. Evidence-based risk-screening procedures should accurately include students who are appropriate for group treatment and exclude students who do not require…

  20. The effects of recurrent physical abuse on the co-development of behavior problems and posttraumatic stress symptoms among child welfare-involved youth.

    Science.gov (United States)

    Yoon, Susan; Barnhart, Sheila; Cage, Jamie

    2018-04-27

    The primary aim of the current study was to examine the longitudinal effects of ongoing physical abuse on the co-development of externalizing behavior problems and posttraumatic stress (PTS) symptoms among child welfare-involved adolescents. Using three waves of data from the National Survey of Child and Adolescent Well-Being, we performed unconditional and conditional parallel process latent growth curve modeling in a structural equation modeling framework. The study sample included 491 adolescents who were between 11 and 13 years of age at baseline. Higher levels of initial PTS symptoms were associated with higher levels of externalizing behavior problems, but the rate of change in PTS symptoms were not significantly associated with the rate of change in externalizing behavior problems over time. Although physical abuse was concurrently associated with both externalizing behavior problems and PTS symptoms at all assessment points, there were no lagged effects. Additionally, we found that physical abuse indirectly affects subsequent development of externalizing behavior problems and PTS symptoms through ongoing physical abuse. Findings highlight the comorbidity of externalizing behaviors and PTS symptoms among early adolescents in the child welfare system, underlining the importance of screening for and addressing these problems simultaneously. Findings also point to the need for continued assessment of and protection from ongoing physical abuse during adolescence. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. The usefulness of contrast during exercise echocardiography for the assessment of systolic pulmonary pressure

    Directory of Open Access Journals (Sweden)

    Cordeiro Ana

    2008-10-01

    Full Text Available Abstract Background The systolic pulmonary artery pressure (PAPs can be accurately estimated, non-invasively, using continuous-wave Doppler (CWD ultrasound measurement of the peak velocity of a tricuspid regurgitant (TR jet. However, it is often difficult to obtain adequate tricuspid regurgitation signals for measurement of PAPs, what could lead to its underestimation. Therefore, utilization of air-blood-saline contrast has been implemented for the improvement of Doppler signal in several clinical contexts. It is now recommended in the evaluation of patients with pulmonary hypertension. Physical activity is severely restricted in patients with PAH, being exertional dypnea the most typical symptom. Exercise stress echo-Doppler imaging allows assessment of the response to exercise. It is an excellent screening test for patients with suspected PAH. Our purpose was to evaluate the value and accuracy of agitated saline with blood contrast echocardiography, in the improvement of the Doppler signal, to quantify PAPs during treadmill exercise-echocardiography. Purpose To evaluate the value of contrast echocardiography, using agitated saline with blood, in the improvement of the Doppler signal used to quantify the pulmonary artery systolic pressure during exercise. Methods From a total of 41 patients (pts, we studied 38 pts (93%, 35 women, aged 54 ± 12 years-old. 27 with the diagnosis of systemic sclerosis, 10 with history of pulmonary embolism and one patient with a suspected idiopathic PAH, who were referred to the Unity of Heart Failure and Pulmonary Hypertension for screening of PAH. According to the Unity protocol, a transthoracic echocardiogram was made, in left decubitus (LD, with evaluation of right ventricle-right atria gradient (RV/RAg. A peripheral venous access was obtained, with a 3-way stopcock and the patients were placed in orthostatism (O, with a new evaluation of RV/RAg. Exercise echocardiography (EE was begun, with evaluation of RV

  2. The first experience of melatonin administration for correction of sleep disturbances in rheumatoid arthritis patients

    Directory of Open Access Journals (Sweden)

    A. E. Karateev

    2004-01-01

    Full Text Available Objective. To assess efficacy melatonin administered for correction of sleep disturbances in pts with rheumatoid arthritis (RA. Material and methods. 3-weeks randomized controlled study of melatonin (Melaxen, Unipharm 3 mg/day (in the evening in 20 RA pts with sleep disturbances was performed. Control placebo group included 10 pts comparable with study group. Effect of the drug on insomnia so as on the main clinical and laboratory indices of RA activity was scored. Results. To the end of follow up study group pts showed improvement of sleep quality in comparison with initial. Frequency of such insomnia signs as feeling of dissatisfaction with night sleep, tiredness persistence after sleep and unpleasant feelings during sleep significantly decreased. The general result of treatment with melaxen was assessed by pt and doctor as improvement or significant improvement in 47,4-63,2% of cases. Morning stiffness, swollen and tender joint counts so as pain intensity significantly decreased during treatment. Improper drug tolerability was noted in only one pt. Signs of insomnia and RA activity did not change in placebo group. Conclusion. Melatonin is an effective and safe drug for correction of sleep disturbances in RA pts. It also showed capacity to decrease inflammatory activity of RA.

  3. The impact of pneumatic tube system on routine laboratory parameters: a systematic review and meta-analysis.

    Science.gov (United States)

    Kapoula, Georgia V; Kontou, Panagiota I; Bagos, Pantelis G

    2017-10-26

    Pneumatic tube system (PTS) is a widely used method of transporting blood samples in hospitals. The aim of this study was to evaluate the effects of the PTS transport in certain routine laboratory parameters as it has been implicated with hemolysis. A systematic review and a meta-analysis were conducted. PubMed and Scopus databases were searched (up until November 2016) to identify prospective studies evaluating the impact of PTS transport in hematological, biochemical and coagulation measurements. The random-effects model was used in the meta-analysis utilizing the mean difference (MD). Heterogeneity was quantitatively assessed using the Cohran's Q and the I2 index. Subgroup analysis, meta-regression analysis, sensitivity analysis, cumulative meta-analysis and assessment of publication bias were performed for all outcomes. From a total of 282 studies identified by the searching procedure, 24 were finally included in the meta-analysis. The meta-analysis yielded statistically significant results for potassium (K) [MD=0.04 mmol/L; 95% confidence interval (CI)=0.015-0.065; p=0.002], lactate dehydrogenase (LDH) (MD=10.343 U/L; 95% CI=6.132-14.554; panalysis and random-effects meta-regression analysis according to the speed and distance of the samples traveled via the PTS revealed that there is relation between the rate and the distance of PTS with the measurements of K, LDH, white blood cells and red blood cells. This meta-analysis suggests that PTS may be associated with alterations in K, LDH and AST measurements. Although these findings may not have any significant clinical effect on laboratory results, it is wise that each hospital validates their PTS.

  4. Posttraumatic stress in survivors 1 month to 19 years after an airliner emergency landing.

    Science.gov (United States)

    Arnberg, Filip K; Michel, Per-Olof; Lundin, Tom

    2015-01-01

    Posttraumatic stress (PTS) is common in survivors from life-threatening events. Little is known, however, about the course of PTS after life threat in the absence of collateral stressors (e.g., bereavement, social stigma, property loss) and there is a scarcity of studies about PTS in the long term. This study assessed the short- and long-term course of PTS, and the influence of gender, education and age on the level and course of PTS, in survivors from a non-fatal airliner emergency landing caused by engine failure at an altitude of 1 km. There were 129 persons on board. A survey including the Impact of Event Scale was distributed to 106 subjects after 1 month, 4 months, 14 months, and 25 months, and to 95 subjects after 19 years (response rates 64-83%). There were initially high levels of PTS. The majority of changes in PTS occurred from 1 to 4 months after the event. There were small changes from 4 to 25 months but further decrease in PTS thereafter. Female gender was associated with higher levels of PTS whereas gender was unrelated to the slope of the short- and long-term trajectories. Higher education was related to a quicker recovery although not to initial or long-term PTS. Age was not associated with PTS. The present findings suggest that a life-threatening experience without collateral stressors may produce high levels of acute posttraumatic stress, yet with a benign prognosis. The findings further implicate that gender is unrelated to trajectories of recovery in the context of highly similar exposure and few collateral stressors.

  5. Posttraumatic stress in survivors 1 month to 19 years after an airliner emergency landing.

    Directory of Open Access Journals (Sweden)

    Filip K Arnberg

    Full Text Available Posttraumatic stress (PTS is common in survivors from life-threatening events. Little is known, however, about the course of PTS after life threat in the absence of collateral stressors (e.g., bereavement, social stigma, property loss and there is a scarcity of studies about PTS in the long term. This study assessed the short- and long-term course of PTS, and the influence of gender, education and age on the level and course of PTS, in survivors from a non-fatal airliner emergency landing caused by engine failure at an altitude of 1 km. There were 129 persons on board. A survey including the Impact of Event Scale was distributed to 106 subjects after 1 month, 4 months, 14 months, and 25 months, and to 95 subjects after 19 years (response rates 64-83%. There were initially high levels of PTS. The majority of changes in PTS occurred from 1 to 4 months after the event. There were small changes from 4 to 25 months but further decrease in PTS thereafter. Female gender was associated with higher levels of PTS whereas gender was unrelated to the slope of the short- and long-term trajectories. Higher education was related to a quicker recovery although not to initial or long-term PTS. Age was not associated with PTS. The present findings suggest that a life-threatening experience without collateral stressors may produce high levels of acute posttraumatic stress, yet with a benign prognosis. The findings further implicate that gender is unrelated to trajectories of recovery in the context of highly similar exposure and few collateral stressors.

  6. Quality-of-life assessment following surgery with or without postoperative radiation therapy for squamous cell carcinoma of the tongue base

    International Nuclear Information System (INIS)

    Nisi, K.W.; Earle, J.M.; Foote, R.L.

    1996-01-01

    Purpose/Objective: To evaluate the quality-of-life after surgery with or without postoperative radiation therapy for carcinoma of the tongue base. Materials and Methods: At the 1995 ASTRO meeting, the University of Florida and MSKCC reported the quality-of-life (QOL) functional outcome of patients treated with primary radiation therapy (RT) for squamous cell carcinoma of the tongue base (BOT). Relatively little data evaluating the QOL following primary surgery has been published. Between January 1974 and December 1993, 89 patients (pts) underwent surgery alone (65 pts) or surgery combined with postoperative radiation therapy (24 pts) for tongue base cancer. Twenty-seven pts were alive at last contact. Three pts have been lost to follow-up and three pts declined to participate in the QOL assessment. Twenty-one pts consented to QOL assessment. Their median follow-up is 5.4 years (range 2.0-20.8 years). These patients completed: 1) the Performance Status Scale for Head and Neck Cancer Patients (PSS), a measure of ability to eat in public, understandability of speech, and normalcy of diet (scale 0-100, best score = 100); and 2) Functional Assessment of Cancer Therapy (FACT) (scale 0-28 for physical and social well-being, and 0-20 for emotional well-being, higher number=best score). Pathologic T stage was T1-7, T2-10, T3-3, T4-1. Twenty patients had ipsilateral neck dissection and 6 had bilateral neck dissection. The 8 patients who were treated with adjuvant RT received a median dose of 60 Gy. Prior to treatment, 62% had either full or part-time employment with a median annual income of $10,000-$40,000. Results: Mean PSS scores for all patients were 82 for eating in public, 92 for understandability of speech, and 78 for normalcy of diet. Normalcy of diet was significantly better in the surgery alone group than in the adjuvant RT group (91 vs. 56, p=0.0005). The ability to eat in public (88 vs. 72, p=NS) and understandability of speech (96 vs. 84, p=NS) did not differ

  7. Continuous 28 day iododeoxyuridine (IUdR) infusion and hyperfractionated accelerated radiotherapy (hart) for malignant glioma: a phase I clinical and thymidine replacement study

    International Nuclear Information System (INIS)

    Schulz, C.A.; Mehta, M.P.; Robins, H.I.; Badie, B.; Arzoomanian, R.; Simon, K.; Alberti, D.; Feierabend, C.; Kunugi, K.A.; Wilding, G.; Kinsella, T.J.

    1997-01-01

    Objectives: Based on preclinical studies demonstrating a direct correlation between duration of IUdR infusion and percent cells labeled as well as amount thymidine replaced by IUdR, we conducted a Phase I trial to: (1) investigate the maximum tolerated dose (MTD) and systemic toxicities of a continuous 28 day IUdR infusion; (2) analyze percent IUdR-thymidine replacement in peripheral granulocytes as a surrogate marker for IUdR incorporation into tumor cells; (3) measure steady state serum IUdR levels; and (4) assess the feasibility of continuous IUdR infusion and HART in the management of malignant glioma. Materials and Methods: Patients (pts.) were required to have a KPS ≥60% and biopsy proven malignant glioma. Pts. received 100 (level 1: 4 pts.), 200 (level 2: 3 pts.), 300 (level 3: 3 pts.), 400 (level 4: 6 pts.) or 500 (level 5:2 pts.) mg/m2/day IUdR by continuous infusion for 28 days. HART started 7 days after IUdR initiation. Total dose was 70 Gy [1.2 Gy BID x 25 days with a 10 Gy. (2.0 x 5 days - q Saturday) boost. Weekly assays were performed for % IUdR incorporation (thymidine replacement) and serum IUdR levels using standard HPLC methods. Standard Phase I toxicity methodology was used. Results: Between June 1994 and December 1996, 18 pts. with a mean age of 52 years were enrolled (16 glioblastoma multiforme and 2 anaplastic astrocytoma). All pts. completed XRT. Two pts. did not complete IUdR, one due to grade 4 IUdR-related toxicities and one due to rapid disease progression. Dose modification occurred in one pt.; drug withheld due to grade 3 AST (SGOT) elevation with re-initiation of drug at the next lowest level. There were no grade ≥3 XRT toxicities. Grade ≥ 3 IUdR toxicities, dose level at which they occurred, number of patients affected and duration of toxicity are presented in Table 1. Thymidine replacement peaks at 3 weeks and increases with dose (Figure 1). Data on steady state plasma IUdR levels will also be presented. Conclusions: Our

  8. Non-Hodgkin's lymphomas in the elderly: prospective studies with specifically devised chemotherapy regimens in 66 patients.

    Science.gov (United States)

    Tirelli, U; Carbone, A; Zagonel, V; Veronesi, A; Canetta, R

    1987-05-01

    The results of 2 consecutive and prospective trials with specifically devised chemotherapy regimens in elderly patients (pts) with non-Hodgkin's lymphoma (NHL) are reported. Between August 1979 and September 1984, 66 pts aged 70 or older (median 75 years) with NHL entered 2 consecutive trials, the former with single agent teniposide 100 mg/m2 i.v. weekly (41 pts), the latter with etoposide and prednimustine (E + P), 100 mg/m p.o. for 5 days every 21 days (25 pts). Forty-five pts were previously untreated, 21 previously treated. Forty-seven pts were of the intermediate and high grade groups according to the Working Formulation; 19 pts were of the low grade; 57 pts were stages III and IV, 9 pts were stages I and II. The median performance status was 70 (range 30-100). The objective response rate in the 66 evaluable pts is 53% with 38% CR; the 3-year overall, disease-free and CR survivals are 21, 12 and 40% respectively. The objective response rate in the 45 previously untreated pts is 58% with 42% CR; the 3-year overall, disease-free and CR survivals are 24, 16 and 58% respectively. The overall toxicity was mild. Severe toxicity (grade III and IV according to WHO criteria) was observed only in 16/498 courses (3.2%), with 1 toxic death (grade IV leucopenia). We experienced the usefulness of a properly orientated clinical approach to elderly pts with NHL. We suggest that a combination regimen like E + P, suitable for oral administration, may be safely employed in a large fraction of pts with NHL.

  9. Varfarin in the complex treatment of antiphospholipid syndrome: preliminary results

    Directory of Open Access Journals (Sweden)

    T M Reshetnyak

    2003-01-01

    Full Text Available Objective. To assess efficacy and tolerance of varfarin in prophylaxis and therapy of thrombotic complications in patients with antiphospholipid syndrome (APS. Methods. 20 pts with APS (5 male and 15 female received varfarin during a year. 8 of them had primary APS (PAPS and 12 -systemic lupus erythematosus with APS (SLE+APS. 2 other pts (I with SLE+APS and I with PAPS received varfarin during the last 4 years. Nobody from 9 pts with PAPS received corticosteroids (CS. In SLE+APS pts CS dose varied from 4 to 20 mg/day and was not increased during follow up. During the study prothrombine time (PT was examined with thromboplastin ( manufactured by Renam having international sensitivity index 1,2 and international normalization relation (INR. Depending on treatment scheme APS pts were divided into 3 groups. Group 1 included 8 pts with INR<2,0, Group 2-7 with INR >3,0, group 3 - 7 pts with INR<2,0 receiving as additional treatment thrombo ASS 100 mg/day and vasonit from 600 to 1200 mg/day. Results. Two pts with INR = 1,8 had thrombosis recurrence (due to leg thrombophlebitis. There were no recurrences in other groups. 2 from 22 pts had "large" bleedings. "Small" bleedings episodes were noted in 7 from 22 pts. Largely that were subcutaneous bleedings (in 4 pts no more than 5 cm of size. Two pts receiving varfarin with INR 1,8 and 2,4 had renal colic. Conclusion. Our preliminary results prove the necessity of inclusion of varfarin in the treatment of pts with APS and thrombosis but intensive anticoagulant effect is not always desired.

  10. Etiology of cardiogenic shock early after open-heart surgery: Assessment by Tc-99m RBC wall motion scintigraphy

    International Nuclear Information System (INIS)

    Bateman, T.; Gray, R.; Chaux, A.; Lee, M.; Matloff, J.; Raymond, M.; Berman, D.

    1984-01-01

    When life-threatening cardiogenic shock (CI 1.8 1/min/m/sup 2/, elevated right and left-side filling pressures) occurs early (0-48 hrs) after open-heart surgery, routine approaches frequently cannot distinguish between expected etiologies: (1) transient systolic failure of the LV, RV, or both, common early postoperatively (postop); (2) perioperative infarct of the LV or RV; (3) myocardial restriction due to active pericardial bleeding or to accumulated clots and fluid; (4) diminished LV reserve from aneurysmectomy; and (5) residual valvular regurgitation. Distinction is critical, because (1), (2), and (4) will be treated by optimizing preload and afterload; (3) with urgent (if active bleeding) or semi-urgent surgery; and (5) with repeat valvular surgery. In 22 pts with unexpected early postop cardiogenic shock, Tc-99m-RBC equilibrium radionuclide ventriculography revealed: global LV (3 pts) or RV (3 pts) dysfunction, new segmental LV dysfunction (2 pts), active bleeding (5 pts) and/or accumulated pericardial fluid ( 8 pts) with hyperdynamic LV and RV, and a small hyperdynamic LV without effusion (1 pt), providing a specific etiologic diagnosis in all cases. In the Cardiac Surgical ICU, therapeutic decisions frequently await and depend on the results of equilibrium radionuclide ventriculography, now routinely performed in postop pts with unexpected cardiogenic shock

  11. Hyperhomocysteinemia - an additional risk factor of thrombosis in systemic lupus erythematosus and antiphospholipid syndrome

    Directory of Open Access Journals (Sweden)

    I. E. Shirokova

    2003-01-01

    Full Text Available Objective. To assess homocystein (HC level in systemic lupus erythematosus (SLE with antiphospholipid syndrome (APS and its relation to thrombosis development and blood lipide spectrum disturbances. Material and methods. 32 pts (12 male and 20 female with mean age 36 12 years and mean disease duration 13 11 years were included. 8 pts had SLE without APS, 13 - SLE with APS and 11 - primary APS (PAPS. All pts were divided into 2 groups depending on blood HC level. 26 pts with HC level more than 12 mcg/d! were included In group 1 and 6 pts with HC level less than 12 mcg/dl - in group 2. HC level was measured with high efficacious liquid chromatography (HELC. Lipid-protein blood spectrum was assessed in all pts. Results. Elevated HC level was revealed in 26 from 32 pts: in 16 with SLE (including 12 pts with APS and in 10 with PAPS. HC concentration did not depend on APS presence, but frequence of hyperhomocysteinemia (HHC significantly associated with APS and thrombotic complications. 20 from 26 (76,9% pts with HHC had thrombosis history. Only I from 6 (16,7% pts with normal HC level had thrombosis history (exact Fisher test p=0,02. HC level did not depend on age and sex. Changes of blood lipid-protein indices were revealed in most pts. Lipid spectrum disturbances were confined largely to cholesterol elevation due to increase of atherogenic lipoproteins cholesterol. Only 22% of pts showed decrease of antiatherogenic lipoproteins concentration. Bblood lipid-protein spectrum indices did not depend on HC level. Conclusion. HHC is present in 84,6% of pts with APS (primary and secondary. In pts with APS HHC is more frequent than in pts without APS. HHC is associated with thrombotic complications. HHC and lipid-protein spectrum disturbances are independent risk factors of thrombotic complications in pts with SLE and APS.

  12. Pharmacoeconomic aspects of osteoporosis problem: analysis of patients willing to pay for the treatment

    Directory of Open Access Journals (Sweden)

    Y F Lesnyak

    2005-01-01

    Full Text Available Objective. To study willingness of pts to pay for osteoporosis (OP treatment by themselves and analysis of factors influencing this decision. Material and methods. 342 pts (317 female, 25 male, mean age 61,4±8,9 years required a special consultation for osteoporosis were asked to fill a questionnaire. All answered questions concerning social, demographic, medical data, assessment of pt knowledge about OP, quality of life assessment with QALY score. To assess pts willingness to pay for OP treatment they were asked to determine sum of money they were ready to pay for an appropriate drug decreasing fracture risk in two times. The pt was to consider 4 scenarios: low, small, moderate and high fracture risk during subsequent life. Results. 86% of pts were ready to pay for OP treatment. The main factors associated with absence of such willingness were older age (OR=1,06, 95% confidence interval 1,о2-1,1, invalidity (OR=3,18, 95% confidence interval 1,54-6,60, loneliness (OR=2,4(, 95% confidence interval 1,27-4,50. These pts were also worse informed about the disease. But family income did not influence the decision to pay. Number of pts ready to pay for the treatment and sum which they were ready to pay directly depended on the probability of fracture (rank test r=0,99 and r=0,28 respectively. The most powerful factor determining the sum pt was ready to pay for the treatment was family income. Next on importance were presence of the work and families consisted of 3 or more members. Personal experience of the pt in treatment with such drugs also had some significance. So pts treated with miacalcic were ready to pay significantly larger sums than other pts with equivalent incomes. Conclusion. Pts willingness to pay for OP treatment depends firstly on social factors and his knowledge about OP. The main factor determining the sum the pt is ready to pay is family income. On the whole sums the pts are ready to pay are significantly less than market price

  13. Methodology for pressurized thermal shock evaluation. Proceedings of the IAEA specialists meeting. Working material

    International Nuclear Information System (INIS)

    1997-01-01

    The meeting was held within the scope of activities of the International Working Group, recognizing that the importance of the PTS phenomena and advances in the subject require regular information exchange in this field. The purpose of the meeting was to provide an opportunity to exchange information as well as new results in research and development, concentrating on the total PTS calculation and including PTS evaluation and application in RPV life time and integrity assessment. The papers presented at the meeting covered problems of thermohydraulics, RPV temperature-stress fields calculations, fracture mechanics approach to integrity assessment as well as discussions on PTS modeling, general procedures for RPV life assessment and mitigation methods other than RPV annealing. Refs, figs, tabs

  14. Methodology for pressurized thermal shock evaluation. Proceedings of the IAEA specialists meeting. Working material

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-09-01

    The meeting was held within the scope of activities of the International Working Group, recognizing that the importance of the PTS phenomena and advances in the subject require regular information exchange in this field. The purpose of the meeting was to provide an opportunity to exchange information as well as new results in research and development, concentrating on the total PTS calculation and including PTS evaluation and application in RPV life time and integrity assessment. The papers presented at the meeting covered problems of thermohydraulics, RPV temperature-stress fields calculations, fracture mechanics approach to integrity assessment as well as discussions on PTS modeling, general procedures for RPV life assessment and mitigation methods other than RPV annealing. Refs, figs, tabs.

  15. Post-traumatic stress symptom development as a function of changing witnessing in-home violence and changing peer relationship quality: Evaluating protective effects of peer relationship quality.

    Science.gov (United States)

    Mishra, Aura A; Christ, Sharon L; Schwab-Reese, Laura M; Nair, Nayantara

    2018-07-01

    In the present study, witnessing in-home violence and peer relationship quality are evaluated as to their relative impact on Post Traumatic Stress (PTS) symptoms among children aged 8 to 17 investigated by child protective services (CPS) for maltreatment exposure. The sample included 2151 children from the National Survey of Child and Adolescent Well-Being II (NSCAW II). Linear growth models were estimated to assess associations between changes in PTS symptoms, witnessing in-home violence, and peer relationship quality over time. Greater frequency of witnessing in-home violence at baseline (i.e. wave 1) was associated with higher baseline PTS symptoms (β = 0.44). Increases in witnessing in-home violence frequency over time (average annual change across three years) had a strong association with increases in PTS symptoms over time (β = 0.88). Baseline peer relationship quality was associated with fewer PTS symptoms at baseline (β = -0.45). Increases in peer relationship quality over time were strongly associated with declines in PTS symptoms over time (β = -0.68). Peer relationship quality at baseline did not moderate baseline or over time associations between witnessing in-home violence and PTS symptoms. The average decline in PTS symptoms due to decreases in witnessing in-home violence and increases in peer relationship quality was 0.51 and 0.65 standard deviations respectively, over the three-year study period. Reducing chronic witnessing in-home violence and promoting the development of healthy social relationships with peers are critical for PTS symptom recovery. Copyright © 2018 Elsevier Ltd. All rights reserved.

  16. Novel perspectives on diagnosis and clinical significance of the post-thrombotic syndrome in children.

    Science.gov (United States)

    Jones, Sophie; Newall, Fiona; Monagle, Paul

    2016-10-01

    Given the increase in venous thromboembolic events (VTE) in children, the incidence, diagnosis and management of post thrombotic syndrome (PTS) in children is of increasing interest. Current challenges facing clinicians caring for children with VTE is the limited evidence of the long-term outcomes for this cohort; specifically the significance and potential functional impairment associated with PTS. This paper reviews the current evidence to elucidate the risk factors for PTS in children, methods for diagnosis and management of PTS in children (aged less than 18 years). Medline, Cinahl and PsycINFO database searches were undertaken using key search terms. Priority areas in need of further research are highlighted. Expert commentary: The two paediatric PTS assessment tools currently in use have been acknowledged to overcall the incidence of mild PTS in children. A PTS tool's ability to distinguish between clinically significant PTS and mild PTS is crucial. Variation in how PTS has been reported in children across the literature suggests that the real incidence of moderate and /or clinically significant PTS in children is unknown. Furthermore, evidence is lacking about the functional impairment experienced by children with clinically significant PTS and what this means for their long-term health.

  17. Self-reported physical inactivity and health complaints: a cross-sectional study of Lithuanian adolescent schoolgirls

    Directory of Open Access Journals (Sweden)

    Romualdas Malinauskas

    2015-05-01

    Full Text Available The study aimed to investigate the associations between physical inactivity and health complaints in relation to posttraumatic stress (PTS symptoms, behavioral and nutritional factors, and sense of coherence (SOC in eighth-grade girls enrolled in secondary schools in Kaunas, Lithuania. A random sample of girls (N = 862 was interviewed anonymously on health complaints, physical activity level, PTS symptoms, Antonovsky’s SOC scale, health behaviors, and dietary patterns. All health complaints were significantly associated with physical inactivity. Crude odds ratio (OR for physical inactivity and health complaints was 1.67 (95%CI: 1.09-2.56; after adjusting for PTS symptoms, the OR decreased to 1.57 (95%CI: 0.95-2.45; further adjustment for smoking, daily alcohol intake, daily consumption of fresh vegetables, and SOC decreased the OR to 1.25 (95%CI: 0.76-2.04. The effect of PTS symptoms and sense of coherence remained stable after all adjustments. The significant association between physical inactivity and health complaints was mediated by PTS symptoms.

  18. Changes in cardiac adrenergic nervous system in patients submitted to transmyocardial laser revascularisation - assessment with I-123-MIBG SPECT

    International Nuclear Information System (INIS)

    Teresinska, A.; Sliwinski, M.; Konieczna, S.; Szymanska, M.; Hendzel, P.; Juraszynski, Z.; Wojnowski, A.; Debski, A.; Szumilak, B.

    2002-01-01

    Meta-iodobenzylguanidine [MIBG] is an analogue of guanethidine, which, after labelling with iodine-123, has been used for cardiac neuronal imaging in conditions such as coronary artery disease, myocardial infarction, heart failure, cardiac arrhythmia, diabetes mellitus, heart transplantation. The aim of our program using I-123-Mibg is: 1) to study the range of influence of the laser energy (CO 2 -high power laser) during trans myocardial laser revascularisation [Tml] on cardiac adrenergic nervous system, and 2) to assess if disruption of this system can be one of the mechanisms responsible for clinical improvement observed early after Tml. Methods: The patients with high pre-operative probability of having sole TMLR or TMLR combined with only 1 bypass are studied before the operation for neuronal activity with I-123-MIBG SPECT [MIBG-0]. The patients (if they were operated according to the assumption) are studied postoperatively with I-123-MIBG SPECT as early as possible from clinical point of view [MIBG-early] and 6 months after operation [MIBG-6m]. Up to now, in 27 pts the preoperative and early postoperative (7-39 days, av. 13±7 days) tests were performed and in 15 pts - also MIBG-6m was performed. The group characteristics: 21M (78%); age: 43-76y, av. 64±10y; all the patients in III/IV CCS class; 20 pts (74%) after 1-2 MI; 5 pts (19%) after earlier CABG or PTCA. Registration of I-123-MIBG SPECT images was started 4 hrs after injection of the radiopharmaceutical. All SPECT studies were assessed in 17 segments (seg) of the LV. The bypassed seg and the septal seg were excluded from the assessment (as not submitted to the laser). Results: In 22 studies (32%), the evaluation of MIBG uptake was not possible because of very low heart uptake and/or very high extra cardiac uptake. Finally, 18 of the preoperative, 18 of the early postoperative and 11 of the late postoperative studies were submitted to segmental analysis. In MIBG-0, there were 172 uptake defects in

  19. Postoperative chemoradiation for resected gastric cancer - is the Macdonald Regimen Tolerable? a retrospective multi-institutional study

    International Nuclear Information System (INIS)

    Kundel, Yulia; Fenig, Eyal; Sulkes, Aaron; Brenner, Baruch; Purim, Ofer; Idelevich, Efraim; Lavrenkov, Konstantin; Man, Sofia; Kovel, Svetlana; Karminsky, Natalia; Pfeffer, Raphael M; Nisenbaum, Bella

    2011-01-01

    Postoperative chemoradiation as per Intergroup-0116 trial ('Macdonald regimen') is considered standard for completely resected high risk gastric cancer. However, many concerns remain with regards to the toxicity of this regimen. To evaluate the safety and tolerability of this regimen in a routine clinical practice setting, we analyzed our experience with its use. As we did not expect a different toxic profile in patients (pts) with positive margins (R1 resection), these were studied together with pts after complete resection (R0). Postoperative chemoradiation therapy was given according to the original Intergroup-0116 regimen. Overall survival (OS) and disease free survival (DFS) rates were calculated using the Kaplan-Meier method. Comparison of OS and DFS between R0 and R1 pts was done using the log-rank test. Between 6/2000 and 12/2007, 166 pts after R0 (129 pts) or R1 (37 pts) resection of locally advanced gastric adenocarcinoma received postoperative chemoradiation; 61% were male and the median age was 63 years (range, 23-86); 78% had T ≥ 3 tumors and 81% had N+ disease; 87% of the pts completed radiotherapy and 54% completed the entire chemoradiation plan; 46.4% had grade ≥ 3 toxicity and 32% were hospitalized at least once for toxicity. Three pts (1.8%) died of toxicity: diarrhea (1), neutropenic sepsis (1) and neutropenic sepsis complicated by small bowel gangrene (1). The most common hematological toxicity was neutropenia, grade ≥ 3 in 30% of pts and complicated by fever in 15%. The most common non-hematological toxicities were nausea, vomiting and diarrhea. With a median follow-up of 51 months (range, 2-100), 62% of the R0 patients remain alive and 61% are free of disease. Median DFS and OS for R0 were not reached. R0 pts had a significantly higher 3-year DFS (60% vs. 29%, p = 0.001) and OS (61% vs. 33%, p = 0.01) compared with R1 pts. In our experience, postoperative chemoradiation as per Intergroup-0116 seems to be substantially toxic

  20. Assessment of pattern and treatment outcome of patients admitted to pediatric intensive care unit, Ayder Referral Hospital, Tigray, Ethiopia, 2015.

    Science.gov (United States)

    Haftu, Hansa; Hailu, Tedrose; Medhaniye, Araya; G/Tsadik, Teklit

    2018-05-24

    To describe admission pattern and outcome with its predictor variable on the mortality of children admitted to pediatric intensive care unit (PICU), Ayder Referral Hospital, Northern Ethiopia, from September 2012 to August 2014. From 680 admitted patients, 400 patients were analyzed. Average age at admission was 62.99 ± 60.94 months, with F:M ratio of 1:1.2. Overall (from infectious and non-infectious) the most commonly affected systems were respiratory (90/400 pts., 22.5%) and central nervous system (83/400 pts., 20.75%). Most were admitted due to meningitis (44/400 pts., 11%), post-operative (43/400 pts., 10.8%) and acute glomerulonephritis (41/400 pts., 10.3%). The overall mortality rate was 8.5%. Multivariable logistic regression shows, use of inotropes (p = 0.000), need for mechanical ventilator (p = 0.007) and presence of comorbid illness (p = 0.002), infectious cause (p = 0.015) and low level of Glasgow coma scale less than eight (p = 0.04) were independent predictors of mortality. From this study, common cause of PICU admission and death was meningitis. This highlights the importance of focusing on the preventable methods in the public such as vaccine, creating awareness about hygiene, and expanding ICU for early detection and for treatment acutely ill children.

  1. Phase I/II study of azacitidine and capecitabine/oxaliplatin (CAPOX) in refractory CIMP-high metastatic colorectal cancer: evaluation of circulating methylated vimentin.

    Science.gov (United States)

    Overman, Michael J; Morris, Van; Moinova, Helen; Manyam, Ganiraju; Ensor, Joe; Lee, Michael S; Eng, Cathy; Kee, Bryan; Fogelman, David; Shroff, Rachna T; LaFramboise, Thomas; Mazard, Thibault; Feng, Tian; Hamilton, Stanley; Broom, Bradley; Lutterbaugh, James; Issa, Jean-Pierre; Markowitz, Sanford D; Kopetz, Scott

    2016-10-11

    Hypermethylation of promoter CpG islands (CIMP) has been strongly implicated in chemotherapy resistance and is implicated in the pathogenesis of a subset of colorectal cancers (CRCs) termed CIMP-high. This phase I/II study in CRC (phase II portion restricted to CIMP-high CRC), treated fluoropyrimidine/oxaliplatin refractory patients with azacitidine (75 mg/m2/day subcutaneously D1-5) and CAPOX (capecitibine and oxaliplatin) every three weeks. Twenty-six patients (pts) were enrolled in this study: 15 pts (12 treated at MTD) in phase I and 11 pts in phase II. No dose limiting toxicities were observed. A total of 14 pts were CIMP-high. No responses were seen. CIMP-high status did not correlate with efficacy endpoints [stable disease (SD) or progression-free survival (PFS)] or baseline vimentin methylation level. Changes in vimentin methylation over time did not correlate with efficacy outcomes. Baseline methylated vimentin correlated with tumor volume (PCIMP-high pts, but no objective responses. Serum methylated vimentin may be associated with benefit from a regimen including a hypomethylation agent, although this study is not able to separate a potential prognostic or predictive role for the biomarker.

  2. [Usefulness of tricuspid annular displacement (TAD) to identify right ventricular dysfunction in normotensive patients with acute pulmonary embolism].

    Science.gov (United States)

    Hugues, T; Yaici, K; Latcu, D-G; Rinaldi, J-P; Zarqane, N; Saoudi, N; Gibelin, P

    2011-02-01

    Echocardiographic criteria of right ventricular dysfunction (RVD) in acute pulmonary embolism (PE) differ among published studies. Assessment of RV systolic function remains difficult because of the RV's complex shape. We aimed to evaluate RV systolic function with TAD in patients (pts) with acute PE. TAD (QLAB, Philips Medical Imaging) was based on a tissue-tracking algorithm that is ultrasound beam angle independent for automated detection of tricuspid annular displacement. Prospective and observational study. All adults' pts who were diagnosed with PE from December 2008 to December 2009 at Princess Grace Hospital, Monaco were eligible for this study after exclusion of history of heart failure. We evaluated 36 consecutive pts with PE (18 male, mean age 62.7 years), which underwent echocardiography, plasma BNP titration during the first day after admission, and a second echocardiography obtained within 48 hours before discharge. TAD value were significantly lower in pts with abnormal RV function by echocardiogram (15.9 ± 0.3 vs. 12.7 ± 0.2 ; P = 0.026). Pts with a normal BNP (TAD (16.4 ± 0.2 vs. 11.2 ± 0.3 mm ; P TAD were significantly improved. There was no difference between TAD among pts with echocardiographic RVD at baseline vs. pts without RVD (14.9 ± 3.7 vs. 16.1 ± 2.9 mm ; P = 0.3). Four pts who deteriorated during short-term observation had substantially lower TAD values than those with uncomplicated courses (7.7 ± 0.4mm vs. 14.6 ± 0.2 mm ; P = 0.001). In conclusion, impaired TAD was associated with decreased RV systolic function in pts with acute PE. To identify the clinical meaning of decreased TAD, larger trials with longer follow-up periods are needed. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  3. [Analysis of the pediatric trauma score in patients wounded with shrapnel; the effect of explosives with high kinetic energy: results of the first intervention center].

    Science.gov (United States)

    Taş, Hüseyin; Mesci, Ayhan; Demirbağ, Suzi; Eryılmaz, Mehmet; Yiğit, Taner; Peker, Yusuf

    2013-03-01

    We aimed to assess the pediatric trauma score analysis in pediatric trauma cases due to shrapnel effect of explosives material with high kinetic energy. The data of 17 pediatric injuries were reviewed retrospectively between February 2002 and August 2005. The information about age, gender, trauma-hospital interval, trauma mechanism, the injured organs, pediatric Glasgow coma score (PGCS), pediatric trauma score (PTS), hemodynamic parameters, blood transfusion, interventions and length of hospital stay (LHS) were investigated. While all patients suffered from trauma to the extremities, only four patients had traumatic lower-limb amputation. Transportation time was 1 hour in 65% of cases. While PTS was found as 8 (p=0.007). Morbidity rates of PTS 8 cases were 29.4% and 5.9%, respectively (p=0.026). While LHS was 22.8 days in PTS LHS was found to be only 4 days in PTS >8 cases. This difference was found to be statistically significant (p=0.001). PTS is very efficient and a time-saving procedure to assess the severity of trauma caused by the shrapnel effect. The median heart rate, morbidity, and LHS increased significantly in patients with PTS <=8.

  4. Long-term fate of left atrial thrombi and incidence of cerebral embolism under continuous anticoagulation therapy; MR-tomographische Evaluation der Inzidenz zerebraler Embolien bei Patienten mit Vorhofflimmern und linksatrialen Thromben

    Energy Technology Data Exchange (ETDEWEB)

    Strach, K.; Meyer, C.; Hackenbroch, M.; Schild, H.; Sommer, T. [Radiologische Universitaetsklinik Bonn (Germany); Tiemann, K. [Medizinische Universitaetsklinik und Poliklinik II, Bonn (Germany); Haase, J. [Klinik Rotes Kreuz, Frankfurt/Main (Germany); Pizulli, L. [Petruskrankenhaus, Bonn (Germany); Omran, H. [St. Marien-Hospital, Bonn (Germany)

    2005-12-15

    Purpose: Patients (pts.) with atrial fibrillation (AF) and atrial thrombi are known to have an increased risk for cerebral embolism. However, little is known about the clinical course of atrial thrombi and the incidence of cerebral embolism in those patients during anticoagulation therapy. The high sensitivity of MR imaging (MRI) including diffusion-weighted imaging (DWI) suggests that this technique could provide an improved estimate of cerebral embolism associated with the presence of left atrial thrombi. The aims of this prospective study were to evaluate (1) the prevalence of clinically silent and apparent cerebral embolism in pts. with newly diagnosed AF and atrial thrombi using MRI/DWI, (2) the long-term fate of atrial thrombi under continued anticoagulation therapy and (3) the incidence of cerebral embolism during a follow-up period of 12 months with continuous anticoagulation therapy. Materials and methods: The study group consisted of 32 pts. with (1) newly diagnosed AF and evidence of left atrial (LA) thrombi detected by TEE and (2) a new start of anticoagulation therapy [International Normalized Ratio (INR) 2.0-3.0]. 19 pts. with (1) newly diagnosed AF and no evidence of atrial thrombi and (2) an equivalent anticoagulation regimen served as the control group. In both groups (a) MRI/DWI studies of the brain (weeks 0, 4, 8, 12, 20, 28, 36, 44, and 52), (b) transesophageal echocardiographic studies (TEE) for assessment of LA-Thrombi (weeks 0 and 52) and (c) clinical neurological assessments (weeks 0, 20 and 52) were performed. Results: In the study group (AF and LA-Thrombi) 11 out of 32 pts. (34%) displayed signs of acute (n=8) or chronic (n=3) cerebral embolism in the initial MRI studies. In 4 out of 32 pts.(13%), MRI/DWI depicted new or additional cerebral emboli (n=12) during the follow-up period despite continuous anticoagulation therapy. 2 (n=2/4; 50%) of these patients had clinically apparent neurological deficits. In the control group 1 out of 19 pts

  5. Exclusive brachytherapy for T1-T2 N0 cancer of the oral tongue: prognostic factors for local control

    International Nuclear Information System (INIS)

    Frezza, G.; Baldissera, A.; Bunkheila, F.; Caliceti, U.; Galuppi, A.; Guidetti, A.; Sorrenti, G.

    1996-01-01

    INTRODUCTION: The files of a group of patients (pts) treated with brachytherapy alone for cancer of the oral tongue were reviewed to assess the prognostic role of T stage, volume of disease, total dose and dose-rate. PATIENTS METHODS AND RESULTS: From 1982 to 1994 46 pts (29 males, 17 females, age 38-84 years, median 63.1 years) were treated with 192 Ir brachytherapy, in 2 cases followed by prophylactic neck dissection for cancer of the oral tongue (T1N0: 19 pts; T2N0: 27 pts). Brachytherapy was performed with hairpins in the early years of the study (17 pts) and more recently with plastic tubes (29 pts), according to the Parts System. Dose ranged from 60-70 Gy with a dose-rate of 0.38-0.62 Gy/h (median 63.8 and 0.52 respectively). Volume of the disease was retrospectively assessed as the product of the three diameters of the lesion calculated for provisional dosimetry (range 0.25- 16 cc.). Median follow up is 72 mos (range: 14-153 mos). RESULTS: Overall local control was 82.6% ((38(46)) pts; T1: (18(19)), 94.7 %; T2: (22(27)), 81.5 %). Five of 8 pts who recurred were submitted to salvage surgery, and 3 of them are alive and free from disease at 34, 52 and 87 mos respectively. Recurrences appeared after 3-13 mos (median 5.5 mos) and were related to total dose ( 63 Gy (1(18)); 5.5 %) and to dose-rate ( 45 cGy/h (4(36)): 11.1 %). The volume of disease was not of prognostic significance since local control was 79.6 % ((6(28)) pts) in pts with a disease smaller than 3 cc. and 88.9 % in pts with large volume ((2(18)) pts). Seven (15.2 %) grade 3 complications (necrosis of the mandibular bone and- or of the soft tissues) were observed. Complication rate was higher in the high dose group (>63 Gy (4(18)) pts: 22.2 %) and was less affected by dose-rate (> 45 cGy/h (6(36)) pts: 16.6 %). No relationship between complications and volume was observed ( 3cc.: 16.6 %). All complications healed spontaneously. DISCUSSION AND CONCLUSION: For T1-T2 cancer of the oral tongue exclusive

  6. A physiotherapy triage assessment service for people with low back disorders: evaluation of short-term outcomes

    Directory of Open Access Journals (Sweden)

    Bath B

    2012-06-01

    Full Text Available Brenna Bath, Punam PahwaCollege of Medicine, University of Saskatchewan, Saskatoon, CanadaPurpose: To determine the short-term effects of physiotherapy triage assessments on self-reported pain, functioning, and general well-being and quality of life in people with low back-related disorders.Methods: Participants with low back–related complaints were recruited from those referred to a spinal triage assessment program delivered by physiotherapists (PTs. Before undergoing the triage assessment, the participants completed a battery of questionnaires covering a range of sociodemographic, clinical, and psychosocial features. The study used the Numeric Pain Rating Scale (NPRS, the Oswestry Disability Index (ODI, and the Medical Outcomes Survey 36-item short-form version 2 (SF-36v2 to assess self-reported pain, function, and quality of life. Baseline measures and variables were analyzed using a descriptive analysis method (ie, proportions, means, medians. Paired samples t-tests or Wilcoxon matched-pair signed-rank tests were used to analyze the overall group differences between the pretest and posttest outcome measures where appropriate.Results: A total of 108 out of 115 (93.9% participants completed the posttest survey. The Physical Component Summary of the SF36v2 was the only measure that demonstrated significant improvement (P < 0.001.Conclusion: A spinal triage assessment program delivered by PTs can be viewed as a complex intervention that may have the potential to affect a wide range of patient-related outcomes. Further research is needed to examine the long-term outcomes and explore potential mechanisms of improvement using a biopsychosocial framework.Keywords: interprofessional practice, quality of life, back pain, orthopedics

  7. Assessment of changes in formations of non-forest woody vegetation in southern Denmark based on airborne LiDAR.

    Science.gov (United States)

    Angelidis, Ioannis; Levin, Gregor; Díaz-Varela, Ramón Alberto; Malinowski, Radek

    2017-09-01

    LiDAR (Light Detection and Ranging) is a remote sensing technology that uses light in the form of pulses to measure the range between a sensor and the Earth's surface. Recent increase in availability of airborne LiDAR scanning (ALS) data providing national coverage with high point densities has opened a wide range of possibilities for monitoring landscape elements and their changes at broad geographical extent. We assessed the dynamics of the spatial extent of non-forest woody vegetation (NFW) in a study area of approx. 2500 km 2 in southern Jutland, Denmark, based on two acquisitions of ALS data for 2006 and 2014 in combination with other spatial data. Our results show a net-increase (4.8%) in the total area of NFW. Furthermore, this net change comprises of both areas with a decrease and areas with an increase of NFW. An accuracy assessment based on visual interpretation of aerial photos indicates high accuracy (>95%) in the delineation of NFW without changes during the study period. For NFW that changed between 2006 and 2014, accuracies were lower (90 and 82% in removed and new features, respectively), which is probably due to lower point densities of the 2006 ALS data (0.5 pts./m 2 ) compared to the 2014 data (4-5 pts./m 2 ). We conclude that ALS data, if combined with other spatial data, in principle are highly suitable for detailed assessment of changes in landscape features, such as formations of NFW at broad geographical extent. However, in change assessment based on multi-temporal ALS data with different point densities errors occur, particularly when examining small or narrow NFW objects.

  8. Relationship among esophageal dysfunction, diabetic gastro-enteropathy, and autonomic neuropathy

    International Nuclear Information System (INIS)

    Yeh, S.H.; Liu, R.S.; Wu, L.C.; Lin, H.D.; Wang, S.J.; Lin, W.H.

    1985-01-01

    This study assessed the relationship of esophageal radionuclide transit (RT) to diabetic gastroenteropethy (CEP) and autonomic neuropathy (AN). Data were acquired in list mode after an oral dose of 0.5 mCi Tc-99m sulfur colloid in 10 ml of water in the supine position. A modified computer routine was used to calculate: (A) total mean transit time (TMTT) in sec, (B) residual fraction after the first swallow (RF), and )C) retrograde index (RI). Twenty-one patients (pts) with diabetes and 25 normal subjects (N) were studied. Eleven pts belonged to Group 1 with symptomatic GEP and AN; 5, Group 2 with no GEP but with AN; and 5, Group 3 with neither. Abnormal RT mainly occurred in Group 1. RI was the best parameter with respective sensitivity and specificity of 0.91 (10/110 and 0.96 (24/25. RI was abnormal in 10/11 pts with GEP (Group 1), but normal in all 10 pts without GEP (Groups 2 and 3). All 5 pts only with AN (group 2) had normal RI. The authors conclude that esophageal dysfunction is present in nearly all pts with diabetic GEP. However, the presence of AN alone will not explain esophageal transit abnormality

  9. ANALYSIS OF DISEASE MODIFYING DRUGS ADMINISTRATION FREGUENCY AND CAUSES OF THEIR WITHDRAWAL IN RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    E V Pavlova

    2000-01-01

    Full Text Available Aim of studdy: To assess the frequency of practical application of different basic drugs in rheumatoid arthritis (RA. Material and methods: Tlxe study was conducted basing of questionner of pts and analysis of ycases by randomized sampling among 103 consequent pts (M:F= 13:90 with reliable RA (ARA, 1987 in rheumatologic department of Clinical Hospital Nol in Ekaterinburg. 74% of pts under study demonstrated systemic manifestations: anemia (in 47 pts, lymphadenopathy (in 34, rheumatoid nodules (in 15, Sjogren s syndrome (in 4, nephropathy (in 4, vascular disturbances including Raynaud s phenomenon, capillarites (by 1 pt. Results: In the course of disease basic therapy was prescribed to 88 out of103 (85.4% pts and one and the same patient could take different basic drugs. Aminochinoline drugs prevailed, after them more frequent were immunodepressants and gold preparations. More rarely pts had sulfasalazin, cuprenil and wobenzym. In general, in 133 out of 184 cases of prescribing basic drugs they were canceled. The reason for cancellation were: prevalently absence of the drug in the pharmaceutical stores (in 48 cases averagely in 8 months of taking the drug; then they insufficient efficacy (44 cases averagely in 1.3 year. In 18 cases pts themselves stopped treatment averagely in 3.5 months of drug taking. Conclusion: In the majority of cases of basic drugs cancellation in RA the cause is their absence in sail especially on free of charge prescription. Cases ofself-cancellation of the drug demonstrate the need of explaining to pts the necessity> of long-term taking disease-modifying drugs.

  10. The Influence of an Orthopedic, Manual Therapy Residency Program on Improved Knowledge, Psychomotor Skills, and Clinical Reasoning in Nairobi, Kenya.

    Science.gov (United States)

    Cunningham, Shala; McFelea, Joni

    2017-01-01

    The purpose of this study was to describe the influence of a post-graduate orthopedic manual therapy residency program in Kenya on the development of physical therapists' (PTs) knowledge and clinical reasoning related to the performance of a musculoskeletal examination and evaluation as compared to an experience-matched control group of PTs waiting to enter the program. A cross-sectional design was utilized in which 12 graduating residents and 10 PTs entering the residency program completed a live-patient practical examination to assess the knowledge, clinical reasoning, and psychomotor skills related to the examination and evaluation of musculoskeletal conditions. The assessment utilized was based on the tasks, procedures, and knowledge areas identified as important to advanced clinicians in the US as outlined by the Orthopaedic Description of Specialty Practice. Inclusion criteria included participation in or acceptance to the residency program, practice as a PT between 3 and 25 years, and 50% of workday being involved in direct patient care. Overall pass rates were analyzed using the Pearson chi-square and Fisher's exact tests to determine if the graduating residents achieved significantly higher scores than experience-matched controls consisting of PTs entering the residency program. PTs completing a post-graduate orthopedic manual therapy residency in Nairobi, Kenya, achieved higher scores and passing rates compared to their colleagues who had not completed a residency program as determined by a live-patient practical examination. Graduating residents demonstrated statistically significant higher scores in the categories of examination, evaluation, and diagnosis. The average live-patient practical examination score for PTs without residency training was 38.2%, and their pass rate was 0.0%. The average live-patient practical examination score for residency-trained PTs was 83.4%, and their pass rate was 92.3%. These findings are statistically significant ( p

  11. Structural integrity assessment of the reactor pressure vessel under the pressurized thermal shock loading

    International Nuclear Information System (INIS)

    Chen, Mingya; Lu, Feng; Wang, Rongshan; Ren, Ai

    2014-01-01

    Highlights: • The regulation and the code are proved to be conservative in the integrity assessment. • This study is helpful to understand the complex influence of the parameters. • The most dangerous case is given for the reference transient. - Abstract: Fracture mechanics analysis of pressurized thermal shock (PTS) is the key element of the integrity evaluation of the nuclear reactor pressure vessel (RPV). While the regulation of 10 CFR 50.61 and the ASME Code provide the guidance for the structural integrity, the guidance has been prepared under conservative assumptions. In this paper, the effects of conservative assumptions involved in the PTS analysis were investigated. The influence of different parameters, such as crack size, cladding effect and neutron fluence, were reviewed based on 3-D finite element analyses. Also, the sensitivity study of elastic–plastic approach, crack type and cladding thickness were reviewed. It was shown that crack depth, crack type, plastic effect and cladding thickness change the safety margin (SM) significantly, and the SM at the deepest point of the crack is not always smaller than that of the surface point, indicating that both the deepest and surface points of the crack front should be considered. For the reference transient, deeper cracks always give more conservative prediction. So compared to the prescribed analyses of a set of postulated defects with varying depths in the ASME code, it only needs to assess the crack with maximum depth in the code for the reference transient according to the conclusions

  12. Hegemonic Masculinity in Sport Education: Case Studies of Pre-Service Physical Education Teachers with Teaching Orientations

    Science.gov (United States)

    Chen, YuChun; Curtner-Smith, Matthew D.

    2015-01-01

    Previous research had indicated that pre-service teachers (PTs) with coaching orientations reinforced sexism and masculine bias while employing the sport education (SE) model. The purpose of the current study was to examine whether or not and the degree to which SE delivered by PTs with teaching orientations served to combat or reinforce sexism…

  13. [Subgroup Analysis of the Non-interventional REASON Study: PFS and OS According to Age, Smoking History, Gender, and Histology in NSCLC Patients Treated with Gefitinib or Chemotherapy].

    Science.gov (United States)

    Schuette, W; Eberhardt, W E E; Waller, C; Schirmacher, P; Dietel, M; Zirrgiebel, U; Radke, S; Thomas, M

    2016-09-01

    Assessment of several clinical factors on progression-free (PFS) and overall survival (OS) in NSCLC patients (pts.) (stage IV) with mutated epidermal growth factor receptor (EGFRm+) treated with gefitinib (gef) or with chemotherapy (CT) under real-world conditions. 285 EGFRm+ pts. of the non-interventional REASON study treated with gef (n = 206) or CT (n = 79) as first-line therapy or with gef (n = 213) or CT (n = 61) in any line throughout the course of therapy were analyzed according to age, gender, smoking history and histology. Compared with CT, patients treated with gef showed prolongation of PFS and OS in all subgroups. PFS was significantly increased in women and non-smokers. OS was significantly increased in women, non-smokers, (ex)-smokers, patients with adenocarcinoma and elderly patients when treated with gef compared to CT. Female gender turned out to be an independent positive predictive factor for OS in patients treated with gef (HRmale: 1.74, p = 0.0009). A clinical benefit of gef was shown for all analyzed clinical subgroups of EGFRm+ pts. This was confirmed for the female gender in a multivariate analysis. © Georg Thieme Verlag KG Stuttgart · New York.

  14. TAREG 2.01/00 Project, ''Validation of neutron embrittlement for VVER 1000 and 440/213 RPVs, with emphasis on integrity assessment''

    International Nuclear Information System (INIS)

    Ahlstrand, R.; Margolin, B.; Kostylev, V.; Yurchenko, E.; Akbashev, I.; Piminov, V.; Nikolaev, Y.; Koshkin, V.; Kharshenko, V.; Chyrko, L.; Bukhanov, V.; Comsa, O.

    2012-01-01

    The irradiation embrittlement and integrity of the VVER reactors has been an important issue in many EC supported TACIS and PHARE projects since 1990. In the EC annual program 2000 two TACIS projects (TAREG 2.01/00 and 2.01/03) were approved on the issue in order to improve the neutron irradiation embrittlement databases, elaborate new trend curves for the embrittlement and to assess the integrity of the RPVs (Reactor Pressure Vessel) by analysing PTS transients (Pressurized Thermal Shock) for some selected Russian and Ukrainian VVER 1000 and 440/213 NPPs. In this paper the TAREG 2.01/00 project is briefly described with some details from the twin project 2.01/03, which served as a materials testing project, providing inputs for the 1st project. As a result of the project new trend curves for neutron irradiation embrittlement were elaborated, based on upgraded and more reliable surveillance results databases. The PTS study shows that the integrity of the selected VVER RPVs can be ensured to the end of RPV design life. (author)

  15. Perspectives of local diclofenacol 1% liniment application in joint diseases

    OpenAIRE

    R M Balabanova; О Н Egorova; Т П Grishaeva; Н Е Lopatina; Г М Tarasova; A O Pchelintseva; Т П Fedina

    2003-01-01

    Objective. To assess efficacy and safety diclofenacol 1% liniment application in comparison with diclo- ran plus. Material and methods. An open controlled 2-weeks trial of diclofenacol 1% liniment on 30 pts with active joint syndrome (group 1) compared with dicloran plus 1% gel on 20 pts (group II). Pts age ranged from 16 to 79 years, mean disease duration was 8,2 1,5 years. Most pts had II activity degree. Results. Diclofenacol 1% liniment applications decreased pain at rest and at movement ...

  16. Efficacy and safety of nimesulide long term administration in patients with osteoarthritis: results of 12-months open controlled study DINAMO (long term administration of nimesulide in osteoarthritis multifactor assessment

    Directory of Open Access Journals (Sweden)

    L I Alexeeva

    2009-01-01

    Full Text Available Objective. To compare efficacy and safety of nimesulide and paracetamol in treatment of patients with osteoarthritis (OA during 12 months. Material and methods. 40 women (mean age 66,8±5,1 years with knee osteoarthritis (II-III stage according to Kellgren-Lawrence having intensive pain (>40 mm on VAS were included. Group 1 pts (n=20 received nimesulide 200-100 mg/day. Group 2 pts were treated with paracetamol till 3 g/day. WOMAC was used as efficacy measure. Safety was assessed with endoscopic examination of upper gastrointestinal tract, ECG, blood pressure and ECG Holter monitoring, clinical and biochemical blood parameters. Statistical significance of differences was assessed with Student’s t-test, χ2 and Fisher exact test Results. WOMAC index decreased during treatment from 1182,7±345,9 to 698,4±351,1 for nimesulide and from 1136,4±313,8 to 1031,6±21 for paracetamol (p<0,05. There were 6 cases of gastrointestinal complications and 4 cases of hypertension development or deterioration in each group. Coronary heart disease developed or deteriorated in 4 patients receiving nimesulide but not in control group. Liver function tests did not deteriorated during treatment with nimesulide. Conclusion. Nimesulide was more effective than paracetamol in treatment of OA. But risk of cardiovascular complications development during treatment with NSAIDs requires serious attention. Nimesulide did not induced liver damage during long term treatment.

  17. Assessment of genotoxic effects of pesticide and vermicompost treated soil with Allium cepa test

    Directory of Open Access Journals (Sweden)

    Shivika Datta

    2018-07-01

    Full Text Available Soil forms a huge reservoir of nutrients that sustains life on earth. Anthropogenic and natural impacts have led to degradation of land which declines the overall quality of soil, water or vegetation. The present study involves comparison of genotoxicity of soil procured from two different agricultural sites, pesticide treated soil (PTS and vermicompost treated soil (VTS. The soil was physico-chemically characterized and showed significant differences in terms of cytotoxicity (root length; mitotic index and genotoxicity (chromosomal aberrations in Allium cepa test. The mitotic index of the control after 24 and 48 h was found to be 26.1 ± 1.6 and 26.1 ± 1.3 respectively. Mitotic index was reduced to 10.3 ± 0.9 and 9.7 ± 0.6 in 100% PTS and 24.4 ± 1.7 and 25.4 ± 0.8 in 100% VTS after 24 and 48 h of exposure, respectively. Clastogenic aberrations were found to be highest (54.5% in 100% PTS which was significantly different from VTS extract. The PTS extracts incurred significantly more cytotoxic and genotoxic effects on A. cepa in comparison to VTS. The result indicates that addition of vermicompost in agriculture field acts as soil ameliorator and plays an important role in promotion of cell division and proliferation, hence good for the plant health and crop productivity.

  18. Palliative effect of Re-186 HEDP in different cancer patients with bone metastases

    International Nuclear Information System (INIS)

    Kucuk, N.O.; Ibis, E.; Aras, G.; Soylu, A.; Baltaci, S.; Beduk, Y.; Ozalp, G.; Canakci, N.

    2001-01-01

    The clinical picture of bone metastases is manifested by pain and loss of mechanical stability. Standard treatment options for bone metastases include external beam radiotherapy and the use of analgesics. Due to a large number of lesions in many patients, the use of radionuclide therapy with beta emitters may be preferable. Re-186 hydroxyethydilene diphosphonate (Re-186 HEDP) is one of the radiopharmaceuticals suitable for palliative treatment of metastatic bone pain. The aim of this study was to investigate palliative and side effects of Re-186 HEDP in pts with different type of cancers. Material and method: Thirty one (17 male, 14 female) patients with cancer (10 prostate, 10 breast, 4 rectum, 5 lung, 2 nasopharynx) and bone metastases were included in the study. Therapy was started with a fixed dose of 1295 MBq of Re-186 HEDP. If necessary, the same dose was repeated at least 3 times after an interval of 10-12 weeks A total of 40 standard doses (1295 MBq Re HEDP, Mallinckrodt, Holland) were given; 6 pts received repeated doses (3 doses in 3 pts, 2 doses in 3 pts). The pts with bone marrow suppression were excluded from the study. The pain relief was assessed with ECOG and Karnofsky status index. All pts were evaluated with standard evaluation forms filled daily a maximum of 10 weeks. Results: The respond rate was found as 87.5% in pts with breast and prostate Ca, 75% in pts with rectum Ca, 50% in pts with nasopharynx Ca and 20% in pts with lung Ca. The overall response rate was 67.5%. The palliation period varied between 6 to 10 weeks. The mean palliation period was 8.1 ± 1.3 weeks. Maximal palliation effect was observed between the 3 rd and the 7 th weeks. Any serious side effects were not seen except mild haematologic toxicity. Discussion and conclusion: It is concluded that Re-186 HEDP is a highly effective agent in the palliation of metastatic bone pain in pts with prostate, breast, rectum cancer, mildly effective in pts with nasopharynx cancer, but not

  19. Phase II study of induction chemotherapy followed by radiotherapy combined with daily cisplatin in stage III inoperable non-small cell lung cancer (NSCLC)

    Energy Technology Data Exchange (ETDEWEB)

    Scolaro, T; Ardizzoni, A; Giudici, S; Grossi, F; Cosso, M; Pennucci, M C; Bacigalupo, A; Rosso, R; Vitale, V

    1997-07-01

    Purpose: Results of radical radiotherapy in the treatment of inoperable NSCLC can be improved by either concurrent daily low-dose Cisplatin as radiosensitizer (Shaake-Koning, N Engl J Med, 1992; 326: 524) or by using neoadiuvant chemotherapy (Dillman, N Engl J Med, 1990; 323: 940). The aim of present study was to evaluate the activity and feasibility of a new chemo-radiotherapy (CT-RT) regimen in which both strategies of RT improvement will be used. Methods: Thirty consecutive patients (pts) were treated with induction CT (Cisplatin 100 mg/m{sup 2} i.v. day 1,22 + Vinblastine 5 mg/m{sup 2} i.v. day 1,8,15,22,29) followed by RT (60 Gy/30 fractions in 6 wks) combined with Cisplatin 5 mg/m{sup 2} daily before RT. Patients' characteristics were: 29 pts were male and 1 female; median age 60.5 yrs (range 44-69); median PS 1 (range 0-1); 21 squamous cell carcinoma and 9 adenocarcinoma; stage III A in 9 pts and stage IIIB in 21 pts. Results: Twenty-three pts were evaluable for RT plus daily Cisplatin toxicity and 29 for CT toxicity (according to WHO). For RT plus daily cisplatin hematological toxicity consisted of grade III leukopenia in 22%, grade III anemia 9% and grade III thrombocytopenia in 9% of pts. Only 2 patients developed severe esophagitis. Only one case of radiation pneumonitis was reported. For induction CT hematological toxicity consisted of grade III-IV leukopenia in 31%, grade II anemia 10% and grade IV thrombocitopenia in 14% of cases. Non-hematological toxicity consisted mainly of grade I peripheral neuropaty and occured in 17% of pts. One case of minor hearing loss and 4 cases of tinnitus were observed at the end of treatment. Twenty-seven pts were evaluable for response. Response rate was 59% with 7 CRs (26%) and 9 PRs (33%); 1 patient had SD (4%), 5 pts PD (20%) and 5 pts (19%) died early (3 for early progression, 1 for toxicity and 1 for cardiac failure). All pts with CR are still alive with a median event-free survival of 23.9 months (range 12

  20. Phase II study of induction chemotherapy followed by radiotherapy combined with daily cisplatin in stage III inoperable non-small cell lung cancer (NSCLC)

    International Nuclear Information System (INIS)

    Scolaro, T.; Ardizzoni, A.; Giudici, S.; Grossi, F.; Cosso, M.; Pennucci, M.C.; Bacigalupo, A.; Rosso, R.; Vitale, V.

    1997-01-01

    Purpose: Results of radical radiotherapy in the treatment of inoperable NSCLC can be improved by either concurrent daily low-dose Cisplatin as radiosensitizer (Shaake-Koning, N Engl J Med, 1992; 326: 524) or by using neoadiuvant chemotherapy (Dillman, N Engl J Med, 1990; 323: 940). The aim of present study was to evaluate the activity and feasibility of a new chemo-radiotherapy (CT-RT) regimen in which both strategies of RT improvement will be used. Methods: Thirty consecutive patients (pts) were treated with induction CT (Cisplatin 100 mg/m 2 i.v. day 1,22 + Vinblastine 5 mg/m 2 i.v. day 1,8,15,22,29) followed by RT (60 Gy/30 fractions in 6 wks) combined with Cisplatin 5 mg/m 2 daily before RT. Patients' characteristics were: 29 pts were male and 1 female; median age 60.5 yrs (range 44-69); median PS 1 (range 0-1); 21 squamous cell carcinoma and 9 adenocarcinoma; stage III A in 9 pts and stage IIIB in 21 pts. Results: Twenty-three pts were evaluable for RT plus daily Cisplatin toxicity and 29 for CT toxicity (according to WHO). For RT plus daily cisplatin hematological toxicity consisted of grade III leukopenia in 22%, grade III anemia 9% and grade III thrombocytopenia in 9% of pts. Only 2 patients developed severe esophagitis. Only one case of radiation pneumonitis was reported. For induction CT hematological toxicity consisted of grade III-IV leukopenia in 31%, grade II anemia 10% and grade IV thrombocitopenia in 14% of cases. Non-hematological toxicity consisted mainly of grade I peripheral neuropaty and occured in 17% of pts. One case of minor hearing loss and 4 cases of tinnitus were observed at the end of treatment. Twenty-seven pts were evaluable for response. Response rate was 59% with 7 CRs (26%) and 9 PRs (33%); 1 patient had SD (4%), 5 pts PD (20%) and 5 pts (19%) died early (3 for early progression, 1 for toxicity and 1 for cardiac failure). All pts with CR are still alive with a median event-free survival of 23.9 months (range 12.3-41.9). Actuarial

  1. The renal scan in pregnant renal transplant patients

    International Nuclear Information System (INIS)

    Goldstein, H.A.; Ziessman, H.A.; Fahey, F.H.; Collea, J.V.; Alijani, M.R.; Helfrich, G.B.

    1985-01-01

    With the greater frequency of renal transplant surgery, more female pts are becoming pregnant and carrying to term. In the renal allograft blood vessels and ureter may be compressed resulting in impaired renal function and/or, hypertension. Toxemia of pregnancy is seen more frequently than normal. Radionuclide renal scan monitoring may be of significant value in this high risk obstetrical pt. After being maintained during the pregnancy, renal function may also deteriorate in the post partum period. 5 pregnant renal transplant pts who delivered live babies had renal studies with Tc-99m DTPA to assess allograft perfusion and function. No transplanted kidney was lost during or after pregnancy as a result of pregnancy. No congenital anomalies were associated with transplant management. 7 studies were performed on these 5 pts. The 7 scans all showed the uterus/placenta. The bladder was always distorted. The transplanted kidney was rotated to a more vertical position in 3 pts. The radiation dose to the fetus is calculated at 0.024 rad/mCi administered. This study demonstrates the anatomic and physiologic alterations expected in the transplanted kidney during pregnancy when evaluated by renal scan and that the radiation burden may be acceptable in management of these pts

  2. Current presentation and management of 7148 patients with atrial fibrillation in cardiology and internal medicine hospital centers: the ATA AF study.

    Science.gov (United States)

    Di Pasquale, Giuseppe; Mathieu, Giovanni; Maggioni, Aldo Pietro; Fabbri, Gianna; Lucci, Donata; Vescovo, Giorgio; Pirelli, Salvatore; Chiarella, Francesco; Scherillo, Marino; Gulizia, Michele Massimo; Gussoni, Gualberto; Colombo, Fabrizio; Panuccio, Domenico; Nozzoli, Carlo; Berisso, Massimo Zoni

    2013-09-10

    Atrial fibrillation (AF) is associated with a high risk of stroke and mortality. To describe the difference in AF management of patients (pts) referred to Cardiology (CARD) or Internal Medicine (MED) units in Italy. From May to July 2010, 360 centers enrolled 7148 pts (54% in CARD and 46% in MED). Median age was 77 years (IQR 70-83). Hypertension was the most prevalent associated condition, followed by hypercholesterolemia (28.9%), heart failure (27.7%) and diabetes (24.3%). MED pts were older, more frequently females and more often with comorbidities than CARD pts. In the 4845 pts with nonvalvular AF, a CHADS2 score ≥ 2 was present in 53.0% of CARD vs 75.3% of MED pts (pmanaged in MED had a significantly lower probability to be treated with OAC. Rate control strategy was pursued in 51.4% of the pts (60.5% in MED and 43.6% in CARD) while rhythm control was the choice in 39.8% of CARD vs 12.9% of MED pts (pmanage pts with large epidemiological differences. Both CARD and MED specialists currently fail to prescribe OAC in accordance with stroke risk. Patients managed by MED specialists have a lower probability to receive an OAC treatment, irrespective of the severity of clinical conditions. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  3. Factors predicting radiation pneumonitis in lung cancer patients: a retrospective study

    International Nuclear Information System (INIS)

    Rancati, T.; Ceresoli, G.L.; Gagliardi, G.; Schipani, S.; Cattaneo, G.M.

    2003-01-01

    Purpose: To evaluate clinical and lung dose-volume histogram based factors as predictors of radiation pneumonitis (RP) in lung cancer patients (PTs) treated with thoracic irradiation. Methods and materials: Records of all lung cancer PTs irradiated at our Institution between 1994 and 2000 were retrospectively reviewed. Eighty-four PTs with small or non-small-cell lung cancer, irradiated at >40 Gy, with full 3D dosimetry data and a follow-up time of >6 months from start of treatment, were analysed for RP. Pneumonitis was scored on the basis of SWOG toxicity criteria and was considered a complication when grade≥II. The following clinical parameters were considered: gender, age, surgery, chemotherapy agents, presence of chronic obstructive pulmonary disease (COPD), performance status. Dosimetric factors including prescribed dose (D iso ), presence of final conformal boost, mean lung dose (D mean ), % of lung receiving ≥20, 25, 30, 35, 40, and 45 Gy (respectively V 20 →V 45 ), and normal tissue complication probability (NTCP) values were analysed. DVHs data and NTCP values were collected for both lungs considered as a paired organ. Median and quartile values were taken as cut-off for statistical analysis. Factors that influenced RP were assessed by univariate (log-rank) and multivariate analyses (Cox hazard model). Results: There were 14 PTs (16.6%) who had ≥grade II pulmonary toxicity. In the entire population, the univariate analysis revealed that many dosimetric parameters (D iso , V 20 , V 30 , V 40 , V 45 ) were significantly associated with RP. No significant correlation was found between the incidence of RP and D mean or NTCP values. Multivariate analysis revealed that the use of mitomycin (MMC) (P=0.005) and the presence of COPD (P=0.026) were the most important risk factor for RP. In the group without COPD (55 PTs, seven RP) a few dosimetric factors (D mean , V 20 , V 45 ) and NTCP values (all models) were associated with RP in the univariate analysis

  4. Magnetic resonance imaging of sacroiliac joints in patients with seronegative spondyloarthritides

    Directory of Open Access Journals (Sweden)

    A. G. Bochkova

    2007-01-01

    Full Text Available Objective. To study diagnostic possibilities of magnetic resonance imaging (MRI of sacroiliac joints (SIJ in pts with seronegative spondyloarthritides (SS. Material and methods. MRI and radiological examination was performed in 15 pts: 10 with ankylosing spondylitis (AS and 5 with undifferentiated SS. MRI was done with Magnetom Symphony apparatus (Siemens, Germany with magnetic-field strength 1,5 tesla. Tl, T2 and T2-FS weighted were used. Tl-FS weighted performed in 3-4 minutes after intravenous infusion of gadolinium were additionally used in 5 pts. Inflammatory and structural (erosions, subchondral sclerosis MRI changes of SIJ were studied. Inflammatory changes of SIJ were analyzed in subchondral bone, bone marrow, joint capsule, joint cavity, interosseous ligaments. SS activity was assessed with BASDAI. Results. Median age of pts was 24 years, median SS duration — 3 years. HLA-B27 was revealed in 13 from 15 pts. All pts had radiological signs of sacroiliitis: 13 - bilateral (12 - II or III stage and 1 — I and III stage according to Kellgren, 2 — unilateral (II stage. So radiological signs of inflammation were revealed in 28 from 30 examined SIJ. MRI signs of sacroiliitis were present in the same 28 SIJ. Subchondral edema of sacrum and/or huckle-bone was revealed in 23 SIJ of 13 pts, bone marrow edema — in 20 SIJ of 13 pts, joint cavity edema - in 21 SIJ of 14 pts, capsule edema — in 12 SIJ of 8 pts, interosseous ligaments inflammation signs — in 3 SIJ of 2 pts. Inflammatory changes of all 5 examined anatomic structures were present in 1, 4 — in 9, 3 — in 13 SIJ. In 1 SIJ inflammation was localized in capsule only. Structural changes were revealed in 22 (73% SIJ of 14 pts. Structural MRI changes of SIJ at II radiological stage of sacroiliitis were noted in 67% and at III stage — in 83%. Combination of inflammatory and structural changes was present in 22 from 30 SIJ (73%. Frequency of such combination was similar at

  5. UPLC-MS method for quantification of pterostilbene and its application to comparative study of bioavailability and tissue distribution in normal and Lewis lung carcinoma bearing mice.

    Science.gov (United States)

    Deng, Li; Li, Yongzhi; Zhang, Xinshi; Chen, Bo; Deng, Yulin; Li, Yujuan

    2015-10-10

    A UPLC-MS method was developed for determination of pterostilbene (PTS) in plasma and tissues of mice. PTS was separated on Agilent Zorbax XDB-C18 column (50 × 2.1 mm, 1.8 μm) with gradient mobile phase at the flow rate of 0.2 ml/min. The detection was performed by negative ion electrospray ionization in multiple reaction monitoring mode. The linear calibration curve of PTS in mouse plasma and tissues ranged from 1.0 to 5000 and 0.50 to 500 ng/ml (r(2)>0.9979), respectively, with lowest limits of quantification (LLOQ) were between 0.5 and 2.0 ng/ml, respectively. The accuracy and precision of the assay were satisfactory. The validated method was applied to the study of bioavailability and tissue distribution of PTS in normal and Lewis lung carcinoma (LLC) bearing mice. The bioavailability of PTS (dose 14, 28 and 56 mg/kg) in normal mice were 11.9%, 13.9% and 26.4%, respectively; and the maximum level (82.1 ± 14.2 μg/g) was found in stomach (dose 28 mg/kg). The bioavailability, peak concentration (Cmax), time to peak concentration (Tmax) of PTS in LLC mice was increased compared with normal mice. The results indicated the UPLC-MS method is reliable and bioavailability and tissue distribution of PTS in normal and LLC mice were dramatically different. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Numerical simulation of the direct contact condensation phenomena for PTS-related in single and combined-effect thermal hydraulic test facilities using TransAT CMFD code

    Energy Technology Data Exchange (ETDEWEB)

    Kadi, Rabah, E-mail: kadi.rkhaled@hotmail.com [Laboratory for Thermal-Hydraulics, Nuclear Research Center of Birine (Algeria); Aissani, Slimane [Hydrocarbons and Chemistry Faculty, University of Boumerdes (Algeria); Bouam, Abdellah [Laboratory for Thermal-Hydraulics, Nuclear Research Center of Birine (Algeria)

    2015-11-15

    Highlights: • TransAT CMFD code application to DCC phenomenon. • LEIS methodology to predict the condensing steam flow rate. • Validation of interfacial phase-change heat transfer and turbulence models. • Correction of damping function at the free surface region. • Numerical validation of previous models using LIM and KAERI & KAIST test facilities. - Abstract: The use of CFD for the industrial studies related to PTS, including DCC is already possible; improvements of the two-phase modeling capabilities have to be undertaken to qualify the codes for the simulation of such flows. The DCC in horizontally stratified flow regime constitutes very considerable challenge exercises for a computational fluid dynamics (CFD) simulation of the thermal hydraulics PTS phenomenon because the interplay between turbulence and interfacial heat and mass transfer problem. The main purpose of our study is to investigate numerically the DCC in horizontally stratified steam water flow in a 2D and 3D channel using TransAT CMFD code. The new methodology known as Large-Eddy & Interface (LEIS) have been implemented for treatment of turbulence combined with interface tracking ITM (level set approach). Among of the so-called ‘coarse-grained’ ITM's models, the modified original surface divergence has been chosen as well as the treatment of the turbulence by URANS and VLES. This contribution addressed on the validation of interfacial phase-change heat transfer and turbulence models with special correction of the damping function at the free surface for single and combined-effect thermal hydraulic studies for LIM and KAERI & KAIST test facilities. The LIES methodology was found to apply successfully to predict the condensing steam flow rate in the all cases of the LIM test case involving a Smooth to Wavy turbulent, concurrent stratified steam-water flow in a 2D channel. The CMFD TransAT code predicting capability is analyzed, comparing the liquid temperature and to much the

  7. Patterns of attention and experiences of post-traumatic stress symptoms following childbirth: an experimental study.

    Science.gov (United States)

    Dale-Hewitt, Vanessa; Slade, Pauline; Wright, Ingram; Cree, Michelle; Tully, Chris

    2012-08-01

    Childbirth for some women can be experienced as a traumatic event whereby it is appraised as threatening to life and associated with feelings of fear, helplessness or horror. These women may develop symptoms consistent with post-traumatic stress disorder or its sub-clinical symptoms (post-traumatic stress, PTS). Cognitive processes such as attentional biases have been identified in individuals with PTS exposed to other traumatic events. This study used an experimental design (the modified Stroop task) to investigate the relationship between attentional biases and PTS symptoms in 50 women who experienced their labour and delivery as stressful and responded with fear, helplessness and horror. Attentional biases away from childbirth words were significantly associated with both symptoms of post-traumatic stress and more negative experiences of childbirth. A negative experience was also associated with more severe symptoms of PTS. Positive experiences were unassociated with attentional biases or symptoms. Post-traumatic stress responses, in this population, may be associated with avoidance, and through influencing cognitive processing, acting as a maintaining factor of distress.

  8. [Exon-dependent Subgroup-analysis of the Non-interventional REASON-Study: PFS and OS in EGFR-mutated NSCLC Patients Treated with Gefitinib or Chemotherapy].

    Science.gov (United States)

    Schuette, W; Dietel, M; Thomas, M; Eberhardt, W; Griesinger, F; Zirrgiebel, U; Radke, S; Schirmacher, P

    2016-08-01

    To analyze the influence of the localization of mutations in the epidermal growth factor receptor (EGFR) gene on progression-free (PFS) and overall survival (OS) in patients (pts) with locally advanced or metastatic non-small cell lung cancer (NSCLC) treated with gefitinib (gef) or chemotherapy (CT) under real world conditions within the REASON study. Subgroups of pts with mutations in exon 19 (n = 141), 18/20 (n = 43), and 21 (n = 104) were analyzed for PFS and OS according to gef or CT treatment and compared using the log-rank test. Pts with mutations in exon 19 and 18/20 treated with gef as first line therapy showed increased PFS and OS compared to CT. This increase was statistically significant in pts with exon 19 mutation (11.3 vs. 6.5 months), but was not found in pts with exon 21 mutation (9.1 vs. 9.3 months). Also, OS was significantly increased in patients with mutation in exon 19 treated with gef ever over all treatment lines compared to CT (21.8 vs. 10.6 months), whereas this was not found in pts with mutation in exon 21 (14.1 vs. 13.9 months). Localization and nature of EGFR mutations influences gefitinib treatment outcomes under routine conditions and should therefore be analyzed in detail. © Georg Thieme Verlag KG Stuttgart · New York.

  9. A longitudinal follow-up of posttraumatic stress: from 9 months to 20 years after a major road traffic accident

    Directory of Open Access Journals (Sweden)

    Rydelius Per-Anders

    2011-03-01

    Full Text Available Abstract Background Although road traffic accidents (RTA are a major cause of injury and a cause of posttraumatic stress (PTS in the aftermath, little is known about the long-term psychological effects of RTA. Methods This prospective longitudinal study assessed long-term PTS, grief, and general mental health after a bus carrying 23 sixth-grade schoolchildren crashed on a school outing and 12 children died. Directly affected (i.e., children in the crash and indirectly affected children (i.e., all pupils in the sixth grade who were not in the crash were surveyed at 9 months (N = 102, 4 years (N = 51, and 20 years (N = 40 after the event. Psychological distress was assessed by single items, including sadness, avoidance, intrusions, and guilt. After 20 years, PTS was assessed by the Impact of Event Scale-Revised. Results Stress reactions were prevalent 9 months after the event, with sadness (69% and avoidance (59% being highly represented in both directly and indirectly affected groups, whereas, nightmares (60% and feelings of guilt (50% were only frequent in those directly affected. The frequency of sadness and avoidance decreased after 4 years in the indirectly exposed (ps p = .003, but not decreased general mental health (p = .14, than those indirectly affected. Conclusions The limitations preclude assertive conclusions. Nonetheless, the findings corroborate previous studies reporting traumatic events are associated with long-term PTS, but not with decreased general mental health.

  10. Perspectives of local diclofenacol 1% liniment application in joint diseases

    Directory of Open Access Journals (Sweden)

    R M Balabanova

    2003-01-01

    Full Text Available Objective. To assess efficacy and safety diclofenacol 1% liniment application in comparison with diclo- ran plus. Material and methods. An open controlled 2-weeks trial of diclofenacol 1% liniment on 30 pts with active joint syndrome (group 1 compared with dicloran plus 1% gel on 20 pts (group II. Pts age ranged from 16 to 79 years, mean disease duration was 8,2 1,5 years. Most pts had II activity degree. Results. Diclofenacol 1% liniment applications decreased pain at rest and at movement and circle of aim joints. In pts with RA effect was more prominent. Dicloran plus provided equivalent results. Local effect of diclofenacol appeared in average after 31,5 min. (from 10 to 73 min and lasted during 118,3 min (from 50 to 240 min.. Diclofenacol allowed to decrease dose of oral NSAIDs in 43,3% of pts and dicloran - in 40% of pts. Diclofenacol safety was good without local and systemic adverse events. Conclusion. Diclofenacol 1% liniment manufactured by Hiperion S.A. (Rumania can be recommended for wide administration in treatment of joint diseases particularly in pts with concomitant gastrointestinal diseases and hypertension.

  11. A phase I trial of PR-104, a pre-prodrug of the bioreductive prodrug PR-104A, given weekly to solid tumour patients

    International Nuclear Information System (INIS)

    McKeage, Mark J; Gu, Yongchuan; Wilson, William R; Hill, Andrew; Amies, Karen; Melink, Teresa J; Jameson, Michael B

    2011-01-01

    The phosphate ester PR-104 is rapidly converted in vivo to the alcohol PR-104A, a nitrogen mustard prodrug that is metabolised to hydroxylamine (PR-104H) and amine (PR-104M) DNA crosslinking agents by one-electron reductases in hypoxic cells and by aldo-keto reductase 1C3 independently of oxygen. In a previous phase I study using a q 3 week schedule of PR-104, the maximum tolerated dose (MTD) was 1100 mg/m 2 and fatigue, neutropenic fever and infection were dose-limiting. The primary objective of the current study was to determine the dose-limiting toxicity (DLT) and MTD of weekly PR-104. Patients with advanced solid tumours received PR-104 as a 1-hour intravenous infusion on days 1, 8 and 15 every 28 days with assessment of pharmacokinetics on cycle 1 day 1. Twenty-six patients (pts) were enrolled (16 male/10 female; median age 58 yrs, range 30 to 70 yrs) who had received a median of two prior chemotherapy regimens (range, 0 to 3) for melanoma (8 pts), colorectal or anal cancer (3 pts), NSCLC (3 pts), sarcoma (3 pts), glioblastoma (2 pts), salivary gland tumours (2 pts) or other solid tumours (5 pts). PR-104 was administered at 135 mg/m 2 (3 pts), 270 mg/m 2 (6 pts), 540 mg/m 2 (6 pts), 675 mg/m 2 (7 pts) and 900 mg/m 2 (4 pts) for a median of two treatment cycles (range, 1 to 7 cycles) and five infusions (range, 1 to 18) per patient. Dose-limiting toxicities (DLTs) during cycle one included grade four thrombocytopenia at 540 mg/m 2 (1 of 6 pts) and grade four thrombocytopenia and neutropenia at 900 mg/m 2 (2 of 4 pts). At an intermediate dose of 675 mg/m 2 , there were no DLTs among a total of seven patients given 12 treatment cycles but all experienced moderate to severe (grade 2 to 4) haematological toxicity. Thrombocytopenia was delayed in its onset and nadir, and its recovery was protracted and incomplete in many patients. There were no complete or partial tumour responses. PR-104-induced thrombocytopenia and neutropenia correlated with plasma AUC of PR-104

  12. A Retrospective Comparison of Ultrasound-Assisted Catheter-Directed Thrombolysis and Catheter-Directed Thrombolysis Alone for Treatment of Proximal Deep Vein Thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Tichelaar, Vladimir Y. I. G., E-mail: ynse.i.tichelaar@uit.no; Brodin, Ellen E.; Vik, Anders; Isaksen, Trond [UiT – The Arctic University of Norway, K. G. Jebsen – Thrombosis Research and Expertise Centre (TREC), Department of Clinical Medicine (Norway); Skjeldestad, Finn Egil [UiT – The Arctic University of Norway, Research Group Epidemiology of Chronic Diseases, Department of Community Medicine (Norway); Kumar, Satish; Trasti, Nora C.; Singh, Kulbir [University Hospital of North Norway, Department of Radiology (Norway); Hansen, John-Bjarne [UiT – The Arctic University of Norway, K. G. Jebsen – Thrombosis Research and Expertise Centre (TREC), Department of Clinical Medicine (Norway)

    2016-08-15

    BackgroundRecent studies have suggested that catheter-directed thrombolysis (CDT) reduces development of post-thrombotic syndrome (PTS). Ultrasound-assisted CDT (USCDT) might enhance the efficiency of thrombolysis. We aimed to compare USCDT with CDT on efficacy, safety, development of PTS, and quality of life after long-term follow-up.MethodsWe describe a retrospective case series of 94 consecutive patients admitted with iliofemoral or more proximal deep vein thrombosis (DVT) to the University Hospital from 2002 to 2011, treated either with CDT or USCDT. Scheduled follow-up visits took place between April 2013 and January 2014. Venography measured the degree of residual luminal obstruction of the affected veins. Each patient completed the Short Form 36-item health survey assessment and the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms questionnaires. PTS was assessed using the Villalta scale.ResultsRisk factors of DVT were equally distributed between groups. In the USCDT group, we observed a significant decline in the duration of thrombolytic treatment (<48 h: 27 vs. 10 %), shortened hospital stay (median 6.0 days (IQR 5.0–9.0) vs. 8.0 (IQR 5.8–12.0)), and less implantation of (intravenous) stents (30 vs. 55 %). There was no difference in patency (76 vs. 79 % fully patent), prevalence of PTS (52 vs. 55 %), or quality of life between groups after long-term follow-up (median 65 months, range: 15–141).ConclusionsIn this observational study, USCDT was associated with shortened treatment duration, shorter hospital stay, and less intravenous stenting, compared to CDT alone without affecting the long-term prevalence of PTS or quality of life.

  13. A Retrospective Comparison of Ultrasound-Assisted Catheter-Directed Thrombolysis and Catheter-Directed Thrombolysis Alone for Treatment of Proximal Deep Vein Thrombosis

    International Nuclear Information System (INIS)

    Tichelaar, Vladimir Y. I. G.; Brodin, Ellen E.; Vik, Anders; Isaksen, Trond; Skjeldestad, Finn Egil; Kumar, Satish; Trasti, Nora C.; Singh, Kulbir; Hansen, John-Bjarne

    2016-01-01

    BackgroundRecent studies have suggested that catheter-directed thrombolysis (CDT) reduces development of post-thrombotic syndrome (PTS). Ultrasound-assisted CDT (USCDT) might enhance the efficiency of thrombolysis. We aimed to compare USCDT with CDT on efficacy, safety, development of PTS, and quality of life after long-term follow-up.MethodsWe describe a retrospective case series of 94 consecutive patients admitted with iliofemoral or more proximal deep vein thrombosis (DVT) to the University Hospital from 2002 to 2011, treated either with CDT or USCDT. Scheduled follow-up visits took place between April 2013 and January 2014. Venography measured the degree of residual luminal obstruction of the affected veins. Each patient completed the Short Form 36-item health survey assessment and the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms questionnaires. PTS was assessed using the Villalta scale.ResultsRisk factors of DVT were equally distributed between groups. In the USCDT group, we observed a significant decline in the duration of thrombolytic treatment (<48 h: 27 vs. 10 %), shortened hospital stay (median 6.0 days (IQR 5.0–9.0) vs. 8.0 (IQR 5.8–12.0)), and less implantation of (intravenous) stents (30 vs. 55 %). There was no difference in patency (76 vs. 79 % fully patent), prevalence of PTS (52 vs. 55 %), or quality of life between groups after long-term follow-up (median 65 months, range: 15–141).ConclusionsIn this observational study, USCDT was associated with shortened treatment duration, shorter hospital stay, and less intravenous stenting, compared to CDT alone without affecting the long-term prevalence of PTS or quality of life.

  14. Substances toxiques persistantes (PTS dans les corps gras : État des lieux d’après le rapport du programme des Nations-Unies pour l’environnement (PNUE

    Directory of Open Access Journals (Sweden)

    Narbonne Jean François

    2003-07-01

    Full Text Available Depuis plus de trente ans, une attention croissante a été portée sur les risques pour la santé humaine posés par la contamination de l’environnement par les substances toxiques persistantes (PTS. Ces composés persistent pendant de longues périodes dans les compartiments abiotiques et biotiques, sont transportés sur de longues distances depuis leurs points sources et s’accumulent chez l’homme et les organismes via les chaînes alimentaires. En 1997, le PNUE propose une liste initiale de 12 substances appelées polluants organiques persistants (POPs : aldrine, endrine, dieldrine, chordane, DDT, heptachlore, toxaphène, mirex, hexachlorobenzène, PCBs, dioxines (PCDDs, furanes (PCDFs. En 2001, de nouveaux composés sont ajoutés sur la liste des PTS en fonction de leurs caractéristiques comme la liposolubilité, leur résistance à la dégradation, leur forte toxicité ou la constance des apports : hexachlorohexane, PAHs, endosulfan, pentachlorophénol, formes organiques des métaux lourds : mercure, étain et plomb, phtalates, PBDEs\\\\PBBs, chlordécone, alkyl phénols, atrazine. Les sources de PTS sont diverses : (1 Utilisation de produits chimiques industriels comme les pesticides ou les emballages, (2 Réservoirs historiques déjà présents dans l’environnement essentiellement dans les sols et les sédiments ou sous forme de stocks périmés, (3 Sous-produits de process, en particulier comme contaminants indésirables de procédés industriels et de combustion. La France a été associée au rapport de la région IV méditerranéenne. Les niveaux dans les compartiments de l’environnement sont rapportés et l’exposition de l’homme via l’alimentation (vecteur essentiel est estimée en fonction des données collectées. Une évaluation des risques associés a été faite quand les données étaient suffisantes (PAHs, PCBs, PCDD\\\\F, Me Hg. Les lipides apparaissent comme vecteurs majeurs des PTS à travers la cha

  15. 'Poker' association of weekly alternating 5-fluorouracil, irinotecan, bevacizumab and oxaliplatin (FIr-B/FOx) in first line treatment of metastatic colorectal cancer: a phase II study

    International Nuclear Information System (INIS)

    Bruera, Gemma; Ficorella, Corrado; Ricevuto, Enrico; Santomaggio, Alessandra; Cannita, Katia; Baldi, Paola Lanfiuti; Tudini, Marianna; De Galitiis, Federica; Mancini, Maria; Marchetti, Paolo; Antonucci, Adelmo

    2010-01-01

    This phase II study investigated efficacy and safety of weekly alternating Bevacizumab (BEV)/Irinotecan (CPT-11) or Oxaliplatin (OHP) associated to weekly 5-Fluorouracil (5-FU) in first line treatment of metastatic colorectal carcinoma (MCRC). Simon two-step design: delta 20% (p 0 50%, p 1 70%), power 80%, α 5%, β 20%. Projected objective responses (ORR): I step, 8/15 patients (pts); II step 26/43 pts. Schedule: weekly 12 h-timed-flat-infusion/5-FU 900 mg/m 2 , days 1-2, 8-9, 15-16, 22-23; CPT-11 160 mg/m 2 plus BEV 5 mg/kg, days 1,15; OHP at three dose-levels, 60-70-80 mg/m 2 , days 8, 22; every 4 weeks. Fifty consecutive, unselected pts < 75 years were enrolled: median age 63; young-elderly (yE) 24 (48%); liver metastases (LM) 33 pts, 66% Achieved OHP recommended dose, 80 mg/m 2 . ORR 82% intent-to-treat and 84% as-treated analysis. Median progression-free survival 12 months. Equivalent efficacy was obtained in yE pts. Liver metastasectomies were performed in 26% of all pts and in 39% of pts with LM. After a median follow-up of 21 months, median overall survival was 28 months. Cumulative G3-4 toxicities per patient: diarrhea 28%, mucositis 6%, neutropenia 10%, hypertension 2%. They were equivalent in yE pts. Limiting toxicity syndromes (LTS), consisting of the dose-limiting toxicity, associated or not to G2 or limiting toxicities: 44% overall, 46% in yE. Multiple versus single site LTS, respectively: overall, 24% versus 20%; yE pts, 37.5% versus 8%. Poker combination shows high activity and efficacy in first line treatment of MCRC. It increases liver metastasectomies rate and can be safely administered. Osservatorio Nazionale sulla Sperimentazione Clinica dei Medicinali (OsSC) Agenzia Italiana del Farmaco (AIFA) Numero EudraCT 2007-004946-34

  16. Political violence exposure, adolescent school violence, and drug use: The mediating role of school support and posttraumatic stress.

    Science.gov (United States)

    Fang, Lin; Schiff, Miriam; Benbenishty, Rami

    2016-01-01

    Adolescents may engage in risk behaviors to cope with the negative psychological impacts resulting from exposure to political violence. Guided by the Deterioration Deterrence Model and General Strain Theory, the present study assessed the mediating role of school support and posttraumatic stress (PTS) on two adolescent risk behaviors (i.e., school violence and drug use) among Arab and Jewish Israeli adolescents. We analyzed data from a nationally representative survey that consisted of 4,733 Israeli high school students (54.5% females; 63.2% Jewish) following the Second Lebanon War. Structural equation modeling using weighted data bootstrapped with 2,000 iterations evaluated the mediated effects of school support and PTS. The results showed that both school support and PTS mediated the pathways from political violence exposure to school violence and drug use. However, although school support and PTS fully mediated the relationship between political violence exposure and these risk behaviors for Jewish students, school support and PTS only partially mediated the relationships for Arab students. While school support can help decrease the detrimental effect of exposure to terrorism and war, Israeli adolescents exposed to more political violence may perceive receiving less school support than those experiencing less exposure. Findings of this study provide evidence for the theorized mediated pathways between political violence exposure and adolescent risk behaviors by PTS and school support. The study serves as a basis for future research that can unpack the relationship between exposure to political violence and adolescent risk-taking behaviors. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  17. Mechanical study of the Saclay piezo tuner PTS (piezo tuning system) Care-SRF-WP8

    International Nuclear Information System (INIS)

    Bosland, P.; Wu, B.

    2005-03-01

    The present tuner is working inside Tesla test facility's cryo-modules without any piezo actuator. Thus the Lorentz force detuning in the pulsed mode of the accelerator is limiting the maximum accelerating field of cavity at about 25 MV/m. Previous studies and tests have demonstrated that the integration of piezo actuators in the tuner can lead to the compensation of the Lorentz force detuning at field higher than 35 MV/m. Our goal is now to develop and optimize a new tuner integrating piezo actuators. The mechanical studies are now finished and fabrication is in progress. This report presents the principle of this new system, its design and reviews the cavity frequency shifts during preparation process and assesses the forces applied by the cavity on the piezo actuators. (A.C.)

  18. Status of reactor pressure vessel embrittlement study in Japan

    International Nuclear Information System (INIS)

    Sasajima, H.

    1997-01-01

    Since the construction of Japanese first commercial nuclear power plant in 1966, 52 nuclear power plants have been commissioned in Japan to commercial operation. Japanese first nuclear power plant has now been service for 30 years and the aging of nuclear power plants is steadily progressing in general. Under these circumstances, the Japan Power Engineering and Inspection Corporation (JAPEIC) is executing, under consignment by the Ministry of International Trade and Industry (MITI), the development and verification test programs for plant integrity evaluation technology by which nuclear power plant aging can be appropriately handled. This paper shows the outline of study dealing with embrittlement of RPV caused by neutron irradiation, as one of the activity of JAPEIC. The embrittlement of RPV caused by neutron irradiation is manifested as a shift of transition temperature and as a reduction in Upper Shelf Energy (USE). In JAPEIC, the study dealing with a shift of transition temperature was conducted in the ''Reactor Pressure Vessel Pressurized Thermal Shock Test Project (the PTS Project)'', and the study dealing with a reduction in USE has been conducted in the ''Nuclear Power Plant Life Management Technology (the PLIM Project)''. And the reconstitution technology of surveillance test specimen has been conducted in PLIM Project as one of the measures to improve monitoring above material characteristic changes. The integrity evaluation under the Pressurized Thermal Shock (PTS) events including the effect of neutron irradiation embrittlement was initiated in 1983 FY as the PTS Project and was completed in the 1991 FY. The study verified that plant integrity could be assured at not only the end of design life, but also an extended service life even when the severest PTS events were postulated. The PLIM Project, designed to develop and verify the integrity evaluation technology dealing with reduction of USE by neutron irradiation, was started in the 1996 FY as a 10

  19. The conceptualization of emotion regulation difficulties, and its association with posttraumatic stress symptoms in traumatized refugees.

    Science.gov (United States)

    Doolan, Emma L; Bryant, Richard A; Liddell, Belinda J; Nickerson, Angela

    2017-08-01

    This study investigated the conceptualization of emotion regulation difficulties in a sample of refugees with varying levels of posttraumatic stress (PTS), and examined whether specific emotion regulation difficulties were associated with PTS severity. Refugees were administered an abbreviated version of the Difficulties in Emotion Regulation Scale, the PTSD Symptom Scale - Interview Version, and the Harvard Trauma Questionnaire. Confirmatory Factor Analysis was used to examine model fit for the 6-factor model originally proposed by the developers of the DERS and the more recently proposed 5-factor model that excludes the awareness subscale. Both models displayed adequate fit. After controlling for age, gender, time in Australia, and trauma exposure, the clarity and strategies subscales were significantly associated with PTS severity. The association between impaired emotional clarity and reduced agency related to accessing regulation strategies and PTS severity in this refugee sample highlights the need for further research to assess interventions that target these disruptions in refugees. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Diagnostic value of F18-FDG PET/CT in patients with the revised definition of fever of unknown origin

    DEFF Research Database (Denmark)

    Prakash, Vineet; Ketharanathan, Nagulabaskaran; Lorenz, Eleanor

    2009-01-01

    Objectives: Fever of unknown origin (FUO) is an increasingly accepted indication for PET/CT where it has a relatively high diagnostic yield. This study assesses its diagnostic value for the revised definition of FUO. Methods: The revised definition of FUO is fever of greater than 38.3C for more...... than 3 weeks duration and an uncertain diagnosis after comprehensive evaluation as an inpatient or outpatient for a minimum of 3 days or 3 outpatient visits, having excluded immunocompromised states. 59 patients (pts) (F=35, age 18-92) with this definition underwent PET with full diagnostic contrast......), neoplasm (6 pts) and drug fever (1 pt). Before ordering a PET/CT, conventional CT or MRI was performed in 43 pts. We considered that a PET/CT was essential to establish the final diagnosis in 15/43 pts (35%) with inconclusive CT or MRI. Conclusions: 18F-FDG PET/CT contributed to establishing a final...

  1. Re-irradiation after salvage mastectomy for local recurrence after a conservative treatment: a retrospective analysis of twenty patients (Nancy: 1988-2001); Re-irradiation parietale apres mastectomie de rattrapage pour recidive d'un cancer du sein apres traitement conservateur: etude retrospective sur 20 patientes (Nancy: 1988-2001)

    Energy Technology Data Exchange (ETDEWEB)

    Racadot, S.; Marchal, C.; Charra-Brunaud, C.; Peiffert, D.; Bey, P. [Centre Alexis-Vautrin, Service de Radiotherapie, 54 - Vandoeuvre-les-Nancy (France); Verhaeghe, J.L. [Centre Alexis-Vautrin, Service de Chirurgie, 54 - Vandoeuvre-les-Nancy (France)

    2003-12-01

    Purpose. - To retrospectively assess the efficacy of post-mastectomy re-irradiation for local relapse of breast cancer. Patients and methods. - Twenty patients, initially treated by conservative surgery and radiotherapy (50 Gy in 25 fractions over 5 weeks) were treated from 1998 to 2001 for a local relapse by salvage mastectomy and re-irradiation (either electron or photon beams). Mean age was 53 years (31-71). Reasons for re-irradiation were that the local relapses were inflammatory (4 pts), multifocal (5 pts), cutaneous (5 pts), involved the nipple (3 pts) or because the surgical margins (either muscle or skin) were involved (3 pts). The median dose of re-irradiation was 45 Gy (33-65) in 15 fractions over 33 days. Mean follow-up was 48 months (5-97). Results. - Fifteen patients remained free of a second local recurrence and 10 were still alive, without metastasis. Neither the dose of re-irradiation nor the irradiated surfaces were prognostic factors of local control (P = 0.877 and P = 0.424). Five patients developed radiation-induced pneumonitis without functional respiratory impairment. The incidence of pneumonitis seemed to be related to the biological dose of re-irradiation (P = 0.037). Other late complications occurred such as pigmentation changes (12 pts), telangiectasia (8 pts), chondritis (2 pts), parietal fibrosis (7 pts), rib fractures (4 pts), severe pain (11 pts) and lymphedema (2 pts). The increase in biological equivalent dose was highly statistically linked with the occurrence of disabling pain (P = 0.0123). Conclusion. - Parietal re-irradiation achieves good and lasting local control with an acceptable rate of acute complications but with a risk of disabling late sequelae such as severe pain. (author)

  2. Re-irradiation after salvage mastectomy for local recurrence after a conservative treatment: a retrospective analysis of twenty patients (Nancy: 1988-2001)

    International Nuclear Information System (INIS)

    Racadot, S.; Marchal, C.; Charra-Brunaud, C.; Peiffert, D.; Bey, P.; Verhaeghe, J.L.

    2003-01-01

    Purpose. - To retrospectively assess the efficacy of post-mastectomy re-irradiation for local relapse of breast cancer. Patients and methods. - Twenty patients, initially treated by conservative surgery and radiotherapy (50 Gy in 25 fractions over 5 weeks) were treated from 1998 to 2001 for a local relapse by salvage mastectomy and re-irradiation (either electron or photon beams). Mean age was 53 years (31-71). Reasons for re-irradiation were that the local relapses were inflammatory (4 pts), multifocal (5 pts), cutaneous (5 pts), involved the nipple (3 pts) or because the surgical margins (either muscle or skin) were involved (3 pts). The median dose of re-irradiation was 45 Gy (33-65) in 15 fractions over 33 days. Mean follow-up was 48 months (5-97). Results. - Fifteen patients remained free of a second local recurrence and 10 were still alive, without metastasis. Neither the dose of re-irradiation nor the irradiated surfaces were prognostic factors of local control (P = 0.877 and P = 0.424). Five patients developed radiation-induced pneumonitis without functional respiratory impairment. The incidence of pneumonitis seemed to be related to the biological dose of re-irradiation (P = 0.037). Other late complications occurred such as pigmentation changes (12 pts), telangiectasia (8 pts), chondritis (2 pts), parietal fibrosis (7 pts), rib fractures (4 pts), severe pain (11 pts) and lymphedema (2 pts). The increase in biological equivalent dose was highly statistically linked with the occurrence of disabling pain (P = 0.0123). Conclusion. - Parietal re-irradiation achieves good and lasting local control with an acceptable rate of acute complications but with a risk of disabling late sequelae such as severe pain. (author)

  3. Overview of the Integrated Pressurized Thermal-Shock (IPTS) study

    International Nuclear Information System (INIS)

    Cheverton, R.D.

    1990-01-01

    By the early 1980s, (PTS)-related, deterministic, vessel-integrity studies sponsored by the US Nuclear Regulatory Commission (NRC) indicated a potential for failure of some PWR vessels before design end of life, in the event of a postulated severe PTS transient. In response, the NRC established screening criteria, in the form of limiting values of the reference nil-ductility transition temperature (RT NDT ), and initiated the development of a probabilistic methodology for evaluating vessel integrity. This latter effort, referred to as the Integrated Pressurized Thermal-Shock (IPTS) Program, included development of techniques for postulating PTS transients, estimating their frequencies, and calculating the probability of vessel failure for a specific transient. Summing the products of frequency of transient and conditional probability of failure for each of the many postulated transients provide a calculated value of the frequency of failure. The IPTS Program also included the application of the IPTS methodology to three US PWR plants (Oconee-1, Calvert Cliffs-1, and HBRobinson-2) and the specification of a maximum permissible value of the calculated frequency of vessel failure. Another important purpose of the IPTS study was to determine, through application of the IPTS methodology, which design and operating features, parameters, and PTS transients were dominant in affecting the calculated frequency of failure. The scope of the IPTS Program included the development of a probabilistic fracture-mechanics capability, modification of the TRAC and RELAP5 thermal/hydraulic codes, and development of the methodology for estimating the uncertainty in the calculated frequency of vessel failure

  4. Posterior tibial slope impacts intraoperatively measured mid-flexion anteroposterior kinematics during cruciate-retaining total knee arthroplasty.

    Science.gov (United States)

    Dai, Yifei; Cross, Michael B; Angibaud, Laurent D; Hamad, Cyril; Jung, Amaury; Jenny, Jean-Yves

    2018-02-23

    Posterior tibial slope (PTS) for cruciate-retaining (CR) total knee arthroplasty (TKA) is usually pre-determined by the surgeon. Limited information is available comparing different choices of PTS on the kinematics of the CR TKA, independent of the balancing of the extension gap. This study hypothesized that with the same balanced extension gap, the choice of PTS significantly impacts the intraoperatively measured kinematics of CR TKA. Navigated CR TKAs were performed on seven fresh-frozen cadavers with healthy knees and intact posterior cruciate ligament (PCL). A custom designed tibial baseplate was implanted to allow in situ modification of the PTS, which altered the flexion gap but maintained the extension gap. Knee kinematics were measured by performing passive range of motion (ROM) tests from full extension to 120° of flexion on the intact knee and CR TKAs with four different PTSs (1°, 4°, 7°, and 10°). The measured kinematics were compared across test conditions to assess the impact of PTS. With a consistent extension gap, the change of PTS had significant impact on the anteroposterior (AP) kinematics of the CR TKA knees in mid-flexion range (45°-90°), but not so much for the high-flexion range (90°-120°). No considerable impacts were found on internal/external (I/E) rotation and hip-knee-ankle (HKA) angle. However, the findings on the individual basis suggested the impact of PTS on I/E rotation and HKA angle may be patient-specific. The data suggested that the choice of PTS had the greatest impact on the mid-flexion AP translation among the intraoperatively measured kinematics. This impact may be considered while making surgical decisions in the context of AP kinematics. When using a tibial component designed with "center" pivoting PTS, a surgeon may be able to fine tune the PTS to achieve proper mid-flexion AP stability.

  5. Tandem autotransplant as first-line consolidative treatment in poor-risk aggressive lymphoma: a pilot study of 36 patients.

    Science.gov (United States)

    Haioun, C; Mounier, N; Quesnel, B; Morel, P; Rieux, C; Beaujean, F; Marolleau, J P; Belhadj, K; Simon, D; Gaulard, P H; Lepage, E; Gisselbrecht, C H; Reyes, F

    2001-12-01

    In the previous LNH87-2 study, consolidative high-dose therapy followed by stem cell transplantation (HDT) improved disease-free survival, as well as survival for patients (pts) presenting with two or three factors of the age-adjusted international prognostic index (Aa-IPI) in first complete remission (CR). In order to improve further the outcome of such patients, we conducted a pilot study of consolidative tandem autotranplant. Thirty-six patients (pts) under 60 years of age with two or three factors of the Aa-IPI were enrolled. Their main characteristics were: diffuse large B-cell lymphoma (83%), Aa-IPI three factors (50%), and marrow involved (36)%. The procedure consisted of 1) induction with four cycles of ACVBP (doxorubicin, cyclophosphamide, vindesine, bleomycin, prednisone) 2) in responding pts, peripheral blood stem cell (PBSC) collection after the fourth cycle of ACVBP (11 pts) or after an additional mobilization regimen (Cyclophosphamide-VP16) (17 pts) 3) a first HDT (mitoxantrone, cyclophosphamide, VP16 and carmustine) followed by PBSC infusion 4) a second HDT (busulfan, carboplatin and melphalan) followed by PBSC infusion. Among the 29 patients responding to induction, 28 received the first HDTand 24 the second. The rates of three-year-event free survival and survival are 47% (95% confidence interval (95% CI: 31%-63%) and 50% (95% CI: 37%-69%), respectively. Eighteen patients remained free of evolutive disease and 18 patients have died, 15 from disease progression and three from treatment-related toxicity after tandem transplant (two veno-occlusive disease and one cerebral toxoplasmosis). We conclude that tandem transplant did not improve the results of the LNH87-2 study in which patients received a single consolidative HDT.

  6. Transurethral resection of the prostate for patients with grade III urinary symptoms following transperineal implantation of the prostate

    International Nuclear Information System (INIS)

    Potters, L; Waldbaum, R; Bosworth, J; Ashley, R

    1996-01-01

    PURPOSE/OBJECTIVE: Patients (Pts) undergoing a I-125 or Pd-103 transperineal implant of the prostate (TPIP) experience urethritis of a varying degree. Most pts with mild to moderate symptoms can be treated with alpha blocking agents. Few pts will experience urethritis that does not respond to medical management, or persists beyond three half life's of the isotope. These pts will have significant quality of life complaints related to their symptoms. The purpose of this study is to present our results of Transurethral resection of the prostate (TURP) for patients with grade III urethritis. MATERIALS AND METHODS: Between November 1992 and January 1996, 378 patients underwent TPIP for clinically localized cancer. Treatment consisted of either a Pd-103 or I-125 implant either alone or in combination with external beam radiation and/or hormones. All the implants used a peripheral loading and urethral sparing technique. All pts were followed after the implant and assessed by DRE, PSA, and symptoms. The grading of urinary symptoms was as follows: Grade I-successful relief with pyridium or an equivalent medication, Grade II-pts requiring various doses of alpha blockers, Grade III-pts with persistent symptoms despite medical management. RESULTS: Of the 378 pts undergoing implant, 358 had sufficient follow-up to be included in this review. Forty two pts (12%) received hormone downsizing prior to implantation. Two hundred and two (56%) underwent a Pd-103 implant and 156 (44%) a I-125 implant; 15 underwent EBRT plus I-125 and 27 with EBRT and Pd-103. One hundred and fifty five (43%) pts experienced grade I urethritis during the first three half life's of the implant, while 116 (32%) experienced grade II urethritis. Twenty eight pts (8%) experienced grade III urethritis that persisted beyond three half life's of the implant. All grade III pts were offered TURP and 26 elected to undergo this procedure. Of the twenty six pts undergoing TURP, 100% experienced relief of their

  7. Treatment of early breast cancer, a long-term follow-up study: the GOCS experience.

    Science.gov (United States)

    Iturbe, Julián; Zwenger, Ariel; Leone, José Pablo; Verdera, Palmira Perez; Vallejo, Carlos; Romero, Alberto; Perez, Juán; Machiavelli, Mario; Leone, Bernardo

    2011-01-01

    Most cases of breast cancer are diagnosed at early stage of disease; therefore, treatment is oriented to increase the disease-free interval (DFI) and overall survival (OS). The prognosis, in comparison with other malignancies, has improved in the last decades as a result of mammographic screening. The aim of the study was to report the incidence of local and distant recurrence, DFI and OS in patients (pts) with stage I and stage II breast cancer over a period of 26 years divided into three groups. From January 1978 to December 2004, 927 women with early breast cancer (EBC) were included, 350 were stage I and 577 Stage II (AJCC 2002). Patients were divided according to the year of diagnosis into three periods of 10 years: Group A (1978-1987) 135 pts, Group B (1988-1997) 412 pts, and Group C (1998-2004) 380 pts. DFI was analyzed from the date of initial diagnosis to the date of local or distant recurrence. OS was estimated from the date of initial diagnosis to the last follow-up or date of death. Median age was 51 years (28-92). Conservative surgery was performed in 69% of pts, adjuvant radiation therapy in 78%, adjuvant chemotherapy in 29%, and adjuvant hormone therapy in 18%. The median follow-up was 8.4 years (0.3-30). The mean tumor size in Group A was 2.7 cm, in Group B 2.2 cm, and in Group C 1.94 cm (p = 0.0001). The percentage of pts with stage I increased from 13% in Group A to 38% in Group B and to 47% in Group C (p = 0.0001). Local recurrence was documented in 5% of all pts, whereas 28% developed metastatic disease. The DFI and OS showed a statistically significant difference among the three groups (p = 0.005). DFI rate at 5, 10, 15, 20, and 25 years was 71%, 67%, 65%, 65%, and 64%, respectively. OS at 5, 10, 15, 20, and 25 years was 82%, 62%, 49%, 39%, and 28%, respectively. Factors that had an effect in OS demonstrated by the multivariate regression analysis were: Tumor size, ER status, and nodal involvement (p < 0.001). Clinical outcomes in EBC in our

  8. Puzzle test: A tool for non-analytical clinical reasoning assessment.

    Science.gov (United States)

    Monajemi, Alireza; Yaghmaei, Minoo

    2016-01-01

    Most contemporary clinical reasoning tests typically assess non-automatic thinking. Therefore, a test is needed to measure automatic reasoning or pattern recognition, which has been largely neglected in clinical reasoning tests. The Puzzle Test (PT) is dedicated to assess automatic clinical reasoning in routine situations. This test has been introduced first in 2009 by Monajemi et al in the Olympiad for Medical Sciences Students.PT is an item format that has gained acceptance in medical education, but no detailed guidelines exist for this test's format, construction and scoring. In this article, a format is described and the steps to prepare and administer valid and reliable PTs are presented. PT examines a specific clinical reasoning task: Pattern recognition. PT does not replace other clinical reasoning assessment tools. However, it complements them in strategies for assessing comprehensive clinical reasoning.

  9. Work participation of patients with musculoskeletal disorders: is this addressed in physical therapy practice?

    Science.gov (United States)

    Oswald, Wiebke; Hutting, Nathan; Engels, Josephine A; Bart Staal, J; Nijhuis-van der Sanden, Maria W G; Heerkens, Yvonne F

    2017-01-01

    Musculoskeletal disorders are the main complaints for visiting a physical therapist (PT) in primary health care; they have a negative effect on an individual's quality of life and result in a major cost to society. Qualitative research has shown that physical therapists (PTs) treating patients with these disorders experience barriers in the integration of occupational factors within their practice, and also revealed a lack of cooperation between PTs and (other) occupational healthcare providers. The aim of this study is to quantitatively investigate how generalist PTs in the Netherlands, who treat patients with musculoskeletal disorders, currently integrate occupational factors within their practice, and to identify their opinions and needs with regard to enhancing the integration of the patient's work within physical therapy practice. A cross-sectional survey was conducted among generalist PTs who treat working-age (18-67 years) patients with musculoskeletal disorders. Generalist PTs were contacted for participation via digital news-mails and asked to fill out an online survey which was developed based on the results of a recent qualitative study. The survey consisted of: i) demographics of the participants, ii) questions on how generalist PTs currently integrate occupational factors within their practice, and iii) asked their opinion about the integration of occupational factors within physical therapy. The PTs were also asked about their needs with regard to the integration of occupational factors and with regard to cooperation with other (occupational) health professionals. All answers (using Likert scales) are presented as the number and percentage of the respondents reporting those specific answers, whereas all other answers are presented as means and standard deviations. Of the 142 respondents, 64% indicated that occupational factors should be addressed to a greater extent within physical therapy. To have the possibility to bill for a workplace assessment

  10. Phase I dose-escalation study of vinflunine hard capsules administered twice a day for 2 consecutive days every week in patients with advanced/metastatic solid tumors.

    Science.gov (United States)

    Calvo, E; Vermorken, J B; Hiret, S; Rodon, J; Cortes, J; Senellart, H; Van den Brande, J; Dyck, J; Pétain, A; Ferre, P; Bennouna, J

    2012-06-01

    Vinflunine is a new microtubule inhibitor of the vinca-alkaloid family. It is marketed in transitional cell carcinoma of urothelial tract as a 20 min infusion given every 3 weeks in Europe. In this phase I study, vinflunine was administered to patients with advanced malignancies as hard capsules given twice a day on days 1-2 every week, with 3 weeks cycles. Serial blood samples were collected during the first cycle for pharmacokinetic investigations. Thirty-six patients (pts) were treated at 6 dose levels 150 (3 pts), 190 (3 pts), 230 (8 pts), 300 mg/day (6 pts) and then 250 (3 pts) and 270 mg/day (13 pts). The Maximal Tolerated Dose (MTD) was reached at 300 mg/day where 2 patients out of 6 experienced a dose limiting toxicity (febrile neutropenia with diarrhea). The lower dose level of 270 mg/day was the recommended dose (RD), the toxicity profile being mainly anaemia, neutropenia, fatigue and constipation. The pharmacokinetic analysis demonstrated the adequacy of the flat-fixed dosing regimen, as no correlation between clearance of vinflunine and body surface area was evidenced. Blood concentrations and exposure increased with dose, and a pharmacokinetic accumulation was observed, which is consistent with the terminal half-life of the compounds. The inter-individual exposure variability at the RD was 35%. Repeated weekly administration of oral vinflunine is feasible and exhibits a moderate inter-individual PK variability. The MTD was achieved at 300 mg/day given for 2 consecutive days. According to the protocol rules, the RD was established at 270 mg/day.

  11. Quantification of the temporal component of left ventricular asynergy by gated cardiac blood pool scans

    International Nuclear Information System (INIS)

    Solot, G.; Chevigne, M.; Rigo, P.

    1985-01-01

    Fourier analysis (F) has demonstrated that left ventricular (LV) dysfunction can be analyzed in two separate component: an amplitude (AM) and a temporal (T) component. Although the former dominates in hypokinesis and akinesis, and the latter in dyskinesis, they are almost always associated and combine to determine the clinical form of asynergy (AS). The mechanical consequences of the T component cannot be assessed continuously by F which requires setting of a threshold. In this study, the authors have analyzed the potential of a new index; the stroke volume efficiency (SV Eff) to evaluate the importance of T AS in patients (pts) with coronary artery disease studied by gated blood pool scans. The authors have studied 14 controls, 8 pts with coronary artery disease without infarction, 56 pts with myocardial infarction (MI) and 21 pts with LV aneurysm. The SV Eff was calculated as follows after normalization and smoothing of the series: maximum and minimum images were created first and a LV region of interest was traced using the F AM image. The SV Eff ratio was calculated within the LV region of interest as ''diastolic counts - systolic counts/maximum counts - minimum counts''. The SV Eff in controls was 94% +- 2. The authors conclude that SV Eff provides a quantitative measurement of T component of LV dysfunction and an estimate of the dyskinetic component in pts with LV aneurysm. It should prove useful to study these patients serially

  12. Correlation of FDG-PET measurements with morphometric tumor response after induction chemotherapy and adjuvant radiotherapy in stage III non-small cell lung cancer (NSCLC)

    International Nuclear Information System (INIS)

    Baum, R.P.; Niesen, A.; Griesinger, F.

    2002-01-01

    Full text: Docetaxel (D) and carboplatin (C) combination chemotherapy (DC) has shown high response rates in advanced NSCLC. Histologic tumor response after chemotherapy or combined modality induction is strongly associated with systemic tumor control and potentially cure. Metabolic tumor response assessed by FDG-PET after induction chemotherapy with etoposide, ifosfamide and cisplatin (VIP) has been shown to be predictive of outcome in NSCLC. Finally, erythropoietin (EPO) may prevent the decrease in hemoglobin levels that was seen in a previous study of DC (median drop 2.7 g/dl) and thus may enhance treatment efficacy. The aim of the present study was to correlate FDG-PET studies with histomorphometric findings after DC induction chemotherapy plus Epo. 33 patients (pts) with NSCLC stage IIIA (7 pts) or IIIB (24 pts) were enrolled and received treatment with D 100 mg/m 2 dl and C AUC 7.5 d2 q21 days for 4 cycles. Epo was given at 10,000 IU s.c. three times a week. All pts received adjuvant radiotherapy. Of 33 enrolled patients, 22 were evaluable for response by CT imaging. 14/22 pts (64 %) achieved PR. Of the 22 responders, 20 were evaluable for repeated FDG-PET studies. 13/20 pts had a decrease of standardized uptake values (SUV) and of the metabolic tumor index (MTI) by >50 %, 9/20 had SUV <2.5 (CR). Seven of these 9 pts underwent tumor resection, and specimens were subjected to morphometric analysis. In 7/7 cases, no vital tumor cells were detected in the specimens. In contrast to our previous study, hemoglobin levels increased by a median of 0.3 g/dl. Morphometric tumor response after induction chemotherapy correlates strongly with metabolic remission by FDG-PET. FDG-PET appears to be a useful non-invasive diagnostic tool to predict pathologic response and potentially long-term outcome in stage III NSCLC. (author)

  13. Quantitative interpretation of myocardial Tl-201 single-photon emission computerized tomograms: A probabilistic approach to the assessment of coronary artery disease

    International Nuclear Information System (INIS)

    Maddahi, J.; Prigent, F.; Staniloff, H.; Garcia, E.; Becerra, A.; Van Train, K.; Swan, H.J.C.; Waxman, A.; Berman, D.

    1985-01-01

    Probabilistic criteria for abnormality would enhance application of stress-redistribution Tl-201 rotational tomography (tomo) for evaluation of coronary artery disease (CAD). Thus, 91 pts were studied, of whom 45 had angiographic CAD (≥ 50% coronary narrowing) and 46 were normal (nl). The validity of this model was prospectively tested in the remaining 51 pts (26 nls and 25 with CAD) by comparing the predicted and observed likelihood of CAD in four subgroups (I-IV). In this paper a logistic model is developed and validated that assigns a CAD likelihood to the quantified size of tomograhic myocardial perfusion defects

  14. Comparison of 11-C-Palmitic Acid (CPA), and 123-I-heptadecanoic acid (IHA) turnover in human heart

    International Nuclear Information System (INIS)

    Notohamiprodjo, G.; Schmid, A.; Spohr, G.; Vyska, K.; Feinendegen, L.E.

    1985-01-01

    This study was designed to compare the results obtained with IHA in the investigation of myocardial fatty acid metabolism (MFAM) with those obtained by the use of CPA.- 8 patients (pts) without clinical signs of heart or metabolic disease were investigated under rest and fasting condition by dynamic PET following i.v. injection of 3 mCi CPA and by conventional scintigraphy following i.v. injection of 3 mCi IHA. Data were collected over a period of 90 min (frame rate was 1/min) and corrected for blood activity and catabolically released 123-I.-In 6 pts a good agreement between CPA and IHA data was observed. The activity release from the myocardium in these cases was biexponential. The ratio Q ranged between 0.7 and 6.7. -In the remaining 2 pts significant discrepancies between CPA and IHA data were observed. Since these pts were known to have cardiac neurosis and the first measurement was carried out with CPA, the authors assumed that the anxiety of the pt during CPA examination is responsible for the changing of the MFAM. This was confirmed by examination of these pts with IHA under mental stress. In both vases the data obtained by the use of CPA agree closely with those obtained by the use of IHA under mental stress. These data indicate that both CPA and IHa are applicable for studying MFAM and that in external assessment of MFAM, not only the dietary status, but also the mental state of the pts should be considered

  15. Comparison of 11-C-Palmitic Acid (CPA), and 123-I-heptadecanoic acid (IHA) turnover in human heart

    Energy Technology Data Exchange (ETDEWEB)

    Notohamiprodjo, G.; Schmid, A.; Spohr, G.; Vyska, K.; Feinendegen, L.E.

    1985-05-01

    This study was designed to compare the results obtained with IHA in the investigation of myocardial fatty acid metabolism (MFAM) with those obtained by the use of CPA.- 8 patients (pts) without clinical signs of heart or metabolic disease were investigated under rest and fasting condition by dynamic PET following i.v. injection of 3 mCi CPA and by conventional scintigraphy following i.v. injection of 3 mCi IHA. Data were collected over a period of 90 min (frame rate was 1/min) and corrected for blood activity and catabolically released 123-I.-In 6 pts a good agreement between CPA and IHA data was observed. The activity release from the myocardium in these cases was biexponential. The ratio Q ranged between 0.7 and 6.7. -In the remaining 2 pts significant discrepancies between CPA and IHA data were observed. Since these pts were known to have cardiac neurosis and the first measurement was carried out with CPA, the authors assumed that the anxiety of the pt during CPA examination is responsible for the changing of the MFAM. This was confirmed by examination of these pts with IHA under mental stress. In both vases the data obtained by the use of CPA agree closely with those obtained by the use of IHA under mental stress. These data indicate that both CPA and IHa are applicable for studying MFAM and that in external assessment of MFAM, not only the dietary status, but also the mental state of the pts should be considered.

  16. Non-invasive determination of myocardial lipid content in Fabry disease by 1H-MR spectroscopy

    International Nuclear Information System (INIS)

    Petritsch, B.; Koestler, H.; Machann, W.; Horn, M.; Weng, A.M.; Goltz, J.P.; Hahn, D.; Beer, M.; Niemann, M.; Weidemann, F.; Wanner, C.

    2012-01-01

    Purpose: In Fabry disease (FD), a progressive deposition of sphingolipids is reported in different organs. The present study applied 1 H magnetic resonance spectroscopy (MRS) to investigate the myocardial lipid content in FD. Materials and Methods: In patients (PTS, n = 15) with genetically proven FD, 1 H MRS of the heart was acquired in the same examination as routine cardiac cine and late enhancement MR imaging. Healthy volunteers (n = 11) without history of cardiac disease served as control (CTL). Myocardial triglycerides in vivo were quantified in 1 H MRS. Left ventricular (LV) ejection fraction (EF) and late enhancement were assessed for the determination of LV systolic function, and onset or absence of myocardial fibrosis. Results: All 1 H MRS revealed resonances for intramyocardial triglycerides. Clinical parameters, e.g. EF (PTS 64 ± 2 % vs. CTL 61 ± 1 %) were similar in PTS and CTL or showed a non-significant trend (LV mass). Apart from a single patient with elevated myocardial triglycerides, no significant impact of Fabry disease on the triglyceride/water resonance ratio (PTS 0.47 ± 0.11 vs. CTL 0.52 ± 0.11 %) was observed in our patient cohort. Conclusion: A comprehensive cardiac evaluation of morphology, function as well as metabolism in Fabry PTS with suspected cardiac involvement is feasible in a single examination. No significant effect of myocardial triglyceride deposition could be observed in patients. The remarkably high myocardial triglyceride content in one patient with advanced FD warrants further studies in PTS with an extended history of the disease. (orig.)

  17. Non-invasive determination of myocardial lipid content in Fabry disease by {sup 1}H-MR spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Petritsch, B.; Koestler, H.; Machann, W.; Horn, M.; Weng, A.M.; Goltz, J.P.; Hahn, D.; Beer, M. [Universitaetsklinikum Wuerzburg (Germany). Inst. fuer Roentgendiagnostik im ZOM; Niemann, M.; Weidemann, F.; Wanner, C. [Universitaetsklinikum Wuerzburg (Germany). Medizinische Klinik I

    2012-11-15

    Purpose: In Fabry disease (FD), a progressive deposition of sphingolipids is reported in different organs. The present study applied {sup 1}H magnetic resonance spectroscopy (MRS) to investigate the myocardial lipid content in FD. Materials and Methods: In patients (PTS, n = 15) with genetically proven FD, {sup 1}H MRS of the heart was acquired in the same examination as routine cardiac cine and late enhancement MR imaging. Healthy volunteers (n = 11) without history of cardiac disease served as control (CTL). Myocardial triglycerides in vivo were quantified in {sup 1}H MRS. Left ventricular (LV) ejection fraction (EF) and late enhancement were assessed for the determination of LV systolic function, and onset or absence of myocardial fibrosis. Results: All {sup 1}H MRS revealed resonances for intramyocardial triglycerides. Clinical parameters, e.g. EF (PTS 64 {+-} 2 % vs. CTL 61 {+-} 1 %) were similar in PTS and CTL or showed a non-significant trend (LV mass). Apart from a single patient with elevated myocardial triglycerides, no significant impact of Fabry disease on the triglyceride/water resonance ratio (PTS 0.47 {+-} 0.11 vs. CTL 0.52 {+-} 0.11 %) was observed in our patient cohort. Conclusion: A comprehensive cardiac evaluation of morphology, function as well as metabolism in Fabry PTS with suspected cardiac involvement is feasible in a single examination. No significant effect of myocardial triglyceride deposition could be observed in patients. The remarkably high myocardial triglyceride content in one patient with advanced FD warrants further studies in PTS with an extended history of the disease. (orig.)

  18. Plasticity of regulation of mannitol phosphotransferase system operon by CRP-cAMP complex in Vibrio cholerae.

    Science.gov (United States)

    Zhou, Yan Yan; Zhang, Hong Zhi; Liang, Wei Li; Zhang, Li Juan; Zhu, Jun; Kan, Biao

    2013-10-01

    The complex of the cyclic AMP receptor protein (CRP) and cAMP is an important transcriptional regulator of numerous genes in prokaryotes. The transport of mannitol through the phosphotransferase systems (PTS) is regulated by the CRP-cAMP complex. The aim of the study is to investigate how the CRP-cAMP complex acting on the mannitol PTS operon mtl of the Vibrio cholerae El Tor biotype. The crp mutant strain was generated by homologous recombination to assess the need of CRP to activate the mannitol PTS operon of V. cholerae El Tor. Electrophoretic mobility shift assays (EMSA) and the reporter plasmid pBBRlux were used to confirm the role that the CRP-cAMP complex playing on the mannitol PTS operon mtl. In this study, we confirmed that CRP is strictly needed for the activation of the mtl operon. We further experimentally identified five CRP binding sites within the promoter region upstream of the mannitol PTS operon mtl of the Vibrio cholerae El Tor biotype and found that these sites display different affinities for CRP and provide different contributions to the activation of the operon. The five binding sites collectively confer the strong activation of mannitol transfer by CRP in V. cholerae, indicating an elaborate and subtle CRP activation mechanism. Copyright © 2013 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

  19. High school students' posttraumatic symptoms, substance abuse and involvement in violence in the aftermath of war.

    Science.gov (United States)

    Schiff, Miriam; Pat-Horenczyk, Ruth; Benbenishty, Rami; Brom, Danny; Baum, Naomi; Astor, Ron Avi

    2012-10-01

    This study examined one-year after effects of exposure to war events on adolescents' Posttraumatic Stress Symptoms (PTS) and risk behaviors (substance use and involvement in school violence). In addition, it addressed two potential vulnerability factors: at the micro level, it examined whether childhood trauma raised the vulnerability of Israeli adolescents to PTS and risk behaviors when exposed to war events. At the macro level, we explored whether ethnicity, i.e., being an Israeli Arab, is a vulnerability factor to PTS and risk behaviors. We used a representative sample of 7th to 11th grade students from the north of Israel that included 4151 students: 1800 Jewish (54.4% boys) and 2351 Arab (41.5% boys). We assessed exposure to war events and childhood traumatic events, PTS and PTSD, substance use (alcohol, cannabis, Ecstasy) and involvement in school violence. The findings revealed extensive exposure to war events among both Jewish and Arab students. A year after the war, its effects on adolescents were still manifested in PTS, and involvement in school violence and substance use. Exposure to child physical abuse was associated with higher levels of PTS symptoms, substance use and involvement in violence. Exposure to other traumatic events was also associated with greater PTS symptoms and involvement in violence but not with greater substance use. Arab students were a more vulnerable population. They reported higher PTS symptoms, more cannabis use and greater involvement in school violence than Jewish students. However, exposure to war events had similar effects on both Arab and Jewish students. We conclude that war effects include a broad range of psychological distress and risk behaviors that last long after the war ends, especially among youth who have experienced childhood trauma and high exposure to war-related stressors. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. Neoadjuvant Treatment With Single-Agent Cetuximab Followed by 5-FU, Cetuximab, and Pelvic Radiotherapy: A Phase II Study in Locally Advanced Rectal Cancer

    International Nuclear Information System (INIS)

    Bertolini, Federica; Chiara, Silvana; Bengala, Carmelo; Antognoni, Paolo; Dealis, Cristina; Zironi, Sandra; Malavasi, Norma; Scolaro, Tindaro; Depenni, Roberta; Jovic, Gordana; Sonaglio, Claudia; Rossi, Aldo; Luppi, Gabriele; Conte, Pier Franco

    2009-01-01

    Purpose: Preoperative chemoradiotherapy followed by surgery represents the standard of care for locally advanced rectal cancer (LARC). Cetuximab has proved activity in advanced colorectal cancer, and its incorporation in preoperative treatment may increase tumor downstaging. Methods and Materials: After biopsy and staging, uT3/uT4 N0/+ LARC received single-agent cetuximab in three doses, followed by weekly cetuximab plus 5-fluorouracil (5-FU), concomitantly with RT. Sample size was calculated according to Bryant and Day test, a two-stage design with at least 10 pathologic complete remissions observed in 60 patients (pts) able to complete the treatment plan. Results: Forty pts with LARC were entered: male/female = 34/6; median age: 61 (range, 28-77); 12 uT3N0 Ed(30%); 25 uT3N1 (62%); 3 uT4N1 (8%); all Eastern Cooperative Oncology Group = 0. Thirty-five pts completed neoadjuvant treatment; 5 (12%) withdrew therapy after one cetuximab administration: three for hypersensitivity reactions, one for rapid progression, and one for purulent arthritis. They continued 5-FU in continuous infusion in association with RT. Thirty-one pts (77%) presented with acnelike rash; dose reduction/interruption of treatment was necessary in six pts (15%): two for Grade 3 acnelike rash, two for Grade 3 gastrointestinal toxicity, and two for refusal. Thirty-eight pts were evaluable for pathological response (one patient refused surgery, and one was progressed during neoadjuvant treatment). Pathological staging was: pT0N0 three pts (8%), pT1N0 1 pt (3%); pT2N0 13 pts (34%), and pT3 19 pts (50%) (N0:9, N1:5; N2:5); pT4 2 pts (5%). Conclusions: Preoperative treatment with 5-FU, cetuximab, and pelvic RT is feasible with acceptable toxicities; however, the rate of pathologic responses is disappointingly low

  1. Continuous infusion (CI) 5-FU and leucovorin (LCV) combined with hepatic (H), nodal (N), and tumor bed (TB) irradiation (XRT) following pancreaticoduodenectomy (PDD) for head of pancreas (HOP) and other periampullary (PA) adenocarcinoma

    International Nuclear Information System (INIS)

    Abrams, R.A.; Yeo, C.J.; Grochow, L.B.; Chakravarthy, A.; Sohn, T.A.; Zahurek, M.L.; Haulk, T.; Ord, S.; Hruban, R.H.; Lillemoe, K.D.; Pitt, H.A.; Cameron, J.L.

    1996-01-01

    Purpose: To make preliminary assessment of whether use of this regimen in the post PDD adjuvant context is associated with: (1) an acceptable toxicity profile and (2) encouraging survival results as compared to either no or standard (GITSG) adjuvant (adj) therapy. Methods: From 10/1/91 through 9/30/95 28 post PDD patients (pts) (21 HOP, 7 PA) received adj chemoxrt with CI 5-FU (200 mg/m 2 ) and LCV (5 mg/m 2 ) via a semi-permanent central line Monday thru Friday along with H, N, and TB XRT. The first 18 pts received XRT doses of 2340 cGy (H) and 5040 cGy (N and TB). The last 10 pts received XRT doses of 2700 cGy (H), 5400 cGy (N), and 5760 cGy (TB). Fraction size = 180 cGy. XRT was administered after computerized and CAT scan based planning using 6 MV or greater photon energy. Therapy began within 10 wks of PDD. 1 month following chemoxrt, pts were to begin the first of 4 monthly cycles of 5-FU/LCV given without xrt but at the same doses and scheduled Monday thru Friday for 2 weeks on followed by 2 weeks off. Results: (M(F)) ratio (12(16)). The median age was 58 yrs (range 44-76). 23 pts had +ve nodes (10 pts had 5 or more +ve nodes). 6 pts had microscopically +ve resection margins of whom 5 also had +ve nodes. 26 pts completed chemoxrt as planned. 1 pt failed to complete chemoxrt due to the onset of immune thrombocytopenia. 1 pt completed after delay due to family death. 15 pts did not complete the planned 4 cycles of 5-FU/LCV (9-disease progression on therapy, 3-toxicity, 3-other). 9 pts had IV catheter problems. 7 pts had mild to moderate emotional depression while on therapy. Pts were monitored for wt loss, decline in performance status, liver, GI, heme, esophageal, oral mucosal and hand/foot toxicities. There were no grade (4(5)) toxicities. The only grade 3 toxicities were hepatic (3 pts) (elevations in AST, ALT, OR ALK PHOS without jaundice or hepatic failure). Median actuarial survival for these 28 pts was 15 months (20 pts deceased). For the 21 HOP pts

  2. Variants of psychiatric disorders in patients with systemic lupus erythematosus

    Directory of Open Access Journals (Sweden)

    T A Lisitsyna

    2008-01-01

    Full Text Available Objective. To analyze prevalence and structure of psychiatric disorders in pts with systemic lupus erythematosus (SLE examining in the Institute of rheumatology of RAMS. Material and methods. 115 pts with SLE with median age 34 [24; 45] years and median disease duration 8 [4; 17] years were included. SLE activity was assessed with SLEDAI. Psychiatric disorders were diagnosed by a psychiatrist according to ICD-10 using some psychiatric and psychological scales. Results. Psychiatric disorders were revealed in 76 from 115 (66% pts. Anxiety-depressive spectrum disorders prevailed (83%: depressive episode (40%, adjustment disorders (24%, generalized anxiety disorder (10%, dysthymia (9%. Severe cognitive dysfunction was revealed in 7% of pts. Pts with and without psychiatric disorders did not significantly differ in age, sex, duration and activity of the disease, duration of treatment and cumulative dose of prednisolone and cytotoxic drugs. Conclusion. Psychiatric disorders are frequent in pts with SLE (66%. Anxiety-depressive disorders prevail among them (83%. Relationship between SLE and psychiatric disorders requires further examination.

  3. Diagnostic information of TL-201 myocardial kinetics shortly after termination of exercise

    International Nuclear Information System (INIS)

    Wackers, F.J.; Fetterman, R.C.; Heitzman, M.; Clements, J.

    1984-01-01

    Traditionally, T1-201 stress imaging is performed immediately post exercise (EX) and 2-4 hrs later. This interval was chosen initially for visual comparison of T1-201 images and more recently for assessment of T1-201 washout (WO). Previously, the authors demonstrated that T1-201 kinetics shortly after EX are variable in patients (pts) with coronary artery disease (CAD). In this study, the authors evaluated the potential diagnostic information to be gained from analysis of early post EX T1-201 kinetics. In 70 pts, quantitative T1-201 stress imaging was performed. Sixteen pts were normal, 54 pts had CAD by angiography. All pts had symptom-limited EX. Serial LAO imaging was performed: 1) 5 min post EX; 2) 30 min post EX; 3) 2 hrs post EX. After interpolative background correction, circumferential WO profiles were generated. All normals had WO of T1-201 at 30 min post EX (average WO 14%). In contrast, 21 (39%) of pts with CAD had accumulation of T1-201, 5 (9%) had no change and 28 (52%) had WO at 30 min post EX. Between 30 min and 2 hrs post EX, 50 of 54 (93%) pts with CAD had WO. At 2 hrs, compared to 5 min post EX, 39 (72%) of pts with CAD had abnormal low WO (<30%) including all 21 with initial accumulation and 3 of 5 with initially no change of T1-201. Thus, whereas at 2 hrs post EX 72% of pts with CAD are abnormal by degree of WO, at 30 min post EX 48% are abnormal by direction of T1-201 kinetics. Continued increase of T1-201 at 30 min post EX is highly specific for CAD, although less sensitive than abnormal WO at 2 hrs post EX. Nevertheless, T1-201 kinetics shortly post EX contribute useful diagnostic information that may enhance reliability and confidence in interpretation of quantitative T1-201 analysis

  4. Phase II trial evaluating the feasibility of interdigitating folfox with chemoradiotherapy in locally advanced and metastatic rectal cancer.

    Science.gov (United States)

    Michael, M; Chander, S; McKendrick, J; MacKay, J R; Steel, M; Hicks, R; Heriot, A; Leong, T; Cooray, P; Jefford, M; Zalcberg, J; Bressel, M; McClure, B; Ngan, S Y

    2014-11-11

    Patients (pts) with metastatic rectal cancer and symptomatic primary, require local and systemic control. Chemotherapy used during chemoradiotherapy (CRT) is adequate for radiosensitisation, but suboptimal for systemic control. The aim of this phase II study was to assess tolerability, local/systemic benefits, of a novel regimen delivering interdigitating intensive chemotherapy with radical CRT. Eligible pts had untreated synchronous symptomatic primary/metastatic rectal cancer. A total of 12 weeks of treatment with split-course pelvic CRT (total 50.4 Gy with concurrent oxaliplatin and 5-FU infusion) alternating with FOLFOX chemotherapy. All pts staged with CT, MRI and FDG-PET pre and post treatment. Twenty-six pts were treated. Rectal primary MRI stage: T3 81% and T4 15%. Liver metastases in 81%. Twenty-four pts (92%) completed the 12-week regimen. All patients received planned RT dose, and for both agents over 88% of patients achieved a relative dose intensity of >75%. Grade 3 toxicities: neutropenia 23%, diarrhoea 15%, and radiation skin reaction 12%. Grade 4 toxicity: neutropenia 15%. FDG-PET metabolic response rate for rectal primary 96%, and for metastatic disease 60%. Delivery of interdigitating chemotherapy with radical CRT was feasible to treat both primary and metastatic rectal cancer. High completion and response rates were encouraging.

  5. Prognostic significance of normal quantitative Tl-201 stress scintigraphy in relation to pretest likelihood of coronary artery disease

    International Nuclear Information System (INIS)

    Russo, D.J.; Russo, D.; Clements, J.; Wackers, F.

    1984-01-01

    A previous study reported an excellent prognosis and low cardiac event rate in patients(pts) with chest pain and normal quantitative T1-201 scintigraphy(SC). Such result would not be unexpected if the population under study had a predominance of pts with low pre-T1-201 likelihood(L) of significant coronary artery disease (CAD). Hence, the authors undertook telephone follow-up in pts with chest pain syndrome and normal quantitative T1-201 exercise SC, and related outcome to pretest L of CAD. Pretest L was determined by serial L analysis on the basis of: symptoms, age, sex, and exercise ECG. All pts had T1-201 SC immediately post exercise and 2 hrs later. After interpolative background correction, circumferential count and washout profiles were generated. All pts had unequivocally normal studies. Of a total of 96 pts studied in 1981-82, 20 pts were lost to follow-up. Of the remaining 76 pts, 45 were males and 31 females. The pretest L of CAD had an inverted Gaussian distribution: thirty-four pts(47%) had 66% L of CAD. Mean follow-up was 22+- 3 months. No deaths occurred. Two pts(3%) (with pretest L of 54% and 94%) had myocardial infarctions, 8 and 22 months respectively after T1-201 stress SC. One pt underwent percutaneous transluminal coronary angioplasty (PTCA) 16 months after T1-201 stress SC. These findings confirm excellent prognostic significance of normal quantitative T1-201 stress scintigraphy

  6. Balsam “Mercana-Artrovit warming” — efficacy and tolerability in knee osteoarthritis

    Directory of Open Access Journals (Sweden)

    E S Tsvetkova

    2007-01-01

    Full Text Available Objective. To assess efficacy, local and systemic tolerability of balsam “Mercana-Artrovit warming” (BMAW containing methylnicotinat, mint and eucalyptus ethereal oils, propylene glycol extracts of eucalyptus, linden, nettle, elecampane, common wormwood, tansy, terpentine oil in knee osteoarthritis (KOA Material and methods. 60 pts were included in a two-week double blind placebo controlled randomized study. BMAW 5 ml was administered in 30 pts (the main group twice a day (in the morning and in the evening on the target knee joint. 30 pts of control group received placebo containing only components of stuff. Demographic and clinical parameters in the main and the control groups were comparable. Inclusion criteria: age from 40 to 70 years, pain intensity in the target joint at least 40 mm on VAS, I-III radiological stage according to Kellgren, Leqesne score 4-10, treatment with NSAIDs during the previous 3 months. Exclusion criteria: indications for intra-articular glucocorticoid injection, clinically significant disturbances of internal organs function and skin damages in the region of knee joint. Clinical efficacy was assessed by WOMAC index, pain at movement and at rest, time of 15 meters walking, general assessment of efficacy (separately by the pt and by the doctor. Frequency and character of adverse events was registered. Results. Local BMAW administration provided statistically significant decrease of WO MAC summated score (p=0,008, pain at movement (p<0,001 and at rest (p<0,005. So analgesic effect of the drug is sufficient for improvement of functional activity of pts with KOA. General efficacy assessment was significantly higher in the main group (Fisher exact test, p<0,005. Placebo did not significantly change efficacy measures. Adverse events were absent in both groups. Conclusion. The results of the study allows to recommend BMAW for local therapy of KOA

  7. Ecodopplercardiografia transesofágica intra-operatória: utilidade na cirurgia da valva mitral The usefulness of intraoperative transesofageal echocardiography for mitral valve surgery

    Directory of Open Access Journals (Sweden)

    Álvaro Villela de Moraes

    1992-12-01

    valor no auxílio do planejamento cirúrgico nas doenças da VM, bem como na avaliação imediaata dos resultados operatórios possibilitando ao cirurgião uma adequada análise anatômica e funcional da estrutura abordada.The usefulness of routine intraoperative transesophageal echocardiography (TEE for mitral valve (MV surgery was studied in 65 patients (pts with MV disease (mean age = 31 ± 14.8 to 62 yrs: 1 - Mitral regurgitation (MR: 19 pts-MV prolapse in 12 pts; Ischemic in 6 pts and post repair of ASD: 1 pt; 2 - Mitral stenosis (MS: 23 pts (4 of them with previous surgery; 3 - MS+MR and/or tricuspid valve (TV lesions: 16 pts; 4 - Bioprosthetic valve (BV dysfunction: 6 pts and 5 - Left atrial myxoma: 1 pt. Initial precardiopulmonary bypass TEE was used to confirm MV dysfunction, TV involvement and to assess LV function. On the 1 st run bypass (RBP, the MV commissurotomy was performed in 27 pts (23 with MS and 4 with MS+MR; the MV was replaced with BV (pericardial #21 to #29 in 18 pts (6 with BV dysfunction and 12 with MS+MR and the MV repair was performed in all of 19 pts with MR. The 2nd RBP was required in 7 pts (11%: 1 pt with MR; 4 pts with MS+MR and 2 pts with MS. TEE caused changes in pre pump plans in 9 pts with TV lesions and in 10 pts with MS or MS+MR - preservation of native in 6 pts in which replacement was planned. Thus intraoperative TEE provides helpful information in MV surgery and can help avoid a mitral replacement in pts with MS or MS+MR.

  8. Trajectories of self-rated health among veterans: a latent growth curve analysis of the impact of posttraumatic symptoms.

    Science.gov (United States)

    Benyamini, Yael; Ein-Dor, Tsachi; Ginzburg, Karni; Solomon, Zahava

    2009-04-01

    To examine the effects of combat stress reaction (CSR) and posttraumatic stress symptoms (PTS) on the level and trajectories of self-rated health (SRH) over 20 years after war exposure. A total of 675 veterans comprising two groups, a CSR group (n = 369) and a matched control group without CSR (n = 306), were assessed in a prospective longitudinal design, 1, 2, 3, and 20 years after their participation in the 1982 Lebanon War. SRH and PTS were assessed repeatedly, at each point of measurement. The CSR participants showed more impaired initial SRH than the controls. Although the CSR group showed an improvement in SRH over time, its SRH level remained lower than that of the control group in all 4 points in time. Initial levels of PTS were associated with more impaired SRH and lower improvement over time. In addition, increased levels of PTS in the first follow-up period were related to poorer SRH, in comparison to the predicted trajectory on the basis of CSR and initial PTS. Stress reaction to war trauma affected the trajectory of SRH over a 20-year period. Although the differences between veterans who had shown acute stress reaction and those who had not persisted over the entire period, there was slow improvement in SRH over time among the more impaired CSR group. PTS in the first years after the war slowed this improvement and thus played a key role in the relationship between war trauma and physical health.

  9. [Results of therapeutics strategy of protein-energy wasting in chronic hemodialysis: a prospective study during 12 months].

    Science.gov (United States)

    Mpio, Ignace; Cleaud, Christine; Arkouche, Walid; Laville, Maurice

    2015-04-01

    Undernutrition (UN) in chronic hemodialysis (CHD) is a recurrent complication and constitutes a major public health problem. This work aims to evaluate the effects of our nutritional strategy (NS) developed among malnourished patients (pts) in CHD. This is a prospective observational study conducted for 12 months (M) in a cohort of 132 pts in CHD including 49 women, mean age 66 ± 16 years and the dialysis vintage 72 ± 74 months. This NS is based on the action of a multidisciplinary team; it provides for moderate UN pts one first phase of an optimization of protein and energy intake in the daily meals; then depending on the clinical course a second phase of oral supplementation at home. For severe UN pts, the optimization of daily meals and the oral supplements at home are reinforced with perdialytic oral supplementation. This modality was also prescribed for moderate UN pts with poor compliance at home. In case of loss of appetite, anorexia, gastrointestinal intolerance or inadequate oral intakes the relay is made by the intradialytic parenteral nutrition (IPN). Methods consist in the evaluation of the serum albumin (ALB), CRP, normalized PCR (nPCR), and Kt/V ratio of urea at baseline (day (D) 0) and at endpoint (M12). The ALB was measured by immunoturbidimetry. Three nutritional profiles were defined, severe UN if ALB ≤ 35 g/L, moderate UN if 35 treatment. The control of inflammation and optimizing dialysis are decisive factors of success. Copyright © 2014 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

  10. Psychological adaptation to life-threatening injury in dyads: the role of dysfunctional disclosure of trauma

    Directory of Open Access Journals (Sweden)

    Laura Pielmaier

    2011-12-01

    Full Text Available Certain modes of trauma disclosure have been found to be associated with more severe symptoms of posttraumatic stress (PTS in different trauma populations: the reluctance to disclose trauma-related thoughts and feelings, a strong urge to talk about it, and physical as well as emotional reactions during disclosure. Although social-contextual influences gain more and more interest in trauma research, no study has yet investigated these “dysfunctional disclosure tendencies” and their association with PTS from an interpersonal perspective.(1 To replicate previous findings on dysfunctional disclosure tendencies in patients with life-threatening injury and their significant others and (2 to study interpersonal associations between dysfunctional disclosure style and PTS at a dyadic level.PTS symptom severity and self-reports on dysfunctional disclosure tendencies were assessed in N=70 dyads comprising one individual with severe traumatic brain injury and a significant other (“proxy” 3 months after injury.Regression analyses predicting PTS symptom severity revealed dysfunctional disclosure tendencies to have incremental validity above and beyond sex, age, and trauma severity within the individual (both patient and proxy, with moderate effect sizes. The interaction between patient's and proxy's disclosure style explained additional portions of the variance in patients’ PTS symptom severity.Findings suggest that dysfunctional disclosure tendencies are related to poorer psychological adaptation to severe traumatic brain injury. This intrapersonal association may be exacerbated by dysfunctional disclosure tendencies on the part of a significant other. Although the results require replication in other trauma samples without brain injury to further generalize the findings beyond the observed population, the study contributes to the expanding literature on the crucial role of interpersonal relationships in trauma recovery.For the abstract or full

  11. Comparison of continuous and intermittent treatment of patients with knee osteoarthritis with combined drug “Teraflex”

    Directory of Open Access Journals (Sweden)

    L I Alexeeva

    2008-01-01

    Full Text Available Objective. To assess efficacy, safety and aftereffect duration of continuous and intermittent treatment of patients with knee osteoarthritis with “Teraflex”. Material and methods. 100 outpatients (2 groups 50 pts in each mainly women (99 pts with knee osteoarthritis 0I-III stage according to Kellgren-Lawrence fulfilling ACR criteria aged 45 to 73 years (mean age 57,8+7,39 years with pain at walking 40 mm and more on visual analog scale (VAS, regularly receiving NSAIDs for 30 days during previous 3 months were included. Follow up duration was 12 months (9 months — treatment and 3 months follow up to assess drug effect in both groups. Group 1 pts received continuous treatment with “Teraflex” during 9 months. Group 2 pts received the drug during 3 months, then treatment was interrupted for 3 months and after that 3-months course was repeated. Ibuprofen was given as a rescue medication 400 mg trice a day with possibility of subsequent decrease of dose. WOMAC index (assessment of pain, stiffness and functional disability, walking speed (15 m, efficacy assessment by doctor ant pt (improvement, absence of response, deterioration, status assessment by doctop and pt (very good, good, moderate, bad, veiy bad, daily requirement in NSAIDs, knee joint sonographic examination data were used as outcome measures. Results. Analgesic effect was achieved in both groups already after 1 month of therapy. At three months not only pain but also stiffness, joint function, WOMAC summated index and walking speed significantly improved in both groups. This improvement was maintained till the end of treatment in both groups. But group 2 pts at 6 months (before the beginning of the second course of treatment showed small increase of pain in damaged joint and summated WOMAC index which significantly differed from group 1 pts. At the end of treatment and in 3 months after the end of treatment these measures did not significantly differed in both groups. At the end

  12. Incidence and Outcomes of Patients With Oral Cavity Squamous Cell Carcinoma and Fourth Primary Tumors: A Long-term Follow-up Study in a Betel Quid Chewing Endemic Area.

    Science.gov (United States)

    Adel, Mohamad; Liao, Chun-Ta; Lee, Li-Yu; Hsueh, Chuen; Lin, Chien-Yu; Fan, Kang-Hsing; Wang, Hung-Ming; Ng, Shu-Hang; Lin, Chih-Hung; Tsao, Chung-Kan; Huang, Shiang-Fu; Kang, Chung-Jan; Fang, Ku-Hao; Wang, Yu-Chien; Chang, Kai-Ping; Fang, Tuan-Jen; Yang, Lan Yan; Yen, Tzu-Chen

    2016-03-01

    The aim of this study was to explore the incidence and outcomes of patients with oral cavity squamous cell carcinoma (OSCC) and fourth primary tumors (PTs) in a betel-chewing endemic area.We retrospectively examined the records of 1836 OSCC patients who underwent radical tumor resection between 1996 and 2014. The outcome measures included the incidence and number of multiple PTs, the main risk factors, and their associations with overall survival (OS).Of the 1836 patients, 1400 (76.3%) had a single PT, 344 (18.7%) a second PT, 67 (3.6%) a third PT, and 25 (1.4%) a fourth PT. Univariate analyses (log-rank test) identified the following factors as significantly associated with a fourth PT: simultaneous first and second PTs, betel quid chewing, buccal subsite, and pT3-4 status. After allowance for the potential confounding effect of other risk factors, all of these factors retained their independent prognostic significance in stepwise multivariate analyses, the only exception being betel chewing. The incidences of second, third, and fourth PTs at 5 and 10 years were 20.2%/34.6%, 4.0%/8.6%, and 1.0%/2.3%, respectively. The 5 and 10-year OS rates (calculated from the diagnosis of each PTs) for patients with a single, second, third, and fourth PTs were 68%/61%, 43%/37%, 45%/39%%, and 30%/30%, respectively (P betel quid-chewing endemic area. Long-term survival rates of patients treated with radical surgery seems acceptable, being 4-fold higher than their counterparts.

  13. Predictors of global job satisfaction among Saudi physiotherapists: a descriptive study.

    Science.gov (United States)

    AlEisa, Einas; Tse, Cynthia; Alkassabi, Othman; Buragadda, Syamala; Melam, Ganeswara Rao

    2015-01-01

    Job satisfaction is an important consideration in the recruitment and retention of physiotherapists (PTs). To date, the job satisfaction of PTs working in Saudi Arabia has not been investigated. The aim of this study was to measure the level of job satisfaction of PTs working in Saudi Arabia and evaluate predictors of job satisfaction. This was a cross-sectional observational study among licensed physical therapists working across 11 health care centers and university hospitals in Riyadh between 2013 and 2014. A total of 183 physical therapists participated in the survey. Level of job satisfaction and factors influencing satisfaction were explored using a purpose-designed job satisfaction questionnaire. It consisted of 8 survey domains, and the scores were normalized to allow between-domain comparison. Global job satisfaction was 37%. The highest levels of job satisfaction were seen in the domains of professional development and teamwork and the lowest levels of job satisfaction in the domains of supervisory/ management relationship (75%) and working environment (60%). Predictors of job satisfaction were gender (OR [odds ratio] 1.4, 95% CI 1.1-2.3), age (OR 0.7, 95% CI 0.5-0.9), relationships with supervisors and managers (OR 1.3, 95% CI 1.2-1.9), working environment (OR 1.2, 95% CI 1.0-2.3), and opportunities for professional development (OR 1.4, 95% CI 1.2-3.7). Saudi PTs were moderately satisfied with their job; strategies should be designed in such a way that they experience a high level of job satisfaction and retention thus resulting in improved rehabilitation services in Saudi Arabia.

  14. The moderating role of rational beliefs in the relationship between irrational beliefs and posttraumatic stress symptomology.

    Science.gov (United States)

    Hyland, Philip; Shevlin, Mark; Adamson, Gary; Boduszek, Daniel

    2014-05-01

    Rational Emotive Behaviour Therapy (REBT) assumes that rational beliefs act as cognitive protective factors against the development of psychopathology; however little empirical evidence exists regarding the nature of the possible protective effects that they offer. The current study investigates whether rational beliefs moderate the impact of irrational beliefs on posttraumatic stress symptomology (PTS). Three hundred and thirteen active law enforcement, military, and related emergency service personnel took part in the current study. Sequential moderated multiple regression analysis was employed to investigate: (i) the direct impact of irrational beliefs on PTS; (ii) the direct impact of rational beliefs on PTS; (iii) the moderating effects of rational beliefs in the relationship between irrational beliefs and PTS. The irrational beliefs predicted by REBT theory emerged as critical predictors of PTS symptomology, in particular Depreciation beliefs. Rational beliefs (Preferences, and Acceptance beliefs) had a direct, negative impact on levels of PTS, and Acceptance beliefs moderated the impact of Catastrophizing beliefs on PTS. Irrational beliefs are important cognitive vulnerability factors in symptoms of PTS, while rational beliefs (Acceptance) appear to have a protective role in the emergence of PTS symptoms, both directly and by moderating the impact of Catastrophizing beliefs.

  15. Six years after the wave. Trajectories of posttraumatic stress following a natural disaster.

    Science.gov (United States)

    Johannesson, Kerstin Bergh; Arinell, Hans; Arnberg, Filip K

    2015-12-01

    The characteristics of long-term trajectories of distress after disasters are unclear, since few studies include a comparison group. This study examines trajectories of recovery among survivors in comparison to individuals with indirect exposure. Postal surveys were sent to Swedish tourists, repatriated from the 2004 Indian Ocean tsunami (n=2268), at 1, 3, and 6 years after the tsunami to assess posttraumatic stress (PTS) and poor mental health. Items were used to ascertain high and moderate disaster exposure groups and an indirect exposure comparison group. Long-term PTS trajectories were best characterized by a resilient (72.3%), a severe chronic (4.6%), a moderate chronic (11.2%) and a recovering (11.9%) trajectory. Trajectories reported higher levels of PTS than the comparison group. Exposure severity and bereavement were highly influential risk factors. These findings have implications regarding anticipation of long-term psychological adjustment after natural disasters and need for interventions after a single traumatic event with few secondary stressors. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Air bubbles and hemolysis of blood samples during transport by pneumatic tube systems.

    Science.gov (United States)

    Mullins, Garrett R; Bruns, David E

    2017-10-01

    Transport of blood samples through pneumatic tube systems (PTSs) generates air bubbles in transported blood samples and, with increasing duration of transport, the appearance of hemolysis. We investigated the role of air-bubble formation in PTS-induced hemolysis. Air was introduced into blood samples for 0, 1, 3 or 5min to form air bubbles. Hemolysis in the blood was assessed by (H)-index, lactate dehydrogenase (LD) and potassium in plasma. In an effort to prevent PTS-induced hemolysis, blood sample tubes were completely filled, to prevent air bubble formation, and compared with partially filled samples after PTS transport. We also compared hemolysis in anticoagulated vs clotted blood subjected to PTS transport. As with transport through PTSs, the duration of air bubble formation in blood by a gentle stream of air predicted the extent of hemolysis as measured by H-index (pair space in a blood sample prevented bubble formation and fully protected the blood from PTS-induced hemolysis (ptransport and was partially protected from hemolysis vs anticoagulated blood as indicated by lower LD (ptransport. Prevention of air bubble formation in blood samples during PTS transport protects samples from hemolysis. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Long term results of mantle irradiation(MRT) alone in 261 patients with clinical stage I-II supradiaphragmatic Hodgkin's disease

    International Nuclear Information System (INIS)

    Wirth, A.; Byram, D.; Chao, M.; Corry, J.; Davis, S.; Kiffer, J.; Laidlaw, C.; Quong, G.; Ryan, G.; Liew, K.

    1997-01-01

    Purpose: We report our results using MRT for clinical stage I-II HD and assess the value of published prognostic criteria in our study population. Pts and Methods: Between 1969 and 1994, 261 pts were treated with MRT alone for clinical stage I-II supradiaphragmatic HD. Pt characteristics: median age-30; M-54%/F-46%; stage IA-52%, IB-2%, IIA-37%, IIB-8%; histology LP-21%, NS-51%, MC-23%, other 5%; median ESR 18. CT abdomen and LAG were performed in 61% and 60% respectively. No pt had prior staging laparotomy. No pt received infradiaphragmatic RT. Central axis dose was 32 Gy-36 Gy. Univariate analysis was performed for prognostic factors for progression-free (PFS) and overall survival(OS). Outcome was assessed in favourable subsets as defined by: EORTC (v. favourable: CSIA, LP or NS histology, age < 40, female, no bulk, ESR < 50; favourable: CSI-II, age < 50, < 4 sites, no bulky mediastinal mass, ESR < 50 with no B symptoms or ESR < 30 with B symptoms); Princess Margaret Hospital (PMH) (IA-IIA, LP or NS histology, ESR < 40, age < 50, no large mediastinal mass, no E lesion). Results: 261 pts completed RT, with 5% requiring treatment interruption for toxicity. Significant factors (P<0.05) for PFS were stage, performance status, histology, B symptoms, number of sites, ESR and bulk. Significant factors (P<0.05) for OS were age, performance status, histology and B symptoms. (The results of a multivariate analysis will be presented.) Results in our study population using published prognostic criteria (in %): Thirty-six percent progressed following RT: 8% in-field; 24% out of field only (including 10% in the paraaortic/splenic region alone); 4% marginal; Fifty-seven percent of relapsed pts remain progression free after subsequent salvage treatment. Two cases of acute leukaemia, 8 cases of non-Hodgkin's lymphoma and 14 (non-skin) carcinomas occurred, of which 11 were in-field. Seventy pts have died. The cause was: HD 41%; other malignancy 20%; cardiovascular 17%; other 15

  18. Pressurized thermal shock in nuclear power plants: Good practices for assessment. Deterministic evaluation for the integrity of reactor pressure vessel

    International Nuclear Information System (INIS)

    2010-02-01

    Starting in the early 1970s, a series of coordinated research projects (CRPs) was sponsored by the IAEA focusing on the effects of neutron radiation on reactor pressure vessel (RPV) steels and RPV integrity. In conjunction with these CRPs, many consultants meetings, specialists meetings, and international conferences, dating back to the mid-1960s, were held. Individual studies on the basic phenomena of radiation hardening and embrittlement were also performed to better understand increases in tensile strength and shifts to higher temperatures for the integrity of the RPV. The overall objective of this CRP was to perform benchmark deterministic calculations of a typical pressurized thermal shock (PTS) regime, with the aim of comparing the effects of individual parameters on the final RPV integrity assessment, and then to recommend the best practices for their implementation in PTS procedures. At present, several different procedures and approaches are used for RPV integrity assessment for both WWER 440-230 reactors and pressurized water reactors (PWRs). These differences in procedures and approaches are based, in principle, on the different codes and rules used for design and manufacturing, and the different materials used for the various types of reactor, and the different levels of implementation of recent developments in fracture mechanics. Benchmark calculations were performed to improve user qualification and to reduce the user effect on the results of the analysis. This addressed generic PWR and WWER types of RPV, as well as sensitivity analyses. The complementary sensitivity analyses showed that the following factors significantly influenced the assessment: flaw size, shape, location and orientation, thermal hydraulic assumptions and material toughness. Applying national codes and procedures to the benchmark cases produced significantly different results in terms of allowable material toughness. This was mainly related to the safety factors used and the

  19. Preoperative concomitant radio chemotherapy in bulky carcinoma of the cervix: Institut Curie experience; Chimioradiotherapie concomitante preoperatoire dans les carcinomes du col uterin de stades IB2 a IIB: experience de l'Institut Curie

    Energy Technology Data Exchange (ETDEWEB)

    Kirova, Y.M.; Bourhaleb, Z.; Campitelli, M.; De la Rochefordiere, A. [Institut Curie, Groupe de Gynecologie, Service d' Oncologie et de Radiotherapie, 75 - Paris (France); Alran, S.; Fourchotte, V. [Institut Curie, Groupe de Gynecologie, Service de Chirurgie, 75 - Paris (France); Plancher, C. [Institut Curie, Groupe de Gynecologie, Service de Biostatistique, 75 - Paris (France); Beuzeboc, P.; Cottu, P. [Institut Curie, Groupe de Gynecologie, Service d' Oncologie Medicale, 75 - Paris (France); Petrow, P. [Institut Curie, Groupe de Gynecologie, Service de Radiologie, 75 - Paris (France); Cremoux, P. de; Sastre-Garau, X. [Institut Curie, Groupe de Pathologie, Service de Radiologie, 75 - Paris (France)

    2009-07-15

    Purpose: To evaluate the treatment results of patients (pts) with Figo stage IB2, IIA, IIB cervical carcinoma (C.C.) treated with preoperative radio chemotherapy, followed by extended radical hysterectomy. Patients and methods: Retrospective study of 148 women treated to the Curie Institute for operable Figo Stage IB2 to IIB, biopsy proved C.C.. Among them, 70 pts, median age 46 years, were treated using the same regimen associating primary radio cis-platinum based chemotherapy,intracavitary LDR brachytherapy, followed by extended radical hysterectomy. Kaplan-Meier estimates were used to draw survival curves. Comparisons of survival distribution were assessed by the log-rank test. Results: Complete histological local-regional response was obtained in 56% of the pts (n = 39). Residual macroscopic or microscopic disease in the cervix was observed in 28 pts (40%). All but one had in situ microscopic residual C.C.. Lateral residual disease in the parametria was also present in nine pts, all with residual C.C.. Pelvic lymph nodes were free from microscopic disease in 56 pts (80%). Eight of 55 (11%) radiological N0 patients had microscopic nodal involvement, as compared to 6/15 (40%) radiological N1 (p = 0.03). Seventeen pts (25%) had residual cervix disease but negative nodes. After median follow-up of 40 months (range, 8-141), 38/70 patients (54.1%) are still alive and free of disease, six (8.6%) alive with disease, and 11 (15.8%) patients were lost for follow-up but free of disease. Conclusion: The treatment of locally advanced C.C. needs a new multidisciplinary diagnostic and treatment approach using new therapeutic arms to improve the survival and treatment tolerance among women presenting this disease. (authors)

  20. Role of adenosine 99MTc sestamibi myocardial perfusion spect in evaluation of symptomatic hypertensives with recent onset left bundle branch block

    International Nuclear Information System (INIS)

    Padma, S.; Sundaram, P.S.; Zachariah, M.; Hariads, K.K.

    2004-01-01

    Objectives: Adenosine pharmacological stress Myocardial Perfusion Imaging (AMPI) is the preferred imaging modality for IHD evaluation in pts with Left Bundle Branch Block (LBBB). Good prognosis has been reported in recent onset LBBB pts with normal MPI. Our aim was to evaluate the utility and analyze the predictive value of SestaMIBI AMPI in symptomatic recent onset LBBB hypertensives for coronary artery disease evaluation. Methods: 29 hypertensive pts, age range 36-72yrs, mean 54+ 6 yrs, M:F- 21:8 with recent onset complete LBBB, under evaluation for typical/atypical angina who had AMPI between Nov 02-Nov 03, were retrospectively analyzed. LBBB was diagnosed ECG wise if there is prolonged QRS complex i.e. 0.125sec or more in sinus/supraventricular rhythm, a QS or rS complex in lead 1, and an R-wave peak time of 0.06sec in leads 1, V5 or V6 with no Q wave in same lead. Pts with prior Myocardial Infarct / revasularisation, pacemaker induced LBBB were excluded. Single day 6 min. Adenosine infusion Stress-rest 99m Tc MIBI gated MPI was performed with a dual head variable angle Gamma Camera at 76-degree angle. Coronary Angiogram (CAG) correlation was available in 24 pts. Results: Myocardial perfusion SPECT images were assessed visually and by a 20-segment model. Location, extent and severity of the LV perfusion defects were evaluated. 6/29 pts (20.7%) had normal stress-rest perfusion in all LV segments.12 (41.4%) had isolated septal fixed defect with normal perfusion in rest of the segments.3 pts (10.3%)showed isolated reversible septal defects while 8(27.6%) had reversible septal defects with reversible defects in other LV segments also. Pts with fixed septal perfusion defect showed moderate to good septal wall thickening in gated SPECT images. While all pts with multiple reversible perfusion defects had angiographically proven coronary artery disease (i.e. 3pts had LAD lesion, 2 had Triple vessel and 3 showed double vessel lesions), 1 out of 3 pts with isolated

  1. Radioiodine therapy in non toxic multi nodular goitre, preliminary results

    International Nuclear Information System (INIS)

    Chiti, A.; Travaini, L.L.; Tadayyon, S.; Vannucchi, G.; Fugazzola, L.; Beck-Peccoz, P.

    2002-01-01

    Aim: Aim of our study was to assess the efficacy of 131 I therapy in patients (pts) affected by non toxic multinodular goitre (NTMG). NTMG is a thyroid disease with a high prevalence, especially in low-iodine intake regions. Treatment of NTMG often requires surgery. However, thyroidectomy may be risky in some patients and radioiodine therapy could be an alternative treatment to reduce thyroid volume. We also evaluated if lithium administration can improve the efficacy of radioiodine treatment in this pts. Material and Methods: We enrolled 39 pts (8 males, 31 females; mean age 59 y, range 40-79 y) affected by NTMG. Mean thyroid volume (TV) at ultrasound was of 46.8 ml (range 18.5-87.3). Pts were randomised in 2 groups. Group 1: iodine therapy + lithium therapy 900 mg/die for 6 days; Group 2: iodine therapy alone. We also define 3 clusters of pts by TV. A:15-30 ml; B:31-40 ml; C: > 40 ml. The 131 I activity (MBq) was calculated as follows: [4.44 (MBq) x 100/24 hours uptake (%)] x TV. All patients are evaluated for thyroid function and TV at 3, 6, 12, 18 and 24 months after treatment, since we postulate that major reduction in thyroid volume will occur 1 year after 131 I therapy. Results: Up to now 16 pts were treated with 131 I (mean activity: 512 MBq) and no side effects from 131 I and lithium therapy were reported. Four out of 5 pts evaluated at 3 months (2 of group 1 and 3 of group 2) had a reduction in TV (mean value: 8.8 ml). Five out of 10 pts had sub-clinical hyperthyroidism at 1 week, likely as a consequence of thyroid tissue destruction. Conclusion: Our preliminary results suggest the safety and effectiveness of 131 I treatment in NTMG. We expect to clarify the role of lithium administration in improving 131 I efficacy. This therapy could have a future role in patients with NTMG that can't be submitted to surgery

  2. Children's Exposure to Violence: The Underlying Effect of Posttraumatic Stress Symptoms on Behavior Problems.

    Science.gov (United States)

    Yoon, Susan; Steigerwald, Stacey; Holmes, Megan R; Perzynski, Adam T

    2016-02-01

    In this study we investigated whether witnessing violence and violence victimization were associated with children's internalizing and externalizing behavior problems and examined the mediating role of posttraumatic stress (PTS) symptoms in these relationships. Secondary data analysis was conducted using 3 waves of data from the National Survey of Child and Adolescent Well-Being. Path analyses were conducted to test direct and indirect effects of violence exposure on behavior problems, using 2,064 children (ages 8-15 years) reported to Child Protective Services for maltreatment. Being a victim of violence in the home was directly associated with more internalizing (β = .06, p = .007) and externalizing behavior problems (β = .07, p = .002), whereas witnessing violence was not directly related to either internalizing (β = .04, p = .056) or externalizing behavior problems (β = .03, p = .130). PTS symptoms mediated the effects of witnessing violence and violence victimization on internalizing behavior problems (β = .02, p = .002). Our findings suggest that PTS symptoms may be a mechanism underlying the association between violence exposure and internalizing behavior problems (R(2) = .23), underscoring the potential importance of assessing PTS symptoms and providing targeted trauma-focused interventions for children exposed to violence at home. Copyright © 2016 International Society for Traumatic Stress Studies.

  3. Application of large-eddy simulation to pressurized thermal shock: Assessment of the accuracy

    International Nuclear Information System (INIS)

    Loginov, M.S.; Komen, E.M.J.; Hoehne, T.

    2011-01-01

    Highlights: → We compare large-eddy simulation with experiment on the single-phase pressurized thermal shock problem. → Three test cases are considered, they cover entire range of mixing patterns. → The accuracy of the flow mixing in the reactor pressure vessel is assessed qualitatively and quantitatively. - Abstract: Pressurized Thermal Shock (PTS) is identified as one of the safety issues where Computational Fluid Dynamics (CFD) can bring real benefits. The turbulence modeling may impact overall accuracy of the calculated thermal loads on the vessel walls, therefore advanced methods for turbulent flows are required. The feasibility and mesh resolution of LES for single-phase PTS are assessed earlier in a companion paper. The current investigation deals with the accuracy of LES approach with respect to the experiment. Experimental data from the Rossendorf Coolant Mixing (ROCOM) facility is used as a basis for validation. Three test cases with different flow rates are considered. They correspond to a buoyancy-driven, a momentum-driven, and a transitional coolant mixing pattern in the downcomer. Time- and frequency-domain analysis are employed for comparison of the numerical and experimental data. The investigation shows a good qualitative prediction of the bulk flow patterns. The fluctuations are modeled correctly. A conservative estimate of the temperature drop near the wall can be obtained from the numerical results with safety factor of 1.1-1.3. In general, the current LES gives a realistic and reliable description of the considered coolant mixing experiments. The accuracy of the prediction is definitely improved with respect to earlier CFD simulations.

  4. Gallium scans of the thorax in patients with acquired immune deficiency syndrome (AIDS): Description and utilization

    Energy Technology Data Exchange (ETDEWEB)

    Le, G.; Chen, D.C.P.; Siegel, M.E.

    1984-01-01

    The pattern of distribution of gallium uptake in the thorax was investigated in patients (pts) with AIDS. Eleven pts (ages 18-53), all active homosexual males suspected of having acute pulmonary infection were studied. Ga lung scans were performed at 24-48 and/or 72 hrs. post injection. The diagnosis of AIDS was based on appropriate clinical and laboratory findings. The Ga activity in the lung was graded from zero = background to 4+ which is > liver activity. Eight of eleven pts have positive Ga scan while seven of eleven pts had positive CXR. Six pts had both positive CXR and Ga scan. One pt had a positive Ga scan with negative CXR, and one with positive CXR and negative Ga scan. The positive Ga scans included 3 pts with 4+ diffuse uptake, two pts with 2+ diffuse uptake, two pts with 1+ diffuse uptake, and two with hilar node uptake. Three pts have focal increased uptake superimposed on diffuse uptake. Two pts with 4+ diffuse uptake had mild abnormality on their CXR. One pt with 4+ uptake in the initial scan shows decreased activity on follow-up with clinical improvement after therapy. Thus, all but two pts with positive Ga scans had diffuse lung uptake. These two patients alone had B cell immunoblastic sarcoma and oral candidiasis. The pattern of Ga lung uptake in pts with AIDS reveal that a majority of positive scans are diffuse (6/8) and the intensity may suggest more active disease than CXR (2 normal) and, thus, the study may be useful in detecting changes from atypical pulmonary infection in this population.

  5. Gallium scans of the thorax in patients with acquired immune deficiency syndrome (AIDS): Description and utilization

    International Nuclear Information System (INIS)

    Le, G.; Chen, D.C.P.; Siegel, M.E.

    1984-01-01

    The pattern of distribution of gallium uptake in the thorax was investigated in patients (pts) with AIDS. Eleven pts (ages 18-53), all active homosexual males suspected of having acute pulmonary infection were studied. Ga lung scans were performed at 24-48 and/or 72 hrs. post injection. The diagnosis of AIDS was based on appropriate clinical and laboratory findings. The Ga activity in the lung was graded from zero = background to 4+ which is > liver activity. Eight of eleven pts have positive Ga scan while seven of eleven pts had positive CXR. Six pts had both positive CXR and Ga scan. One pt had a positive Ga scan with negative CXR, and one with positive CXR and negative Ga scan. The positive Ga scans included 3 pts with 4+ diffuse uptake, two pts with 2+ diffuse uptake, two pts with 1+ diffuse uptake, and two with hilar node uptake. Three pts have focal increased uptake superimposed on diffuse uptake. Two pts with 4+ diffuse uptake had mild abnormality on their CXR. One pt with 4+ uptake in the initial scan shows decreased activity on follow-up with clinical improvement after therapy. Thus, all but two pts with positive Ga scans had diffuse lung uptake. These two patients alone had B cell immunoblastic sarcoma and oral candidiasis. The pattern of Ga lung uptake in pts with AIDS reveal that a majority of positive scans are diffuse (6/8) and the intensity may suggest more active disease than CXR (2 normal) and, thus, the study may be useful in detecting changes from atypical pulmonary infection in this population

  6. Painful tonic spasm in neuromyelitis optica spectrum disorders: Prevalence, clinical implications and treatment options.

    Science.gov (United States)

    Liu, Ju; Zhang, Qin; Lian, Zhiyun; Chen, Hongxi; Shi, Ziyan; Feng, Huiru; Miao, Xiaohui; Du, Qin; Zhou, Hongyu

    2017-10-01

    Painful tonic spasm (PTS) is a common symptom in patients with neuromyelitis optica spectrum disorders (NMOSD). This study aimed to obtain further insights into the prevalence, characteristics, and treatment of PTS in patients with NMOSD, and to systematically investigate and compare the clinical features and prognosis of NMOSD with and without PTS. We reviewed the medical records and prospectively interviewed patients with NMOSD who attended the West China Hospital of Sichuan University in Chengdu, China between September 2014 and December 2016. In total, 52 of the 230 patients with NMOSD experienced PTS (22.61%). Patients with NMOSD and PTS were characterized by a higher age at onset (P = 0.017), higher annual relapse rate (ARR) (P = 0.003), higher ARR of myelitis (P = 0.011), and a tendency to experience pruritus (P = 0.025). Sodium channel blocking antiepileptic drugs (carbamazepine or oxcarbazepine) had higher efficacy than gabapentin in the treatment of PTS (P = 0.001). Although the progression index was higher in patients with PTS, this difference did not reach statistical significance (P = 0.05). Our study suggested that immunosuppressors for the prevention of relapse should be administered without delay in patients with NMOSD and PTS. Owing to the side effects of carbamazepine, we recommend oxcarbazepine as the first-line of treatment for PTS in patients with NMOSD. Whether PTS is a marker of disease severity in NMOSD remains to be determined, requiring a long-term prospective observational study. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Diagnosis of essential tremor vs. Parkinson's disease: NeuroSPECT by means of Trodat-1 Tc99m, a marker of Dopamine Transporter

    International Nuclear Information System (INIS)

    Mena, I.; Diaz, F.

    2002-01-01

    Background Information. We have recently reported that NeuroSPECT (NSP) of the Dopamine Transporter (DAT) is a highly sensitive method for early diagnosis of Parkinson's disease. Objectives. To evaluate the sensitivity of NSP of DAT in patients with essential tremor (E.T.) and compare them with parkinsonian patients (pts.) and normal controls, in order to assess the sensitivity to detect symptomatic impairment of concentration of DAT in Parkinson's Disease (PD) and normality in essential tremor, thus becoming an important diagnostic tool for this differential clinical diagnosis. Materials and Methods. The present study concerns 13 patients with essential tremor (E.T.), 20 pts. with Parkinson's Disease (P.D.). The ET pts, 5/13 were female and there mean age was 62 y. The PD pts age 62±11 years. The UPDRS V was 1, mean evolution, of 3.0 years, 5/20 were females. The average UPDRS III was 14,. They were compared with 25 healthy controls, 20/25 females, mean age was 54±14 years. The mean age of 13 E.T. pts was 60 y. (range 24-81 y). At onset of E.T. the mean age was 40 y. ( range 5-67 y.) 7 pts. were classified as sporadic tremor and 6 pts. as familial tremor. The frequency of tremor was 6.4 cycles/sec and the amplitude fluctuated between moderate and very intense. 8/13 pts suffered prolongation of postural tremor into resting tremor, while 3 of them had been diagnosed as P.D. at other Institutions. 3/13 pts had postural and brachial tremor, head tremor(5/13 pts.) voice or chin tremor in 1/13 pts. 3/13 pts suffered impairment of mild postural tremor during writing, eating or drinking. Three-dimensional images of the distribution of DAT in brain were gathered 4 hours after iv. injection of 30 mCi of Trodat-1 Tc 99m. Results. In normal controls there is maximal concentration of DAT in caudate and putamen. We establish a comparison with the occipital cortex where there is mild non specific concentration of DAT. In 13 pts. with Essential Tremor there was no significant

  8. Variation in anticonvulsant selection and EEG monitoring following severe traumatic brain injury in children – Understanding resource availability in sites participating in a comparative effectiveness study

    Science.gov (United States)

    Kurz, Jonathan E.; Poloyac, Samuel M.; Abend, Nicholas S.; Fabio, Anthony; Bell, Michael J.; Wainwright, Mark S.

    2016-01-01

    Objective Early post-traumatic seizures (PTS) may contribute to worsened outcomes after traumatic brain injury (TBI). Evidence to guide the evaluation and management of early PTS in children is limited. We undertook a survey of current practices of continuous electroencephalographic monitoring (cEEG), seizure prophylaxis and the management of early PTS to provide essential information for trial design and the development of PTS management pathways. Design Surveys were sent to site principal investigators at all 43 sites participating in the ADAPT (Approaches and Decisions in Acute Pediatric TBI) trial at the time of the survey. Surveys consisted of 12 questions addressing strategies to (i) implement cEEG monitoring, (ii) PTS prophylaxis, (iii) treat acute PTS, (iv) treat status epilepticus (SE) and refractory status epilepticus (RSE) and (v) monitor anti-seizure drug levels. Setting Institutions comprised a mixture of free-standing children’s hospitals and university medical centers across the United States and Europe. Measurements and Main Results cEEG monitoring was available in the pediatric intensive care unit in the overwhelming majority of clinical sites (98%); however, the plans to operationalize such monitoring for children varied considerably. A similar majority of sites report that administration of prophylactic anti-seizure medications is anticipated in children (93%), yet a minority reports that a specified protocol for treatment of PTS is in place (43%). Reported medication choices varied substantially between sites, but the majority of sites reported pentobarbital for RSE (81%). Presence of an treatment protocols for seizure prophylaxis, early PTS, post-traumatic SE and RSE was associated with decreased reported medications (all p pediatric severe TBI. The substantial variation in cEEG implementation, choice of seizure prophylaxis medications, and management of early PTS across institutions was reported, signifying areas of clinical uncertainty that

  9. The particular prediction of normal MPI in diabetic patients

    International Nuclear Information System (INIS)

    Wu, Z.-F.; Li, S.-J.; Liu, H.-Y.; Liu, J.Z.; Li, X.F.; Cheng, Y.; Zhang, Y.W.; Wang, J.

    2007-01-01

    Full text: Objectives: To explore the prognostic value of normal SPECT MPI in diabetic pts. Methods: 1371 consecutively registered pts suspected with CAD were studied using rest SPECT MPI, and 1047 cases (76.37%) were followed up successfully. The mean interval of following up was 33.25±14.95(1∼56) months, and even longer than 18 months for pts with no cardiac events (CE). Results: Of 1047 pts, 172 were diabetic. During the follow up period, there are 42 cardiac events in 172 diabetic patients, and 86 in 857 non-diabetics. Diabetic pts had significantly higher rates of cardiac events (24.4% versus 9.8%; chi-square 28.5, P<0.0001). In the 567 pts with normal MPI, there are 4 cardiac events in 54 diabetic pts and 6 cases in 513 nondiabetic pts. The diabetic pts had significantly higher rates of cardiac events compared with the non-diabetic pts (7.41% versus 1.17%, Fisher's Exact Test, P=0.01). Conclusions: A normal SPECT has a high negative predictive value, but diabetic patients had significantly higher cardiac events rate compared with non-diabetic patients, what ever the MPI is normal or abnormal. (author)

  10. Depression in Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Badema Čengić

    2010-04-01

    Full Text Available Depression is the most frequent psychological complication of haemodialysis (HD patients (pts and has been associated with impaired Quality of Life (QoL. The aim of our study was to investigate the prevalence of depression in HD pts in relation to sociodemographic factors and the relationship between depression and QoL.200 pts from Clinic for haemodialysis in Sarajevo, B&H were participating in the study. Mean age was S7,26±13,78 years and mean HD duration was 64’26±58,18 months. From the test material we applied BDI and SF-36.51% of our pts have shown depression (BDI>11 in various degrees (30%-mild depression, 8,5%-moderate depression and 12,5%-severe depression. As we could expect, the most emphasized symptoms of depression were somatic symptoms. 55,5% of pts have shown QoL lower then average. Sociodemographic data such as gender, marital status and HD duration did not influence significantly on pt’s QoL and occurrence of depression (p>0,05. As the age of the pts increased, level of depression increased too and QoL significantly decreased (p<0,05. Employed pts have shown significantly better QoL and lower level of depression in relation to unemployed pts (p<0,05. As the educational level of pts increased, QoL increased too and level of depression significantly decreased (p<0,05. Pts in 1st HD shift were significantly more depressed and have significantly worse mental health in compare to pts in 3rd HD shift (p<0,05. Our results showed a high prevalence of depressive symptoms among the study group that was linked to trend of poor QoL.

  11. Itopride hydrochloride efficacy in the management of delayed gastric emptying in type 1 diabetis mellitus patients in the presence of autonomic neuropathy

    Directory of Open Access Journals (Sweden)

    Irina Yur’evna Budennaya

    2014-06-01

    Full Text Available Aim. Evaluation of the itopride (Ganaton?, Abbot therapy efficacy in the management of gastrointestinal (GI symptoms and gastric motor function (GMF in type 1 diabetis mellitus (T1DM patients (pts in the presence of GMF dysfunction and other forms of diabetic autonomic neuropathy (DAN. Materials and Methods. The total of 34 patients with T1DM, GMF dysfunction and DAN were selected for randomized, prospective, open-label, comparative study. The duration of the study was 6 weeks. The study group (17 pts received itopride 150 mg total daily. The control group (17 pts did not receive any treatment for GMF. А questionnaire was used for the assessment of gastrointestinal (GI symptoms. Gastric emptying velocity was evaluated with 13C-octanoate breath test. Results. As a result of itopride therapy there was a statistically significant decrease in the amount of time (T1/2 needed for the gastric emptying. The median amount of time decreased from 89.0 [82.3; 101.0] min to 53.0 [82.3; 101.0] min (p

  12. [Analysis of the clinical course of disease and subsequent dialysis therapy in a group of patients with rheumatoid arthritis and end-stage renal disease].

    Science.gov (United States)

    Majdan, Maria; Stepniak, Cezary; Piotrowicz, Sebastian; Broniek, Karina; Blajer, Beata; Bednarek-Skublewska, Anna

    2005-04-01

    The chronic nephropathy is often present in pts with rheumatoid arthritis (RA). In the study the authors retrospectively analyzed the clinical course of the disease and outcomes of subsequent dialysotherapy in a group of pts with RA and end-stage renal disease ESRD. During last 5 years ESRD connected with RA was found in 10 (8 F, 2 M) pts out of 325 chronically dialyzed pts (peritoneal dialysis and hemodialysis) representing 3,1% of pts. The mean age at the initiation of dialysotherapy in these pts was 62,8 +/- 10,2 (range 46-76) years. Mean time from the diagnosis of RA to the start of dialysotherapy was 18,8 +/- 11,6 (range 5-40) years. Earlier the patients were treated with many disease modifying antirheumatic drugs (DMARDS) also with glucocorticosteroids and many nonsteroidal anti-inflammatory drugs. It means that they had rather aggressive type of RA. Amyloidosis was histological confirmed in 6 pts (4 F, 2 M). Peritoneal dialysis (PD) was the first choice therapy in 8 pts (2 on APD, 6 on CAPD). The main complication was increased incidence of peritonitis. 3 pts died on PD after 5, 9, 24 months (respectively) of CAPD treatment. 3 pts were transferred to HD after 5, 15, 18 (respectively) months of CAPD because of recurrent peritonitis. 2 pts up to date continue PD (one 12 months, the second 46 months on CAPD). In 5 pts who needed hemodialysis treatment there have been very serious problems with permanent vascular access formation. All used permanent indwelling catheters (Permcath). We concluded that: occurrence of ESRD in pts with RA was connected with aggressive type of disease. Pts with RA represent a dialysis group that is particularly prone to complications of PD (enteric peritonitis) and HD (vascular access problems). It seems to be connected with secondary vasculitis often found in pts with aggressive type of RA.

  13. Is chronic st segment elevation a marker of myocardial non viability in patients with Q wave anteroseptal mi? - correlation with myocardial perfusion SPECT

    International Nuclear Information System (INIS)

    Padma, S; Zachariah, M.; Haridas, K K

    2004-01-01

    segments 5±0.8) while 90/137 (66%) did not show viability (mean viable segments 2±0.9). In ST negative group, 56/103 pts (54%) showed viability (mean viable segments 6±0.7) while 47/103 (46%) did not show viability (mean viable segments 3±0.4). Based on results of MPSPECT from ST positive group 31/47 pts (65%) underwent revascularisation and 27/31 pts (88%) showed an improvement in LV systolic function at least by 5%. Conclusion: Our study shows MPSPECT is an effective way of assessing viability even in presence of chronic ST elevation in Q wave ASMI patients. The mere fact of persistent chronic ST elevation in patients with ASMI does not exclude viability and should not preclude the cardiologist from assessing the patients for revascularisation potential. (authors)

  14. Sequencing of chemotherapy (CT) and radiotherapy (RT) following conservative surgery (CS) for patients with early-stage breast cancer: results of a randomized trial

    Energy Technology Data Exchange (ETDEWEB)

    Recht, A; Come, SE; Silver, B; Gelman, RS; Hayes, DF; Shulman, LN; Henderson, IC; Harris, JR

    1995-07-01

    .03). Overall outcome and patterns of failure were analyzed by intent-to-treat; all enrolled pts were included. Median FU in surviving pts was 58 mo (range, 10-124 mo). Results: 5-yr actuarial failure rates (i.e., failure at any site) and overall survival (OS) rates were not statistically different between the arms, but the 5-yr actuarial total risk of developing distant metastases (DM) (i.e, at any time during observation) was significantly greater in the RT-first arm. The first sites of failure in the RT-first and CT-first arms were: local failure (LF) with or without simultaneous DM or regional nodal failure (RNF) - 9 vs. 14; RNF without other failure - 0 vs. 2; and DM (with or without simultaneous RNF) - 36 vs. 18. Of note, 1 LF in the RT-first arm was among the 2 pts who refused their assigned sequence. Because of differing lengths of potential observation for each pt, the 5-yr crude failure rates were used to assess the difference in patterns of failure. The difference was of borderline significance. The proportions of pts receiving at least 85% of the planned drug doses were lower in the RT-first arm than the CT-first arm for cyclophosphamide (46% v. 64%, p-bar=0.006), doxorubicin (43% vs. 64%, p-bar=0.002), and d.15 methotrexate (22% vs. 46%, p-bar=0.0002). There were no differences between the arms in the d.1 methotrexate or 5FU doses. Conclusions: The overall risk of distant failure was higher in the RT-first arm in this study. This may reflect both the longer interval to initiating CT and the lower drug doses given in pts first receiving RT. The risk of local failure was higher in the CT-first arm, consistent with prior studies suggesting that the SRI has an impact on the effectiveness of RT. Further study is needed of other factors that may affect these results. Alternative ways of combining RT and CT which do not sacrifice their effectiveness while minimizing treatment toxicity should be explored.

  15. Sequencing of chemotherapy (CT) and radiotherapy (RT) following conservative surgery (CS) for patients with early-stage breast cancer: results of a randomized trial

    International Nuclear Information System (INIS)

    Recht, A; Come, SE; Silver, B; Gelman, RS; Hayes, DF; Shulman, LN; Henderson, IC; Harris, JR

    1995-01-01

    .03). Overall outcome and patterns of failure were analyzed by intent-to-treat; all enrolled pts were included. Median FU in surviving pts was 58 mo (range, 10-124 mo). Results: 5-yr actuarial failure rates (i.e., failure at any site) and overall survival (OS) rates were not statistically different between the arms, but the 5-yr actuarial total risk of developing distant metastases (DM) (i.e, at any time during observation) was significantly greater in the RT-first arm. The first sites of failure in the RT-first and CT-first arms were: local failure (LF) with or without simultaneous DM or regional nodal failure (RNF) - 9 vs. 14; RNF without other failure - 0 vs. 2; and DM (with or without simultaneous RNF) - 36 vs. 18. Of note, 1 LF in the RT-first arm was among the 2 pts who refused their assigned sequence. Because of differing lengths of potential observation for each pt, the 5-yr crude failure rates were used to assess the difference in patterns of failure. The difference was of borderline significance. The proportions of pts receiving at least 85% of the planned drug doses were lower in the RT-first arm than the CT-first arm for cyclophosphamide (46% v. 64%, p-bar=0.006), doxorubicin (43% vs. 64%, p-bar=0.002), and d.15 methotrexate (22% vs. 46%, p-bar=0.0002). There were no differences between the arms in the d.1 methotrexate or 5FU doses. Conclusions: The overall risk of distant failure was higher in the RT-first arm in this study. This may reflect both the longer interval to initiating CT and the lower drug doses given in pts first receiving RT. The risk of local failure was higher in the CT-first arm, consistent with prior studies suggesting that the SRI has an impact on the effectiveness of RT. Further study is needed of other factors that may affect these results. Alternative ways of combining RT and CT which do not sacrifice their effectiveness while minimizing treatment toxicity should be explored

  16. The Romanian National Program for Liver Transplantation - 852 Procedures in 815 Patients over 17 Years (2000-2017): A Continuous Evolution to Success.

    Science.gov (United States)

    Popescu, Irinel; Ionescu, Mihnea; Braşoveanu, Vladislav; Hrehoreţ, Doina; Copca, Narcis; Lupaşcu, Cristian; Botea, Florin; Dorobanţu, Bogdan; Alexandrescu, Sorin; Grigorie, Mihai; Matei, Emil; Zamfir, Radu; Lungu, Vasile; Tomescu, Dana; Droc, Gabriela; Ungureanu, Daniela; Fota, Ruxandra; Manga, Graţiela; Popescu, Mihai; Popa, Laura; Gheorghe, Liana; Iacob, Speranţa; Pietrăreanu, Corina; Mihailă, Mariana; Mic, Laurenţiu; Constantinescu, Sanda; Gheorghe, Cristian; Cotruta, Bogdan; Lupescu, Ioana; Grasu, Mugur; Boroş, Mirela; Dumitru, Radu; Toma, Mihai; Paslaru, Liliana; Vlad, Laura; Constantinescu, Ileana; Dima, Ileana; Herlea, Vlad; Becheanu, Gabriel; Pecheanu, Cătălin; Sasalovici, Daniela

    2017-01-01

    Background: Liver transplantation (LT) has become an established treatment for end-stage liver disease, with more than 20.000 procedures yearly worldwide. The aim of this study was to analyze the results of Romanian National Program of LT. Methods: Between April 2000 and April 2017, 817 pts received 852 LTs in Romania. Male/female ratio was 487/330, while adult/pediatric ratio was 753/64, with a mean age of 46 years (median 50 yrs; range 7 months - 68 yrs). Main LT indications were HBV cirrhosis (230 pts; 28.2%), HCC (173 pts; 21.2%), and HCV cirrhosis (137 pts; 16.8%). Waiting time and indications for LT, patient and donor demographics, graft features, surgical procedures, and short and long-term outcomes were analyzed. Results: DDLT was performed in 682 pts (83.9%): whole LT in 662 pts (81%), split LT in 16 pts (2.3%), reduced LT in 2 pts (0.2%), and domino LT in 1 pts (0.1%). LDLT was performed in 135 pts (16.5%): right hemiliver in 93 pts (11.4%), left lateral section in 28 pts (3.4%), left hemiliver in 8 pts (1%), left hemiliver with segment 1 in 4 pts (0.5%), and dual graft LDLT in 2 pts (0.2%). Overall major morbidity rate was 31.4% (268 pts), while perioperative mortality was 7.9% (65 pts). Retransplantation rate was 4.3% (35 pts): 27 whole LTs, 3 reduced LTs, 3 split LTs, and 2 LDLT. Long-term overall 1-, 3-, and 5-year estimated survival rates for patients were 87.9%, 81.5%, and 79.1%, respectively. One-, 3-, and 5-year overall mortality on waiting list also decreased significantly over time from 31.4%, 54.1% and 63.5%, to 4.4%, 13.9% and 23.6%, respectively. Conclusions: The Romanian National program for liver transplantation addresses all causes of acute and chronic liver failure or liver tumors in adults and children, using all surgical techniques, with good long-term outcome. The program constantly evolved over time, leading to decreased mortality rate on the waiting list. Celsius.

  17. Bronchoplastic operations for lung cancer

    International Nuclear Information System (INIS)

    Cicenas, S.; Naujokaitis, P.; Jackevicius, A. and others

    2002-01-01

    Objective of our work was to evaluate efficacy of bronchoplastic operations for lung cancer and time to progression in combined treatment. From 1997 till 2001, 57pts were operated for early I-IIB stages of lung cancer. Operations were: tracheal resections in 3pts (5.2%), window right pneumonectomies in 5pts (8.7%), window left pneumonectomies in 2pts (3.5%), window right upper lobe in 22pts (38.5%), bifurcation resections 2pts (3.5%), sleeve right upper lobe resections 7pts (12.2%), sleeve left upper lobe resections in 11pts (19.2%). We had complications: in 7pts (12.2%) suture failure, 26pts (45.6%) obstructive pneumonia, 3pts (5.2%) kinking of anastomosis, 2pts (3.7%) bronchial bleeding, 6pts (10.5%) covered bronchial fistulas, 5pts (8.7%) died after operations. 32pts (56%) underwent radiation after surgery, 13pts (22.8%) radiation and chemotherapy. Three-year survival was in 82.4% (47pts), in 10pts (17.4%) disease progressed. Bronchoplastic operations are sufficient for early lung cancer treatment. Three-year was in survival 82.7% of pts. Seventeen percent of patients failed after combined treatment. (author)

  18. The Role of Physical Therapists in Living Environment Maintenance of the Home-bound Elderly Disabled.

    Science.gov (United States)

    Takemasa, Seiichi; Abe, Yoko; Nagao, Toru; Murakami, Masahito; Koeda, Hideki; Naruse, Susumu; Gotou, Makoto; Uesugi, Masayuki; Inoue, Yuri; Nanba, Yoshihumi

    2013-07-01

    [Purpose] This study explored the roles of physical therapists (PTs) in living environment maintenance, which is essential for living securely and stably at home, and examines how physical therapists can fulfill these roles more efficiently and effectively. [Subjects and Methods] A questionnaire on living environment maintenance was given to PTs working at randomly selected hospitals, health care facilities for the elderly requiring long-term care, home-visit nursing stations, and other such facilities and directly providing physical therapy to the home-bound elderly disabled. The subjects of the study were 77 PTs who returned valid responses. [Results] For awareness of systems for living environment maintenance, PTs were more aware of the system based on the Long-Term Care (LTC) Insurance Act than the system based on the Act on Welfare for the Home-Bound Elderly Disabled. PTs who have worked at two or more types of medical, welfare, and intermediate institutions were more aware of such systems than PTs who have worked at only one type. For PTs handling living environment maintenance for the home-bound elderly disabled, approximately 80% of respondents answered that they have handled some living environment maintenance, and PTs with longer clinical experience have handled more living environment maintenance cases. [Conclusion] The results demonstrated that PTs understand their living environment maintenance work well and handle the work. The results, however, also suggested that educational and operational improvements are urgently required for PTs handling living environment maintenance essential for the lives of the home-bound elderly disabled.

  19. Validation of binding of SE-75 labeled sucralfate to sites of gastrointestinal ulceration

    Energy Technology Data Exchange (ETDEWEB)

    Maurer, A.H.; Knight, L.C.; Kollman, M.; Krevsky, B.; Pleet, D.; D' Ercole, F.; Siegel, J.A.; Fisher, R.S.; Malmud, L.S.

    1985-05-01

    This study was performed to determine if and for how long sucralfate (SU) binds selectively to sites of gastro-intestinal (GI) ulceration. Se-Su was prepared by sulfating sucrose with tracer Se-75 and precipitating it as the basic Al salt. All patients (pts) had endoscopy to confirm the presence of either: esophagitis (n=5), gastritis (GA) (n=5), gastric ulcers (GU) (n=5), duodenal ulcers (DU) (n=5), or no ulceration (NU) (n=5). Following an overnight fast the pts swallowed 1 gm with 100 ..mu..Ci of Se-SU and were imaged continuously over 24 hours or until no activity remained in the upper GI tract. Pts with GU visually demonstrated focal SU binding at the ulcers for an average of 3.9 +- 1.1 hrs. with a mean GET of 68 +- 25 min. Mean GET for pts with DU was prolonged, 171 +- 63 min, however focal binding at duodenal ulcers was not seen. All pts with GA had diffuse retention of SU in the stomach with a mean GET of 118 +- 34 min. Focal binding of SU at all sites of esophagitis was seen with a T-1/2 of 65 +- 32 min at the ulcerations. In conclusion these data support the theory that the mechanism of ulcer healing with SU is related to its ability to adhere to the ulcer site forming a protective barrier. In addition Se-SU is a potential ulcer imaging agent which can be used to noninvasively assess healing.

  20. Validation of binding of SE-75 labeled sucralfate to sites of gastrointestinal ulceration

    International Nuclear Information System (INIS)

    Maurer, A.H.; Knight, L.C.; Kollman, M.; Krevsky, B.; Pleet, D.; D'Ercole, F.; Siegel, J.A.; Fisher, R.S.; Malmud, L.S.

    1985-01-01

    This study was performed to determine if and for how long sucralfate (SU) binds selectively to sites of gastro-intestinal (GI) ulceration. Se-Su was prepared by sulfating sucrose with tracer Se-75 and precipitating it as the basic Al salt. All patients (pts) had endoscopy to confirm the presence of either: esophagitis (n=5), gastritis (GA) (n=5), gastric ulcers (GU) (n=5), duodenal ulcers (DU) (n=5), or no ulceration (NU) (n=5). Following an overnight fast the pts swallowed 1 gm with 100 μCi of Se-SU and were imaged continuously over 24 hours or until no activity remained in the upper GI tract. Pts with GU visually demonstrated focal SU binding at the ulcers for an average of 3.9 +- 1.1 hrs. with a mean GET of 68 +- 25 min. Mean GET for pts with DU was prolonged, 171 +- 63 min, however focal binding at duodenal ulcers was not seen. All pts with GA had diffuse retention of SU in the stomach with a mean GET of 118 +- 34 min. Focal binding of SU at all sites of esophagitis was seen with a T-1/2 of 65 +- 32 min at the ulcerations. In conclusion these data support the theory that the mechanism of ulcer healing with SU is related to its ability to adhere to the ulcer site forming a protective barrier. In addition Se-SU is a potential ulcer imaging agent which can be used to noninvasively assess healing

  1. Lifetime Traumatic Experiences and Disordered Eating among University Students: The Role of Posttraumatic Stress Symptoms

    Directory of Open Access Journals (Sweden)

    Vilija Malinauskiene

    2018-01-01

    Full Text Available The associations between lifetime traumatic events (TEs, posttraumatic stress (PTS symptoms, and disordered eating (DE were studied in a sample of 614 university students (mean age 20 years. An anonymous questionnaire included 32 lifetime TEs, IES-revised measured PTS symptoms, and EAT-26 evaluated DE symptoms. Statistical analyses included Pearson correlations and structural equation models (SEM with bootstrapping method. Findings reveal the prevalence of DE in 8.1% of participants, while 73.9% of students experienced at least one lifetime TE. 52.0% of students with DE had PTS symptoms (p<0.0001 and 30.8% of students with lifetime TEs had PTS symptoms (p<0.001. In SEM, direct paths from lifetime TEs to PTS symptoms (0.38, p<0.0001 and from PTS symptoms to DE (0.40, p<0.0001 were observed. The final SEM confirmed the mediating role of PTS symptoms in the path between some TEs (traffic accident and seriously injured and DE among the university students. If PTS symptoms are associated with DE, then addressing PTS symptoms in the context of DE treatment may improve treatment efficacy.

  2. Pressurized Thermal Shock Analysis for OPR1000 Pressure Vessel

    Energy Technology Data Exchange (ETDEWEB)

    Bhowmik, P. K.; Shamim, J. A.; Gairola, A.; Suh, Kune Y. [Seoul National Univ., Seoul (Korea, Republic of)

    2014-10-15

    The study provides a brief understanding of the analysis procedure and techniques using ANSYS, such as the acceptance criteria, selection and categorization of events, thermal analysis, structural analysis including fracture mechanics assessment, crack propagation and evaluation of material properties. PTS may result from instrumentation and control malfunction, inadvertent steam dump, and postulated accidents such as smallbreak (SB) LOCA, large-break (LB) LOCA, main steam line break (MSLB), feedwater line breaks and steam generator overfill. In this study our main focus is to consider only the LB LOCA due to a cold leg break of the Optimized Power Reactor 1000 MWe (OPR1000). Consideration is given as well to the emergency core cooling system (ECCS) specific sequence with the operating parameters like pressure, temperature and time sequences. The static structural and thermal analysis to investigate the effects of PTS on RPV is the main motivation of this study. Specific surface crack effects and its propagation is also considered to measure the integrity of the RPV. This study describes the procedure for pressurized thermal shock analysis due to a loss of coolant accidental condition and emergency core cooling system operation for reactor pressure vessel.. Different accidental events that cause pressurized thermal shock to nuclear RPV that can also be analyzed in the same way. Considering the limitations of low speed computer only the static analysis is conducted. The modified LBLOCA phases and simplified geometry can is utilized to analyze the effect of PTS on RPV for general understanding not for specific specialized purpose. However, by integrating the disciplines of thermal and structural analysis, and fracture mechanics analysis a clearer understanding of the total aspect of the PTS problem has resulted. By adopting the CFD, thermal hydraulics, uncertainties and risk analysis for different type of accidental conditions, events and sequences with proper

  3. Fracture mechanics assessment of surface and sub-surface cracks in the RPV under non-symmetric PTS loading

    Energy Technology Data Exchange (ETDEWEB)

    Keim, E; Shoepper, A; Fricke, S [Siemens AG Unternehmensbereich KWU, Erlangen (Germany)

    1997-09-01

    One of the most severe loading conditions of a reactor pressure vessel (rpv) under operation is the loss of coolant accident (LOCA) condition. Cold water is injected through nozzles in the downcomer of the rpv, while the internal pressure may remain at a high level. Complex thermal hydraulic situations occur and the fluid and downcomer temperatures as well as the fluid to wall heat transfer coefficient at the inner surface are highly non-linear. Due to this non-symmetric conditions, the problem is investigated by three-dimensional non-linear finite element analyses, which allow for an accurate assessment of the postulated flaws. Transient heat transfer analyses are carried out to analyze the effect of non-symmetrical cooling of the inner surface of the pressure vessel. In a following uncoupled stress analysis the thermal shock effects for different types of defects, surface flaws and sub-surface flaws are investigated for linear elastic and elastic-plastic material behaviour. The obtained fracture parameters are calculated along the crack fronts. By a fast fracture analysis the fracture parameters at different positions along the crack front are compared to the material resistance. Safety margins are pointed out in an assessment diagram of the fracture parameters and the fracture resistance versus the transient temperature at the crack tip position. (author). 4 refs, 10 figs.

  4. Evaluating risk factors for endemic human Salmonella Enteritidis infections with different phage types in Ontario, Canada using multinomial logistic regression and a case-case study approach

    Directory of Open Access Journals (Sweden)

    Varga Csaba

    2012-10-01

    Full Text Available Abstract Background Identifying risk factors for Salmonella Enteritidis (SE infections in Ontario will assist public health authorities to design effective control and prevention programs to reduce the burden of SE infections. Our research objective was to identify risk factors for acquiring SE infections with various phage types (PT in Ontario, Canada. We hypothesized that certain PTs (e.g., PT8 and PT13a have specific risk factors for infection. Methods Our study included endemic SE cases with various PTs whose isolates were submitted to the Public Health Laboratory-Toronto from January 20th to August 12th, 2011. Cases were interviewed using a standardized questionnaire that included questions pertaining to demographics, travel history, clinical symptoms, contact with animals, and food exposures. A multinomial logistic regression method using the Generalized Linear Latent and Mixed Model procedure and a case-case study design were used to identify risk factors for acquiring SE infections with various PTs in Ontario, Canada. In the multinomial logistic regression model, the outcome variable had three categories representing human infections caused by SE PT8, PT13a, and all other SE PTs (i.e., non-PT8/non-PT13a as a referent category to which the other two categories were compared. Results In the multivariable model, SE PT8 was positively associated with contact with dogs (OR=2.17, 95% CI 1.01-4.68 and negatively associated with pepper consumption (OR=0.35, 95% CI 0.13-0.94, after adjusting for age categories and gender, and using exposure periods and health regions as random effects to account for clustering. Conclusions Our study findings offer interesting hypotheses about the role of phage type-specific risk factors. Multinomial logistic regression analysis and the case-case study approach are novel methodologies to evaluate associations among SE infections with different PTs and various risk factors.

  5. Prevention of Depression and Anxiety Symptoms in Adolescents: 42 and 54 Months Follow-Up of the Aussie Optimism Program-Positive Thinking Skills.

    Directory of Open Access Journals (Sweden)

    Julie eJohnstone

    2014-05-01

    Full Text Available Anxiety and depression are the most commonly reported mental health problems amongst Australian children and adolescents. The Aussie Optimism Program: Positive Thinking Skills (AOP- PTS is a universal intervention program based on cognitive and behavioral strategies and aimed to prevent anxiety and depression in the middle primary school children aged 9-10 years old. 370 students randomly assigned to the intervention and control condition participated in the 42 and 54 months follow – up study. The intervention group received the AOP-PTS 10-week program and the control group received the regular Health Education curriculum. Students were assessed on anxiety, depression and attribution style at school whilst parents reported on their child’s externalizing and internalising problems at home. Results showed there were no significant reduction across groups in the depressive and anxiety symptoms, and attribution style at either 42 or 54 months follow-up. These findings suggest that AOP-PTS has short and medium term effects but were not sustained in longer term period. Future strategies to achieve the desirable outcomes in a longitudinal study are discussed.

  6. Potential effect of fracture technology on IPTS [Integrated Pressurized Thermal Shock] analysis (Fracture toughness: Kla and Klc and warm prestressing)

    International Nuclear Information System (INIS)

    Dickson, T.L.

    1990-01-01

    A major nuclear plant life extension issue to be confronted in the 1990's is pressure vessel integrity for the pressurized thermal shock (PTS) loading condition. Governing criteria associated with PTS are included in ''The PTS Rule'' (10 CFR 50.61) and Regulatory Guide 1.154: Format and Content of Plant-Specific Pressurized Thermal Shock Safety Analysis Reports for Pressurized Water Reactors. The results of the Integrated Pressurized Water Reactors. The results of the Integrated Pressurized Thermal Shock (IPTS) Program, along with risk assessments and fracture analyses performed by the NRC and reactor system vendors, contributed to the derivation of the PTS Rule. Over the last several years, the Heavy Section Steel Technology (HSST) Program at the Oak Ridge National Laboratory (ORNL) has performed a series of large-scale fracture-mechanics experiments. The Thermal Shock Experiments (TSE), Pressurized Thermal Shock Experiments (PTSE), and Wide Plate Experiments (WPE) produced K IC and K Ia data that suggest increased mean K IC and K Ia curves relative to the ones used in the IPTS study. Also, the PTSE and WPE have demonstrated that prototypical nuclear reactor pressure vessel steels are capable of arresting a propagating crack at K I values considerably above 220 MPa√m, the implicit limit of the ASME Code and the limit used in the IPTS studies. This document provides a discussion of the results of these experiments

  7. Basal cell carcinoma in farmers: an occupation group at high risk.

    Science.gov (United States)

    Szewczyk, Mateusz; Pazdrowski, Jakub; Golusiński, Paweł; Dańczak-Pazdrowska, Aleksandra; Łuczewski, Łukasz; Marszałek, Sławomir; Majchrzak, Ewa; Golusiński, Wojciech

    2016-04-01

    Skin cancer is the most commonly diagnosed cancer type worldwide, and 80 % of skin cancers are basal cell carcinoma (BCC). The main risk factor for developing BCC is exposure to ultraviolet radiation (UVR), particularly high-dose exposure at a young age. Outdoor workers, particularly farmers, are at high risk of developing BCC. However, studies of BCC in this population are scant. To comprehensively evaluate all cases of BCC of the head and neck region treated during the years 2007-2013 at our hospital in Poland, and to compare the tumour characteristics in farmers to non-farmers. Retrospective analysis of 312 patients treated for head and neck BCC during the study period (2007-2013). Most patients (198 cases; 63 %) were males, with 114 females (37 %). Median age was 73 years (range 32-96 years). The most common tumour location was the nose and cheek (114 pts; 37 %) followed by the auricle (82 pts; 26 %), lips (54 pts; 18 %), scalp (26 pts; 8 %), and eye (36 pts; 12 %). The most common disease stage on presentation was stage T2 (104 pts, 33 %), followed by stage T1 (79 pts; 25 %), stage T3 (89 pts; 28 %), and stage T4 (40 pts; 14 %). By occupation, farmers accounted for 33 % of all patients (102 of 312 pts). The most common tumour localisations in the farmer subgroup were the nose and cheek (50 pts; 49 %; p farmer group were significantly younger than non-farmers (62 vs. 73 years; p Farmers were significantly more likely to present disease recurrence (27 vs. 12 % of cases; p farmers. It is therefore necessary to consider enhancing educational programmes and other preventative measures in this occupational group and to evaluate the effectiveness of such programmes.

  8. Structural and electrochemical properties of polythiophene

    Energy Technology Data Exchange (ETDEWEB)

    Senthilkumar, B.; Thenamirtham, P. [Solid State Ionics and Energy Devices Laboratory, Department of Physics, Bharathiar University, Coimbatore 641 046 (India); Kalai Selvan, R., E-mail: selvankram@buc.edu.in [Solid State Ionics and Energy Devices Laboratory, Department of Physics, Bharathiar University, Coimbatore 641 046 (India)

    2011-08-15

    Polythiophenes (PTs) were prepared by chemical oxidative polymerization method in presence and absence of three different (cationic - CTAB, anionic - SDS and non-ionic - Triton X-100) surfactants using FeCl{sub 3} as oxidant. The prepared PTs were characterized by FT-IR, UV-Vis, XRD, SEM and cyclic voltammetry studies. The FT-IR spectra inferred the polymerization of thiophene and elucidate the corresponding functional groups of PTs. Our results on the UV-Vis spectra demonstrate the n-{pi}* electronic transition of the conjugated molecules. Further the red shift in the absorption peak confirms the longer conjugation length of PTs. The amorphous nature of the PTs was inferred from the XRD pattern. The PTs prepared with surfactant exhibited different morphology compared to PT prepared without surfactant. The specific capacitances (SC) of the prepared PTs were calculated using cyclic voltammetry technique, the PT prepared with TRITRON X-100 exhibited higher SC of 117 F/g compared to SC of surfactant free PT (78 F/g). Hence, the PTs prepared with surfactants were found to be suitable electrode materials for redox supercapacitors.

  9. MRI based volumetric assessment of knee cartilage after ACL-reconstruction, correlated with qualitative morphologic changes in the joint and with clinical outcome. Is there evidence for early posttraumatic degeneration?; MRT-basierte Knorpelvolumetrie nach Kreuzbandersatzplastik in Korrelation mit qualitativen Gelenkveraenderungen und dem klinischen Outcome. Gibt es Hinweise auf fruehzeitige posttraumatische degenerative Veraenderungen?

    Energy Technology Data Exchange (ETDEWEB)

    Arnoldi, A.P.; Weckbach, S.; Horng, A.; Reiser, M. [Ludwig-Maximilians-Univ. Muenchen (Germany). Dept. of Clinical Radiology; Nussbickel, C. [Klinikum Garmisch-Partenkirchen (Germany). Dept. of Internal Medicine; Noebauer, I. [Medizinische Universitaet Wien (Austria). Klinik fuer Radiodiagnostik; Zysk, S. [Orthopaedie Zentrum Groebenzell (Germany). Center of Orthopaedics; Glaser, C. [NYU Medical Center, New York, NY (United States). Dept. of Radiology

    2011-12-15

    Purpose: The purpose of this study was to analyze potential quantitative and qualitative changes of the knee cartilage and joint indicative of early posttraumatic OA 4 years after ACL-reconstruction and to correlate the MRI-findings with the clinical outcome (CO). Materials and Methods: 1.5 T MRI-scans were performed on 9 patients post-op and 4 years later. Using a high-resolution T 1-w-fs-FLASH-3D-sequence cartilage volume (cVol) and thickness (mTh) were quantified. Using standard PD-w fs and T 1-w sequences qualitative changes of the joint structures were analyzed based on the WORMS-score. CO was rated by an orthopaedic surgeon using Lysholm-score, OAK-score, Tegner-activity-score (TAS), and Arthrometer KT-1000 testing. Results: Mean changes of cVol were -1.8 % (range: -5.9 %; + 0.7 %) and of mTh -0.8 % (range: -3.0 %; + 1.1 %). No significant change (95 %-CI) could be identified for any compartment. Three patients developed new peripatellar ostheophytes, acute trauma related changes mostly decreased. Mean outcome of Lysholm-score and OAK-score were 90 pts and 86 pts, mean TAS was 4.3 pts. Average maximum tibial translation reached 5.2 mm comparing to 6.7 mm on the healthy contralateral side. Conclusion: Despite a tendency towards decreased cVol and mTh 4 years after ACL-reconstruction qMRI revealed no significant cartilage loss. Newly developing osteophytes did not match with the observed good CO. This small pilot study motivates future quantitative and qualitative-structural MRI-based assessment of articular cartilage and other joint structures in order to improve diagnostic tools for the detection of early OA. (orig.)

  10. Access to environmental reward mediates the relation between posttraumatic stress symptoms and alcohol problems and craving.

    Science.gov (United States)

    Acuff, Samuel F; Luciano, Matthew T; Soltis, Kathryn E; Joyner, Keanan J; McDevitt-Murphy, Meghan; Murphy, James G

    2018-04-01

    Symptoms of posttraumatic stress (PTS) show significant comorbidity with alcohol use, but little is known about the mechanisms that might account for this comorbidity. Deficits in reward functioning have long been implicated in alcohol misuse and more recently in PTS reactions, but no study has examined whether reward deprivation may serve as a transdiagnostic risk factor for comorbid PTS-alcohol misuse. The current cross-sectional study sought to test the behavioral economic hypothesis that reward deprivation would be related to both PTS symptoms and alcohol problems, and would mediate the relation between PTS symptoms and alcohol problems in college students. We recruited a diverse sample of urban college students (N = 203, M age = 21.5 years, SD = 5.5; 79.5% female; 56.8% White, 28.1% Black, .9% Asian, 9.8% Multiracial) who endorsed both alcohol use and PTS symptoms. Reward deprivation (lack of access to, and ability to, experience reward) was related to alcohol problems, and a lack of access to reward was related to PTS symptoms. Furthermore, reward access mediated the relation between PTS symptoms and alcohol problems and craving, after controlling for alcohol use, age, gender, and race. These data provide preliminary support for behavioral economic models of alcohol comorbidity and suggest that treatments for combined PTS and alcohol misuse should attempt to reduce barriers to accessing natural rewards. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  11. Genetic and Clinical Characteristics of Phyllodes Tumors of the Breast

    Directory of Open Access Journals (Sweden)

    Ji-Yeon Kim

    2018-02-01

    Full Text Available PURPOSE: Phyllodes tumors (PTs of the breast are rare, accounting for less than 1% of all breast tumors. Among PTs, malignant PTs (MPTs have malignant characteristics and distant metastases occur in about 20% to 30% of MPTs. However, there is no effective treatment for MPTs with distant metastasis, resulting in an abject prognosis. We performed targeted deep sequencing on PTs to identify the associations between genetic alterations and clinical prognosis. METHODS: We performed targeted deep sequencing to evaluate the genetic characteristics of PTs and analyzed the relationships between clinical and genetic characteristics. RESULTS: A total of 17 PTs were collected between 2001 and 2012. Histologic review was performed by pathologists. The samples included three benign PTs, one borderline PT, and 13 MPTs. The most frequently detected genetic alteration occurred in the TERT promoter region (70.6%, followed by MED12 (64.7%. EGFR amplification and TP53 alteration were detected in four MPTs without genetic alterations in MED12 and TERT promoter regions. Genetic alterations of RARA and ZNF703 were repeatedly found in PTs with local recurrence, and genetic alterations of SETD2, BRCA2, and TSC1 were detected in PTs with distant metastasis. Especially, MPT harboring PTEN and RB1 copy number deletion showed rapid disease progression. CONCLUSIONS: In this study, we provide genetic characterization and potential therapeutic target for this rare, potentially lethal disease. Further large-scale comprehensive genetic study and functional validation are warranted.

  12. Adolescent substance use in Israel: The roles of exposure to political traumas and posttraumatic stress symptoms.

    Science.gov (United States)

    Schiff, Miriam; Fang, Lin

    2014-06-01

    Previous studies have not examined the potential mediating role of posttraumatic stress symptoms (PTS) and moderating roles of gender and ethnicity among adolescents in the aftermath of political traumas, especially in the Middle East. This study of Israeli adolescents aimed to begin bridging these gaps in knowledge. We addressed the following hypotheses: (a) greater exposure to multiple political traumas would be associated with adolescent substance use; (b) greater PTS would be associated with adolescent substance use; (c) PTS would mediate the association of exposure to multiple political traumas on substance use; and (d) gender and ethnicity would moderate the pathways from exposure and PTS to substance use. A nationally representative sample included 4,733 Grade 10 and 11 students (half were females; 36.8% were Arabs). Results of bootstrapping estimations found a significant direct link between exposure to multiple political traumas and substance use, as well as an indirect link through PTS. Gender moderated the relationship between PTS and substance use, while ethnicity moderated the association between exposure and substance use. Specifically, female adolescent substance use decreased when their PTS increased. Arab adolescents who had greater exposure to multiple political traumas used more substances. PTS may be an important mechanism by which trauma exposure is associated with increased substance use. Screening adolescents for PTS and substance use, shortly after political trauma, is essential to address the potential risk factors in vulnerable adolescents.

  13. Using collaborative technology to enhance pre-service teachers' pedagogical content knowledge in Science

    Science.gov (United States)

    Donnelly, Dermot Francis; Hume, Anne

    2015-01-01

    Background:Supporting pre-service teacher (PT) collaboration as a means of professional learning is a challenging but essential task for effective practice. However, teacher placements or practicums in schools, which is common practice within teacher education programmes, can often isolate PTs from sharing their experiences with each other. Further, the articulation of effective pedagogical practices by high-quality teachers is limited, restricting PTs' ability to access such professional knowledge. Purpose:This study investigates how the introduction of a collaborative technology, a wiki, may enhance existing and new opportunities for pre-service teachers' (PTs) to develop pedagogical content knowledge (PCK). Sample:Seven PT chemistry teachers of varied backgrounds participated in this study. Design and method:The PTs were learning to collaboratively formulate and document their early topic-specific teaching knowledge using a pedagogical tool known as Content Representation (CoRe) design. Once scaffolded into this process, the PTs continued and extended this collaborative work online through the introduction of a wiki. Data were collected for qualitative analysis through the CoRe artefacts, a semi-structured focus group interview, and PTs' reflective essays about their collaborative experiences representing their teaching knowledge in CoRes through the wiki. Results:Data analysis highlighted that while wiki use showed some potential for collaborative representation when participants were not face-to-face, the PTs were hesitant in critiquing each other's work. As such, the online representations remained relatively static without face-to-face interaction. However, developing artefacts online was favoured over established practice and the access to artefacts of their peers on the wiki enhanced PTs' consideration for their own PCK. Conclusion:Wikis show some potential in the hosting of CoRes, but issues in simultaneous posting and lack of chat functionality may

  14. Intracranial germinomas: a case for low dose radiation therapy alone

    International Nuclear Information System (INIS)

    Harrigan, Patricia M.; Loeffler, Jay S.; Shrieve, Dennis; Tarbell, Nancy J.

    1995-01-01

    Purpose: To determine the optimal dose and treatment outcome of patients treated with radiation for intracranial germinoma. Materials and Methods: Between 1975 and 1995, 39 patients with a diagnosis of intracranial germinoma were treated with radiation (RT) to the central nervous system. All but one pt received whole brain (WB) RT, (median dose: 3240 cGy range: 1500-4437 cGy) and a boost to the tumor volume (median total tumor volume dose: 5200 cGy, range: 3960-5950 cGy). Thirty-one pts received RT to the spine (median dose: 2500, range: 1875-3750). Eleven pts were treated with low dose RT and a tumor volume boost, (WB dose ≤ 2550 cGy, and spine dose ≤ 2160 cGy). Five pts were treated with cisplatin-based chemotherapy and low dose WB RT. Fifteen pts were biopsy-proven and 18 presented with multiple midline germinomas (MMG). Among all pts, 33% had serum or CSF positive for low levels of HCG and none of 19 (9 biopsy-proven) germinomas measured positive for AFP tumor marker. Six of 22 (27%) pts who had spine imaging or CSF cytology had evidence of tumor seeding. The male-to female-ratio was 1.4. Median age at diagnosis was 14 yrs for male pts and 9.5 yrs for females (p=.02, overall age range: 1-31 yrs). Median follow-up for survivors is 64 months (range: 1-226 months). Toxicity of treatment relative to dose was assessed. Results: The 5-yr. actuarial rate of disease-free survival (DFS) and overall survival for presumed germinomas was 97%. No pts died of germinoma. One pt died of a shunt infection who had received concurrent chemotherapy and low dose whole brain RT. Among the low dose RT alone group 6 pts received whole brain RT of ≤ 2550 cGy and 9 pts were treated with spinal RT of ≤ 2160 cGy without chemotherapy. Two of these pts had CSF cytology positive for tumor seeding. Additionally, 8 pts received a total dose to the tumor volume of ≤ 4800 cGy without chemotherapy. The 5-yr DFS was 100%. Five pts were treated with cisplatin-based chemotherapy followed

  15. Intracranial germinomas: a case for low dose radiation therapy alone

    Energy Technology Data Exchange (ETDEWEB)

    Harrigan, Patricia M; Loeffler, Jay S; Shrieve, Dennis; Tarbell, Nancy J

    1995-07-01

    Purpose: To determine the optimal dose and treatment outcome of patients treated with radiation for intracranial germinoma. Materials and Methods: Between 1975 and 1995, 39 patients with a diagnosis of intracranial germinoma were treated with radiation (RT) to the central nervous system. All but one pt received whole brain (WB) RT, (median dose: 3240 cGy range: 1500-4437 cGy) and a boost to the tumor volume (median total tumor volume dose: 5200 cGy, range: 3960-5950 cGy). Thirty-one pts received RT to the spine (median dose: 2500, range: 1875-3750). Eleven pts were treated with low dose RT and a tumor volume boost, (WB dose {<=} 2550 cGy, and spine dose {<=} 2160 cGy). Five pts were treated with cisplatin-based chemotherapy and low dose WB RT. Fifteen pts were biopsy-proven and 18 presented with multiple midline germinomas (MMG). Among all pts, 33% had serum or CSF positive for low levels of HCG and none of 19 (9 biopsy-proven) germinomas measured positive for AFP tumor marker. Six of 22 (27%) pts who had spine imaging or CSF cytology had evidence of tumor seeding. The male-to female-ratio was 1.4. Median age at diagnosis was 14 yrs for male pts and 9.5 yrs for females (p=.02, overall age range: 1-31 yrs). Median follow-up for survivors is 64 months (range: 1-226 months). Toxicity of treatment relative to dose was assessed. Results: The 5-yr. actuarial rate of disease-free survival (DFS) and overall survival for presumed germinomas was 97%. No pts died of germinoma. One pt died of a shunt infection who had received concurrent chemotherapy and low dose whole brain RT. Among the low dose RT alone group 6 pts received whole brain RT of {<=} 2550 cGy and 9 pts were treated with spinal RT of {<=} 2160 cGy without chemotherapy. Two of these pts had CSF cytology positive for tumor seeding. Additionally, 8 pts received a total dose to the tumor volume of {<=} 4800 cGy without chemotherapy. The 5-yr DFS was 100%. Five pts were treated with cisplatin-based chemotherapy

  16. SPECT-CT bone scintigraphy in cancer patients

    International Nuclear Information System (INIS)

    Sergieva, S; Alexandrova, A.; Nikolova, N.; Dimcheva, M.; Baichev, G.

    2012-01-01

    Full text: Introduction: SPECT-CT study allows the precise correlation between functional and morphological data on the same image. Methods: Whole body bone scan (WBBS) is a diagnostic modality still firmly established as a valuable tool to assess skeleton abnormalities. CT is an imaging method for characterizing destruction of the bone spongy lesions, their consolidation or calcium accumulation. This fact allows differentiation of the osteolytic metastases from the osteosclerotic and mixed lesions and also from degenerative ones. Whole body bone scan followed by SPECT-CT scanning increases the accuracy of the study and potentially accelerates the diagnosis of the patient based on a single imaging session. This is especially important in cancer patients. Results and discussion: After retrospectively review of WBBS and SPECT-CT fused images 141 bone lesions in 89 pts were analyzed The skeletal findings with previously uncertain character were classified as definitely benign, indeterminate or definitely malignant. 1. 47 (33%) of all lesions in 36 pts could be correlated with benign degenerative findings on SPECT-CT images. 5 (3%) lesions in 3 of these pts were indeterminate on the SPECT-CT images. They were localized in the area of articulation parts and corpus of the thoracic vertebra and ribs. After additional MRT examination and 6 months follow-up these changes were considered degenerative: osteopathy changes and presence of spondyloarthrosis and osteochondrosis; compression fractures due to advanced osteoporosis. These pts were with prolonged chormono/chemotherapy; chronic inflammatory disease of the coxofemoral articulation, coxarthrosis, aseptic necrosis of the femoral head and postoperative sacroiliitis; post-traumatic fractures or surgical intervention; hyperplastic degenerative lesions in the skeleton and asymmetrical pelvic bone structures due to M. Paget. 2. 41 (28,1%) single osseous metastatic spots (up to 3 foci) were scanned in 31 pts. 3. 13 (10

  17. The impact of increased weekend physiotherapy service provision in critical care: a mixed methods study.

    Science.gov (United States)

    Duncan, Catharine; Hudson, Megan; Heck, Carol

    2015-01-01

    At the hospital studied, weekend physiotherapy (WEPT) is routinely provided and in 2013 WEPT was increased from one (PRE) to three (POST) physiotherapists (PTs) to cover intensive care and ward patients. (1) To evaluate the impact of increased WEPT on patient volumes, treatments provided and conditions treated in critical care and wards; and (2) to understand the PTs' perspectives on the new coverage model. A mixed methods design was utilized. The quantitative component consisted of retrospective document reviews of all weekend patients treated January 1-May 5 (PRE) and May 11-December 31 (POST). The qualitative component used a questionnaire to collect staff feedback. PRE-POST comparisons were conducted using χ(2) or Mann-Whitney U tests. Significant (p = 0.00) increases POST were seen in number of patients treated, number of mobility treatments provided and number of post-surgical patients seen in both clinical areas. The majority of survey respondents reported feeling adequately trained, but had concerns regarding the impact of increased WEPT on work-life balance. PTs perceived enhanced service was beneficial for continuity of weekday care and improved patient function. Future studies need to focus on measuring the effect of increased weekend provision on outcomes, preventing complications and length of stay.

  18. Fracture mechanics analysis of reactor pressure vessel under pressurized thermal shock - The effect of elastic-plastic behavior and stainless steel cladding -

    International Nuclear Information System (INIS)

    Joo, Jae Hwang; Kang, Ki Ju; Jhung, Myung Jo

    2002-01-01

    Performed here is an assessment study for deterministic fracture mechanics analysis of a pressurized thermal shock (PTS). The PTS event means an event or transient in pressurized water reactors (PWRs) causing severe overcooling (thermal shock) concurrent with or followed by significant pressure in the reactor vessel. The problems consisting of two transients and 10 cracks are solved and maximum stress intensity factors and maximum allowable nil-ductility reference temperatures are calculated. Their results are compared each other to address the general characteristics between transients, crack types and analysis methods. The effects of elastic-plastic material behavior and clad coating on the inner surface are explored

  19. Effectiveness of compression stockings to prevent the post-thrombotic syndrome (The SOX Trial and Bio-SOX biomarker substudy: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Rodger Marc A

    2007-07-01

    Full Text Available Abstract Background Post thrombotic syndrome (PTS is a burdensome and costly complication of deep venous thrombosis (DVT that develops in 20–40% of patients within 1–2 years after symptomatic DVT. Affected patients have chronic leg pain and swelling and may develop ulcers. Venous valve disruption from the thrombus itself or thrombus-associated mediators of inflammation is considered to be a key initiating event for the development of venous hypertension that often underlies PTS. As existing treatments for PTS are extremely limited, strategies that focus on preventing the development of PTS in patients with DVT are more likely to be effective and cost-effective in reducing its burden. Elastic compression stockings (ECS could be helpful in preventing PTS; however, data on their effectiveness are scarce and conflicting. Methods/Design The SOX Trial is a randomized, allocation concealed, double-blind multicenter clinical trial. The objective of the study is to evaluate ECS to prevent PTS. A total of 800 patients with proximal DVT will be randomized to one of 2 treatment groups: ECS or placebo (inactive stockings worn on the DVT-affected leg daily for 2 years. The primary outcome is the incidence of PTS during follow-up. Secondary outcomes are severity of PTS, venous thromboembolism (VTE recurrence, death from VTE, quality of life and cost-effectiveness. Outcomes will be evaluated during 6 clinic visits and 2 telephone follow ups. At baseline, 1 and 6 months, blood samples will be obtained to evaluate the role of inflammatory mediators and genetic markers of thrombophilia in the development of PTS (Bio-SOX substudy. Discussion The SOX Trial will be the largest study and the first with a placebo control to evaluate the effectiveness of ECS to prevent PTS. It is designed to provide definitive data on the effects of ECS on the occurrence and severity of PTS, as well as DVT recurrence, cost-effectiveness and quality of life. This study will also

  20. Asthma and posttraumatic stress symptoms 5 to 6 years following exposure to the World Trade Center terrorist attack.

    Science.gov (United States)

    Brackbill, Robert M; Hadler, James L; DiGrande, Laura; Ekenga, Christine C; Farfel, Mark R; Friedman, Stephen; Perlman, Sharon E; Stellman, Steven D; Walker, Deborah J; Wu, David; Yu, Shengchao; Thorpe, Lorna E

    2009-08-05

    The World Trade Center Health Registry provides a unique opportunity to examine long-term health effects of a large-scale disaster. To examine risk factors for new asthma diagnoses and event-related posttraumatic stress (PTS) symptoms among exposed adults 5 to 6 years following exposure to the September 11, 2001, World Trade Center (WTC) terrorist attack. Longitudinal cohort study with wave 1 (W1) enrollment of 71,437 adults in 2003-2004, including rescue/recovery worker, lower Manhattan resident, lower Manhattan office worker, and passersby eligibility groups; 46,322 adults (68%) completed the wave 2 (W2) survey in 2006-2007. Self-reported diagnosed asthma following September 11; event-related current PTS symptoms indicative of probable posttraumatic stress disorder (PTSD), assessed using the PTSD Checklist (cutoff score > or = 44). Of W2 participants with no stated asthma history, 10.2% (95% confidence interval [CI], 9.9%-10.5%) reported new asthma diagnoses postevent. Intense dust cloud exposure on September 11 was a major contributor to new asthma diagnoses for all eligibility groups: for example, 19.1% vs 9.6% in those without exposure among rescue/recovery workers (adjusted odds ratio, 1.5 [95% CI, 1.4-1.7]). Asthma risk was highest among rescue/recovery workers on the WTC pile on September 11 (20.5% [95% CI, 19.0%-22.0%]). Persistent risks included working longer at the WTC site, not evacuating homes, and experiencing a heavy layer of dust in home or office. Of participants with no PTSD history, 23.8% (95% CI, 23.4%-24.2%) reported PTS symptoms at either W1 (14.3%) or W2 (19.1%). Nearly 10% (9.6% [95% CI, 9.3%-9.8%]) had PTS symptoms at both surveys, 4.7% (95% CI, 4.5%-4.9%) had PTS symptoms at W1 only, and 9.5% (95% CI, 9.3%-9.8%) had PTS symptoms at W2 only. At W2, passersby had the highest rate of PTS symptoms (23.2% [95% CI, 21.4%-25.0%]). Event-related loss of spouse or job was associated with PTS symptoms at W2. Acute and prolonged exposures were both

  1. Efficiency of radioiodine therapy in Graves disease and adenoma toxicum and incidence of hypothyroidism

    International Nuclear Information System (INIS)

    Petrovski, Z.P.

    2002-01-01

    The aim of the this study was to evaluate different states in hyperthyroid patients and incidence of hypothyroidism after I-131 therapy.We observed a total of 184 hyperthyroid pts, from which 108(58,7%)pts with Graves' disease,65(35,3%)pts with single toxicum nodule and 11(6%)pts with toxicum multinodular goitre,treated with radioiodine therapy during the period 1986-2001.Dose of I-131 orally administered ranged 150-1100MBq and was calculated according to the 'MBq/gram' method.The radioiodine-131 therapy was performed once in 69,5%(128/184)pts,twice in 21,2%(39/184)pts and in 9,3%(17/184)pts more than two doses. Completely cured of hyperthyroidism occurred in 61%(66/108)pts with Graves' disease,81,8%(9/11)pts with toxic multinodular goiter and 90,7%(59/65)pts with single toxic nodule. The patients in our study were evaluated 6 months to 15 years after received J-131 therapy. Incidence of early hypothyroidism within one year was 23,1%(25/108) in Graves' disease,9%(1/11) in toxic multinodular goiter and 4,6%(3/65) with single toxicum nodule.Overall incidence of hypothyroidism within one year was 17,6% and had cumulative increase of Graves' disease every following year approximately for 3%,while for adenoma toxicum there was no any significant changes. We concluded that radioiodine therapy is simple,comfortable radical method for medical treatment of hyperthyroidism and indicate higher incidence of hypothyroidism in patients treated with I-131 for Graves' disease than that of patients treated for toxicum multinodular goiters and single toxic nodule

  2. Using knowledge brokers to facilitate the uptake of pediatric measurement tools into clinical practice: a before-after intervention study

    Directory of Open Access Journals (Sweden)

    Cameron Dianne

    2010-11-01

    Full Text Available Abstract Background The use of measurement tools is an essential part of good evidence-based practice; however, physiotherapists (PTs are not always confident when selecting, administering, and interpreting these tools. The purpose of this study was to evaluate the impact of a multifaceted knowledge translation intervention, using PTs as knowledge brokers (KBs to facilitate the use in clinical practice of four evidence-based measurement tools designed to evaluate and understand motor function in children with cerebral palsy (CP. The KB model evaluated in this study was designed to overcome many of the barriers to research transfer identified in the literature. Methods A mixed methods before-after study design was used to evaluate the impact of a six-month KB intervention by 25 KBs on 122 practicing PTs' self-reported knowledge and use of the measurement tools in 28 children's rehabilitation organizations in two regions of Canada. The model was that of PT KBs situated in clinical sites supported by a network of KBs and the research team through a broker to the KBs. Modest financial remuneration to the organizations for the KB time (two hours/week for six months, ongoing resource materials, and personal and intranet support was provided to the KBs. Survey data were collected by questionnaire prior to, immediately following the intervention (six months, and at 12 and 18 months. A mixed effects multinomial logistic regression was used to examine the impact of the intervention over time and by region. The impact of organizational factors was also explored. Results PTs' self-reported knowledge of all four measurement tools increased significantly over the six-month intervention, and reported use of three of the four measurement tools also increased. Changes were sustained 12 months later. Organizational culture for research and supervisor expectations were significantly associated with uptake of only one of the four measurement tools. Conclusions KBs

  3. Using knowledge brokers to facilitate the uptake of pediatric measurement tools into clinical practice: a before-after intervention study.

    Science.gov (United States)

    Russell, Dianne J; Rivard, Lisa M; Walter, Stephen D; Rosenbaum, Peter L; Roxborough, Lori; Cameron, Dianne; Darrah, Johanna; Bartlett, Doreen J; Hanna, Steven E; Avery, Lisa M

    2010-11-23

    The use of measurement tools is an essential part of good evidence-based practice; however, physiotherapists (PTs) are not always confident when selecting, administering, and interpreting these tools. The purpose of this study was to evaluate the impact of a multifaceted knowledge translation intervention, using PTs as knowledge brokers (KBs) to facilitate the use in clinical practice of four evidence-based measurement tools designed to evaluate and understand motor function in children with cerebral palsy (CP). The KB model evaluated in this study was designed to overcome many of the barriers to research transfer identified in the literature. A mixed methods before-after study design was used to evaluate the impact of a six-month KB intervention by 25 KBs on 122 practicing PTs' self-reported knowledge and use of the measurement tools in 28 children's rehabilitation organizations in two regions of Canada. The model was that of PT KBs situated in clinical sites supported by a network of KBs and the research team through a broker to the KBs. Modest financial remuneration to the organizations for the KB time (two hours/week for six months), ongoing resource materials, and personal and intranet support was provided to the KBs. Survey data were collected by questionnaire prior to, immediately following the intervention (six months), and at 12 and 18 months. A mixed effects multinomial logistic regression was used to examine the impact of the intervention over time and by region. The impact of organizational factors was also explored. PTs' self-reported knowledge of all four measurement tools increased significantly over the six-month intervention, and reported use of three of the four measurement tools also increased. Changes were sustained 12 months later. Organizational culture for research and supervisor expectations were significantly associated with uptake of only one of the four measurement tools. KBs positively influenced PTs' self-reported knowledge and self

  4. A comparison of work-related physical activity levels between inpatient and outpatient physical therapists: an observational cohort trial.

    Science.gov (United States)

    Brewer, Wayne; Ogbazi, Raluchukwu; Ohl, Devan; Daniels, Jeffry; Ortiz, Alexis

    2016-06-16

    Physical therapists (PTs) work in a variety of healthcare settings with varied levels of physical activity demands placed on them. The purpose of this study is to compare the physical activity (PA) levels between PTs in inpatient versus outpatient environments for one work week using a cross-sectional design. Sixty-one PTs (30 inpatient, 31 outpatient) wore a tri-axial accelerometer and inclinometer for one work-week. The number steps-per-day, PA intensities, energy expenditures and postural positions adopted during the work day were recorded. Significantly longer amounts of time spent sitting was found for inpatient PTs regardless of the significantly higher number of steps-per-day. Outpatient PTs had a higher number of breaks from sedentary activity with those breaks being longer than the inpatient PTs. The percentage of time spent performing moderate-vigorous PA approached significance implying more time was spent performing these types of activities for outpatient PTs. The energy expenditures between the two groups of PTs were not different. This study compared the differences in physical activity levels between physical therapists who worked at inpatient versus outpatient environment as little is known about their activity levels. Inpatient physical therapists took more steps per day than outpatient physical therapists but the outpatient physical therapists were less sedentary and took more frequent and longer breaks from sedentary activities. The energy expenditures were similar between both types of therapists and this may be reflective of the gender and bodyweight differences between the groups that equalizes the energy expenditures. The findings of this study suggests that there are differences in the physical activity demands between inpatient and outpatient physical therapists. The results of this study may serve dual purposes: (1) employers may be able to more accurately describe the expected physical activity demands to future employees; (2

  5. 131I therapy for hyperthyroidism with large goitre

    International Nuclear Information System (INIS)

    Zhang Chenggang

    2002-01-01

    Objective: This retrospective analysis is to study the effects of radioiodine in hyperthyroidism with large goitre and observe the possibility to take the place of surgery. Methods: 82 patients (pts) with hyperthyroidism including 51 female and 31 male, age ranging from 11 to 75 years old (mean 35.43 ± 12.14), were treated with 131 I. All patients presented with typical clinical and biochemical hyperthyroidism and were followed up for 3-38 months after 131 I treatment. Patients were categorized into 2 diagnostic groups: Graves disease (43 pts) and toxic multinodular goitres (39 pts). Gland weights were estimated by palpation and scintigraphy. Cold nodule had not been found in scintigraphy in all pts. The dose in mCi administered were determined according to therapeutic history, thyroid weight (g), rate of uptake 131 I, patient's symptoms and course of disease, etc. 76 pts (92.7%) had iII degree goitre. Goitre weight was stratified into 150-200 g (67 pts), 201-300 g (13 pts) and 400-500 g (2pts). 71 pts (86.6%) were given one dose of 131 I, 10 pts (12.2%) two doses, one patient had three doses. The mean first dose was 39.26 ± 19.63 mCi (14-130 mCi). The mean first μCi/g was 142.89±32.29 μCi (59-200). Results: 24 pts (29.3%) had complete remission (euthyroid), 19 pts (23.2%) had partial resolution. 39 (47.6%) pts had hypothyroidism (HP) including 8 permanent HP, 11 transient HP, 3 subclinical HP and 17 indeterminate HP. The later group had HP that could not be decided to be transient or permanent because the time of following up was less than one year. After 131 I therapy, goitres of 43 pts (52.4%) became 0 degree, 34 pts (41.5%) became I degree, 4 pts (4.9%) had II degree and only one pt still had a III degree goitre. Conclusions: 131 I therapy is a safe and effective method for treating hyperthyroidism with large goitre. If the large goitre does not have cold nodule in scintigraphy, 131 I treatment may replace surgery

  6. Emotional, physical, and sexual abuse and the association with symptoms of depression and posttraumatic stress in a multi-ethnic pregnant population in southern Sweden.

    Science.gov (United States)

    Wangel, Anne-Marie; Ryding, Elsa Lena; Schei, Berit; Östman, Margareta; Lukasse, Mirjam

    2016-10-01

    This study aims to describe the prevalence of emotional, physical, and sexual abuse and analyze associations with symptoms of depression and posttraumatic stress (PTS) in pregnancy, by ethnic background. This is a cross-sectional study of the Swedish data from the Bidens cohort study. Ethnicity was categorized as native and non-native Swedish-speakers. Women completed a questionnaire while attending routine antenatal care. The NorVold Abuse Questionnaire (NorAQ) assessed a history of emotional, physical or sexual abuse. The Edinburgh Depression Scale-5 measured symptoms of depression. Symptoms of Posttraumatic Stress (PTS) included intrusion, avoidance and numbness. Of 1003 women, 78.6% were native and 21.4% were non-native Swedish-speakers. Native and non-native Swedish-speakers experienced a similar proportion of lifetime abuse. Moderate emotional and physical abuse in childhood was significantly more common among non-native Swedish-speakers. Sexual abuse in adulthood was significantly more prevalent among native Swedish-speakers. Emotional and sexual abuse were significantly associated with symptoms of depression for both natives and non-natives. Physical abuse was significantly associated with symptoms of depression for non-natives only. All types of abuse were significantly associated with symptoms of PTS for both native and non-native Swedish-speakers. Adding ethnicity to the multiple binary regression analyses did not really alter the association between the different types of abuse and symptoms of depression and PTS. The prevalence of lifetime abuse did not differ significantly for native and non-native Swedish-speakers but there were significant differences on a more detailed level. Abuse was associated with symptoms of depression and PTS. Being a non-native Swedish-speaker did not influence the association much. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. A method to identify early ventricular dysfunction using resting gated blood pool scans (GBPS) in patients with coronary artery disease (CAD)

    International Nuclear Information System (INIS)

    Schwarzberg, R.J.; Seldin, D.W.; Johnson, L.L.; Alderson, P.O.

    1984-01-01

    To determine the sensitivity of regional 1st and 2nd time derivative (1DV, 2DV) images to assess ventricular function (VF) in CAD, the resting GBPS of 8 normal patients (pts) and 20 pts with CAD who had coronary angiography and contrast ventriculography (CV) were analyzed. The 1DV and 2DV of the systolic time-activity curve were determined for each left ventricular pixel in the GBPS. These values were displayed as functional images that were reviewed by three readers to determine the presence of regional abnormalities. No regional abnormalities were seen in the conventional GBPS or 1DV or 2DV images of the 8 normal pts. Regional GBPS and DV image abnormalities were seen in all 10 pts with CAD and abnormal wall motion by CV. The DV image abnormalities were in the distribution of 18/22 coronary arteries (CA) with ≥50% stenoses; 2 of these regions showed normal wall motion by CV and conventional GBPS. DV images were abnormal in 2/8 CAs without significant stenoses. In addition, regional DV image abnormalities were present in 9 of 10 pts with CAD who had normal wall motion and global ejection fraction by both CV and resting GBPS. These 10 pts showed regional abnormalities in the distribution of 13/15 CAs with significant stenoses and 2/15 CAs without such stenoses. The results suggest that time derivative functional images derived from resting GBPS provide a more sensitive means for detecting regional left ventricular dysfunction than several other current methods, especially in pts with mild CAD

  8. Rheumatoid arthritis: Clinical, SPECT and MRI investigations

    International Nuclear Information System (INIS)

    Ascoli, G.; Cinti, P.; Nonni, M.; Rossi, B.

    2002-01-01

    Aim: To demonstrate psychometric test and neuroimaging technic capacity in subclinical conditions of cerebral affection in patients with rheumatoid arthritis; to demonstrate agreement between topographic cerebral site and morphological signs in neuroimaging study; to evaluate agreement between cognitive deficits and rheumatoid severity. Material and Method: We have enrolled 20 patients, 17 pts. (85%) showed low score evocative for executive function limitation; 6 pts. (33%) showed attention anomaly, movement organization and verbal fluency. SPECT acquisition shows frontal lobe uptake in 95% (19/20 pts.) extended to parietal lobs in 42% (8/19pts.); 1 pt. Shows normal uptake and very high score. RMN study shows a specific sign of leukoencephalopaty in 35% (7/20pts.) and liquoral spaces increased in 25% (5/20 pts.). Conclusions: Frequent cognitive functions alteration during rheumatoid arthritis; very high topographic agreement between cognitive deficits and cerebral perfusion uptake showed by SPECT study; significant correlation between severity index and disease activity and cognitive deterioration; necessity of further longitudinal study for greater number of patient; pathogenetic disconnect mechanism cortical-subcortical by vasculitic reason or deafferentation jointed to negative interaction between motor limit and cognitive deficit

  9. Quantification of the extent and severity of myocardial ischemia in single-vessel disease using stress-redistribution thallium-201 single-photon emission computerized tomography

    Energy Technology Data Exchange (ETDEWEB)

    Prigent, F.; Maddahi, J.; Garcia, E.; VanTrain, K.; Friedman, J.; Bietendorf, J.; Swan, H.J.C.; Waxman, A.; Berman, D.

    1984-01-01

    Single-vessel coronary artery (CA) disease (SVD) is not uniformly benign: long-term prognosis is likely to be related to the extent (E) and severity (S) of myocardial ischemia (isch). To assess the ability of stress thalium-201 (Tl) single photon emission computerized tomography (SPECT) to quantify E and S of isch, the authors studied 15 patients (pts) without myocardial infarction who had SVD (8 LAD, 4 RCA, and 3 LCX). SPECT cuts were analyzed using maximum count circumferential profiles (CPs) which were compared with previously established normal (nl) limits derived from 20 nl pts. E of isch was defined as the % of the CP points falling below nl, S and depth (D) of ischemia respectively expressed the total and the mean % by which the abnormal points fell below normal limits. Although all pts had SVD, the range of E, S and D of isch was wide (0 to 48% and 0 to 38% and 0 to 20% respectively). CA scores (CS) were derived using a 15-point system accounting for the distribution of the diseased CA, location, and degree of stenosis, and collateral supply. CS varied from 1.2 to 8. E and S significantly correlated with CS (r=.74,p=.001, and r=.78, p=.000, respectively). The 6 pts with a D less than or equal to .1 had 75% CA stenosis whereas 5 of the 9 pts with D <.1 had only 50-75% stenosis. Thus, the authors conclude that: 1) pts with SVD have highly differing degrees of isch; 2) E, S and D scores from Tl SPECT correlate favorably with the angiographic extent and severity of disease; and 3) SPECT offers potential for quantification of the magnitude of isch and may become a useful, noninvasive prognostic indicator.

  10. Catheter-Directed Thrombolysis for Treatment of Deep Venous Thrombosis in the Upper Extremities

    International Nuclear Information System (INIS)

    Vik, Anders; Holme, Pal Andre; Singh, Kulbir; Dorenberg, Eric; Nordhus, Kare Christian; Kumar, Satish; Hansen, John-Bjarne

    2009-01-01

    Traditional anticoagulant treatment of deep venous thrombosis (DVT) in the upper extremities (UEDVT) is associated with a relatively high incidence of postthrombotic syndrome (PTS). Catheter-directed thrombolysis (CDT) for UEDVT would provide efficient thrombolysis with less subsequent PTS than during traditional anticoagulation. Primary efficacy, complications, and long-term results after CDT are reported in a retrospective cohort (2002-2007) of patients (n = 30) with DVT in the upper extremities. PTS was assessed by a modified Villalta scale. UEDVT was unprovoked in 11 (37%) cases and effort related in 9 (30%) cases. The median duration of symptoms prior to CDT was 7.0 days (range, 1-30); median duration of thrombolysis treatment, 70 h (range, 24-264 h); and the median amount of rt-PA infused during CDT, 52 mg (range, 19-225 mg). Major bleeding was registered in three (9%) patients, and CDT was stopped prematurely in three patients due to local hematoma. No intracerebral bleeding, clinical pulmonary embolism, or deaths occurred during treatment. Grade II (>50%) or III (>90%) lysis was present in 29 patients (97%) at the end of CDT. Bleeding complications increased by each day of delay from the debut of symptoms to the start of treatment (OR, 1.20; 95% CI, 1.01-1.42). At follow-up (n = 29; median, 21 months; range, 5-58 months), 11 (38%) patients had occluded veins, whereas 18 (62%) had patent veins. However, stenosis of varying severity was present in eight of those with a patent vein. No patients had severe PTS, whereas six (21%) experienced mild PTS. In conclusion, our retrospective cohort study of patients with UEDVT showed that treatment restored venous drainage, with a subsequent low frequency of mild PTS at follow-up. Early intervention with CDT prevented bleeding complications.

  11. DOES URINARY DIVERSION IMPROVE THE QUALITY OF LIFE IN OBSTRUCTIVE UROPATHY SECONDARY TO ADVANCED PELVIC MALIGNANCY?

    Directory of Open Access Journals (Sweden)

    Shivashankarappa

    2016-02-01

    Full Text Available INTRODUCTION The incidence of patients presenting with advanced pelvic malignancy with obstructive uropathy is high in our country. Relentless progress of the malignancy will cause deterioration of renal function, aggravation of pain, infection, deterioration of Quality of Life (QOL, uremia and death. Decreased renal function is considered as a contraindication for palliative chemo and radiotherapy. However urinary diversion in these patients will lead to improvement in renal function and may help in administration of palliative therapy and thus, improve the quality of life of these patients. MATERIALS AND METHODS The present study includes the obstructive uropathy patients secondary to pelvic malignancy referred to our institution for urinary diversion between Jan 2010 to Dec 2014. Total 40 patients were included, of which, 25 patients underwent PCN, 9 patients retrograde DJ stenting, 4 patients refused the treatment, 2 patients were not fit for any intervention due to coagulopathy & comorbid conditions. Of 34 treated patients, 30 were female patients and 4 were male patients. All the patients were explained about the procedure and proper consent taken. Laboratory investigations like CBC, coagulation profile, LFT, routine urine analysis, urine C&S and serum electrolytes were carried out. Haemodialysis was done for 10 patients whose serum creatinine was >6mg% & potassium >6meq. USG guided PCN insertion was done in 8 patients, and in those who failed in this procedure, fluoroscopic C-ARM guided PCN insertion done in 17 patients. Post operatively RFT and serum electrolytes were assessed on 3, 7, 15, & 30th day. PCN catheter was changed once in 3 months. RESULTS 8 patients succeeded in USG guided PCN insertion and 17 patients who failed USG PCN insertion, was done under C–Arm guidance. 3 patients received blood transfusion. No deaths were seen during or post procedure in the hospital. Renal functions improved and normalised in most of the

  12. C-reactive protein in antiphospholipid syndrome: relationship with cardiovascular pathology

    Directory of Open Access Journals (Sweden)

    N V Seredavkina

    2009-01-01

    Full Text Available Objective. To assess relationship of high sensitivity C reactive protein (hsCRP level in pts with antiphospholipid syndrome (APS with clinico-laboratory features and cardiovascular pathology. Material and methods. 206 pts were included. 58 from them had primary APS (PAPS, 72 –systemic lupus erythematosus (SLE with APS and 76 – SLE. 29 from 76 pts of the latter group were positive on anticardiolipin antibodies (ACA – SLE with antiphospholipid antibodies (APhL and 47 – low positive or negative on ACA – SLE without APhL. 72 persons without autoimmune diseases were included into control group. CRP (with high sensitivity immuno-nephelometric assay, APhL (with solid phase immuno-enzyme assay, plasma lipids were evaluated, sonography with measurement of intima-media complex (IMC thickness of common carotid arteries, carotid artery bulbs and internal carotid arteries, electrocardiography (ECG, echocardiography (EchoCG, Holter ECG monitoring were performed. Results. HsCRP serum level in pts was significantly higher than in control: 2,55 [0,71; 7,04] mg/l (varied from 0,15 to 39,85 vs 0,68 [0,26; 1,97] mg/l (varied from 0,1 to 9,61, p<0,001. Most high hsCRP concentration was found in SLE with APS (p=0,02. HsCRP level in pts with PAPS with history of combined or isolated arterial thrombosis was significantly higher than in pts with SLE and APS having the same localization of thrombosis. HsCRP concentration less than 3 mg/l correlated with duration of postthrombotic period in pts with PAPS. HsCRP level also correlated with triglyceride concentration, body mass index, summated coronary risk and magistral arteries IMC thickness. Conclusion. HsCRP elevation in pts with APS was associated with development of combined and arterial thrombosis as well as with traditional risk factors of atherosclerosis.

  13. [A decade of antiretroviral therapy: a profile of patients with 10 years of highly effective triple therapy].

    Science.gov (United States)

    Wilson, Gonzalo; Wolff, Marcelo

    2012-06-01

    Highly effective antiretroviral triple therapy (TAR3) has led to a significant increase in survival of patients (pts) infected with human immunodeficiency virus. In 1999 it was started in the Chilean public health system, including Arriarán Foundation (FA) access to TAR, reaching full coverage since 2003. By October 31, 2009 124 pts had reached 10 years of uninterrupted TAR3 in FA. To describe and analyze the profile of pts, their therapeutic regimen (s) and clinical outcomes during 10 years of TAR3. Retrospective descriptive study. We reviewed the records of pts who had reached 10 years of uninterrupted TAR3 in FA. Demographic data, baseline and virological staging at start of TAR3, comorbidities and complications were recorded. Drug regimens used were analyzed, as well as toxicity, virological and immunological outcomes, frequency and reasons for change in therapy. Complications were classified as opportunistic and not opportunistic during this evolution and the latest known clinical and laboratory data were registered. A database program based on Excel was used. 121/124 pts were available for analysis, 76.8% male, male-female ratio was 3.3:1. Baseline median age: 36 years (20-69); CD4 cells 176/ mm³ (8-1,224) with 65.3% average of 3.5 therapies regimens during the decade (range, 1 [14 pts, 11.5%] to 7 [3 pts, 2.4%]), with average duration of 42 months each and a median of 36 months. As initial TAR3 regimen 2 backbone nucleoside analogues (ITRN) was the most frequent, with a protease inhibitor (PI) in 51.2% and non-nucleoside RTIs (NNRTIs) in 38.8%. Adverse reactions were the main reason for change of therapy (24.7%), followed by virological failure (24.2%) and treatment simplification (16.6%). At the latest assessment, all with > 10 years of TAR3 median CD4 was 602 cells/mm³, 11 pts (9%) had CD4 < 200/mm³; 85.2% had undetectable VL (< 80 copies/mL); the remaining 14.8% had a median of 1,800 copies/mL. Only 2 pts (1.7%) were in AIDS clinical stage. Current

  14. Radionuclide transit in esophageal varices

    International Nuclear Information System (INIS)

    Yeh, S.H.; Wang, S.J.; Wu, L.C.; Liu, R.S.; Tsai, Y.T.; Chiang, T.T.

    1985-01-01

    This study assessed esophageal motility in patients with esophageal varices by radionuclide transit studies. Data were acquired in list mode after an oral dose of 0.5 mCi Tc-99m sulfur colloid in 10 ml of water in the supine position above a low-energy all-purpose collimator of a gamma camera. The condensed image (CI) superimposed with a centroid curve was also produced in each case. Twenty-five normal subjects (N) and 32 patients (pts) with esophageal varices by endoscopy (large varices in Grades IV and V in 8 and small varices in Grade III or less in 24) were studied. TMTT, RTT, RF, and RI were all significantly increased in pts as compared to N. Especially, the transit time for the middle third (6.7 +- 2.6 sec vs 3.5 +- 0.9 sec in N, rho < 0.005) had the optimal sensitivy and specificity of 88% each at the cutoff value of 4.2 sec as determined by ROC analysis. In summary, radionuclide transit disorders occur in the majority of pts with esopageal varices. The middle RTT and CI are both optimal in sensitivity and specificity for detecting the abnormalities

  15. Exploring the association between posttraumatic growth and PTSD: a national study of Jews and Arabs following the 2006 Israeli-Hezbollah war.

    Science.gov (United States)

    Hall, Brian J; Hobfoll, Stevan E; Canetti, Daphna; Johnson, Robert J; Palmieri, Patrick A; Galea, Sandro

    2010-03-01

    Posttraumatic growth (PTG)-deriving benefits following potentially traumatic events-has become a topic of increasing interest. We examined factors that were related to self-reported PTG, and the relationship between PTG and symptoms of post-traumatic stress (PTS) following the 2006 Israel-Hezbollah. Drawing from a national random sample of Israel, data from 806 terrorism-exposed Israeli adults were analyzed. PTG was associated with being female, lower education, greater recent terrorism exposure, greater loss of psychosocial resources, greater social support, and greater self-efficacy. PTG was a consistent predictor of PTS across hierarchical linear regression models that tested whether demographic, stress, or personal resources moderated the relationship between PTG and PTS. PTG did not relate to PTS differently for people who differed by age, sex, ethnicity, education, religiosity, degree of terrorism exposure, self-efficacy, nonterrorism stressful life events, and loss of psychosocial and economic resources. PTG was not related to well-being for any of these subgroups.

  16. Posttraumatic stress and growth: the contribution of cognitive appraisal and sense of belonging to the country.

    Science.gov (United States)

    Dekel, Rachel; Nuttman-Shwartz, Orit

    2009-05-01

    The study has three aims: (1) to compare the effect of the Qassam attacks in two types of communities: development town and kibbutz; (2) to examine the relationship between posttraumatic stress (PTS) and posttraumatic growth (PTG); and (3) to examine the contribution that level of exposure, cognitive appraisal, and sense of belonging to the country make to PTS and PTG. The sample consisted of 134 residents, 67 living on two kibbutzim and 67 living in the development town of Sderot. Results revealed that the development town residents reported more PTS symptoms and more PTG than did the kibbutz residents, and the association between PTS and PTG was positive. In addition, the findings show that most of the predictors contribute to either PTS or PTG, or predicted them differently. The discussion examines the results in light of the current literature on PTS and PTG.

  17. Pneumatic tube system transport does not alter platelet function in optical and whole blood aggregometry, prothrombin time, activated partial thromboplastin time, platelet count and fibrinogen in patients on anti-platelet drug therapy

    Science.gov (United States)

    Enko, Dietmar; Mangge, Harald; Münch, Andreas; Niedrist, Tobias; Mahla, Elisabeth; Metzler, Helfried; Prüller, Florian

    2017-01-01

    Introduction The aim of this study was to assess pneumatic tube system (PTS) alteration on platelet function by the light transmission aggregometry (LTA) and whole blood aggregometry (WBA) method, and on the results of platelet count, prothrombin time (PT), activated partial thromboplastin time (APTT), and fibrinogen. Materials and methods Venous blood was collected into six 4.5 mL VACUETTE® 9NC coagulation sodium citrate 3.8% tubes (Greiner Bio-One International GmbH, Kremsmünster, Austria) from 49 intensive care unit (ICU) patients on dual anti-platelet therapy and immediately hand carried to the central laboratory. Blood samples were divided into 2 Groups: Group 1 samples (N = 49) underwent PTS (4 m/s) transport from the central laboratory to the distant laboratory and back to the central laboratory, whereas Group 2 samples (N = 49) were excluded from PTS forces. In both groups, LTA and WBA stimulated with collagen, adenosine-5’-diphosphate (ADP), arachidonic acid (AA) and thrombin-receptor-activated-peptide 6 (TRAP-6) as well as platelet count, PT, APTT, and fibrinogen were performed. Results No statistically significant differences were observed between blood samples with (Group 1) and without (Group 2) PTS transport (P values from 0.064 – 0.968). The AA-induced LTA (bias: 68.57%) exceeded the bias acceptance limit of ≤ 25%. Conclusions Blood sample transportation with computer controlled PTS in our hospital had no statistically significant effects on platelet aggregation determined in patients with anti-platelet therapy. Although AA induced LTA showed a significant bias, the diagnostic accuracy was not influenced. PMID:28392742

  18. Blood histamine release: A new allergy blood test

    International Nuclear Information System (INIS)

    Faraj, B.A.; Gottlieb, G.R.; Camp, V.M.; Lollies, P.

    1985-01-01

    Allergen-mediated histamine release from human leukocytes represents an important model for in vitro studies of allergic reactions. The purpose of this study was to determine whether the measurement of histamine released in allergic patients (pts) by radioenzymatic assay following mixing of their blood with common allergens represents a reliable index for diagnosis of atopic allergy. Three categories of allergies were used: (1) housedust and mite; (2) cat and dog dander; (3) trees and grasses and ragweed mixture. The presence of allergy was established by intradermal skin testing in the study group of 82 pts. Significant atopy was defined as ≥ 3+ (overall range 0-4 +, negative to maximum) on skin testing. The test was carried out in tubes with 0.5 ml heparinized blood, 0.5 ml tris albumin buffer, and one of the allergens (60-100 PNU/ml). In 20 controls without allergy, there always was ≤ 4% histamine release (normal response). A significant allergen-mediated histamine release, ranging from 12 to 30% of the total blood histamine content, was observed in 96% of the pts with skin test sensitivity of ≥ 3+. There was good agreement between skin testing and histamine release in terms of the allergen causing the response. Thus, measurement of histamine release in blood in response to allergen challenge represents a clinically useful in vitro test for the diagnosis of atopic allergy. Because data can be obtained from a single sample and are highly quantitative, this new method should have application to the longitudinal study of allergic pts and to the assessment of interventions

  19. Etanercept In the treatment of AA-amyloidosis in juvenile rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    H Mihels

    2004-01-01

    Full Text Available Objective. To study effect of etanercept, an antagonist of serum A amyloid production in the AA amyloidosis treatment in juvenile idiopathic arthritis (JIA. Material and methods. Etanercept was administered to all pts with AA amyloidosis admitted to Garmisch-Paterkirchen pediatric rheumatological clinic beginning with 2000. C-reactive protein (CRP, degree of proteinuria and serum creatinin were used as preliminary outcome measures. Results. 11 pts with seronegative JIA (6 boys and 5 girls were included in the study. Mean follow up duration was l,9±l.01 years. 8 children had systemic, 2 - olygoarticular and one - polyarticular disease onset. Before the study all pts had CRP level elevation (1,03-8,29 mg/dl, mean 4,53 mg/dl. 8 from 11 had marked proteinuria (364-7400 mg/24 hours, mean 1186 mg/24 hours. 2 from 11 had serum creatinin elevation. During etanercept treatment CRP level normalized in 2 and significantly decreased in 4 pts. Proteinuria decreased in 4 from 8 pts. Significant change of creatinin level was not achieved. One girl who did not have improvement during etanercept treatment showed CRP normalization and decrease of proteinuria when the drug was changed to infliximab. Conclusion. Treatment with etanercept provided improvement in almost 2/3 from 11 pts with JIA and AA amyloidosis. Etanercept may be the drug of choice in pts with normal creatinine level in the absence of proteinuria. When it fails another tumor necrosis factor antagonist such as infliximab should be used. It is necessary to extend volume and duration of the study to get more reliable data on etanercept efficacy in JIA pts with AA amyloidosis.

  20. Developing a Web Platform to Support a Community of Practice: A Mixed Methods Study in Pediatric Physiotherapy.

    Science.gov (United States)

    Pratte, Gabrielle; Hurtubise, Karen; Rivard, Lisa; Berbari, Jade; Camden, Chantal

    2018-01-01

    Web platforms are increasingly used to support virtual interactions between members of communities of practice (CoP). However, little is known about how to develop these platforms to support the implementation of best practices for health care professionals. The aim of this article is to explore pediatric physiotherapists' (PTs) perspectives regarding the utility and usability of the characteristic of a web platform developed to support virtual communities of practice (vCoP). This study adopted an explanatory sequential mixed methods design. A web platform supporting the interactions of vCoP members was developed for PTs working with children with developmental coordination disorder. Specific strategies and features were created to support the effectiveness of the platform across three domains: social, information-quality, and system-quality factors. Quantitative data were collected from a cross-sectional survey (n = 41) after 5 months of access to the web platform. Descriptive statistics were calculated. Qualitative data were also collected from semistructured interviews (n = 9), which were coded, interpreted, and analyzed by using Boucher's Web Ergonomics Conceptual Framework. The utility of web platform characteristics targeting the three key domain factors were generally perceived positively by PTs. However, web platform usability issues were noted by PTs, including problems with navigation and information retrieval. Web platform aiming to support vCoP should be carefully developed to target potential users' needs. Whenever possible, users should co-construct the web platform with vCoP developers. Moreover, each of the developed characteristics (eg, newsletter, search function) should be evaluated in terms of utility and usability for the users.

  1. The probabilistic structural integrity assessment of reactor pressure vessels under pressurized thermal shock loading

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Mingya, E-mail: chenmingya@cgnpc.com.cn [Suzhou Nuclear Power Research Institute, 215004 Suzhou, Jiangsu Province (China); Lu, Feng; Wang, Rongshan; Yu, Weiwei [Suzhou Nuclear Power Research Institute, 215004 Suzhou, Jiangsu Province (China); Wang, Donghui [State Nuclear Power Plant Service Company, 200237 Shanghai (China); Zhang, Guodong; Xue, Fei [Suzhou Nuclear Power Research Institute, 215004 Suzhou, Jiangsu Province (China)

    2015-12-01

    Highlights: • The methodology and the case study of the FAVOR software were shown. • The over-conservative parameters in the DFM were shown. • The differences between the PFM and the DFM were discussed. • The limits in the current FAVOR were studied. - Abstract: The pressurized thermal shock (PTS) event poses a potentially significant challenge to the structural integrity of the reactor pressure vessel (RPV) during the long time operation (LTO). In the USA, the “screening criteria” for maximum allowable embrittlement of RPV material, which forms part of the USA regulations, is based on the probabilistic fracture mechanics (PFM). The FAVOR software developed by Oak Ridge National Laboratory (ORNL) is used to establish the regulation. As the technical basis of FAVOR is not the most widely-used and codified methodologies, such as the ASME and RCC-M codes, in most countries (with exception of the USA), proving RPV integrity under the PTS load is still based on the deterministic fracture mechanics (DFM). As the maximum nil-ductility-transition temperature (RT{sub NDT}) of the beltline material for the 54 French RPVs after 40 years operation is higher than the critical values in the IAEA-TECDOC-1627 and European NEA/CSNI/R(99)3 reports (while still obviously lower than the “screening criteria” of the USA), it may conclude that the RPV will not be able to run in the LTO based on the DFM. In the FAVOR, the newest developments of fracture mechanics are applied, such as the warm pre-stress (WPS) effect, more accurate estimation of the flaw information and less conservation of the toughness (such as the three-parameter Weibull distribution of the fracture toughness). In this paper, the FAVOR software is first applied to show both the methodology and the results of the PFM, and then the limits in the current FAVOR software (Version 6.1, which represents the baseline for re-assessing the regulation of 10 CFR 50.61), lack of the impact of the constraint effect

  2. Coping responses in the midst of terror: the July 22 terror attack at Utøya Island in Norway.

    Science.gov (United States)

    Jensen, Tine K; Thoresen, Siri; Dyb, Grete

    2015-02-01

    This study examined the peri-trauma coping responses of 325 survivors, mostly youth, after the July 22, 2011 terror attack on Utøya Island in Norway. The aim was to understand peri-trauma coping responses and their relation to subsequent post-traumatic stress (PTS) reactions. Respondents were interviewed face-to-face 4-5 months after the shooting, and most were interviewed at their homes. Peri-trauma coping was assessed using ten selected items from the "How I Cope Under Pressure Scale" (HICUPS), covering the dimensions of problem solving, positive cognitive restructuring, avoidance, support seeking, seeking understanding, and religious coping. PTS reactions were assessed with the UCLA PTSD Reaction Index. The participants reported using a wide variety of coping strategies. Problem solving, positive cognitive restructuring, and seeking understanding strategies were reported most often. Men reported using more problem-solving strategies, whereas women reported more emotion-focused strategies. There were no significant associations between age and the use of coping strategies. Problem solving and positive cognitive restructuring were significantly associated with fewer PTS reactions. The results are discussed in light of previous research and may help to inform early intervention efforts for survivors of traumatic events. © 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

  3. Measurement of Posterior Tibial Slope Using Magnetic Resonance Imaging.

    Science.gov (United States)

    Karimi, Elham; Norouzian, Mohsen; Birjandinejad, Ali; Zandi, Reza; Makhmalbaf, Hadi

    2017-11-01

    Posterior tibial slope (PTS) is an important factor in the knee joint biomechanics and one of the bone features, which affects knee joint stability. Posterior tibial slope has impact on flexion gap, knee joint stability and posterior femoral rollback that are related to wide range of knee motion. During high tibial osteotomy and total knee arthroplasty (TKA) surgery, proper retaining the mechanical and anatomical axis is important. The aim of this study was to evaluate the value of posterior tibial slope in medial and lateral compartments of tibial plateau and to assess the relationship among the slope with age, gender and other variables of tibial plateau surface. This descriptive study was conducted on 132 healthy knees (80 males and 52 females) with a mean age of 38.26±11.45 (20-60 years) at Imam Reza hospital in Mashhad, Iran. All patients, selected and enrolled for MRI in this study, were admitted for knee pain with uncertain clinical history. According to initial physical knee examinations the study subjects were reported healthy. The mean posterior tibial slope was 7.78± 2.48 degrees in the medial compartment and 6.85± 2.24 degrees in lateral compartment. No significant correlation was found between age and gender with posterior tibial slope ( P ≥0.05), but there was significant relationship among PTS with mediolateral width, plateau area and medial plateau. Comparison of different studies revealed that the PTS value in our study is different from other communities, which can be associated with genetic and racial factors. The results of our study are useful to PTS reconstruction in surgeries.

  4. Prostate Cancer Clinical Trials Group: The University of Michigan Site

    Science.gov (United States)

    2012-04-01

    Michigan Cancer Center, Ann Arbor, MI Abstract Disclosures Abstract: Background: Cabozantinib ( Cabo ) is an inhibitor of MET and VEGFR2. MET signaling...promotes tumor growth, invasion and metastasis. Methods: mCRPC patients (pts) with progressive measurable disease (mRECIST) received Cabo at 100 mg...qd PO over a 12 week (wk) lead-in stage. Response was assessed q6 wks. Treatment ≥ wk 12 was based on response: pts with PR continued open-label Cabo

  5. Mono centric evaluation of the skin and cardiac toxicities of the concomitant administration of trastuzumab and radiotherapy; Evaluation monocentrique de la tolerance de l'association concomitante de trastuzumab et de radiotherapie

    Energy Technology Data Exchange (ETDEWEB)

    Kirova, Y.M.; Caussa, L.; Dendale, R.; Campana, F.; Tournat, H.; Fourquet, A.; Bollet, M.A. [Institut Curie, Dept. d' Oncologie-Radiotherapie, 75 - Paris (France); Granger, B.; Savignoni, A. [Institut Curie, Service de Bio-Statistique, 75 - Paris (France); Pierga, J.Y. [Institut Curie, Dept. d' Oncologie-Medicale, 75 - Paris (France)

    2009-07-15

    Purpose Prospective mono centric study of the skin and heart tolerance of a concurrent administration of trastuzumab (T) and radiotherapy (R.T.) for breast cancer (B.C.). Patients and methods From February 2004 to January 2007, 57 patients (pts), were treated by a concomitant administration of T and normo-fractionated R.T. of either whole breast ({+-} boost) or chest. The perfusion of T started either with or after chemotherapy (CT). Left ventricular ejection fractions (L.E.V.F.), assessed at baseline, before start of R.T., after completion of R.T. and then every four to six months with either echocardiography or multiple gated acquisition scanning, were considered normal if greater or equal to 50% or stated so by the cardiologist. Inclusion criteria included a normal L.V.E.F. at baseline. Skin toxicity was evaluated using C.T.C.A.E., V.3 ( for common terminology criteria for adverse events, version 3.0). Median age was 49 years (25-80). CT with anthracycline was administered in 84% (total dose 300 mg/m2). All but one patient (treated weekly) received T every three weeks (8 mg/kg followed by 6 mg/kg) for a median duration of 12 months (6-33). The internal mammary chain was irradiated in 88% of cases. Median follow-up for L.V.E.F. assessment was 13 months (2-33). Results L.V.E.F. at pre-R.T. were normal in 54 pts (100%, three Missing Data [M.D.]), at post-R.T. in 56 pts (98%, no M.D.) and at last follow-up in 53 pts (95%, one M.D.). There were two grade 0, 44 grade I and 11 grade II skin reactions. For the 27 patients with a skin toxicity assessment after six months, late skin toxicity was grade 0 in 22 pts, grade 1 in four, grade 2 in one. Conclusion Provided that the technique is adapted, the acute skin and heart toxicities of the concomitant administration of T-R.T. appeared satisfactory. More patients and longer follow-up are still mandatory. (authors)

  6. Factors influencing post-traumatic stress in Korean forensic science investigators.

    Science.gov (United States)

    Yoo, Yang-Sook; Cho, Ok-Hee; Cha, Kyeong-Sook; Boo, Yun-Jeong

    2013-09-01

    The aim of this study was to understand factors that influence post-traumatic stress (PTS) in Korean forensic science investigators. A total of 111 forensic science investigators were recruited in Korea. PTS was measured using the tool modified by Choi (2001) from the original developed by Foa, Riggs, Dancu, and Rothbaum (1993) based on DSM-IV. Factors influencing PTS included demographic and job-related characteristics, emotional intelligence, and death anxiety. PTS scores were positively correlated with personality type, fatigue from work, and death anxiety. PTS scores were negatively correlated with length of career as a forensic science investigator and emotional intelligence. The factors that had the greatest influence on PTS were death anxiety, years spent as a forensic science investigator, personality type, emotional intelligence, fatigue, and homicide experience. The explanatory power of these six factors was 44.0%. Therefore, it is necessary to regularly evaluate the mental health of those who are vulnerable to PTS. Based on these results, various interventions could be implemented for promoting overall health of the forensic science investigators. Copyright © 2013. Published by Elsevier B.V.

  7. Three dimensional finite element analysis of the influence of posterior tibial slope on the anterior cruciate ligament and knee joint forward stability.

    Science.gov (United States)

    Qi, Yong; Sun, Hongtao; Fan, Yueguang; Li, Feimeng; Wang, Yunting; Ge, Chana

    2018-03-23

    To explore the biomechanical influence of posterior tibial angle on the anterior cruciate ligament and knee joint forward stability. The left knee joint of a healthy volunteer was scanned by CT and MRI. The data were imported into Mimics software to obtain 3D models of bone, cartilage, meniscus and ligament structures, and then Geomagic software was used to modify of the image. The relative displacement between tibia and femur and the stress of ACL were recorded. ACL tension was 12.195 N in model with 2∘ PTS, 12.639 N in model with 7∘ PTS, 18.658 N in model with 12∘ PTS. the relative displacement of the tibia and femur was 2.735 mm in model with 2∘ PTS, 3.086 mm in model with 7∘ PTS, 3.881 mm in model with 12∘ PTS. In the model with 30∘ flexion, the maximum tension of ACL was 24.585 N in model with 2∘ PTS, 25.612 N in model with 7∘ PTS, 31.481 N in model with 12∘ PTS. The relative displacement of the tibia and femur was 5.590 mm in model with 2∘ PTS, 6.721 mm in model with 7∘ PTS, 6.952 mm in model with 12∘ PTS. In the 90∘ flexion models, ACL tension was 5.119 N in model with 2∘ PTS, 8.674 N in model with 7∘ PTS, 9.314 N in model with 12∘ PTS. The relative displacement of the tibia and femur was 0.276 mm in model with 2∘ PTS, 0.577 mm in model with 7∘ PTS, 0.602 mm in model with 12∘ PTS. The steeper PTS may be a risk factor in ACL injury.

  8. Lenalidomide in relapsed and refractory multiple myeloma disease: feasibility and benefits of long-term treatment.

    Science.gov (United States)

    Zago, Manola; Oehrlein, Katharina; Rendl, Corinna; Hahn-Ast, Corinna; Kanz, Lothar; Weisel, Katja

    2014-12-01

    Lenalidomide in combination with dexamethasone is an effective and well-established treatment of relapsed or refractory multiple myeloma (rrMM) disease. Due to the scarcity of reports assessing benefit and risk of long-term lenalidomide treatment in non-selected rrMM patients, we retrospectively analysed the long-term outcome in patients with rrMM treated with lenalidomide and dexamethasone. Sixty-seven patients (pts) who were treated with lenalidomide/dexamethasone for rrMM in the approved indication from 2007 to 2011 were included in this retrospective, single-centre analysis. Kaplan-Meier survival estimates were compared between total population, patients on lenalidomide for more than 12 months (mo) and patients discontinuing therapy earlier than 12 months. Median overall survival (OS) of the total patient population was 33.2 mo. OS of pts treated beyond 12 mo was 42.9 mo compared to 20.2 mo (p = 0.027) for pts stopping lenalidomide earlier than 12 mo for other reasons than progression disease (PD). OS of pts >12 mo on lenalidomide treatment did not significantly differ between pts who had received previous autologous transplantation, allogeneic transplantation or conventional therapy. Main non-hematologic toxicities were infections of grade 3/4 in 25 % and thrombembolic events of all grades in 18 % of patients. To the best of our knowledge, this is the first report on feasibility and efficacy of long-term lenalidomide treatment in a non-selected patient cohort. OS of pts >12 mo on lenalidomide is superior when compared to pts discontinued earlier for reasons other than PD. Our data confirm the current use of lenalidomide as a continuous long-term treatment strategy.

  9. Outcomes and predictors of failure of thrombolysis for iliofemoral deep venous thrombosis.

    Science.gov (United States)

    Avgerinos, Efthymios D; Hager, Eric S; Naddaf, Abdallah; Dillavou, Ellen; Singh, Michael; Chaer, Rabih A

    2015-01-01

    Catheter-directed thrombolysis (CDT) with adjunctive mechanical techniques, when successful, is reported to alleviate symptoms of acute iliofemoral deep venous thrombosis (IFDVT) and to lower the occurrence of the post-thrombotic syndrome (PTS). This study aimed to determine longer term outcomes of catheter-based interventions for IFDVT and to identify predictors of immediate and mid-long-term failures that would guide optimal patient selection. Consecutive patients who underwent CDT or pharmacomechanical thrombolysis for IFDVT between May 2007 and March 2013 were identified from a prospectively maintained database. Assessment of predictors of immediate periprocedural failure was based on the degree of clot lysis (≤ 50% vs >50%) and 30-day recurrence of DVT. Long-term anatomic and clinical failures and outcomes were assessed by ultrasound imaging of the lysed segments and Villalta score (≥ 5 vs <5). Survival analysis was used to assess primary patency and PTS morbidity. Multivariate binary logistic and Cox regression models were used to determine predictors of anatomic and clinical failures. During the study period, 93 patients (118 limbs; mean age, 49.4 ± 16.2 years; 47 women) with symptoms averaging 11.1 ± 9.6 days in duration were treated with various combinations of CDT or pharmacomechanical thrombolysis; in 52 (56%), at least one iliocaval stent was deployed. Immediate treatment failure was seen in 11 patients (12%) predicted by the preoperative indication "phlegmasia" (odds ratio, 3.12; P = .042) and recent surgery (odds ratio, 19.6; P = .018). At a mean ultrasonographic follow-up of 16 ± 14 months (range, 1-65 months), six more patients sustained a rethrombosis, accounting for an overall 3-year primary patency of 72.1%. In the long-term model, loss of primary patency was associated with recent surgery (hazard ratio [HR], 4.04; P = .023), malignant disease (HR, 6.75; P = .016), and incomplete thrombolysis (≤ 50%) (HR, 5.83; P < .001). By

  10. Chronic renal failure (CRF in children in Jugoslavia

    Directory of Open Access Journals (Sweden)

    Peco-Antić Amira

    2003-01-01

    Full Text Available The aim of this study was to analyse the demographic variables of chronic non-terminal (CRF and terminal (TRF renal failure patients (pts younger than 19 years treated in Serbia in June 2001. The prevalence of CRF pts was registered as 4,7 per million total population (pmtp or 14,1 per million child population (pmcp while corresponding values for TRF pts were 4,5 pmtp or 13,5 pmcp. The incidence of TRF pts during the period Jan.2000-Jan.2002 was 4,35 pmcp. Boys dominated only among CRF pts (34:14; 60,4% beeing between the ages of 6 and 19 yrs while at the time of diagnosis of HBI, 33,3 % of boys were yanger than 2 yrs.The causes of CRF were: reflux nephropathy 58,3%, congenital kidney disease 16,7%, familial/hereditary 14,6% glomerulonephritis 6,2% and Willms tu 4,1%. Reflux nephropathy was also the most common underlying disease of TRF accounted for 36,9% of total cases while glomerulonephritis was responsible for 23,9 %. Reflux nephropathy was associated with neural tube defect in 53,3% and with congenital lower urinary tract obstruction in 66,7%. The most of CRF (81,25% and TRF pts (95,6% were from Serbia, the others were from Monte Negro and Republic Srpska. The most of CRF (65% and TRF (80% pts were treated in University Children’s Hospital in Belgrade. Of CRF pts 46% had serum sreatinine 100-200 μmol/l, in 11% of pts it was 400-600 μmol/l and 2% of pts were in pre-terminal CRF. One third of CRF pts had proteinuria 150-500 mg/l, and second third had proteinuria greater of 1000 mg/l. Anemia was present in 54% of CRf pts, and arterial hypertension in 56%. Hemodialysis was dominant treatment modality for TRF pts and only 23,9% had functioning transplant. Conclusion: This is the first national study of demographic characteristics of pediatric CRF in Serbia. Since its prevalence is considerably lower than that in Western and North European countries the true prevalence is some what higher. The increasing incidence of pediatric TRF from 2

  11. Persistent seizures following failed surgery - Ictal SPECT and correlation with video EEG and follow-up

    International Nuclear Information System (INIS)

    Raja, S.; Gupta, A.; Kotagal, P.

    2002-01-01

    Introduction: A significant proportion (30-70%) of seizure patients (pts) have recurrent seizures post surgically. Up to 40-60% of these pts may benefit from re-evaluation and repeat surgical resections. Follow-up MRI is generally not useful in these patients due to post-surgical changes. Recently, ictal SPECT (IC) has been shown to be useful for the localization of seizure focus. We retrospectively analyzed the utility of IC in patients with unsuccessful surgical resections. Methods: Review of medical charts of all pts with IC from 1995 to 2001 was performed to identify pts with recurrent seizures who had IC studies. A total of 15 pts (male = 6, female 9; mean age = 17.9 yrs., range 6-31 yr.) were identified. All pts received 74-140 MBq of Tc-99m ECD each within 30 sec (range 14-81 sec) of seizure onset and were imaged within 6 hr post injection. For the inter-ictal (INT) scan, they received a similar dose and were imaged within 15 min post-injection on a triple-head gamma camera (Triad Trionix, Twinsburg, Ohio). The reconstructed transverse images were co-registered and normalized to the total counts of the INT. Greater than 10% increase in counts on the IC compared to the INT was considered positive for ictally-enhanced perfusion. The ICs were classified as localizable, lateralizable, or discordant with respect to vEEG. Results: Ictal SPECT and vEEG were concordant and lateralized the seizure focus in 14/15 pts, while both modalities were concordant and localized the foci in 7/15 pts, they were discordant for laterialization in 1 pt, and for localization in 8 pts. The MRI in 13/15 pts prior to the IC, revealed post surgical changes at the resection site, while in two pts MRI showed residual/recurrent tumor. Repeat resections and post-surgical follow-up (30 days to > 2 yrs) were available in 6/15 pts, 5 of these pts with repeat surgical resections of concordantly localized seizure foci by IC and vEEG, had good post-surgical outcome (Engel's I/II), while in the

  12. Alternative splicing affects the targeting sequence of peroxisome proteins in Arabidopsis.

    Science.gov (United States)

    An, Chuanjing; Gao, Yuefang; Li, Jinyu; Liu, Xiaomin; Gao, Fuli; Gao, Hongbo

    2017-07-01

    A systematic analysis of the Arabidopsis genome in combination with localization experiments indicates that alternative splicing affects the peroxisomal targeting sequence of at least 71 genes in Arabidopsis. Peroxisomes are ubiquitous eukaryotic cellular organelles that play a key role in diverse metabolic functions. All peroxisome proteins are encoded by nuclear genes and target to peroxisomes mainly through two types of targeting signals: peroxisomal targeting signal type 1 (PTS1) and PTS2. Alternative splicing (AS) is a process occurring in all eukaryotes by which a single pre-mRNA can generate multiple mRNA variants, often encoding proteins with functional differences. However, the effects of AS on the PTS1 or PTS2 and the targeting of the protein were rarely studied, especially in plants. Here, we systematically analyzed the genome of Arabidopsis, and found that the C-terminal targeting sequence PTS1 of 66 genes and the N-terminal targeting sequence PTS2 of 5 genes are affected by AS. Experimental determination of the targeting of selected protein isoforms further demonstrated that AS at both the 5' and 3' region of a gene can affect the inclusion of PTS2 and PTS1, respectively. This work underscores the importance of AS on the global regulation of peroxisome protein targeting.

  13. Effects of coding dictionary on signal generation: a consideration of use of MedDRA compared with WHO-ART.

    Science.gov (United States)

    Brown, Elliot G

    2002-01-01

    To support signal generation a terminology should facilitate recognition of medical conditions by using terms which represent unique concepts, providing appropriate, homogeneous grouping of related terms. It should allow intuitive or mathematical identification of adverse events reaching a threshold frequency or with disproportionate incidence, permit identification of important events which are commonly drug-related, and support recognition of new syndromes. It is probable that the Medical Dictionary for Regulatory Activities (MedDRA) preferred terms (PTs) or high level terms (HLTs) will be used to represent adverse events for the purposes of signal generation. A comparison with 315 WHO Adverse Reaction Terminology (WHO-ART) PTs showed that for about 72% of WHO-ART PTs, there were one or two corresponding MedDRA PTs. However, there were instances where there were many MedDRA PTs corresponding to single WHO-ART PTs. In many cases, MedDRA HLTs grouped large numbers of PTs and sometimes there could be problems when a single HLT comprises PTs which represent very different medical concepts, or conditions which differ greatly in their clinical importance. Further studies are needed to compare the way in which identical data sets coded with MedDRA and with other terminologies actually function in generating and exploring signals using the same methods of detection and evaluation.

  14. Non invasive adjustment of fluid status in critically ill patients on renal replacement therapy. Role of Electrical Cardiometry

    Directory of Open Access Journals (Sweden)

    Khaled Hamed Mahmoud

    2016-08-01

    Full Text Available Background: Electrical Cardiometry allows measurement of fluid status using thoracic fluid content (TFC, cardiac output, cardiac index, systemic vascular resistance index which could be ideal noninvasive hemodynamic monitoring for patients undergoing hemodialysis (HD. Objectives: Investigating the relation between changes in TFC and amount of fluid removal during HD session and to monitor hemodynamic parameters to avoid episodes of hemodynamic compromise during HD session. Methods: Thirty critically ill patients on HD were enrolled. Clinical assessment of volume overload and hemodynamics (BP, MAP, CVP, monitored by Electrical Cardiometry ICON® before HD and all through sessions. Results: Out of studied patients males represented 46.7% (n = 14 with mean age 48 ± 16 years. There was positive correlation between UF volume and TFC (r = 0.410, P = 0.025. Out of the 30 pts studied 18 pts (60% were hemodynamically stable vs 12 pts (40% that had hypotension represented by non responders group and had lower TFC compared to the hemodynamically stable group (26.45 kohm−1 vs 37.8 kohm−1 with P value of 0.004 indicating that they were hypovolemic. Out of the 30 pts studied 18 pts (60% weren’t congested vs 12 pts (40% remained persistently congested after accomplishing HD session with significantly higher TFC when compared to those who got rid of congestion (43.14 ± 9.9 kohm−1 vs 25.44 ± 5.5 kohm−1 with P value of 0.0001 indicating that they were still hypervolemic. Using analysis of ROC curve TFC at 25.34 kohm−1 was a significant predictor of hypotension with P value of 0.002, AUC 83.4%, sensitivity 67% and specificity 100%. Also TFC cutoff value predicting persistent congestion was 37.02 kohm−1 with P value of 0.0001, AUC 95.8%, sensitivity 83% and specificity 100%. Conclusion: Electrical Cardiometry is an evolving noninvasive tool for adjusting fluid status of critically ill patient on RRT using thoracic fluid

  15. Incremental value of combined 99MTc tetrofosmin parathyroid scintigraphy, rapid intra operative PTH assays and minimally invasive radio-guided surgery (MIRS) in optimizing parathyroidectomies

    International Nuclear Information System (INIS)

    Padma, S.; Kumar, S.; Babu, T.; Kumar, H.; Nair, V.; Nair, G.K.

    2004-01-01

    Objective: Aim of our study was to evaluate incremental diagnostic value of 99mTc Tetrofosmin parathyroid SPECT (TPSPECT), rapid intra operative quick parathyroid hormone measurement (QPTH) combined with radio guidance provided by scintillation probe (Minimally Invasive Radio guided Surgery MIRS) in parathyroid surgeries. While TPSPECT is an established investigation in preoperative workup of hyperparathyroidism patients , MIRS is a relatively new concept in Indian subcontinent. Methods: 29 pts (M: F = 18: 11), age range 16- 65 yrs (mean 41+ 9 yrs) having clinical and biochemical hyperparathyroidism underwent TPSPECT between Jan 02 -04, using 20 mci IV 99mTc Tetrofosmin. Pts with familial hyperparathyroidism , previous nodular goiters and previous neck irradiation were excluded from study. Scintigraphy comprised of immediate, delayed planar and SPECT imaging of neck and chest. Imagewise abnormal, persistent tracer uptake was considered positive for adenoma and diffuse uptake for hyperplasia. 26 pts underwent exploration (22 adenomas and 4 hyperplasias).18 pts had benefit of intraoperative QPTH. A select group (after Dec 2003) i.e. 9 pts got the assistance of radioguided probing. Peroperatively NM physician used cordless handheld gamma probe (Gamma Finder, World of Medicine, Germany) in neck and mediastinum to detect parathyroid adenoma / hyperplasias. A five fold increase in radioactive counts perceived by probe when compared to background was considered positive for parathyroid adenoma / hyperplasia. If PTH levels fell from baseline by at least 50%, the surgery was concluded as complete. Results: In all 22 pts suspected to have primary hyperparathyroidism TPSPECT identified adenomas (100 % sensitivity). While planar imaging had a sensitivity of 90.1% (20/22 pts), SPECT identified the adenoma in all pts. Interestingly only 3/22 pts had ectopic glands while 5 had more than one adenomas. The most commonly involved gland was left inferior. In secondary

  16. Application of a Prognostic Scale to Estimate the Mortality of Children Hospitalized with Community-acquired Pneumonia.

    Science.gov (United States)

    Araya, Soraya; Lovera, Dolores; Zarate, Claudia; Apodaca, Silvio; Acuña, Julia; Sanabria, Gabriela; Arbo, Antonio

    2016-04-01

    Pneumonia is a major cause of mortality in children. The objective of this study was to construct a prognostic scale for estimation of mortality applicable to children with community-acquired pneumonia (CAP). This observational study included patients younger than 15 years with a diagnosis of CAP who were hospitalized between 2004 and 2013. A point-based scoring system based on the modification of the PIRO scale used in adults with pneumonia was applied to each child hospitalized with CAP. It included the following variables: predisposition (age pneumonia) and organ dysfunction (kidney failure, liver failure and acute respiratory distress syndrome). One point was given for each feature that was present (range, 0-10 points). The association between the modified PIRO score and mortality was assessed by stratifying patients into 4 levels of risk: low (0-2 points), moderate (3-4 points), high (5-6 points) and very high risk (7-10 points). Eight hundred sixty children hospitalized with CAP were eligible for study. The mean age was 2.8 ± 3.2 years. The observed mortality was 6.5% (56/860). Mortality ranged from 0% for a low PIRO score (0/708 pts), 18% (20/112 pts) for a moderate score, 83% (25/30 pts) for a high score and 100% (10/10 pts) for a very high modified PIRO score (P < 0.001). The present score accurately discriminated the probability of death in children hospitalized with CAP, and it could be a useful tool to select candidates for admission to intensive care unit and for adjunctive therapy in clinical trials.

  17. 18F-FDG imaging with a coincidence dual-headed gamma camera (Co-PET) in the diagnosis, staging and management of lung cancer

    International Nuclear Information System (INIS)

    Lin, P.; Chu, J.; Pocock, N.; Quach, T.; Sorensen, B.

    1999-01-01

    Full text: FDG-PET has an established role in the management of lung cancer, while the experience with FDG-Co-PET is limited. Our study aims to demonstrate the feasibility of Co-PET in staging and management of lung cancer. Thirty-nine Co-PET studies were performed on our first 36 patients (pts) with primary lung cancer between November 1997 and October 1998. Tomography of brain and torso with an ADAC Solus MCD gamma camera was performed (60 min after 200 MBq of 18 FFDG and > 6 h fasting). Histology subgroups included squamous (14 pts), small cell (1), adeno-carcinoma (11), broncho-alveolar (1), large cell (8), carcinoid (1). CT/clinical staging subgroups included 18 pts in stage 1, 4 in stage 2, 7 in stage 3a, 2 in stage 3b, 8 in stage 4. Compared with CT/clinical staging, FDG upstaged 5 pts (14%) with regional nodal metastases (mets) and 8 pts (22%) with distant mets (cervical = 2, lung = 1, brain = 3, bone = 3, abdomen = 4). FDG under-staged 2 pts in 3 sites (all < 15 mm). Surgical nodal staging was performed in 14 pts: false-positives occurred in 3 CT and 1 Co-PET studies, and false-negatives in one CT/Co-PET. Site sensitivities for primary (smallest 7 mm) and regional lymph nodes are 100% and 88% respectively. Specificities for primary and regional nodes are 100% and 96% respectively. Co-PET also has impact on management: treatment intent (6 pts), radiotherapy fields (1), diagnosis of lung mets (2) and radiation pneumonitis (1). In conclusion, our initial data demonstrate FDG-Co-PET scanning could provide a valuable addition to conventional imaging studies in diagnosis, staging and management of lung cancer

  18. Identification of lactose phosphotransferase systems in Lactobacillus gasseri ATCC 33323 required for lactose utilization.

    Science.gov (United States)

    Francl, Alyssa L; Hoeflinger, Jennifer L; Miller, Michael J

    2012-04-01

    Improving the annotation of sugar catabolism-related genes requires functional characterization. Our objective was to identify the genes necessary for lactose utilization by Lactobacillus gasseri ATCC 33323 (NCK334). The mechanism of lactose transport in many lactobacilli is a lactose/galactose-specific permease, yet no orthologue was found in NCK334. Characterization of an EI knockout strain [EI (enzyme I) is required for phosphotransferase system transporter (PTS) function] demonstrated that L. gasseri requires PTS(s) to utilize lactose. In order to determine which PTS(s) were necessary for lactose utilization, we compared transcript expression profiles in response to lactose for the 15 complete PTSs identified in the NCK334 genome. PTS 6CB (LGAS_343) and PTS 8C (LGAS_497) were induced in the presence of lactose 107- and 53-fold, respectively. However, L. gasseri ATCC 33323 PTS 6CB, PTS 8C had a growth rate similar to that of the wild-type on semisynthetic deMan, Rogosa, Sharpe (MRS) medium with lactose. Expression profiles of L. gasseri ATCC 33323 PTS 6CB, PTS 8C in response to lactose identified PTS 9BC (LGAS_501) as 373-fold induced, whereas PTS 9BC was not induced in NCK334. Elimination of growth on lactose required the inactivation of both PTS 6CB and PTS 9BC. Among the six candidate phospho-β-galactosidase genes present in the NCK334 genome, LGAS_344 was found to be induced 156-fold in the presence of lactose. In conclusion, we have determined that: (1) NCK334 uses a PTS to import lactose; (2) PTS 6CB and PTS 8C gene expression is strongly induced by lactose; and (3) elimination of PTS 6CB and PTS 9BC is required to prevent growth on lactose.

  19. Spinal bone metastases in gynecologic malignancies: a retrospective analysis of stability, prognostic factors and survival

    International Nuclear Information System (INIS)

    Foerster, Robert; Habermehl, Daniel; Bruckner, Thomas; Bostel, Tilman; Schlampp, Ingmar; Welzel, Thomas; Debus, Juergen; Rief, Harald

    2014-01-01

    The aim of this retrospective study was to evaluate the stability of spinal metastases in gynecologic cancer patients (pts) on the basis of a validated scoring system after radiotherapy (RT), to define prognostic factors for stability and to calculate survival. Fourty-four women with gynecologic malignancies and spinal bone metastases were treated at our department between January 2000 and January 2012. Out of those 34 were assessed regarding stability using the Taneichi score before, 3 and 6 months after RT. Additionally prognostic factors for stability, overall survival, and bone survival (time between first day of RT of bone metastases and death from any cause) were calculated. Before RT 47% of pts were unstable and 6 months after RT 85% of pts were stable. Karnofsky performance status (KPS) >70% (p = 0.037) and no chemotherapy (ChT) (p = 0.046) prior to RT were significantly predictive for response. 5-year overall survival was 69% and 1-year bone survival was 73%. RT is capable of improving stability of osteolytic spinal metastases from gynecologic cancer by facilitating re-ossification in survivors. KPS may be a predictor for response. Pts who received ChT prior to RT may require additional bone supportive treatment to overcome bone remodeling imbalance. Survival in women with bone metastases from gynecologic cancer remains poor

  20. Is chronic ST segment elevation a marker of myocardial non viability in patients with Q wave anteroseptal MI? Correlation with myocardial perfusion SPECT

    International Nuclear Information System (INIS)

    Padma, S.; Zachariah, M.; Haridas, K.K.

    2004-01-01

    segments 5±0.8) while 90/137 (66%) did not show viability (mean viable segments 2 + 0.9). In ST negative group, 56/103 pts (54%) showed viability (mean viable segments 6±0.7) while 47/103 (46%) did not show viability (mean viable segments 3±0.4). Based on results of MPSPECT from ST positive group 31/47 pts (65%) underwent revascularisation and 27/31 pis (88%) showed an improvement in LV systolic function at least by 5%. Conclusion: Our study shows MPSPECT is an effective way of assessing viability even in presence of chronic ST elevation in Q wave ASMI patients. The mere fact of persistent chronic ST elevation in patients with ASMI does not exclude viability and Should not preclude the cardiologist from assessing the patients for revasularisation potential. (authors)

  1. Parvovirus B19 infections serological diagnostics in rheumatic diseases

    Directory of Open Access Journals (Sweden)

    L P Ananjeva

    2005-01-01

    Full Text Available Objective. To study contamination with parvovirus B19 of a group of patients with rheumatic diseases (RD. Methods. 77 pts with RD (mean age 42,5 years, 79% female admitted to Institute of Rheumatology of RAMS were examined. 34 of them had rheumatoid arthritis (RA, 11 - systemic lupus erythematosus (SLE and Sjogren's disease (SD, 15 with osteoarthritis (OA and seronegative spondyloarthritides (SS and 17 with early (before a year undifferentiated arthritis (EUA. Quantitative determination of IgM and IgG serum antibodies to parvovirus BI9 was performed by I FA with IBL kits (Hamburg, Germany. Results. Anti-B19 IgG antibodies were found in 52% of pts, IgM antibodies - only in one case. Mean antibodies values in pts with RD of disease duration less then 6 months were significantly higher then in pts with longer disease duration (21,5+36 U/ml and 8,4+14.7 U/ml respectively, p<0,05. Anti-B 19 antibodies were present in 62% of pts with RA, 53% of pts with EUA, 45% of pts with SD, 33% of pts with OA and SS. High levels of antibodies (4-10 times higher positivity threshold were revealed in 13 pts with different RD with short duration of joint syndrome (6,3±7,6 months and fever at presentation. A case of B19 parvovirus infection in a boy of 3 years age accompanied by symptoms of Still's disease is described.

  2. Prevention of heterotopic ossification about the hip using perioperative radiotherapy: Results of two randomized trials in 410 patients

    International Nuclear Information System (INIS)

    Seegenschmiedt, M. Heinrich; Keiholz, Ludwig; Martus, Peter; Woelfel, Rainer; Henning, Friedrich; Sauer, Rolf

    1996-01-01

    BACKGROUND: In-vivo data (Kantorowitz et al., 1991) indicate the efficacy of pre- and postoperative radiotherapy (RT) in suppressing development of heterotopic ossification (HO) after hip surgery. Since 1987 two prospective randomized trials were initiated at our institution to assess the comparative efficacy of 'high-dose RT' versus 'low-dose RT' (HOP study 1) and 'preoperative RT' versus 'postoperative RT' (HOP study 2). A control arm without radiotherapy (RT) was avoided, as only those patients (pts) were entered, who had a very high risk to develop HO after hip arthroplasty. PATIENTS and METHODS: In HOP study 1 (accrual: June 1987 - June 1992), 249 pts were randomized between the following postoperative RT schedules: 'low-dose RT' with 5 x 2 Gy, 10 Gy total RT dose (N = 129) versus 'high dose RT' with 5 x 3.5 Gy, 17.5 Gy total RT dose (N = 121); RT was applied with daily fractionation starting at postoperative day 1 - 4. In HOP study 2 (accrual : July 1992 - July 1995), 161 pts were randomized between 'preoperative RT' using a single dose of 7 Gy (N = 80 pts) and postoperative RT with 5 x 3.5 Gy (N = 51 pts). In both studies only patients were includes with one or multiple of the following risk factors for HO: ipsi- (55%) or contralateral HO (33%), hypertrophic osteoarthritis (48%), repeated hip surgery, acetabular fracture or severe hip trauma (43%); 62% of all pts had at least two risk factors. The structure of the relevant and possibly confounding patient and disease parameters and risk factors was similar in each of the treatment arms within the two randomized studies. - The assessment of 'treatment failures' was based upon the comparison of the amount of HO seen on the immediately postoperative radiograph as compared to radiographs obtained at least 6 months after surgery (Brooker Score). Any progression of HO by Brooker score was regarded as treatment failure. RESULTS: At last FU, in January 1996 both studies 369 of 410 pts (90%) had received an effective

  3. Detailed computational fluid dynamics calculations in order to assess respective safety issues regarding existing nuclear power plant. Interpretation and presentation of results

    International Nuclear Information System (INIS)

    2014-11-01

    The results of analysis showed that in case of injection of cold water to loops water temperature stratification in the pipes will occur if all the RCPs (Reactor Coolant Pump) are stopped. This water temperature stratification can lead to temperature misreading by sensors if they are located improperly, and may lead to wrong operation of PTS (Pressurized Thermal Shock) protection system. Therefore, results of current analysis can be used to choose the correct locations for temperature sensors to be installed in order to determine whether PTS protection system should be activated

  4. Adenocarcinoma of the endometrium treated with combined irradiation and surgery: study of 437 patients

    International Nuclear Information System (INIS)

    Touboul, E.; Belkacemi, Y.; Deniaud-Alexandre, E.; Ganansia, V.; Schlienger, M.; Buffat, L.; Lefranc, J.P.; Blondon, J.; Lhuillier, P.; Uzan, S.; Jannet, D.; Milliez, J.; Uzan, M.; Antoine, M.; Ginesty, C.; Jamali, M.

    2001-01-01

    To identify prognostic actors and treatment toxicity in a series of operable endometrial adenocarcinomas. Between November 1971 and October 1992, 437 patients (pts) with endometrial carcinoma, staged according to the 1988 FIGO staging system, underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy without (n = 140) or with (n = 297) pelvic lymph node dissection. The chronology of RT was not randomized and depended on the usual practices of the surgical teams. Group I: 79 pts received preoperative utero-vaginal brachytherapy (mean total dose [MD]: 57 Gy). Group II: 358 pts received postoperative RT (196 pts received vaginal brachytherapy alone [MD: 50 Gy], 158 pts had external beam pelvis RT [EPRT] [MD: 46 Gy over 5 weeks] followed by vaginal brachytherapy [MD: 17 Gy], and 4 pts had EPRT alone [MD: 46 Gy over 5 weeks]). The mean follow-up was 128 months. The 10-year disease-free survival rate was 86%. From 57 recurrences, 12 were isolated loco-regionally. Multivariate analysis showed that independent factors decreasing the probability of disease-free survival were: histologic type (clear cell carcinoma, p = 0.038), largest histologic tumor diameter > 3 cm (p = 0.015), histologic grade (p = 0.008), myometrial invasion > 1/2 (p 0.0055), and 1988 FIGO staging system (p= 9.10 -8 ). In group II, the addition of EPRT did not seem to improve locoregional control. The postoperative complication rate was 7%. The independent factors increasing the risk of postoperative complications were FIGO stage (p = 0.02) and pelvic lymph node dissection (p = 0.011). The 10-year rate for grade 3 and 4 late radiation complications according to the LENT-SOMA scoring system was 3.1 %. EPRT independently increased the 10-year rate for grade 3 and 4 late radiation complications (R.R.: 5.6, p = 0.0096). EPRT increases the risk of late radiation complications. After surgical and histopathologic staging with pelvic lymph node dissection, in a subgroup of intermediate risk

  5. Quantification of total phosphorothioate in bacterial DNA by a bromoimane-based fluorescent method.

    Science.gov (United States)

    Xiao, Lu; Xiang, Yu

    2016-06-01

    The discovery of phosphorothioate (PT) modifications in bacterial DNA has challenged our understanding of conserved phosphodiester backbone structure of cellular DNA. This exclusive DNA modification in bacteria is not found in animal cells yet, and its biological function in bacteria is still poorly understood. Quantitative information about the bacterial PT modifications is thus important for the investigation of their possible biological functions. In this study, we have developed a simple fluorescence method for selective quantification of total PTs in bacterial DNA, based on fluorescent labeling of PTs and subsequent release of the labeled fluorophores for absolute quantification. The method was highly selective to PTs and not interfered by the presence of reactive small molecules or proteins. The quantification of PTs in an E. coli DNA sample was successfully achieved using our method and gave a result of about 455 PTs per million DNA nucleotides, while almost no detectable PTs were found in a mammalian calf thymus DNA. With this new method, the content of phosphorothioate in bacterial DNA could be successfully quantified, serving as a simple method suitable for routine use in biological phosphorothioate related studies. Copyright © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  6. Effects of exposure to community violence and family violence on school functioning problems among urban youth: The potential mediating role of posttraumatic stress symptoms

    Directory of Open Access Journals (Sweden)

    Tia eMcGill

    2014-02-01

    Full Text Available Adolescents who are exposed to violence during childhood are at an increased risk for developing posttraumatic stress (PTS symptoms. The literature suggests that violence exposure might also have negative effects on school functioning, and that PTS might serve as a potential mediator in this association. The purpose of the current study was to replicate and extend prior research by examining PTS symptoms as a mediator of the relationship between two types of violence exposure and school functioning problems among adolescent youth from an urban setting. Participants included a sample of 121 junior high and high school students (M= 15 years; range= 13-16 years; 60 males, 61 females within high-crime neighborhoods. Consistent with our hypotheses, community violence and family violence were associated with PTS symptoms and school functioning problems. Our data suggest that community and family violence were indirectly related to school functioning problems through PTS symptoms. Findings from this study demonstrate that PTS symptoms potentially mediate the relationship between violence exposure and school functioning problems across two settings (community and home. Future research should further examine protective factors that can prevent youth violence exposure as well as negative outcomes related to violence.

  7. The presence of proliferative breast disease with atypia does not influence outcome in invasive breast cancer treated with conservative surgery and radiation

    International Nuclear Information System (INIS)

    Fowble, B.; Hanlon, A.L.; Patchefsky, A.; Hoffman, J.P.; Sigurdson, E.R.; Goldstein, L.J.

    1997-01-01

    Purpose: Atypical hyperplasia (AH) (ductal or lobular) represents a marker for an increased risk for subsequent breast cancer in either breast, especially in premenopausal women and those with a positive family history. However, the impact of the presence of AH in association with an invasive breast cancer on ipsilateral breast recurrence rates or contralateral breast cancer in women treated with conservative surgery and radiation is unknown. For a number of clinicians the presence of marked proliferative changes with atypia at the time of diagnosis of an invasive cancer is an indication for mastectomy. In an attempt to address this issue, we compared the outcome of patients (pts) with proliferative disease with atypia to those in whom this pathologic feature was absent. Materials and Methods: From 1982-1994, 1537 women with stage I-II breast cancer underwent excisional biopsy, axillary dissection and radiation. 459 of these women had pathologic evaluation of the background adjacent benign breast tissue and represent the study population. The median followup was 6.3 yrs (range .1-14.5). The median age was 55 yrs (range 24 to 88). 23% had positive axillary nodes. 25% received adjuvant chemotherapy (CMF or CAF) with (9%) or without (16%) tamoxifen. 24% received tamoxifen alone. The study population was divided into 2 groups: 131 pts with atypical hyperplasia (ductal 99 pts, lobular 20 pts, and type not specified 12 pts) and 328 pts with no proliferative changes or proliferative changes without atypia. The comparability of the 2 groups was assessed for the following factors: clinical (race, age, menopausal status, method of detection of primary, primary tumor size, and family history), pathologic (histology, final resection margin, pathologic nodal status, presence or absence of LCIS, histologic subtype DCIS when present and estrogen and progesterone receptor status) and treatment related (re-excision and adjuvant chemotherapy and/or tamoxifen). Outcome was evaluated

  8. Preliminary results of pre-operative 5-FU, low dose leucovorin (LV), and concurrent radiation therapy (RT) for resectable T3 rectal cancer

    International Nuclear Information System (INIS)

    Grann, Alison; Minsky, Bruce D.; Cohen, Alfred M.; Saltz, Leonard; Kelsen, David P.; Kemeny, Nancy; Ilson, David; Guillem, Jose G.; Paty, Philip B.; Bass, Joanne

    1996-01-01

    PURPOSE: We report the downstaging, acute toxicity, and preliminary local control and survival of pre-op 5-FU, low dose LV, and concurrent RT followed by post-op LV/5-FU for pts with clinically resectable, T3 rectal cancer. MATERIALS AND METHODS: A total of 32 pts (M:26, F:6) were prospectively treated from 12/91-8/95. Eligibility criteria included adequate hematologic indicies, primary adenocarcinoma limited to the pelvis, and T3 disease confirmed by transrectal ultrasound. Twenty five pts were considered clinically to require an APR on initial (pre-treatment) assessment by their operating surgeon. The median age was 56 (range: 24-80), and the median distance from the anal verge was 5.0cm (range: 3-9cm). Pts received 2 monthly cycles (bolus daily X 5) of LV (20mg/m2) and 5-FU (325mg/m2), beginning concurrently with day 1 of RT, followed by surgery 4-5 weeks later. RT included 4680 cGy to the pelvis followed by a boost to 5040 cGy. Post-operatively, pts received a median of 2 monthly cycles (range: 0-10 cycles) of LV (20 mg/m2) and 5-FU (425mg/m2). A toxicity assessment was performed at each visit using the NCI toxicity criteria modified for gastrointestinal toxicity. The median follow-up was 12 months (range: 3-48 months). All 32 patients were included in the analysis of toxicity, sphincter preservation, and downstaging. Analysis of patterns of failure and survival was limited to the 15 pts who had a minimum follow-up of 1yr or developed failure prior to 1 yr. For this subset the median follow-up was 24 months (range: 3-48 months). RESULTS: During the pre-op segment, individual grade 3+ acute toxicities were; diarrhea: 16%, bowel movements: 16%, leukopenia: 12%. The incidence of total toxicity was 25% ((8(32))). The median nadir counts were; WBC: 2.9 (range: 1.7-5.6), HGB: 12.4 (range: 7.1-15.0), and PLT (X1000): 161 (range: 113-237). The pathologic complete response rate was 9% ((3(32))). An additional 13% ((4(32))) had negative lymph nodes and 1-2 microscopic

  9. Fracture Analysis of Vessels. Oak Ridge FAVOR, v06.1, Computer Code: Theory and Implementation of Algorithms, Methods, and Correlations

    Energy Technology Data Exchange (ETDEWEB)

    Williams, P. T. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Dickson, T. L. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Yin, S. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2007-12-01

    The current regulations to insure that nuclear reactor pressure vessels (RPVs) maintain their structural integrity when subjected to transients such as pressurized thermal shock (PTS) events were derived from computational models developed in the early-to-mid 1980s. Since that time, advancements and refinements in relevant technologies that impact RPV integrity assessment have led to an effort by the NRC to re-evaluate its PTS regulations. Updated computational methodologies have been developed through interactions between experts in the relevant disciplines of thermal hydraulics, probabilistic risk assessment, materials embrittlement, fracture mechanics, and inspection (flaw characterization). Contributors to the development of these methodologies include the NRC staff, their contractors, and representatives from the nuclear industry. These updated methodologies have been integrated into the Fracture Analysis of Vessels -- Oak Ridge (FAVOR, v06.1) computer code developed for the NRC by the Heavy Section Steel Technology (HSST) program at Oak Ridge National Laboratory (ORNL). The FAVOR, v04.1, code represents the baseline NRC-selected applications tool for re-assessing the current PTS regulations. This report is intended to document the technical bases for the assumptions, algorithms, methods, and correlations employed in the development of the FAVOR, v06.1, code.

  10. Blood coagulation parameters and activity indices in patients with systemic lupus erythematosus

    Directory of Open Access Journals (Sweden)

    A. A. Arshinov

    2005-01-01

    Full Text Available Objective. To assess coagulation parameters and activity indices in pts with systemic lupus erythematosus (SLE. Material and methods . 86 pts with SLE (83 female and 3 male were examined. 12 of them had antiphospholipid syndrome. Mean age was 35,9±1,5 years (from 18 to 58 years, mean disease duration was 9,8+1,4 years. Control group consisted of 60 healthy volunteers with mean age 37,1+4,1 years. SLE activity assessment was performed with SLAM, SLEDAI and ECLAM indices. Results. SLE pts showed 5-fold (p<0,01 increase of spontaneous platelets aggregation and more than 3-fold increase of factor von Willebrand antigen (FWA concentration. Platelet activation in pts was accompanied by decrease of platelet aggregation with collagen (on 27%, p<0,01. Characteristic sign of coagulation hemostasis activation was significant increase of soluble fibrin-monomer complexes (SFMC concentration on 81 % (p<0,01 so as increase D-dimers level in 53,3% of pts. Fibrinogen concentration was increased on 29%, spontaneous fibrinolysis parameters were decreased on 20%, antithrombin (AT 111 - on 21% in comparison with control. Direct correlation between activity indiccs and SFMC(ECLAM, r=0,5, fibrinogen concentration (SLAM, r=0,34, D- dimers level (ECLAM, r=0,5, spontaneous platelet aggregation (ECLAM, r=0,5 so as inverse correlation with AT III activity (SLEDAI, r-0,73 was revealed. Conclusion. Changes of hemostasis parameters in SLE may serve as predictors of thrombotic disorders development and indication to drug correction of blood coagulation disorders. Direct correlation between blood coagulation system activity and indices of SLE activity.

  11. The impact of evaluating platelet transfusion need by platelet mass index on reducing the unnecessary transfusions in newborns.

    Science.gov (United States)

    Kahvecioglu, Dilek; Erdeve, Omer; Alan, Serdar; Cakir, Ufuk; Yildiz, Duran; Atasay, Begum; Arsan, Saadet

    2014-11-01

    Almost 95% of the platelet transfusions (PTs) conducted in the neonatal intensive care unit (NICU) are prophylactic transfusions. Guidelines for prophylactic PTs are based on platelet counts, but not on platelet functions. Nowadays, in order to reduce unnecessary transfusions, utilizing platelet mass index (PMI) was investigated. The aim of study is to find out whether PTs performed in our NICU during last 2 years were in accordance with the current guideline and to evaluate whether the frequency of PTs should be reduced if PMI was considered. Forty-three infants who received 96 prophylactic PTs were enrolled in the study. The guideline utilized in our NICU advocate keeping the platelet count: (a) >100 000 in pre/post-operative, (b) >50 000 in unstable and (c) >20 000 in stable patients. According to PMI criteria, PT should be performed if PMI: (a) platelet functions into account may yield lower transfusion rate, lower costs and better conservation of blood bank resources.

  12. Relationships between presenteeism and work-related musculoskeletal disorders among physical therapists in the Republic of Korea.

    Science.gov (United States)

    Bae, Young-Hyeon

    2017-12-14

    This study investigated the relationship between presenteeism and work-related musculoskeletal disorders (WMSDs) among physical therapists (PTs) in the Republic of Korea. Questionnaires were given to 600 PTs in the Republic of Korea. General and occupational characteristics and the prevalence of presenteeism and absenteeism were self-reported on the questionnaire. Stepwise regression analyses were used to evaluate the effects of presenteeism and other variables on general and occupational characteristics. Of the 490 PTs who responded, 399 (81.4%) reported at least one WMSD. There was a low incidence rate of absenteeism, but work impairment scores indicate there was a high incidence of presenteeism. In the stepwise regression analyses, the incidence of WMSDs was highest in cases of presenteeism. The results of this study demonstrate that there is a high incidence rate of WMSDs in Republic of Korean PTs, that WMSDs are related to presenteeism and that PTs demonstrate high presenteeism and low absenteeism.

  13. The influence of young age and positive family history on local recurrence after three treatment strategies for ductal carcinoma in situ

    International Nuclear Information System (INIS)

    Szelei-Stevens, Kathleen A.; Kuske, Robert R.; Bolton, John S.; Bowen, John C.; Fuhrman, George M.; Fineberg, Barbara B.

    1997-01-01

    Purpose: Three recent studies have investigated the influence of a positive family history (+FH) of breast cancer on the prognosis of DCIS patients treated by conservative surgery and radiation therapy (CS+RT), with two studies showing a higher risk of locoregional relapse (LRR) in these patients (pts) and another showing no significant difference. Since three treatment strategies have been used for DCIS at our institution, we evaluated the influence of +FH and young age on outcome by treatment method. Materials and Methods: Between 1/1/82 and 12/31/92, one hundred and twenty-eight pts were treated for DCIS by mastectomy (Mast) (n=50, 39%), local excision alone (Loc Exc) (n=43, 34%), and CS+RT (n=35, 27%). No pts were lost to follow-up. Median follow-up (FUP) is 6.0 years. Median age was 59 years (range 28 to 86). Thirty-nine pts had a +FH of breast cancer, 26 in a first-degree relative (mother or sister), and 26 in a second-degree relative (grandmother, aunt, or cousin). Thirteen pts had a +FH in both first and second-degree relatives. Final margins of resection were positive in three pts, negative in 97, and unknown in 28. Thirty-four pts had comedo histologic subtype. Results: Six women developed a recurrence in the treated breast, and all of these were initially treated by Loc Exc. There were no recurrences in the Mast or CS+RT groups. The five year overall actuarial LRR rate was 95.2%. The 5- and 10-year overall survival (OS) rates were 95.4% and 85.7% respectively. The cause-specific survival (CSS) was 99.2% and 97.3% at 5 and 10 years. Pts with a +FH had a 10.3% LRR, versus a 2.3% LRR for pts with a negative FH (p 0.05). Four of 44 pts (9.1%) 50 years of age or younger recurred, compared to 2 of 84 pts (2.4%) over the age of 50 (p = 0.10). Fifteen pts in this study had both a +FH and were 50 years of age or younger. Among these women, the recurrence rate was 20%. Women in this group treated by Loc Exc had a LRR of 38% (3 of 8). Other factors such as

  14. The Efficacy of the Enhanced Aussie Optimism Positive Thinking Skills Program in Improving Social and Emotional Learning in Middle Childhood

    Directory of Open Access Journals (Sweden)

    Jacqueline D Myles-Pallister

    2014-08-01

    Full Text Available The aim of the current study was to investigate the effects of the modified and enhanced Aussie Optimism Positive Thinking Skills Program (AO-PTS on Year 4 and 5 children’s social and emotional learning (SEL skills. AO-PTS is a universal-school based program that is implemented by class teachers as part of regular school curricula and was developed for the prevention of depression and anxiety. The study comprised a total of 683 Year 4 and 5 students from 10 private primary schools in Western Australia. Students were assessed on two subscales of emotional attribution at school whilst parents reported on their children’s externalizing and internalizing problems outside of school and at home. Two analyses were conducted: seven intervention schools were assessed at pre- and post-test (Analysis 1 and pre-post change in three intervention schools were compared to pre-post change in three matched control schools (Analysis 2. Results from Analysis 1 showed that the intervention children had increased in their overall emotional attribution accuracy and decreased in total difficulties and hyperactivity; Results from Analysis 2 revealed no intervention effect on emotional attribution accuracy or internalizing or externalizing problems. These findings suggest that the enhanced AO-PTS’s effects on SEL were not evident in the short-term period after intervention. The non-significant findings and future directions for AO-PTS research and program modification were discussed.

  15. Biomechanical Effects of Posterior Condylar Offset and Posterior Tibial Slope on Quadriceps Force and Joint Contact Forces in Posterior-Stabilized Total Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Kyoung-Tak Kang

    2017-01-01

    Full Text Available This study aimed to determine the biomechanical effect of the posterior condylar offset (PCO and posterior tibial slope (PTS in posterior-stabilized (PS fixed-bearing total knee arthroplasty (TKA. We developed ±1, ±2, and ±3 mm PCO models in the posterior direction and −3°, 0°, 3°, and 6° PTS models using a previously validated FE model. The influence of changes in the PCO and PTS on the biomechanical effects under deep-knee-bend loading was investigated. The contact stress on the PE insert increased by 14% and decreased by 7% on average as the PCO increased and decreased, respectively, compared to the neutral position. In addition, the contact stress on post in PE insert increased by 18% on average as PTS increased from −3° to 6°. However, the contact stress on the patellar button decreased by 11% on average as PTS increased from −3° to 6° in all different PCO cases. The quadriceps force decreased by 14% as PTS increased from −3° to 6° in all PCO models. The same trend was found in patellar tendon force. Changes in PCO had adverse biomechanical effects whereas PTS increase had positive biomechanical effects. However, excessive PTS should be avoided to prevent knee instability and subsequent failure.

  16. Non-ulcer dyspepsia associated with NSAID intake: possibility of antacid drugs application

    Directory of Open Access Journals (Sweden)

    A. E. Karateev

    2003-01-01

    Full Text Available Objective. To investigate the comparative efficacy of Magalphil 800 in NSAID-associated dyspepsia. Patients and methods. 30 pts with rheumatic diseases (RD receiving NSAIDs and having dyspeptic symptoms were included. Pts were divided into 2 groups: group 1 (n=20, 2 males, 18 females, mean age 51,7+12,3 yTs, 7 pts had single erosion of stomach, 1 - multiple erosions, 1 - ulcer of stomach; group 2 (n=10, 1 male. 9 females, mean age 46,2±14,6 yrs, 2 pts had single erosion of stomach. Concomitant therapies (corticosteroids, cytotoxics were approximately the same in both groups. Pts in Group 1 received one tablet of Magalphil 800 four times a day; pts in Group 2 were treated by ranitidine 150 mg bid. Therapy of RD was not changed during the study. Subjective complains were controlled after 2 weeks. Results. Complains related to dyspepsia disappeared in all pts of Group 1 and in 8 pts of Group 2 after 5,2±2,4 and 7,3±3,8 days of treatment respectively (p>0,05. Healing of ulcer in 1 and healing of erosions in 5 pnts was observed in Group 1. Conclusions. Magalphil 800 is effective in NSAID-associated dyspepsia and can be used for treatment of NSAID-induced gastropathy.

  17. {sup 99m}Tc-HYNIC-spermine for imaging polyamine transport system-positive tumours: preclinical evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Pesnel, Sabrina [Institut de Recherche Pierre Fabre, Centre de Recherche en Oncologie Experimentale, Toulouse (France); UPS TAAM - CIPA, CNRS, Orleans (France); Guminski, Yves; Imbert, Thierry [Institut de Recherche Pierre Fabre, Division de Chimie Medicinale III, Castres (France); Pillon, Arnaud; Guilbaud, Nicolas; Kruczynski, Anna; Bailly, Christian [Institut de Recherche Pierre Fabre, Centre de Recherche en Oncologie Experimentale, Toulouse (France); Lerondel, Stephanie [UPS TAAM - CIPA, CNRS, Orleans (France); Le Pape, Alain [UPS TAAM - CIPA, CNRS, Orleans (France); Universite Francois Rabelais, INSERM U618, Tours (France)

    2011-10-15

    F14512 exploiting the polyamine transport system (PTS) for tumour cell delivery has been described as a potent antitumour agent. The optimal use of this compound will require a probe to identify tumour cells expressing a highly active PTS that might be more sensitive to the treatment. The aim of this study was to design and characterize a scintigraphic probe to evaluate its uptake in cancer cells expressing the PTS. Three polyamines coupled to a hydrazinonicotinamide (HYNIC) moiety were synthesized and labelled with {sup 99m}Tc. Their radiochemical purity was determined by HPLC. The plasma stability of the {sup 99m}Tc-HYNIC-spermine probe and its capacity to accumulate into PTS-active cells were also evaluated. In vitro internalization was tested using murine melanoma B16/F10 cells and human lung carcinoma A549 cells. Biodistribution was determined in healthy mice and tumour uptake was studied in B16/F10 tumour-bearing mice. A HL-60-Luc human leukaemia model was used to confront single photon emission computed tomography (SPECT) images obtained with the {sup 99m}Tc-labelled probe with those obtained by bioluminescence. The {sup 99m}Tc-HYNIC-spermine probe was selected for its capacity to accumulate into PTS-active cells and its stability in plasma. In vitro studies demonstrated that the probe was internalized in the cells via the PTS. In vivo measurements indicated a tumour to muscle scintigraphic ratio of 7.9{+-}2.8. The combined bioluminescence and scintigraphic analyses with the leukaemia model demonstrated that the spermine conjugate accumulates into the tumour cells. The {sup 99m}Tc-HYNIC-spermine scintigraphic probe is potentially useful to characterize the PTS activity of tumours. Additional work is needed to determine if this novel conjugate may be useful to analyse the PTS status of patients with solid tumours. (orig.)

  18. Radionuclide gastric emptying time study for patients with cervical and thoracic esophageal cancer after resection

    International Nuclear Information System (INIS)

    Liu Lin; Tang Jin; Wang Yonggang; Li Jiaxiu

    1994-01-01

    Semi-solid meal was mixed with 99m Tc-DTPA and used as test meal given to patients orally. Gastric emptying time was measured in 70 patients after resection of esophageal cancer and 24 normal subjects. 70 patients were divided into 3 groups: (1) 14 cases with cervical esophageal cancer operated by using colon to replace the esophagus (CRE group). (2) 28 cases with cervical esophageal cancer operated by using stomach to replace the esophagus (SRE group). (3) 28 patients with thoracic esophageal cancer after resection only (TE group). The range of gastric emptying time of normal subjects was 53.9 +- 10.5%/60 minutes. The results showed that SRE group (28 pts) had a more rapid gastric emptying time than that of normal subjects. CRE group (14 pts) and TE group (28 pts) had slower gastric emptying time than that of normal subjects

  19. Clinical Experiences and Mediational Activities in Urban Teacher Preparation: Learning and Critical Consciousness

    Directory of Open Access Journals (Sweden)

    Craig Willey

    2016-11-01

    Full Text Available In a longitudinal design experiment conducted within an urban teacher preparation program, we employed ethnographic and auto-ethnographic methods to investigate the following questions: 1 In what ways do clinical experiences (CEs support prospective teachers’ (PTs development of knowledge, skills, and dispositions necessary for urban teaching? 2 How is it determined that adjustments need to be made to the design and facilitation of CEs, and what did these adjustments yield in terms of student learning outcomes? The program centers and leverages CEs in order for PTs to connect theory and practice, particularly an awareness of, and skills associated with, equitable teaching practices. In our two-year field-based program, CEs included community explorations, one-on-one and small group work with children, two student teaching practicums, and various school-community events. We describe the process undertaken to maximize the benefits yielded from CEs. After working with three cohorts of PTs for their entire professional training, we found that: 1 focusing attention on the intentional design and assessment of the mediational activities coupled with CEs leads to more nuanced understandings and enactments of culturally relevant teaching among PTs; and 2 CEs afford PTs abundant opportunities to shape complex identities as urban teachers. Specifically, we found that clinical experiences and corresponding mediational activities support PTs’ understanding of families of color, allow them to recognize and address problematic schooling practices, and strengthen PTs’ otherwise fragile critical consciousness. We conclude that strategic interventions can provide clarity for PTs around what has been learned, and what is left to be developed

  20. Octogenarians with early stage NSCLC undergoing SBRT-same outcomes as younger patients?

    DEFF Research Database (Denmark)

    Jeppesen, Stefan Starup; Schytte, T.; Brink, C.

    2015-01-01

    Purpose/Objective: The increase in life expectancy leads to an increased number of elderly patients (pts) diagnosed with NSCLC. Octogenarians can be a treatment challenge due to frailty and comorbidity. Stereotactic Body Radiotherapy (SBRT) has become the standard treatment for medical inoperable...... pts with early stage NSCLC. However, it is unknown if all pts have same benefit of SBRT due to lack of randomized studies. This retrospective single-institution study reports survival and control rates for medical inoperable octogenarians vs. pts 80 and 80 and 137 were 80 and 0.05). No difference...... in comorbidity measured by Charlson Score Index was observed. SBRT was generally well tolerated. A log rank test showed a significant difference of OS between patients >80 and 80 and 80 and...

  1. Comparison of diclofenac-emulgel local application with oral ibuprofen administration for the treatment of active interphalangeal hand joints osteoarthritis (Heberden and/or Bushar nodules

    Directory of Open Access Journals (Sweden)

    J Zacher

    2007-01-01

    Full Text Available Objective. To assess efficacy and tolerability of diclofenac-emulgel local application in comparison with oral ibuprofen administration for the treatment of active interphalangeal hand joints osteoarthritis (Heberden and/or Bushar nodules. Material and methods. 321 pts were randomized into two groups. Diclofenac-emulgel (active drug and placebo ibuprofen tablets were administered in one of them, placebo diclofenac-emulgel and ibuprofen tablets (active drug — in the other. Diclofenac was administered as 10 cm strip locally 4 times a day and 400 mg of ibuprofen were given 3 times a day. Frequency of improvement was used as the main outcome measure. Improvement was registered if pain on 100 mm visual analog scale decreased at least by 40%. Disease activity, pain at rest, pain at movement, morning stiffness, grip strength and quality of life were used as additional outcome measures. Results. To the end of treatment according to 5% lower equivalency limit local therapy was at least as effective as oral administration of ibuprofen (p=0,007. Administration of both treatment methods provided also comparable improvement of all additional outcome measures. Both treatment methods showed good tolerability but more pts with receiving ibuprofen experienced serious adverse events than those using diclofenac (9 and 4 pts respectively. There was also similar proportion of pts prematurely withdrawn due to side effects (n=21: 5 (3% from them received diclofenac and 16 (10% - ibuprofen. Similar ratio of adverse events attributed to study treatment was revealed. Such events were present in 2 pts using diclofenac and in 13 (8,3% receiving ibuprofen. Most of these events applied to gastrointestinal tract (in 1 pt using diclofenac and in 8 pts receiving ibuprofen. Conclusion. Local treatment of active interphalangeal hand joints osteoarthritis (Heberden and/or Bushar nodules with diclofenac is at least as effective as systemic administration of ibuprofen

  2. The Anterior Branch of the Left Inferior Phrenic Artery Arising from the Right Inferior Phrenic Artery: An Angiographic and CT Study

    International Nuclear Information System (INIS)

    Hieda, Masashi; Toyota, Naoyuki; Kakizawa, Hideaki; Ishikawa, Masaki; Horiguchi, Jun; Ito, Katsuhide

    2009-01-01

    The purpose of this study was to retrospectively analyze the frequency and anatomical pattern of the anterior branch of the left inferior phrenic artery (LIPA) arising from the right inferior phrenic artery (RIPA). Angiography of the RIPA for patients (n = 140) with hepatic malignancy was retrospectively reviewed. The frequency at which the anterior branch of the LIPA arose from the RIPA was 14.3% (20 of 140 patients [pts]). Among the three branches that may arise from the RIPA in these cases (the anterior branch of the LIPA and the anterior and posterior branches of the RIPA), the anterior branch of the LIPA was the first branch of the RIPA in 9 of 20 pts (45%), and the posterior branch of the RIPA in 11 of 20 pts (55%). The anterior branch of the LIPA ran along the ventral side of the esophagus or stomach and supplied the esophagogastric region and dome of the left diaphragm in all cases. In conclusion, the anterior branch of the LIPA arises from the RIPA at a comparatively high frequency. In embolization of the RIPA, to effectively treat and avoid possible complications, interventionalists should be aware of this potential variant anatomy.

  3. Rapid tomato volatile profiling by using proton-transfer reaction mass spectrometry (PTS-MS)

    NARCIS (Netherlands)

    Farneti, B.; Cristescu, S.M.; Costa, G.; Harren, F.J.M.; Woltering, E.J.

    2012-01-01

    The availability of rapid and accurate methods to assess fruit flavor is of utmost importance to support quality control especially in the breeding phase. Breeders need more information and analytical tools to facilitate selection for complex multigenic traits such as flavor quality. In this study,

  4. Box Isolation of Fibrotic Areas (BIFA): A Patient-Tailored Substrate Modification Approach for Ablation of Atrial Fibrillation.

    Science.gov (United States)

    Kottkamp, Hans; Berg, Jan; Bender, Roderich; Rieger, Andreas; Schreiber, Doreen

    2016-01-01

    Catheter ablation strategies beyond pulmonary vein isolation (PVI) for treatment of atrial fibrillation (AF) are less well defined. Increasing clinical data indicate that atrial fibrosis is a critical common left atrial (LA) substrate in AF patients (pts). We applied a new substrate modification concept according to the individual fibrotic substrate as estimated from electroanatomic voltage mapping (EAVM) in 41 pts undergoing catheter ablation of AF. First, EAVM during sinus rhythm was done in redo cases of 10 pts with paroxysmal AF despite durable PVI. Confluent low-voltage areas (LVA) were found in all pts and were targeted with circumferential isolation, so-called box isolation of fibrotic areas (BIFA). This strategy led to stable sinus rhythm in 9/10 pts and was transferred prospectively to first procedures of 31 pts with nonparoxysmal AF. In 13 pts (42%), no LVA (atrial tachycardia was achieved in 72.2% of pts and in 83.3% of pts with 1.17 procedures/patient. In approximately 40% of pts with nonparoxysmal AF, no substantial LVA were identified, and PVI alone showed high success rate. In pts with paroxysmal AF despite durable PVI and in approximately 60% of pts with nonparoxysmal AF, individually localized LVA were identified and could be targeted successfully with the BIFA strategy. © 2015 Wiley Periodicals, Inc.

  5. ASSESSMENT OF BONE TISSUE CONDITION BY METHOD OF COMPUTED TOMOGRAPHY IN PTS WITH RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    T A Raskina

    2002-01-01

    Full Text Available Aim: To estimate the bone mineral density (BMD in patients with dilVerent variants of rheumatoid arthritis (RA. Materials and methods: The study included 65 patients with the acknowledged RA, who were not treated with corticosteroids, basic remedies and antiosteoporosis therapies. The group comprises 26 women оГ reproductive age (I group and 28 women in postmenopause period. The investigations were held with the computer tomograph “Tomoscan” Philips. Results: The comparative analysis of BMD disorders frequency in the studied groups shows that in RA women of postmenopause period osteopenia accounts for 57,1%, osteoporosis - for 32,1% of patients, which is twice as often as in premenopausal women period: 30,8% and 15,4% respectively. BMD levels in RA are correlated with rheumatoid lactor, destructive tendency in bones and high activity of disease.

  6. Alterations in rotation thromboelastometry (ROTEM®) parameters: point-of-care testing vs analysis after pneumatic tube system transport.

    Science.gov (United States)

    Martin, J; Schuster, T; Moessmer, G; Kochs, E F; Wagner, K J

    2012-10-01

    Thromboelastometry as point-of-care (POC) testing enables the analysis of the clotting process at the bedside, providing rapid results to guide haemostatic therapy. However, POC testing utilizes medical staff who are managing critically ill patients, as non-laboratory personnel may not be sufficiently trained to run the devices. To resolve these problems, thromboelastometry can be performed in the central laboratory and rapid transport of samples can be accomplished via a pneumatic tube system (PTS). This study compares thromboelastometry parameters of blood samples analysed immediately with those analysed after PTS transport. In patients with normal haemostasis, two arterial blood samples were collected from each patient (n=92) in citrated plastic tubes to investigate the assays INTEM (n=35), EXTEM (n=27), and FIBTEM (n=30). One blood sample was analysed immediately, the other sample after PTS transport. Thromboelastometry was performed using a single ROTEM(®) device. The mean clot firmness values were significantly lower for PTS samples in both the INTEM (-0.7 mm cf. -1.1 mm) and EXTEM (-1.4 cf. -1.7 mm) assays. INTEM coagulation time (CT) was significantly lower in PTS samples with a mean difference of -13 s. EXTEM CT was significantly higher in PTS samples with a mean difference of +3.9 s. Thromboelastometry parameters of blood samples analysed after PTS transport are significantly altered compared with those analysed immediately. However, in patients with normal haemostasis, the alterations were small and without clinical consequence, implying that analysis after PTS transport is an acceptable alternative to prompt analysis at the bedside. Further studies should focus on patients with impaired haemostasis.

  7. The Impact of SMAD4 Loss on Outcome in Patients with Advanced Pancreatic Cancer Treated with Systemic Chemotherapy

    Directory of Open Access Journals (Sweden)

    Steffen Ormanns

    2017-05-01

    Full Text Available The role of the tumor suppressor mothers against decapentaplegic homolog 4 (SMAD4 has not yet been defined in patients (pts with advanced pancreatic cancer (aPC. This translational research study was designed to evaluate the impact of tumoral SMAD4 loss on clinicopathological parameters and outcome in PC patients receiving palliative chemotherapy. Using immunohistochemistry, we examined SMAD4 expression in tumor tissue of 143 aPC pts treated within completed prospective clinical and biomarker trials. In uni- and multivariate analyses, SMAD4 expression status was correlated to clinicopathological patient characteristics and outcome. At chemotherapy initiation, 128 pts had metastatic PC; most pts (n = 99 received a gemcitabine-based regimen. SMAD4 loss was detected in 92 pts (64%; patient characteristics such as gender, age, tumor grading, disease stage or number of metastatic sites had no significant impact on tumoral SMAD4 status. In univariate analyses, SMAD4 loss had no impact on overall survival (hazard ratio (HR 1.008, p = 0.656; however, we observed a prolonged progression-free survival (HR 1.565, p = 0.038 in pts with tumoral SMAD4 loss. This finding was confirmed in multivariate analyses (HR 1.790, p = 0.040, but only for gemcitabine-treated pts. In contrast to previous studies in resectable PC, loss of SMAD4 expression was not associated with a negative outcome in patients with advanced PC receiving systemic chemotherapy.

  8. Differentiation between benign phyllodes tumors and fibroadenomas of the breast on MR imaging

    International Nuclear Information System (INIS)

    Kamitani, Takeshi; Matsuo, Yoshio; Yabuuchi, Hidetake; Fujita, Nobuhiro; Nagao, Michinobu; Kawanami, Satoshi; Yonezawa, Masato; Yamasaki, Yuzo; Tokunaga, Eriko

    2014-01-01

    Purpose: The purpose of this study was to determine the factors that contribute to the differentiation between phyllodes tumors (PTs) and fibroadenomas (FAs) on MR imaging. Materials and methods: This retrospective study included 19 PTs and 18 FAs with ≥2 cm diameter. The presence or absence of a capsule and internal septum, the extent of lobulation, and the apparent diffusion coefficient (ADC) values were determined. The presence or absence of a cystic component, the time–intensity curve, and the signal intensity on delayed-phase contrast-enhanced T1WI were also evaluated in 31 patients (16 PTs and 17 FAs) who underwent a contrast-enhanced study. Results: Cystic components were seen in 10 of the 16 PTs (63%) and in 4 of the 17 FAs (24%; P = 0.03). The PTs showed strong lobulation more frequently compared to the FAs (14/19 [74%] vs. 7/18 [39%], respectively; P = 0.04). Though there was no significant difference, PT tended to be heterogeneous more frequently on the delayed phase of the contrast-enhanced T1WI compared to the FA (11/16 [69%] vs. 7/17 [41%], respectively). No significant difference was found in the other findings. Conclusions: Although PTs and FAs show similar MR findings, the presence of a cystic component, strong lobulation, and heterogeneity on delayed-phase contrast-enhanced T1WI suggests a PT

  9. Differentiation between benign phyllodes tumors and fibroadenomas of the breast on MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kamitani, Takeshi, E-mail: kamitani@radiol.med.kyushu-u.ac.jp [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Matsuo, Yoshio, E-mail: yymatsuo@radiol.med.kyushu-u.ac.jp [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Yabuuchi, Hidetake, E-mail: yabuuchi@shs.kyushu-u.ac.jp [Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Fujita, Nobuhiro, E-mail: n-fujita@radiol.med.kyushu-u.ac.jp [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Nagao, Michinobu, E-mail: minagao@radiol.med.kyushu-u.ac.jp [Department of Molecular Imaging and Diagnostic Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Kawanami, Satoshi, E-mail: kawanami_01@mac.com [Department of Molecular Imaging and Diagnostic Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Yonezawa, Masato, E-mail: ymasato@radiol.med.kyushu-u.ac.jp [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Yamasaki, Yuzo, E-mail: yyama@radiol.med.kyushu-u.ac.jp [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Tokunaga, Eriko, E-mail: eriko@surg2.med.kyushu-u.ac.jp [Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); and others

    2014-08-15

    Purpose: The purpose of this study was to determine the factors that contribute to the differentiation between phyllodes tumors (PTs) and fibroadenomas (FAs) on MR imaging. Materials and methods: This retrospective study included 19 PTs and 18 FAs with ≥2 cm diameter. The presence or absence of a capsule and internal septum, the extent of lobulation, and the apparent diffusion coefficient (ADC) values were determined. The presence or absence of a cystic component, the time–intensity curve, and the signal intensity on delayed-phase contrast-enhanced T1WI were also evaluated in 31 patients (16 PTs and 17 FAs) who underwent a contrast-enhanced study. Results: Cystic components were seen in 10 of the 16 PTs (63%) and in 4 of the 17 FAs (24%; P = 0.03). The PTs showed strong lobulation more frequently compared to the FAs (14/19 [74%] vs. 7/18 [39%], respectively; P = 0.04). Though there was no significant difference, PT tended to be heterogeneous more frequently on the delayed phase of the contrast-enhanced T1WI compared to the FA (11/16 [69%] vs. 7/17 [41%], respectively). No significant difference was found in the other findings. Conclusions: Although PTs and FAs show similar MR findings, the presence of a cystic component, strong lobulation, and heterogeneity on delayed-phase contrast-enhanced T1WI suggests a PT.

  10. In vitro-in vivo study on the effects of plant compounds on rumen fermentation, microbial abundances and methane emissions in goats.

    Science.gov (United States)

    Martínez-Fernández, G; Abecia, L; Martín-García, A I; Ramos-Morales, E; Hervás, G; Molina-Alcaide, E; Yáñez-Ruiz, D R

    2013-12-01

    Two in vitro and one in vivo experiments were conducted to investigate the effects of a selection of plant compounds on rumen fermentation, microbial concentration and methane emissions in goats. Treatments were: control (no additive), carvacrol (CAR), cinnamaldehyde (CIN), eugenol (EUG), propyl propane thiosulfinate (PTS), propyl propane thiosulfonate (PTSO), diallyl disulfide (DDS), a mixture (40 : 60) of PTS and PTSO (PTS+PTSO), and bromochloromethane (BCM) as positive control with proven antimethanogenic effectiveness. Four doses (40, 80, 160 and 320 µl/l) of the different compounds were incubated in vitro for 24 h in diluted rumen fluid from goats using two diets differing in starch and protein source within the concentrate (Experiment 1).The total gas production was linearly decreased (Prumen content per day) and BCM (50, 100 and 160 mg/l rumen content per day) during the 9 days on methane emissions (Experiment 3). The addition of PTS and BCM resulted in linear reductions (33% and 64%, respectively, P≤ 0.002) of methane production per unit of dry matter intake, which were lower than the maximum inhibition observed in vitro (87% and 96%, respectively). We conclude that applying the same doses in vivo as in vitro resulted in a proportional lower extent of methane decrease, and that PTS at 200 mg/l rumen content per day has the potential to reduce methane emissions in goats. Whether the reduction in methane emission observed in vivo persists over longer periods of treatments and improves feed conversion efficiency requires further research.

  11. Paradoxical effects of radioiodine therapy in functional thyroid autonomy and mild immunothyropathy

    International Nuclear Information System (INIS)

    Dunkelmann, S.; Rudolph, F.; Prillwitz, A.; Groth, P.; Schuemichen, C.

    1998-01-01

    Aim: To examine all cases with Graves' disease after radioiodine therapy of autonomously functioning thyroid tissue (AFFT) in order to find the cause. Methods: We retrospectively studied 1428 pts who were treated between 11/93 and 3/97 with radioiodine for AFTT and who underwent at least one control examination. Results: 15 (1.1%) of all pts developed Graves' disease 8.4 (4-13) months after radioiodine therapy. There was no direct suggestion of Graves' disease (TRAK negative, no endocrine ophthalmopathy) in any pt at the time of radioiodine therapy. More detailed analysis of anamnestic data, however, revealed evidence that immunothyropathy predated radioiodine therapy in 11 of the 15 pts. Paradoxical effects of radioiodine therapy manifested as an increase in immunothyropathy 14 pts, a deterioration in metabolism in 11 pts and a first occurrence of endocrine ophthalmopathy in 5 pts. Conclusion: Exacerbation of preexisting, functional primarily insignificant immunothyropathia is held responsible in most cases for the observed paradoxical effects after radioiodine therapy, resulting in radiation-induced manifest Graves' disease; however no therapeutical consequences are recommended. (orig.) [de

  12. Prognostic models for predicting posttraumatic seizures during acute hospitalization, and at 1 and 2 years following traumatic brain injury.

    Science.gov (United States)

    Ritter, Anne C; Wagner, Amy K; Szaflarski, Jerzy P; Brooks, Maria M; Zafonte, Ross D; Pugh, Mary Jo V; Fabio, Anthony; Hammond, Flora M; Dreer, Laura E; Bushnik, Tamara; Walker, William C; Brown, Allen W; Johnson-Greene, Doug; Shea, Timothy; Krellman, Jason W; Rosenthal, Joseph A

    2016-09-01

    discriminate well. Year 1 and year 2 models showed fair to good predictive validity for PTS. Cranial surgery, although medically necessary, requires ongoing research regarding potential benefits of increased monitoring for signs of epileptogenesis, PTS prophylaxis, and/or rehabilitation/social support. Future studies should externally validate models and determine clinical utility. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

  13. Effects of Exposure to Community Violence and Family Violence on School Functioning Problems among Urban Youth: The Potential Mediating Role of Posttraumatic Stress Symptoms

    Science.gov (United States)

    McGill, Tia M.; Self-Brown, Shannon R.; Lai, Betty S.; Cowart-Osborne, Melissa; Tiwari, Ashwini; LeBlanc, Monique; Kelley, Mary Lou

    2014-01-01

    Adolescents who are exposed to violence during childhood are at an increased risk for developing posttraumatic stress (PTS) symptoms. The literature suggests that violence exposure might also have negative effects on school functioning, and that PTS might serve as a potential mediator in this association. The purpose of the current study was to replicate and extend prior research by examining PTS symptoms as a mediator of the relationship between two types of violence exposure and school functioning problems among adolescent youth from an urban setting. Participants included a sample of 121 junior high and high school students (M = 15 years; range = 13–16 years; 60 males, 61 females) within high-crime neighborhoods. Consistent with our hypotheses, community violence and family violence were associated with PTS symptoms and school functioning problems. Our data suggest that community and family violence were indirectly related to school functioning problems through PTS symptoms. Findings from this study demonstrate that PTS symptoms potentially mediate the relationship between violence exposure and school functioning problems across two settings (community and home). Future research should further examine protective factors that can prevent youth violence exposure as well as negative outcomes related to violence. PMID:24570897

  14. Study on radiation-inducible genes

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Sang Yong; Kim, Dong Ho; Joe, Min Ho; Song, Hyu Npa

    2012-01-15

    Transcription of previously identified radiation-inducible genes, uscA and cyoA, was examined responding to radiation. The putative promoter regions of both genes were cloned into pRS415 vector containing lacZ, and the core promoter region necessary for radiation response were determined through promoter deletion method. To investigate the role of uscA, which is assumed to be small RNA related with radiation response, a deletion mutant strain of uscA was constructed. However, uscA deletion did not affect bacterial survival against radiation exposure. The use of bacteria as anticancer agents has attracted interest. In this study, we tried to develop tumor targeting bacteria in which the radiation-inducible promoter activate a transgene encoding a cytotoxic protein. For outward secretion of anticancer protein produced inside bacteria, the N-terminal 140 amino acid of SspH1 was found to function as a secretion signal peptide. To create an attenuated tumor-targeting bacteria, Salmonella ptsI mutant strain was constructed, and we found that its virulence decreased. Finally, the tumor-targeting ability of ptsI mutant was verified by the use of in-vivo imaging analysis.

  15. Study on radiation-inducible genes

    International Nuclear Information System (INIS)

    Lim, Sang Yong; Kim, Dong Ho; Joe, Min Ho; Song, Hyu Npa

    2012-01-01

    Transcription of previously identified radiation-inducible genes, uscA and cyoA, was examined responding to radiation. The putative promoter regions of both genes were cloned into pRS415 vector containing lacZ, and the core promoter region necessary for radiation response were determined through promoter deletion method. To investigate the role of uscA, which is assumed to be small RNA related with radiation response, a deletion mutant strain of uscA was constructed. However, uscA deletion did not affect bacterial survival against radiation exposure. The use of bacteria as anticancer agents has attracted interest. In this study, we tried to develop tumor targeting bacteria in which the radiation-inducible promoter activate a transgene encoding a cytotoxic protein. For outward secretion of anticancer protein produced inside bacteria, the N-terminal 140 amino acid of SspH1 was found to function as a secretion signal peptide. To create an attenuated tumor-targeting bacteria, Salmonella ptsI mutant strain was constructed, and we found that its virulence decreased. Finally, the tumor-targeting ability of ptsI mutant was verified by the use of in-vivo imaging analysis

  16. Posttraumatic stress, partner violence victimization, and harmful drinking: risk factors for relationship discord in new parents.

    Science.gov (United States)

    Sotskova, Alina; Woodin, Erica M

    2013-11-01

    The first year of parenthood can be a stressful time, especially for high-risk couples. Symptoms of posttraumatic stress (PTS) have been associated with decreased intimacy, communication, and relationship adjustment, yet there is a lack of research on how PTS symptoms might affect couples in early parenthood. Furthermore, there is little evidence regarding the way in which PTS symptoms may affect couples above and beyond known risk factors such as intimate partner violence (IPV) and harmful alcohol use. The current study investigated how PTS symptoms were related to new parents' relationship satisfaction in the context of IPV and harmful drinking. Ninety-eight heterosexual couples filled out questionnaires 1 year after the birth of their first child. Hierarchical multiple regression analyses indicated that, for men, PTS symptoms predicted lower relationship satisfaction over and above IPV victimization and harmful drinking. However, for women, psychological IPV victimization was the only significant multivariate predictor. In addition, for men, PTS symptoms interacted with harmful drinking to predict poorer relationship satisfaction. The results suggest that women's relationship satisfaction is particularly linked to psychological IPV victimization during early parenthood, whereas men's relationship satisfaction is particularly associated with their own harmful drinking and PTS symptoms. Implications are discussed.

  17. Posttraumatic stress following pediatric injury: update on diagnosis, risk factors, and intervention.

    Science.gov (United States)

    Kassam-Adams, Nancy; Marsac, Meghan L; Hildenbrand, Aimee; Winston, Flaura

    2013-12-01

    After pediatric injury, transient traumatic stress reactions are common, and about 1 in 6 children and their parents develop persistent posttraumatic stress (PTS) symptoms that are linked to poorer physical and functional recovery. Meta-analytic studies identify risk factors for persistent PTS, including preinjury psychological problems, peritrauma fear and perceived life threat, and posttrauma factors such as low social support, maladaptive coping strategies, and parent PTS symptoms. There is growing prospective data indicating that children's subjective appraisals of the injury and its aftermath influence PTS development. Secondary prevention of injury-related PTS often involves parents and focuses on promoting adaptive child appraisals and coping strategies. Web-based psychoeducation and targeted brief early intervention for injured children and their parents have shown a modest effect, but additional research is needed to refine preventive approaches. There is a strong evidence base for effective psychological treatment of severe and persistent PTS via trauma-focused cognitive behavioral therapy; evidence is lacking for psychopharmacological treatment. Pediatric clinicians play a key role in preventing injury-related PTS by providing "trauma-informed" pediatric care (ie, recognizing preexisting trauma, addressing acute traumatic stress reactions associated with the injury event, minimizing potentially traumatic aspects of treatment, and identifying children who need additional monitoring or referral).

  18. Brain Perfusion Changes in Intracerebral Hemorrhage

    International Nuclear Information System (INIS)

    Mititelu, R.; Mazilu, C.; Ghita, S.; Rimbu, A.; Marinescu, G.; Codorean, I.; Bajenaru, O.

    2006-01-01

    Full text: Purpose: Despite the latest advances in medical treatment and neuro critical care, patients suffering spontaneous intracerebral hemorrhage (SICH) still have a very poor prognosis, with a greater mortality and larger neurological deficits at the survivors than for ischemic stroke. Many authors have shown that there are many mechanisms involved in the pathology of SICH: edema, ischemia, inflammation, apoptosis. All of these factors are affecting brain tissue surrounding hematoma and are responsible of the progressive neurological deterioration; most of these damages are not revealed by anatomical imaging techniques. The aim of our study was to asses the role of brain perfusion SPECT in demonstrating perfusion changes in SICH patients. Method: 17 SICH pts were studied. All pts underwent same day CT and brain SPECT with 99mTcHMPAO, 24h-5d from onset of stroke. Results: 14/17 pts showed a larger perfusion defect than expected after CT. In 2 pts hematoma diameter was comparable on CT and SPECT; 1pt had quasinormal aspect of SPECT study. In pts with larger defects, SPECT revealed a large cold spot with similar size compared with CT, and a surrounding hypo perfused area. 6/17 pts revealed cortical hyper perfusion adjacent to hypo perfused area and corresponding to a normal-appearing brain tissue on CT. In 3 pts we found crossed cerebellar diaskisis.In 2 pts we found cortical hypo perfused area in the contralateral cortex, with normal appearing brain tissue on CT. Conclusions: Brain perfusion SPECT revealed different types of perfusion changes in the brain tissue surrounding hematoma. These areas contain viable brain tissue that may be a target for future ne uroprotective strategies. Further studies are definitely required to demonstrate prognostic significance of these changes, but we can conclude that brain perfusion SPECT can play an important role in SICH, by early demonstrating functional changes responsible of clinical deterioration, thus allowing prompt

  19. Enhancing Elementary Pre-service Teachers' Plant Processes Conceptions

    Science.gov (United States)

    Thompson, Stephen L.; Lotter, Christine; Fann, Xumei; Taylor, Laurie

    2016-06-01

    Researchers examined how an inquiry-based instructional treatment emphasizing interrelated plant processes influenced 210 elementary pre-service teachers' (PTs) conceptions of three plant processes, photosynthesis, cellular respiration, and transpiration, and the interrelated nature of these processes. The instructional treatment required PTs to predict the fate of a healthy plant in a sealed terrarium (Plant-in-a-Jar), justify their predictions, observe the plant over a 5-week period, and complete guided inquiry activities centered on one of the targeted plant processes each week. Data sources included PTs' pre- and post-predictions with accompanying justifications, course artifacts such as weekly terrarium observations and science journal entries, and group models of the interrelated plant processes occurring within the sealed terraria. A subset of 33 volunteer PTs also completed interviews the week the Plant-in-a-Jar scenario was introduced and approximately 4 months after the instructional intervention ended. Pre- and post-predictions from all PTs as well as interview responses from the subgroup of PTs, were coded into categories based on key plant processes emphasized in the Next Generation Science Standards. Study findings revealed that PTs developed more accurate conceptions of plant processes and their interrelated nature as a result of the instructional intervention. Primary patterns of change in PTs' plant process conceptions included development of more accurate conceptions of how water is used by plants, more accurate conceptions of photosynthesis features, and more accurate conceptions of photosynthesis and cellular respiration as transformative processes.

  20. Managing the Accessibility on Mass Public Transit: the Case of Hong Kong

    Directory of Open Access Journals (Sweden)

    Siman Tang

    2008-11-01

    Full Text Available Public transit services (PTS improve mobility and accessibility, and reduce car dependence. It is ideal if PTS are financially sustainable, with affordable fares and expedient quality. The success of PTS on accessibility improvement can be reflected by their level of patronage: do travelers choose to use them in lieu of their private cars? PTS in Hong Kong are renowned for their quality and profitability, superbly addressing the accessibility need for the city; they carry over 90% of the 11 million daily trips. A comparison of the per capita train-car and bus-vehicle kilometer run of PTS in Hong Kong with those in London and Singapore, however, suggests that it is not purely the supply that affects the use or accessibility of PTS in Hong Kong. By tracing and analyzing the development of PTS in Hong Kong over the past two decades, we found evidence that the high level of accessibility on mass public transit in the territory can be attributed to the land use policy of developing compact, high-density township, accompanying transport policies of granting high priority to the development of mass transit facilities and providing ways to ensure the financial viability of privately operated PTS, especially the innovative approach of integrating the development of public transport facility and property so as to exploit their synergy. In this paper, we study and highlight elements that contribute to the development of high accessibility on mass public transit in Hong Kong.

  1. Communication Pattern And Skill Of Leaders In Private University Management

    OpenAIRE

    Ani Yuningsih; Dadan Mulyana

    2017-01-01

    Communication strategies and skills supported by mutually supportive management tools are one of the managerial skills that must be mastered by private university (PTS) leaders. Leadership communication skills and style will form organizational communication patterns that will become the foundation for a healthy and effective organizational climate to develop its vision and mission. This research is done by using case study method at some PTS which is representation of PTS profile in West Jav...

  2. Regional osteoporosis in western Sydney women

    International Nuclear Information System (INIS)

    Larcos, G.; Lawson-Smith, R.

    1998-01-01

    Full text: Recently, 15% of elderly Japanese-American women have been shown to have marked heterogeneity of bone mineral density (BMD) between measured sites. The purposes of this study were to determine (1 ) the prevalence of this finding in an Australian population; and (2) potential association with clinical factors such as age, years since menopause (YSM), alcohol, smoking, family history, exercise, and body mass index. One hundred and fourteen peri-or post- menopausal Caucasian women (mean age 55 + 8.8 years) were referred for osteoporotic (OP) fracture risk assessment. Patients (pts) had no disorders or drugs known to affect BMD and no evidence of scoliosis or arthritic change. Bone densitometry of the lumbar spine (PA), hip and distal radius were measured using a Norland XR-26. According to WHO criteria, 30 pts (26%) were normal (T score > -1) at all sites; no pts (0%) had generalised OP (T score < -2.5); 29 (25%) had OP in one or two sites only (hip = 25, spine = 13, wrist = 1); the remaining 55 pts (48%) were osteogenic (-2.5 < T score < -1) in at least one site. Using multivariate logistic regression analysis, only YSM predicted regional OP (odds ratio = 1.14; p< O.001) Thus, clinically important heterogeneity of BMD occurs in about 25% of Western Sydney women; of clinical factors only YSM is independently associated with regional OP. Fracture risk classification may be improved by BMD measurement of multiple sites

  3. Regional osteoporosis in western Sydney women

    Energy Technology Data Exchange (ETDEWEB)

    Larcos, G.; Lawson-Smith, R. [Westmead Hospital, Westmead, NSW (Australia). Department of Nuclear Medicine and Ultrasound

    1998-03-01

    Full text: Recently, 15% of elderly Japanese-American women have been shown to have marked heterogeneity of bone mineral density (BMD) between measured sites. The purposes of this study were to determine (1 ) the prevalence of this finding in an Australian population; and (2) potential association with clinical factors such as age, years since menopause (YSM), alcohol, smoking, family history, exercise, and body mass index. One hundred and fourteen peri-or post- menopausal Caucasian women (mean age 55 + 8.8 years) were referred for osteoporotic (OP) fracture risk assessment. Patients (pts) had no disorders or drugs known to affect BMD and no evidence of scoliosis or arthritic change. Bone densitometry of the lumbar spine (PA), hip and distal radius were measured using a Norland XR-26. According to WHO criteria, 30 pts (26%) were normal (T score > -1) at all sites; no pts (0%) had generalised OP (T score < -2.5); 29 (25%) had OP in one or two sites only (hip = 25, spine = 13, wrist = 1); the remaining 55 pts (48%) were osteogenic (-2.5 < T score < -1) in at least one site. Using multivariate logistic regression analysis, only YSM predicted regional OP (odds ratio = 1.14; p

  4. Posttraumatic Stress among Young Urban Children Exposed to Family Violence and Other Potentially Traumatic Events

    Science.gov (United States)

    Crusto, Cindy A.; Whitson, Melissa L.; Walling, Sherry N.; Feinn, Richard; Friedman, Stacey R.; Reynolds, Jesse; Amer, Mona; Kaufman, Joy S.

    2014-01-01

    This study examines the relationship between the number of types of traumatic events experienced by children 3 to 6 years old, parenting stress, and children’s posttraumatic stress (PTS). Parents/caregivers provided data for 154 urban children admitted into community-based mental health and/or developmental services. By parent/caregiver report, children experienced an average of 4.9 different types of potentially traumatic events. Nearly one-quarter of the children evidenced clinically significant PTS. PTS was positively and significantly related to family violence and other family-related trauma exposure, nonfamily violence/trauma exposure, and parenting stress. Additionally, parenting stress partially mediated the relationship between family violence/trauma exposure and PTS. This study highlights the need for early violence/trauma exposure screening in help-seeking populations so that appropriate interventions are initiated. PMID:21171132

  5. Adenocarcinoma of the endometrium treated with combined irradiation and surgery: Study of 437 patients

    International Nuclear Information System (INIS)

    Touboul, Emmanuel; Belkacemi, Yazid; Buffat, Laurent; Deniaud-Alexandre, Elisabeth; Lefranc, Jean-Pierre; Lhuillier, Pierre; Uzan, Serge; Jannet, Denis; Uzan, Michele; Antoine, Martine; Huart, Judith; Ganansia, Valerie; Milliez, Jacques; Blondon, Jean; Housset, Martin; Schlienger, Michel

    2001-01-01

    Purpose: To identify prognostic factors and treatment toxicity in a series of operable endometrial adenocarcinomas. Methods and Materials: Between November 1971 and October 1992, 437 patients (pts) with endometrial carcinoma, staged according to the 1988 FIGO staging system (225 Stage IB, 107 Stage IC, 4 Stage IIA, 35 Stage IIB, 30 Stage IIIA, 6 Stage IIIB, and 30 Stage IIIC), underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy without (n=140) or with (n=297) pelvic lymph node dissection. The chronology of adjuvant RT was not randomized and depended on the usual practices of the surgical teams. Seventy-nine pts (Group I) received preoperative low-dose-rate uterovaginal brachytherapy (mean dose [MD]: 57 Gy). Three hundred fifty-eight pts (Group II) received postoperative RT. One hundred ninety-six pts received low-dose-rate vaginal brachytherapy alone (MD: 50 Gy). One hundred fifty-eight pts had external beam pelvic RT (MD: 46 Gy) followed by low-dose-rate vaginal brachytherapy (MD: 17 Gy). Four pts had external beam pelvic RT alone (MD: 47 Gy). The mean follow-up from the beginning of treatment was 128 months. Results: The 10-year disease-free survival rate was 86%. From 57 recurrences, only 12 were isolated locoregional recurrences. The independent factors decreasing the probability of disease-free survival were as follows: histologic type (clear-cell carcinoma, p=0.038), largest histologic tumor diameter >3 cm (p=0.015), histologic grade (p=0.008), myometrial invasion > 1/2 (p=0.005), and 1988 FIGO staging system (p=9.10 -8 ). In Group II, the addition of external beam pelvic RT did not seem to independently improve vaginal or pelvic control. The postoperative complication rate was 7%. The independent factors increasing the risk of postoperative complications were stage FIGO (p=0.02) and pelvic lymph node dissection (p=0.011). The 10-year rate for Grade 3 and 4 late radiation complications according to the LENT-SOMA scoring system was 3

  6. Bone pathology inpsoriatic arthritis

    Directory of Open Access Journals (Sweden)

    V. V. Badokin

    2007-01-01

    Full Text Available Objective. To study different variants of osteolysis in pts with psoriatic arthritis (PA and to reveal their relationship with other clinico-radiological features of joint damage. Material and methods. 370 pts with definite PA having different variants of joint damage were included. Radiological examination of bones and joints (in some cases large picture frame was performed. Morphological evaluation of synovial biopsies was done in 34 pts with PA and 10 pts with rheumatoid arthritis (RA. Results. Different types of osteolysis were revealed in 80 (21,6% pts. Osteolytic variant of joint damage was present in 29 pts. 33 pts had acral, 48 — intra-articular osteolysis and 16 - true bone atrophy. Frequency and intensity of bone resorption were associated with severity of PA. Acral osteolysis correlated with arthritis of distal interphalangeal joints and onychodystrophy. Intra-articular osteolysis was most often present in distal interphalangeal joints of hands and metacarpophalangeal joints (39,6% and 41,7% respectively. Characteristic feature of PA was combination of prominent resorption with formation of bone ankylosis and periosteal reaction. Ankylosis was present in 33,3% of pts with intra-articular osteolysis and in 60% of pts with combination of different osteolysis variants. Systemic reaction of microcirculation in synovial biopsies was most prominent in osteolytic variant: marked thickening of capillary and venule basal membrane with high level of acid phosphatase, increased capillary and precapillary blood flow with stasis features, vascular lymphocyte and macrophage infiltration, productive vasculitis with annular wall thickening, thrombovasculitis and villi deep layer sclerosis. Conclusion. Different variants of osteolysis show bone involvement in PA. Acral and intra- articular osteolysis association with bone ankylosis and periostitis proves their common pathogenetic entity.

  7. Pentavalent 99Tcm - DMSA SPECT in primary brain tumours of glial cell origin

    International Nuclear Information System (INIS)

    Chung, D.K.; Evans, S.G.; Larcos, G.; Gruenewald, S.; Kumar, V.; Barton, M.

    1999-01-01

    Full text: 99 Tc m (V)-DMSA [DMSA(V)] has shown promise in brain tumour imaging. This study aimed to assess the role of DMSA(V) brain SPET in glioma for: (1) predicting the histopathological grade of malignancy, (2) monitoring response to therapy and (3) discriminating recurrent tumour from post-radiotherapy necrosis. Twenty-three patients (pts) (14 men, 9 women) of mean age 57 years (range 20-79) were referred with a lesion on CT/MRI (14 new presentations, 5 known and 4 suspected tumour recurrence). Up to 555 MBq of 99 Tc m (V)DMSA were administered and SPET was acquired at 3 h. Tumour uptake ratio (UR) was calculated by the ratio of activity in the tumour to a region in the contralateral brain. All 19 pts with known tumour showed DMSA(V) uptake. The 14 pts with new tumours (10 grade IV, I grade III, 2 grade II and 1 necrotic tumour) had a pre-therapy mean UR of 7.7 (range 2.8-13.6). The 3 lower-grade tumours were scattered widely within this range. Four pts completed radiotherapy and returned for a post-therapy scan, where the UR was less than the pre-therapy UR in 2, unchanged in 1 and greater in 1. The 5 known recurrent tumours had a mean UR of 13.5 (range 7.3-24.9). In the 4 pts with suspected recurrence, the DMSA(V) scan result agreed with clinical course or PET in 3 but was falsely positive in 1. In summary, 99 Tc m (V)-DMSA: (1) showed uptake in all known glial cell tumours in this series, however the UR did not correlate with the histopathological grade; (2) may be useful for discriminating tumour recurrence from post-radiotherapy necrosis; and (3) may have a role in predicting post-therapy prognosis

  8. Directly measured secondhand smoke exposure and COPD health outcomes

    Directory of Open Access Journals (Sweden)

    Balmes John

    2006-06-01

    Full Text Available Abstract Background Although personal cigarette smoking is the most important cause and modulator of chronic obstructive pulmonary disease (COPD, secondhand smoke (SHS exposure could influence the course of the disease. Despite the importance of this question, the impact of SHS exposure on COPD health outcomes remains unknown. Methods We used data from two waves of a population-based multiwave U.S. cohort study of adults with COPD. 77 non-smoking respondents with a diagnosis of COPD completed direct SHS monitoring based on urine cotinine and a personal badge that measures nicotine. We evaluated the longitudinal impact of SHS exposure on validated measures of COPD severity, physical health status, quality of life (QOL, and dyspnea measured at one year follow-up. Results The highest level of SHS exposure, as measured by urine cotinine, was cross-sectionally associated with poorer COPD severity (mean score increment 4.7 pts; 95% CI 0.6 to 8.9 and dyspnea (1.0 pts; 95% CI 0.4 to 1.7 after controlling for covariates. In longitudinal analysis, the highest level of baseline cotinine was associated with worse COPD severity (4.7 points; 95% CI -0.1 to 9.4; p = 0.054, disease-specific QOL (2.9 pts; -0.16 to 5.9; p = 0.063, and dyspnea (0.9 pts; 95% CI 0.2 to 1.6 pts; p Conclusion Directly measured SHS exposure appears to adversely influence health outcomes in COPD, independent of personal smoking. Because SHS is a modifiable risk factor, clinicians should assess SHS exposure in their patients and counsel its avoidance. In public health terms, the effects of SHS exposure on this vulnerable subpopulation provide a further rationale for laws prohibiting public smoking.

  9. Detection of circulating tumour cells in peripheral blood of patients with malignant pleural mesothelioma.

    Science.gov (United States)

    Raphael, Jacques; Massard, Christophe; Gong, Inna Y; Farace, Françoise; Margery, Jacques; Billiot, Fanny; Hollebecque, Antoine; Besse, Benjamin; Soria, Jean-Charles; Planchard, David

    2015-01-01

    The independent prognostic value of Circulating Tumour Cells (CTC) level has been demonstrated in several solid tumours. There is currently few data on Malignant Pleural Mesothelioma (MPM) and CTC. We investigated whether the presence of CTC was correlated with prognosis factors and treatment efficacy. MPM patients (pts) were enrolled in a prospective monocentric study. CTC detection was made using the "CellSearch" assay. The correlation between the presence of CTC and worse prognosis factors was assessed using the X(2) test. Comparison of Overall Survival (OS) and Progression Free Survival (PFS) according to CTC detection was performed using the log-rank test. Twenty-seven MPM pts with a median follow-up of 4.2 months were included. CTC were detected in 44% of pts with a median level of 1.5. No significant correlation was observed between the presence of CTC and worse prognosis factors. Moreover, CTC detection was not a significant predictor of OS or PFS (p=0.155 and p=0.32 respectively). CTC were detected in a small cohort of MPM patients. We couldn't demonstrate a significant prognostic value or a difference in OS/PFS between CTC levels. Further analyses, validation studies and detection techniques are needed to establish their real clinical value in MPM.

  10. Retrospective study of 87 interstitial brachytherapy for facial skin carcinomas

    International Nuclear Information System (INIS)

    Berland, E.; Bolla, M.; Saillard, F.; Beani, J.C.; Lebeau, J.; Fillon, J.P.; Vrousos, C.

    1996-01-01

    From 1977 to 1983, 83 patients (pts) with 87 facial skin carcinomas (FSC) were treated with interstitial brachytherapy (BT) in our department. Median age was 70 years (43-97 y). There was 61 basal cell carcinomas and 26 squamous cell carcinomas. 28 of them corresponded to local relapse of FSC initially treated without BT. TNM stadification was as following: T1+rT1=72,4%; T2+rT2=23%; T3+rT3=2,3%; T4+rT4=2,3%. The median follow-up was 53 months (8 months to 15 years). Different techniques were used:hypodermic needles,plastic tubes, Raynal method. A dose of 60 Gy was prescribed on the reference isodose, according to the PARIS system. Specific overall survival was 98,8% at 5 and 10 y. Local control at 5 and 10 y was 100 and 90% for FSC treated in first intention, and 81,2% for recurrent FSC. This was highly significant (p=0,002 Logrank test) Functional sequelae were appreciated according to the RTOG/EORTC scale: 29 occurred in 21 pts.60% of them were depigmentation ((11(29))) and epilation ((6(29))). Among the 21 FSC of the eyelid, one lacrimal stenosis occurred (4,8%) Cosmetic results were judged 'good' or 'very good' for 83% of the pts (BONVALLOT criteria). Bad results occured more frequently for recurrent FSC According to the litterature, our study shows that interstitial BT is a good alternative to surgery for facial skin carcinoma for elderly patients

  11. Peak-to-average power ratio reduction in orthogonal frequency division multiplexing-based visible light communication systems using a modified partial transmit sequence technique

    Science.gov (United States)

    Liu, Yan; Deng, Honggui; Ren, Shuang; Tang, Chengying; Qian, Xuewen

    2018-01-01

    We propose an efficient partial transmit sequence technique based on genetic algorithm and peak-value optimization algorithm (GAPOA) to reduce high peak-to-average power ratio (PAPR) in visible light communication systems based on orthogonal frequency division multiplexing (VLC-OFDM). By analysis of hill-climbing algorithm's pros and cons, we propose the POA with excellent local search ability to further process the signals whose PAPR is still over the threshold after processed by genetic algorithm (GA). To verify the effectiveness of the proposed technique and algorithm, we evaluate the PAPR performance and the bit error rate (BER) performance and compare them with partial transmit sequence (PTS) technique based on GA (GA-PTS), PTS technique based on genetic and hill-climbing algorithm (GH-PTS), and PTS based on shuffled frog leaping algorithm and hill-climbing algorithm (SFLAHC-PTS). The results show that our technique and algorithm have not only better PAPR performance but also lower computational complexity and BER than GA-PTS, GH-PTS, and SFLAHC-PTS technique.

  12. Risk stratification of patients with hypertension using exercise thallium-201 scintigraphy

    International Nuclear Information System (INIS)

    Iskandrian, A.S.; Hakki, A.H.; Kane, S.

    1985-01-01

    Hypertension (HT) is an important risk factor in coronary heart disease (CHD) and cardiac morbidity and mortality. This study examined the value of clinical, ECG, exercise (EX) and thallium-201 imaging descriptors that identify patients (pts) with HT at high risk. The 337 pts in the study underwent EX thallium-201 testing for evaluation of chest pain due to suspected or proven CHD. The mean age was 55 years, of whom 79% were still on active anti-HT therapy at the time of the study. The EX thallium scintigrams were evaluated qualitatively and quantitively using circumferential profile analysis. The scans were abnormal in 162 pts (48%) and reversible perfusion defects were present in 106 of the 162 pts (65%). At a folllowup fo up to 74 months, (15 +- 9 mean +- SD), 11 pts had hard cardiac events: 2 died of cardiac causes and 9 had non-fatal acute myocardial infractions. There were no significant differences between those with and without events in age, EX heart rate and double product, EX duration, blood pressure and EX ECG changes. Univariate and multivariate survival analysis (Cox regression model) of important clinical, ECG, EX and thallium variables, identified the presence of abnormal EX images as the only predictor of outcome. (X/sup 2/ = 5.4, p< 0.02). No other variable provided additional prognostic information. Actuarial life table analysis showed that pts with abnormal images had significantly more events than those with normal images (p = 0.008, Mantel-Cox). Thus, EX thallium imaging is useful in risk stratification in pts with HT. The presence of abnormal images identify a subgroup at high risk for future events

  13. [Evaluation of immunosuppressive treatment on homocystein levels in patients after kidney transplantation during a 2 year observation period].

    Science.gov (United States)

    Aksamit, Dariusz; Janda, Katarzyna; Kuźniewski, Marek; Krzanowski, Marcin; Ignacak, Ewa; Betkowska-Prokop, Alina; Chowaniec, Eve; Sułowicz, Wladysław

    2012-01-01

    The aim of the study was to evaluate the influence of the type of prescribed immunosuppression: cyclosporine A (CsA) vs. tacrolimus (Tac) on remote homocystein levels in patients (pts) after kidney transplantation (Ktx). The study included 51 pts (17 F, 34 M) aged 15 to 62 years (mean 38.1) after cadaver Ktx. The mean observation period equaled 21.2 months (6 -24); while total observation period was 90 personlyears. Before Ktx, 46 pts were treated with maintenance hemodialysis (HD), while 5 by peritoneal dialysis (PD). After Ktx, patients had immunosuppression prescribed according to the following schemes: prednisone (P) + CsA + azathioprine (AZA) - 12 pts; P + CsA + mycophenolate mofetil (MMF) -26 pts; P + Tac + MMF - 11 pts; and P + Tac + AZA - 2 pts. Hcy level was measured using high performance liquid chromatography (HPLC). Serum creatinine level was measured by standard method using the Hitachi 917 analyzer. Creatinine clearance was calculated based on the Cockcroft-Gault formula. Patient's blood was drawn before Ktx and 3, 6, 9, 12,15, 18, 21 and 24 months post procedure. Delayed graft function (DGF) after Ktx was diagnosed in 29 pts (56.9%) and this group required from 4 to 28 HD sessions (mean 14 sessions). Hcy level did not significantly differ between pts requiring (29 pts) and not requiring (22 pts) HD treatment after Ktx. It was also noted that the number of performed HD sessions did not significantly correlate with Hcy levels 24 months after Ktx (R =0.04, p=0.81). No relationship was found (non-parametric Spearman test) between the drop in Hcy level 3 months after Ktx as compare with value before Ktx and ischemia time (R=0.09, p=0.49), number of compatible HLA A and B (R=0.07, p=0.63), and DR antigens (R=0.09, p=0.51). Decrease in Hcy level (before Ktx and 24 months after Ktx) did not significantly correlate with the above parameters, respectively: R=-0.14, p=0.40; R=0.06, p=0.73; R=0.12, p=0.45; R=0.11, p=0.50. Decrease in Hcy level (before Ktx and 3

  14. SMALL-DOSE CYTOKINES IN COMBINATION WITH 5-FLUOROURACIL IN OLISSEMINATED RENAL CELL CARCINOMA: FINAL RESULTS OF A RANDOMIZED TRIAL

    Directory of Open Access Journals (Sweden)

    L. V. Demidov

    2009-01-01

    Full Text Available Background: High and intermediate IL-2 regimens are difficult to recommend because of great toxicity and efficacy is not sufficient. We suggest that a combination of very low-dose cytokines is effective and safe in metastatic renal cell carcinoma (MRCC patients (pts. A prospective randomized study was started in 2003. The primary end-point was a response rate. Methods: The eligibility criteria included histopathologically confirmed MRCC, ECOG PS 0-2, no autoimmune diseases, no brain metastases, and normal organ function. All pts were randomized in three arms: IL-2 alone, 1.5 MIU, iv, t.i.w., weeks 1—3 or IL-2 1.0 MIU, iv, t.i.w., weeks 1—3 plus IFN 5 MIU, sc, t.i.w, weeks 1—3 or biochemotherapy group 5-FU, 500 mg/m2, iv, once a week, weeks 1—3 plus IL-2 1.0 MIU, iv, t.i.w., weeks 1—3 plus IFN 5 MIU, sc, t.i.w., weeks 1—3. Courses were repeated every three weeks. A response was assessed according to the RECIST every 2 courses.Results: 64 pts were enrolled, of whom 63 were analyzed. Their median age was 55.4 years (range 16—74. 42.9% of the patients had pre- viously received chemo- or immunotherapy. 55.6 percent of the pts had poor prognosis (according to Motzer et al., 2002. Bone metastases were present in 52.4% of the pts. Sixteen patients treated with IL-2 alone showed no CR, PR, 2 SD, or 14 PD. Of 23 patients in the IL-2+IFN group, there were 5 PR, 8 SD, and 10 PD, with a response rate of 21.7%. Amongst 24 patients in the 5-FU+IL-2+IFN group, there were 1 CR, 3 PR, 10 SD, and 10 PD, with a response rate of 16.7%. One-year survival was 20.0%, 81.3% and 81.0%, respectively. The influenza-like syndrome was the most common side effect in the pts who received IFN (89.1%, grade 1, CTC. Hypotension associated with IL-2 (all groups was seen in 56.3% (50%, grade 1 and 6.3%, grade 2. The other adverse reactions were 12.7% grade 1 neutropenia and vomiting in 4.7% pts (Group 3.Conclusion: All regimens are well tolerated. Small-dose IL-2

  15. Actovegin administration in patients with ulcerated gout tophuses

    Directory of Open Access Journals (Sweden)

    M S Eliseev

    2005-01-01

    Full Text Available Objective. To study actovegin efficacy in the treatment of chronic skin ulcers due to ulceration of tophuses in pts with chronic tophaceous gout. Materials and methods. 6 pts with chronic tophaceous gout aged 52 to 77 years with disease duration from 6 to 20 years with longstanding persisting skin ulcers due to tophuses ulceration were included. In addition to allopuri- nol, steroid and nonsteroidal anti-inflammatory drugs they were treated with actovegin 20% intravenously and local applications of 2% actovegin gel. Clinical examination was performed before and after the course of therapy- Results. Two from six pts showed healing of single chronic ulcers to the end of the treatment course. In the remaining pts ulcer count and size decrease was achieved. Conclusion. Actovegin administration in combined therapy of chronic skin ulcers in pts with chronic tophaceous gout promoted healing of the defects in all cases.

  16. Pre-operative radio-chemo-thermotherapy for advanced (T3-4) and/or recurrent rectal carcinomas

    International Nuclear Information System (INIS)

    Wust, P.; Gremmler, M.; Rau, B.; Loeffel, J.; Gellermann, J.; Stahl, H.; Vogl, T.; Riess, H.; Schlag, P.; Felix, R.

    1995-01-01

    Objective: Recent studies suggest that pre-operative radio-chemotherapy in locally advanced rectal cancer can increase resectability and local control (T4 stages), and might facilitate sphincter-preserving surgery (T3 stages). However, response rates are still unsatisfactory for radiotherapy alone, and are only slightly better for radio-chemotherapy. Radiofrequency hyperthermia has now achieved a technical stage already suitable for treating this tumor entity effectively in clinical practice. Therefore, a trimodal pre-operative approach for T3-4 rectal carcinomas has been investigated in a phase I/II study. Materials and Methods: A phase I/II study was conducted on 30 pts with advanced and/or recurrent rectal cancer. (7(30)) pts had recurrences, (9(30)) uT3, (14(30)) T4-stage of the primary. Initial tumor stage was assessed by endosonography, CT and occasionally MRI (T1-w ± Echovist, T2-w, proton density). Radiotherapy was delivered in prone position using a belly-board, three-field technique, standard blocks, 5x1.8 → 45 Gy in 5 weeks. In parallel, 5-FU (300-350 mg/kg, dose escalation) and folinic acid (50 mg) on days 1-5 and days 22-28. Regional hyperthermia was administered using the annular phased array applicator SIGMA-60 once a week. Index temperatures T x were deduced from thermal mapping scans in endocavitary/intratumoral catheters. Re-staging was done by endosonography and CT. Four weeks after radiotherapy, surgery was performed with preference to continence preserving operations. If the tumor remained unresectable, a boost to a total tumor dose of 60 Gy was claimed. Results: (7(30)) pts (23%) did not undergo resection because their tumors remained technically non-resectable: 4 pts with persistent local control of 12-18 mts, 2 pts with progressive disease, 1 pt with too short observation time. (23(30)) pts underwent surgery: only 1 R2-resection, 22 R0-resections. The patho-histological analysis documented 4 CR (17%) at the primary tumor, 12 PR

  17. Clinical Experiences and Mediational Activities in Urban Teacher Preparation: Learning and Critical Consciousness

    Directory of Open Access Journals (Sweden)

    Craig Willey

    2016-11-01

    Full Text Available In a longitudinal design experiment conducted within an urban teacher preparation program, we employed ethnographic and auto-ethnographic methods to investigate the following research questions: 1 In what ways do clinical experiences (CEs support prospective teachers’ (PTs development of knowledge, skills, and dispositions necessary for urban teaching? 2 How is it determined that adjustments need to be made to the design and facilitation of CEs, and what did these adjustments yield in terms of student learning outcomes? The program centers and leverages CEs in order for PTs to connect theory and practice, particularly an awareness of, and skills associated with, equitable teaching practices. In our two-year field-based program, CEs include community explorations, one-on-one and small group work with children, two student teaching practicums, and various school-community events. We describe the iterative design process undertaken to maximize the benefits yielded from CEs. After working with three cohorts of PTs for their entire professional training, we found that: 1 focusing attention on the intentional design and assessment of the mediational activities coupled with CEs leads to more nuanced understandings and enactments of culturally relevant teaching among PTs; and 2 CEs afford PTs abundant opportunities to shape complex identities as urban teachers. Specifically, we found that clinical experiences and corresponding mediational activities support PTs’ understanding of families of color, allow them to recognize and address problematic schooling practices, and strengthen PTs’ otherwise fragile critical consciousness. We conclude that strategic interventions can provide clarity for PTs around what has, indeed, been learned at particular intervals in the program, and what is left to be developed in the final practicum and beyond.

  18. TRAC-PF1 analyses of potential pressurized-thermal-shock transients at a Combustion-Engineering PWR

    International Nuclear Information System (INIS)

    Koenig, J.E.; Spriggs, G.D.; Smith, R.C.

    1984-01-01

    Los Alamos is participating in a program to assess the risk of pressurized thermal shock (PTS) to a reactor vessel. Our role is to provide best-estimate thermal-hydraulic analyses of 12 postulated overcooling transients using TRAC-PF1. These transients are hypothetical and include multiple operator/equipment failures. Calvert Cliffs/Unit-1, a Combustion-Engineering plant, is the pressurized water reactor modeled for this study. The utility and the vendor supplied information for the comprehensive TRAC-PF1 model. Secondary and primary breaks from both hot-zero-power and full-power conditions were simulated for 7200 s (2 h). Low bulk temperatures and loop-flow stagnation while the system was at a high pressure were of particular interest for PTS analysis. Three transients produced primary temperatures below 405 K (270 0 F - the NRC screening criterion) with system repressurization. Six transients indicated flow stagnation would occur in one loop but not both. One transient showed flow stagnation might occur in both loops. Oak Ridge National Laboratory will do fracture-mechanics analysis using these TRAC-PF1 results and make the final determination of the risk of PTS

  19. Comparison of subdermal and peritumoral injection techniques of lymphoscintigraphy to determine the sentinel lymph node in breast cancer

    International Nuclear Information System (INIS)

    Mudun, A.; Eroglu, A.; Berberoglu, K.; Cantez, S.; Asoglu, O.; Ozmen, V.; Muslumanoglu, M.; Bozfakioglu, Y.

    2002-01-01

    Aim: The aim of this study was to evaluate the value of two different injection techniques for lymphoscintigraphy (LS) to determine the axillary sentinel lymph node (SLN) in patients (pts) with breast cancer. Patients and Methods: Thirty-six pts with early breast cancer were prospectively studied. For LS with peritumoral (PT) injection, Tc 99m-rhenium sulfide colloid (20 Mbq/ml total) was injected into four quadrants around the tumor and 2-hour delayed static images of anterior and lateral chest of pts were obtained with a dual-head gamma camera. For subdermal (SD) lymphoscintigraphy the same dose in one injector was injected subdermally into the skin over the tumor. Dynamic images for 45 minutes and later 5-minutes static images of anterior and lateral chest were obtained. On the operation intraoperatif gamma probe was used to find the axillary SLN(s) and followed by primary tumor excision and level 1-2 axillary dissection. SLN(s) and whole axillary specimens were evaluated by histopathologically. Results: With both injection techniques, 16/36 pts had completely identical drainage sites and equal no. of the SLNs. Nineteen of 36 pts showed identical lymphatic drainage sites with different no. of SLNs. With PT injection 9/36 pts, with SD injections 2/36 pts (%92) did not show any drainage and SLN. Intrasurgical gamma probe revealed axillary SLN(s) in 35/36 pts (success rate % 97). With both injection techniques there was no significant difference between the success rate of SLN detection and ages of pts, size and site of the tumor and history of previous excisional biopsy. Internal mammary lymphatics (IM) drainage visualization rate were 8/36 with PT injections and 3/36 with SD injections. Other LNs visualization rate were 7/36 with PT injections and 8/36 with SD injections. Conclusion: These findings showed that the success rate of SD injection technique is higher than PT injection technique in visualizing the axillary SLN. To increase the visualization of axillary

  20. Is it time to rethink the role of hyperfractionated radiotherapy in the management of children with newly-diagnosed brainstem glioma?: Results of a Pediatric Oncology Group Phase III trial comparing conventional VS. hyperfractionated radiotherapy

    International Nuclear Information System (INIS)

    Mandell, L.; Kadota, R.; Douglass, E.C.; Fontanesi, J.; Freeman, C.; Cohen, M.; Kovnar, E.; Burger, P.; Sanford, R.A.; Kepner, J.; Friedman, H.; Kun, L.

    1997-01-01

    Purposes/Objective: In June 1992, POG began accrual to a Phase III study, POG 9239, designed to compare the time to disease progression, overall survival, and toxicities observed in children with newly diagnosed brainstem glioma treated with 100 mg/m 2 of infusional Cisplatin and randomized to either conventional vs. hyperfractionated radiotherapy. The trial was closed in March 1996, having achieved its accrual goal. Materials and Methods: Patients (pts) eligible for study were those between 3 and 21 years of age with previously untreated tumors arising in the pons. Histologic confirmation of diagnosis was not mandatory, provided that the clinical and MRI scan findings were typical for diffusely infiltrating pontine glioma. Treatment (Rx) consisted of a six-week course of local field radiotherapy with either once a day treatment (Rx 1) of 180 cGy per fraction to a total dose of 5400 cGy or a twice a day regimen (Rx 2) of 117 cGy per fraction to a total dose of 7020 cGy (the second of the three hyperfractionated dose escalation levels of POG 8495). Because of previously reported poor results with conventional radiotherapy alone, Cisplatin was included as a potential radiosensitizer in an attempt to improve progression-free and ultimate survival rates. Based on results of the Phase I Cisplatin dose escalation trial, POG 9139, 100 mg/m 2 was chosen for this trial and was delivered by continuous infusion over a 120-hour period, beginning on the first day of radiotherapy and repeated during Weeks 3 and 5. Of the 132 pts accrued to the study, 94 are eligible for review based upon time since entry, 47 in each Rx arm. In Rx 1, there were 23 males and 24 females, ranging in age from 40 to 161 mo (median, 77 mo); in Rx 2, there were 20 males and 27 females, ranging in age from 41 to 212 mo (median, 77 mo). As of 4/18/96, the study coordinator had not yet verified eligibility and assessed the evaluability of the remaining pts. Results: All results are from time of diagnosis

  1. Intraoperative radiation therapy for locally advanced gynecological malignancies

    International Nuclear Information System (INIS)

    Haddock, M.G.; Petersen, I.A.; Webb, M.J.; Wilson, T.O.; Podratz, K.C.; Gunderson, L.L.

    1996-01-01

    Purpose: Evaluate disease control and survival in patients with locally advanced gynecological malignancies who received intraoperative radiation therapy with electrons (IOERT) as a component of treatment. Methods and Materials: Between March 1983 and June 1995, 63 patients (pts) with locally advanced primary (9 pts) or recurrent (54 pts) gynecological malignancies received IOERT as a component of attempted curative therapy. The site of origin was uterine cervix in 40 pts, uterine corpus in 16 pts, vagina in 5 pts, and ovary in 2 pts. Thirty-eight patients with recurrent disease had been previously irradiated (median prior RT dose 5040 cGy, range 900-8400). External beam radiotherapy (EBRT) was given to 43 of 63 pts either before or after IOERT (900-6570 cGy, median 4960 cGy). Chemotherapy was given to 21 pts prior to IOERT and following IOERT in 2 pts. IOERT doses ranged from 800 cGy to 2500 cGy with a median of 1750 cGy. The median IOERT dose was 2000 cGy in 20 patients with gross residual disease and 1500 cGy in 43 patients with microscopic residual disease. Endpoints included central control within the IOERT cone, local control, distant failure, disease free survival and overall survival. Variables evaluated for impact on disease outcome included tumor grade, primary site, prior RT, IOERT dose, EBRT dose, residual disease at time of IOERT, and use of chemotherapy. Results: Survival and disease control data are presented in the table below. There was no impact of any disease or treatment related variable on local or central failure. Pts with microscopic residual disease at the time of IOERT had significantly fewer distant metastases than pts with gross residual (5 yr 31% vs. 77%, p = 0.001) and improved survival (5 yr 37% vs. 10%, p = 0.02). Patients with recurrent disease after previous RT had survival and disease control rates which were similar to those seen in pts without priot RT. Toxicity ≥ grade 3 due to IOERT was observed in 11 pts (17%). Conclusion: A

  2. Clinical utility of circulating cell-free DNA in advanced colorectal cancer.

    Directory of Open Access Journals (Sweden)

    Allan A Lima Pereira

    Full Text Available Circulating cell-free DNA (cfDNA isolated from the plasma of cancer patients (pts has been shown to reflect the genomic mutation profile of the tumor. However, physician and patient assessment of clinical utility of these assays in patients with metastatic colorectal cancer (mCRC has not been previously described.Patients were prospectively consented to a prospective genomic matching protocol (Assessment of Targeted Therapies Against Colorectal Cancer [ATTACC], with collection of blood for cfDNA extraction and sequencing of a 54-gene panel in a CLIA-certified lab. Formalin-fixed, paraffin-embedded (FFPE tissue from prior resections or biopsies underwent 50-gene sequencing. Results from both assays were returned to the treating physicians for patient care and clinical trial selection. Follow-up surveys of treating physicians and chart reviews assessed clinical utility.128 mCRC pts were enrolled between 6/2014 and 1/2015. Results were returned in median of 13 and 26 days for cfDNA and FFPE sequencing, respectively. With cfDNA sequencing, 78% (100/128 of samples had a detectable somatic genomic alteration. 50% of cfDNA cases had potentially actionable alterations, and 60% of these could be genomically matched to at least one clinical trial in our institution. 50% (15/30 of these pts enrolled onto an identified matched trial. Physicians reported that the cfDNA testing improved the quality of care they could provide in 73% of the cases, and that 89% of pts reported greater satisfaction with the efforts to personalize experimental therapeutic agents.cfDNA sequencing can provide timely information on potentially actionable mutations and amplifications, thereby facilitating clinical trial enrollment and improving the perceived quality of care.

  3. [Adrenomedullin--the link between the sympathetic nervous system activation and peripheral vasodilatation in some patients with vasovagal syncope].

    Science.gov (United States)

    Gajek, Jacek; Zyśko, Dorota; Halawa, Bogumił

    2004-09-01

    Adrenomedullin (ADM) is a potent vasodilator playing role in regulation of central hemodynamic. The concentration of plasma ADM in healthy people increases under the influence of orthostatic stress. In patients with vasovagal syncope (VS) the changes in ADM concentration could be responsible either for syncope provocation or prevention. The aim of the study was to assess the influence of phase of the head-up tilt test (HUTT) in which the syncope occurred on the plasma concentration of ADM. The study was performed in 25 patients (pts) (18 women and 7 men), mean age 45.0+/-16.1 years with cardiodepressive reactions during HUTT according to the Italian protocol with nitroglycerine (NTG) provocation if necessary: Syncope was caused in 23 pts due to vasovagal reaction: in 17 pts syncope occurred after NTG provocation (group 1), and in 6 pts occurred in the passive phase of tilt (group 2a), in 2 pts due to dysautonomic reactions (group 2b). The head-up tilt test was performed according to ESC guidelines. The blood for ADM concentration was drawn after 30 min supine rest (ADM 1) and immediately after syncope (ADM 2). ADM level was measured using radioimmunological method. The results. In group 1 plasma level of ADM significantly decreased after the HUTT (3.2+/-3.4 vs 1.7+/-1,4 pg/0.1 ml; p<0.05) and in group 2a increased significantly (1.3+/-0.8 vs 2.7+/-1.3 pg/0.1 ml; p<0.05) comparing to baseline values. The ADM concentration did not differ between the groups in baseline conditions and was significantly higher after the syncope in group 2a (p<0.05). Conclusions. The excessive increase of ADM concentration during the passive phase of HUTT could play the causative role in pathogenesis of VS occurring early during the HUTT. In patients with VS after NTG provocation the decrease of ADM concentration can be the result of hemodynamic changes in the presence of vasodilating drug and may be the mechanism that could prevent the syncope.

  4. Heavy-Section Steel Technology program overview

    International Nuclear Information System (INIS)

    Pennell, W.E.

    1990-01-01

    This paper presents a status review of ongoing HSST program tasks aimed at refining the technology used in analysis of reactor pressure vessel fracture margins under pressurized thermal-shock (PTS) loading. Specific fracture-technology issues addressed include vessel flaw density and distribution, shallow flaws, fracture-toughness data transfer, circumferential cracks, ductile tearing and the influence of low-tearing toughness in stainless steel cladding. Preliminary results from the analysis and test programs are presented, together with interim assessments of their potential impact on a reactor vessel PTS analysis. 31 refs., 23 figs., 1 tab

  5. [Postoperative rehabilitation in patients with peripheral nerve lesions].

    Science.gov (United States)

    Petronić, I; Marsavelski, A; Nikolić, G; Cirović, D

    2003-01-01

    Injuries of extremities can be followed by various neuromuscular complications. Injury of peripheral nerves directly depended on the topographic localization of injury (fractures, cuts, contusions). The neuromuscular complications were diagnosed and under follow-up, based on clinical, x-ray, neurologic and neurophysiological findings. The timing of physical treatment and assessment of the necessary neurosurgical intervention depended on the obtained findings. After surgeries, we continued to apply physical treatment and rehabilitation. The aim of the paper was to assess the significance of proper timing for surgery and adequate postoperative rehabilitation, as well as treatment results, depending on the extent of peripheral nerve injury. Based on the study condocted in the period from 2000-2002, most surgeries were done on the ulnar nerve (4 pts), median nerve (4 pts), radial nerve (3 pts), peroneal nerve (2 pts) and plexus brachialis (3 pts). Paresis and peripheral nerve paralysis, associated with sensibility disorders, predominated in clinical features. In most patients surgery was done during the first 3-6 months after injury. In early postoperative Postoperative rehabilitation in patients with peripherial treatment positioning of extremities with electrotherapy were most often used in early postoperative treatment, Bioptron and dosed kinesitherapy. Depending on the neurophysiological findings, in later treatment stage we included electrostimulation, thermotherapy, kinesitherapy and working therapy, with the necessary application of static and dynamic orthroses. Study results showed that the success of treatment depended on the extent of injury, i.e. whether suture of liberalization of the nerve had been done, on the adequate timing of surgery, as well as on the adequate timing and application of physical therapy and rehabilitation. More rapid and complete functional recovery was achieved if the interval between injury and surgery was shorter, as well as

  6. Aspen Delineation - Plumas National Forest, FRRD [ds376

    Data.gov (United States)

    California Natural Resource Agency — The database represents delineations of aspen stands associated with stand assessment data (PLUMAS_NF_FEATHERRIVER_PTS) collected in aspen stands in the Plumas...

  7. Exercise-induced intra-ventricular gradients as a frequent potential cause of myocardial ischemia in cardiac syndrome X patients

    Directory of Open Access Journals (Sweden)

    Almeida Ana G

    2008-01-01

    Full Text Available Abstract Background The development of intra-ventricular gradients (IVG during dobutamine or exercise stress is not infrequent, and can be associated to symptoms during stress. The purpose of this study was to assess the occurrence of IVG during exercise stress echocardiography in cardiac syndrome X patients. Methods We prospectively evaluated 91 patients (pts mean aged 51 ± 12 years (age ranged 20 to 75 years old, 44 of whom were women. All pts had angina, positive exercise ECG treadmill testing, normal rest echocardiogram and no coronary artery disease on coronary angiogram (cardiac X syndrome. After complete Doppler echocardiographic evaluation with determination of left ventricular outflow tract index (LVOTi, relative left ventricular wall thickness (RLVWT and left ventricular end-diastolic volume index (LVDVi, all patients underwent stress echocardiography with two-dimensional and Doppler echographic evaluation during and after treadmill exercise. Results For analysis purpose patients were divided in 2 groups, according to the development of IVG. Doppler evidence of IVG was found in 33 (36% of the patients (Group A, with mean age 47 ± 14 years old (age ranged 20 to 72 years and with a mean end-systolic peak gradient of 86 ± 34 mmHg (ranging from 30 to 165 mmHg. The IVG development was accompanied by SAM of the mitral valve in 23 pts. Three of these pts experienced symptomatic hypotension. Ten were women (30% pts. 58 pts in group B, 34 of whom were women (59% (p = 0,01 vs group A, mean aged 53,5 ± 10,9 years old (age ranged 34 to 75 years (p = 0,03 vs group A, did not develop IVG. LVOTi was 10,29 ± 0,9 mm/m2 in group A and 11,4 ± 1 mm/m2 in group B (p 2 in group A and 56 ± 11,6 ml/m2 in group B (p = 0,000. Conclusion 1. A significant number of patients with cardiac X syndrome developed IVG during upright exercise in treadmill. These pts (group A are mainly males and younger than those who did not develop IVG. 2. The development of IVG

  8. SPECT determination of regional cerebral blood flow in hypertensive patients before and after clonidine

    International Nuclear Information System (INIS)

    Devous, M.D.; Reed, W.G.; Chehabi, H.H.; Bonte, F.J.

    1985-01-01

    Regional cerebral blood flow (rCBF) was determined by SPECT of 133-Xe inert gas washout in 18 hypertensive patients (PTS) upon admission and after treatment with oral clonidine (CL, 0.2 mg, then 0.1 mg/hr until diastolic pressure reached 105 mm Hg or fell by 30 mm Hg). CL reduced mean arterial pressure (MAP) from 160 (200/140) to 133 (150/100) mm Hg over 4-6 hr. RCBF was quantitated in 14 gray matter regions from cross-sectional images and analyzed for differences from normal controls and changes with CL. Initial rCBF was lower in HI PTS than in either normal controls of LO PTS in all brain regions. CL lowered MAP in HI PTS by 52 +- 15 mm Hg and caused reduction in all gray matter regions except right frontal and right temporal (mean reduction 5 +- 2 ml/min/100 g, rho<.05). RCBF images were also evaluated by two trained observers for initial regional defects and for changes with CL. LO PTS were more likely to have defects in rCBF images at rest which would resolve with CL. HI PTS frequently had normal images at rest and developed defects with CL. In summary, the study suggests that SPECT may be useful in detecting rCBF abnormalities in hypertensive PTS at rest and following reductions in MAP

  9. Is neoadjuvant chemotherapy prior to radio-chemotherapy beneficial in T4 anal carcinoma?

    Science.gov (United States)

    Moureau-Zabotto, L; Viret, F; Giovaninni, M; Lelong, B; Bories, E; Delpero, J R; Pesenti, C; Caillol, F; de Chaisemartin, C; Minsat, M; Monges, G; Sarran, A; Resbeut, M

    2011-07-01

    This study retrospectively describes the outcome of a series of 38 patients (pts) with T4 anal carcinoma exclusively treated by radio and chemotherapy. From 1992 to 2007, 38 pts with UST4-N0-2-M0 anal carcinoma were treated with exclusive radiotherapy and chemotherapy. All patients received external beam radiotherapy (EBRT) (median dose 45 Gy) with a concomitant chemotherapy (5-fluorouracil-cisplatin). Eleven patients received neo-adjuvant chemotherapy (5-fluorouracil-cisplatin). After 2-8 weeks, a 15-20 Gy boost was delivered either with EBRT (20 pts) or interstitial (192)Ir brachytherapy (18 pts). Mean follow-up was 66 months. After chemoradiation therapy (CRT), 13 pts (34%) had a complete response, 23 pts (60%) a response >50% (2 pts were not evaluated). The 5-year-disease-free survival was 79.2 ± 6.5%, and the 5-year overall survival was 83.9 ± 6%. Eight patients developed tumor progression (mean delay 8.8 months), six of them requiring a salvage surgery with definitive colostomy for local relapse. Late severe complication requiring colostomy was observed in 2 pts. The 5-year-colostomy-free survival was 78 ± 6.9%. Patients who received primary chemotherapy had a statistically significant better 5-year colostomy-free survival (100% vs. 38 ± 16.4%, P = 0.0006). T4 anal carcinoma can be treated with a curative intent using a sphincter-sparing approach of CRT, and neo-adjuvant chemotherapy should be considered prior to radiotherapy. Copyright © 2011 Wiley-Liss, Inc.

  10. Negative Social Relationships Predict Posttraumatic Stress Symptoms Among War-Affected Children Via Posttraumatic Cognitions.

    Science.gov (United States)

    Palosaari, Esa; Punamäki, Raija-Leena; Peltonen, Kirsi; Diab, Marwan; Qouta, Samir R

    2016-07-01

    Post traumatic cognitions (PTCs) are important determinants of post traumatic stress symptoms (PTS symptoms). We tested whether risk factors of PTS symptoms (trauma, demographics, social and family-related factors) predict PTCs and whether PTCs mediate the association between risk factors and PTS symptoms among war-affected children. The participants were 240 Palestinian children 10-12 years old, half boys and half girls, and their parents. Children reported about psychological maltreatment, sibling and peer relations, war trauma, PTCs, PTS symptoms, and depression. Parents reported about their socioeconomic status and their own PTS symptoms. The associations between the variables were estimated in structural equation models. In models which included all the variables, PTCs were predicted by and mediated the effects of psychological maltreatment, war trauma, sibling conflict, and peer unpopularity on PTS symptoms. Other predictors had statistically non-significant effects. Psychological maltreatment had the largest indirect effect (b* = 0.29, p = 0.002) and the indirect effects of war trauma (b* = 0.10, p = 0.045), sibling conflict (b* = 0.10, p = 0.045), and peer unpopularity (b* = 0.10, p = 0.094) were lower and about the same size. Age-salient social relationships are potentially important in the development of both PTCs and PTS symptoms among preadolescents. Furthermore, PTCs mediate the effects of the risk factors of PTS symptoms. The causality of the associations among the variables is not established but it could be studied in the future with interventions which improve the negative aspects of traumatized children's important social relationships.

  11. The Effect of Pneumatic Tube Systems on the Hemolysis of Biochemistry Blood Samples.

    Science.gov (United States)

    Cakirca, Gokhan; Erdal, Huseyin

    2017-05-01

    Pneumatic tube systems (PTSs) are widely used in many hospitals because they lead to reduced turnaround times and cost efficiency. However, PTSs may affect the quality of the blood samples transported to the laboratory. The aim of this study was to investigate the effect of the PTS used in our hospital on the hemolysis of the biochemical blood samples transported to the laboratory. A total of 148 samples were manually transported to the laboratory by hospital staff, 148 samples were transported with the PTS, and 113 were transported with the PTS without use of sponge-rubber inserts (PTSws). Hemolysis rates and the levels of biochemical analytes for the different transportation methods were compared. No significant difference was found between the samples transported manually and with the PTS with regard to hemolysis rate and the levels of biochemical analytes. However, the samples transported with the PTSws showed a significant difference compared with the samples transported manually and with the PTS with regard to hemolysis rate and potassium and lactate dehydrogenase levels. The percentages of the samples that exceeded the permissible threshold for the hemolysis among the samples transported manually, with the PTS, and with the PTSws were 10%, 8%, and 47%, respectively. A PTS can be used safely for transporting biochemistry blood samples to the laboratory. However, a sponge-rubber insert that holds sample tubes must be used with the PTS to prevent the hemolysis of blood samples. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  12. Efficacy of drainage blood reinfusion in early postoperative period after total hip arthroplasty in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    N B Shelokova

    2008-01-01

    Full Text Available To study effect of drainage blood reinfusion in early postoperative period (EPP after total hip arthroplasty (THA in patients with rheumatoid arthritis (RA. Material and methods. Primary THA was performed in 51 RA pts with hip damage (49 female, 2 male aged from 26 to 68 years. 42 THA were performed with “Endosystems and Implants” (ESI endoprosthesis, and 21 — with “Mathys” endoprosthesis. The pts were divided into two groups. Standard infusion-transfusion therapy with donor blood components was performed in group 1 pts (n=26 to compensate blood loss in EPP. In group 2 pts (n=25 drainage blood reinfusion was done with active aspiration system Handy Vac TM ATS (Unomedical. Group 1 pts had more prominent circulatory and neurologic disturbances in EPP: hypodynamic variant of circulation with elevation of peripheral vascular resistance till 5-7 day of postoperative period, prominent hypersympathicotonia and a large number of posttransfusion reactions. Evaluation of hemodynamic and vegetative disturbances showed advantage of blood loss compensation and vegetative disturbances normalization with drainage blood reinfusion in EPP after THA in comparison with standard pts management.

  13. Etiology of Hypopituitarism in Adult Patients: The Experience of a Single Center Database in the Serbian Population

    Directory of Open Access Journals (Sweden)

    M. Doknić

    2017-01-01

    Full Text Available There are only a few published studies related to the population-based etiology of hypopituitarism. New risks for developing hypopituitarism have been recognized in the last 10 years. Aim. To present data regarding the etiology of hypopituitarism collected in a tertiary center over the last decade. This is a cross-sectional database study. Patients and Methods. We included 512 patients (pts with hypopituitarism, with a mean age of 45.9 ± 1.7 yrs (range: 18–82; male: 57.9%. Results. Nonfunctional pituitary adenomas were presented in 205 pts (40.5%, congenital causes in 74 pts (14.6%, while acromegaly and prolactinomas were presented in 37 (7.2% and 36 (7.0% patients, respectively. Craniopharyngiomas were detected in 30 pts (5.9%, and head trauma due to trauma brain injury-TBI and subarachnoid hemorrhage-SAH in 27 pts (5.4%. Survivors of hemorrhagic fever with renal syndrome (HFRS and those with previous cranial irradiation were presented in the same frequency (18 pts, 3.5% each. Conclusion. The most common causes of hypopituitarism in our database are pituitary adenomas. Increased awareness of the other causes of pituitary dysfunction, such as congenital, head trauma, extrapituitary cranial irradiation, and infections, is the reason for a higher frequency of these etiologies of hypopituitarism in the presented database.

  14. Etiology of Hypopituitarism in Adult Patients: The Experience of a Single Center Database in the Serbian Population

    Science.gov (United States)

    Pekić, S.; Miljić, D.; Popović, V.; Stojanović, M.; Petakov, M.

    2017-01-01

    There are only a few published studies related to the population-based etiology of hypopituitarism. New risks for developing hypopituitarism have been recognized in the last 10 years. Aim. To present data regarding the etiology of hypopituitarism collected in a tertiary center over the last decade. This is a cross-sectional database study. Patients and Methods. We included 512 patients (pts) with hypopituitarism, with a mean age of 45.9 ± 1.7 yrs (range: 18–82; male: 57.9%). Results. Nonfunctional pituitary adenomas were presented in 205 pts (40.5%), congenital causes in 74 pts (14.6%), while acromegaly and prolactinomas were presented in 37 (7.2%) and 36 (7.0%) patients, respectively. Craniopharyngiomas were detected in 30 pts (5.9%), and head trauma due to trauma brain injury-TBI and subarachnoid hemorrhage-SAH in 27 pts (5.4%). Survivors of hemorrhagic fever with renal syndrome (HFRS) and those with previous cranial irradiation were presented in the same frequency (18 pts, 3.5% each). Conclusion. The most common causes of hypopituitarism in our database are pituitary adenomas. Increased awareness of the other causes of pituitary dysfunction, such as congenital, head trauma, extrapituitary cranial irradiation, and infections, is the reason for a higher frequency of these etiologies of hypopituitarism in the presented database. PMID:28702053

  15. Correlation between coronary artery calcification and the need for revascularization in patients with no previous diagnosis of arterial coronary disease

    Energy Technology Data Exchange (ETDEWEB)

    Prazeres, Carlos Eduardo Elias dos; Cury, Roberto Caldeira; Bello, Juliana Hiromi Silva Matsumoto [Instituto do Coracao (InCor/FM/USP), Sao paulo, SP (Brazil); Magalhaes, Tiago Augusto [Hospital Pro-Cardiaco, Rio de Janeiro, RJ (Brazil); Moreira, Valeria de Melo; Carlos Eduardo Rochitte, E-mail: rochitte@gmail.com, E-mail: crochitte@hcor.com.br [Hospital do Coracao (HCOR), Sao Paulo, SP (Brazil)

    2012-10-15

    Introduction: about half of deaths from coronary heart disease (CHD) are not preceded by cardiac symptoms or previous diagnosis. Quantification of coronary artery calcification (CAC) by computed tomography is a strong predictor of events and improves the stratification the Framingham Risk Score. Objective: to evaluate the ability of the calcium score to predict the necessity invasive treatment (bypass (CABG) or intervention coronary percutaneous (ICP)) with no previous CAD. Method: retrospective study in pts without prior CAD and with quantification of CAC during 2009. The CAC was obtained in 64 multislice CT without contrast, with synchronized ECG acquisition, 120kV, 80-100mA, radiation <1mSv, and measured by the Agatston calcium score (CS) (threshold of 130 HU). Mean, median, and diagnostic tests were used. Results: We evaluated 263 pts (171 men), 59±13 years, BMI = 27.7 kg/m2, and mean follow up of 18±3 months. The total CS was 199.5±24.39. In patients with diabetes (DM), the CS was 320.5±67.56 and 166±24.47 in non-DM. The 23 patients who underwent invasive treatment had an average CS of 692 ± 72.3 versus 134.7 ± 21.35 in patients not treated (p <0.001). Of the 47 pts with CS ≥ 400, 17 were treated (CABG or ICP). Of the 216 pts with CS <400, 6 underwent treatment. Of the treated pts, 15 without diabetes had average CS 672.7 ± 92.04 versus 728.3 ± 11 of DM (8pts). In pts without DM who not underwent invasive treatment (191 pts), only 18 pts had SC ≥ 400. Conclusion: CS ≥ 400 was a strong predictor of revascularization (CABG or ICP) with good diagnostic performance in patients without prior diagnosis of CAD in the following 18 months. (author)

  16. Acute toxicity and efficacy of postoperative combined modality therapy for adenocarcinoma of the pancreas

    International Nuclear Information System (INIS)

    Davis, Brian J.; Raben, Adam; Casper, Ephraim; Minsky, Bruce D.

    1996-01-01

    PURPOSE: To examine the acute toxicity and outcome in patients (pts) treated with combined modality therapy following resection of adenocarcinoma of the pancreas. MATERIALS AND METHODS: From 2/88 to 2/96, 34 pts (M:20, F:14) received postoperative combined modality therapy following a pancreatic resection. Tumor location included; head only: 28, head and ampulla: 1, ampulla only: 1, body and tail: 2, and tail only: 2. Postoperative stages included: stage I: 7 (21%) and stage III: 27 (79%). Pts were referred for combined modality therapy based on surgeon preference. In general, pts were treated who had one or more adverse prognostic factors. These included positive local/regional lymph nodes (79%), positive margins (50%) or disease invasive into adjacent structures (85 %). Radiation fields included the original primary tumor bed (based on preoperative CT scans) and peri-pancreatic and para-aortic lymph nodes adjacent to vertebral bodies T10 through L3. No attempt was made to include the entire pancreas in the radiation field. Patients received 5040 cGy at 180 cGy/day using a 3 or 4 field technique and CT-based treatment planning. Concurrent bolus 5-FU (375-500 mg/m 2 ) was delivered on the first three and last three days of radiation. Post-radiation maintenance bolus 5-FU was given to 7 patients for a median of 6 cycles. A toxicity assessment using the NCI toxicity criteria was performed at each weekly visit and 4 weeks following the completion of combined modality therapy. The median follow-up was 13 months (range: 2-36 months). Patterns of failure as a component of failure were assessed by radiographic criteria and, in 2 pts, by intraoperative evaluation for symptomatic progression of disease. Local/regional failure was defined as recurrence within the radiation field. Distant failure included liver, peritoneal seeding, and extra-abdominal sites. Actuarial survival was calculated from the time of surgery using the Kaplan-Meier method. RESULTS: The only grade 3

  17. Cost-effectiveness of additional catheter-directed thrombolysis for deep vein thrombosis

    Science.gov (United States)

    ENDEN, T.; RESCH, S.; WHITE, C.; WIK, H. S.; KLØW, N. E.; SANDSET, P. M.

    2013-01-01

    Summary Background Additional treatment with catheter-directed thrombolysis (CDT) has recently been shown to reduce post-thrombotic syndrome (PTS). Objectives To estimate the cost effectiveness of additional CDT compared with standard treatment alone. Methods Using a Markov decision model, we compared the two treatment strategies in patients with a high proximal deep vein thrombosis (DVT) and a low risk of bleeding. The model captured the development of PTS, recurrent venous thromboembolism and treatment-related adverse events within a lifetime horizon and the perspective of a third-party payer. Uncertainty was assessed with one-way and probabilistic sensitivity analyzes. Model inputs from the CaVenT study included PTS development, major bleeding from CDT and utilities for post DVT states including PTS. The remaining clinical inputs were obtained from the literature. Costs obtained from the CaVenT study, hospital accounts and the literature are expressed in US dollars ($); effects in quality adjusted life years (QALY). Results In base case analyzes, additional CDT accumulated 32.31 QALYs compared with 31.68 QALYs after standard treatment alone. Direct medical costs were $64 709 for additional CDT and $51 866 for standard treatment. The incremental cost-effectiveness ratio (ICER) was $20 429/QALY gained. One-way sensitivity analysis showed model sensitivity to the clinical efficacy of both strategies, but the ICER remained < $55 000/QALY over the full range of all parameters. The probability that CDT is cost effective was 82% at a willingness to pay threshold of $50 000/QALY gained. Conclusions Additional CDT is likely to be a cost-effective alternative to the standard treatment for patients with a high proximal DVT and a low risk of bleeding. PMID:23452204

  18. Correlation between the treated volume, the GTV and the CTV at the time of brachytherapy and the histopathologic findings in 33 patients with operable cervix carcinoma

    International Nuclear Information System (INIS)

    Muschitz, S.; Petrow, P.; Briot, E.; Petit, C.; De Crevoisier, R.; Duvillard, P.; Morice, P.; Haie-Meder, C.

    2004-01-01

    Background and purpose: This study correlates the treated volume, the GTV and the CTV at the time of intracavitary brachytherapy (BT) with the histopathological findings obtained by surgery (S) in 33 patients (pts) with cervix carcinoma. Patients and methods: Sixteen pts (group I), FIGO stage IB1 (1), IB2 (4), IIB (10), IIIB (1), received external beam radiotherapy (EBT) with a total dose of 45 Gy in 5 weeks and concomitant CISPLATIN 40 mg/m 2 weekly, followed by BT up to a total dose of 15 Gy. S was performed 6-8 weeks thereafter. Seventeen pts (group II), FIGO IA2 (1), IB1 (14), IIB (2), were treated by BT alone with a total dose of 60 Gy and S after 6-8 weeks. All pts had a MRI examination after BT with a moulded applicator in situ for exact delineation of GTV, CTV and critical organs and a 3D dosimetry directly from MRI data. Results: In group I (EBT+BT+S), the histopathological findings showed complete tumour sterilization (CR) in 56% of pts. Residual disease (RD) was found in 43%. Dosimetric data showed in pts with CR a larger mean treated volume (213 vs. 166 cm 3 ) and a better mean coverage of the GTV and the CTV by the reference isodose (99 and 91%) as in pts with RD (85 and 77%). In group II (BT+S), CR was found in 52%, RD in 41%. Dosimetric data showed a larger mean treated volume (154 vs. 109 cm 3 ) for pts with RD and a mean coverage of the GTV and the CTV by the reference isodose of 97 and 84% vs. 89 and 80% for pts with CR. Conclusions: An incomplete coverage of the GTV and/or the CTV by the reference isodose is an important risk factor for RD at the time of surgery. Furthermore, for pts who received BT alone, tumour size seemed to be a limiting factor for an accurate coverage of the CTV by the reference isodose

  19. Prevention and treatment of the post-thrombotic syndrome and of the chronic thromboembolic pulmonary hypertension.

    Science.gov (United States)

    Pesavento, Raffaele; Prandoni, Paolo

    2015-02-01

    Post-thrombotic syndrome (PTS) and chronic thromboembolic pulmonary hypertension (CTEPH) are late complications of venous thromboembolism. The purpose of this review is to present and discuss recently published studies that have improved our knowledge of PTS and CTEPH. The current understanding of the pathophysiology of PTS and CTEPH is discussed as well as the importance of chronic residual venous thrombosis, some polymorphisms of plasminogen activator inhibitor-1, and the current concept of misguided thrombus resolution. The surprising finding that elastic compression stockings may not be effective in preventing PTS and the novel medical treatment in CTEPH are discussed in detail. Novel direct oral anticoagulants show potential for prevention of PTS. No firm conclusions can be drawn on the efficacy of elastic stockings. Novel treatments of CTEPH for inoperable patients and those with persistent pulmonary hypertension after surgery have become available and further research on wider indication for their use is urgently needed.

  20. Radiotherapy effect in conservation treatment for breast cancer

    International Nuclear Information System (INIS)

    Sachini, V.; Ferreri, A.J.M.; Farante, G.; Agresti, R.; Galimberti, V.; Zurrida, S.; Veronesi, P.

    1994-01-01

    Radiotherapy (RT) in conservative treatment for breast cancer (CT-BC) has been proven to be determinant for the local control of the disease. Radiation therapy was described by several authors as the most important factor affecting the cosmetic results of this treatment. Technical progress in RT, use of filters and wedges and an increased knowledge of the influence of fraction size total dose and irradiated volume on breast tissues contributed to avoid major radiotherapeutic side effects in the CT-BC. Cosmetic outcome from 2 groups of patients (pts) with breast cancer in stage T 1-2(T> = 2,5 cm) N 0-1 M o0 of the prospective trial Milan III were compared. Both groups pts (n=89) were treated with quadrantectomyand axillary dissection. 49 pts received complementary RT with a dose of 50 Gy over 5 weeks with a daily fraction of 2 Gy and a further boost of 10 Gy (10 MeV electrons) on the scar. Remaining 40 pts did not receive RT. Cosmetic results were subjectively and objectively (asymmetry index) evaluated. No significant cosmetic differences were observed between the 2 study groups. A good or excellent symmetry was observed in 59% of irradiated pts and 64% of non irradiated pts. Negative results were observed in 4% and 2% respectively. Subjective ovulation showed similar results, with a good or excellent symmetry in 57% of irradiated pts and 72.5% of non irradiated pts. Poor results were observed in 16.3% and 27.5% respectively. Telangiectasia were observed in 4% of irradiated pts, while hypertrophied scars were only noted in non irradiated pts (15%). No acute side effects of RT, as erythema or ulceration of breast skin, were recorded. In our experience, the standard dose of 50 Gy administered by two opposite tangential fields plus a 10 Gy boost did not affect the cosmetic results of CT.BC, whereas it provided a better local control of disease. The possibility to avoid RT in selected group of pts should be justified by the discomfort of this treatment for the pt, cost

  1. Long term results of compression sclerotherapy.

    Science.gov (United States)

    Labas, P; Ohradka, B; Cambal, M; Reis, R; Fillo, J

    2003-01-01

    To compare the short and long term results of different techniques of compression sclerotherapy. In the past 10 years the authors treated 1622 pts due to chronic venous insufficiency. There were 3 groups of patients: 1) Pts treated by Sigg's technique using Aethoxysclerol, 2) Pts treated by Fegan's technique with Fibrovein, and 3) Pts treated by Fegan's procedure, but using a combination of both sclerosants. In all cases, the techniques of empty vein, bubble air, uninterrupted 6-week compression and forced mobilisation were used. In the group of pats. treated by Sigg's procedure, the average cure rate was 67.47% after 6 months, 60.3% after 5 years of follow-up. In Fegan's group this rate was 83.6% after 6 months and 78.54% after 5 year assessment. Statistically, significant differences were found only by the disappearance of varices and reduction of pain in favour of Fegan's technique. In the group of pts treated by Fegan's (Aethoxysclerol + Fibrovein) this rate after 5 years was 86%. The only statistically significant difference was found by the disappearance of varices in favour of Fegan's technique using a combination of 2 detergent sclerosants. Sclerotherapy is effective when properly executed in any length of vein no matter how dilated it has become. The recurrences are attributed more to inadequate technique than to the shortcoming of the procedure. Sclerotherapy is miniinvasive, with few complications, and can be repeated on out-patient basis. (Tab. 1, Ref. 22.).

  2. Aspen Delineation - Sierra State Parks [ds380

    Data.gov (United States)

    California Natural Resource Agency — The database represents delineations of aspen stands associated with stand assessment data (SIERRA_SP_PTS) collected in aspen stands on lands administered by the...

  3. Aspen Delineation - Sequoia National Forest [ds378

    Data.gov (United States)

    California Natural Resource Agency — The database represents delineations of aspen stands associated with stand assessment data (SEQUOIA_NF_PTS) collected in aspen stands in the Cannell Meadows Ranger...

  4. Validation of the Federal Aviation Administration Air Traffic Control Specialist Pre-Training Screen.

    Science.gov (United States)

    1994-02-01

    Two formal validation studies of the Air Traffic Control Specialist Pre Training Screen (ATCS/PTS), a 5 day computer administered test battery, are described. The ATCS/PTS was designed to replace the 9 week US Federal Aviation Administration (FAA) Ac...

  5. Comparison of acetazolamide-enhanced brain SPECT using Tc-99m ECD with cerebral angiography in patients with cerebrovascular disease

    International Nuclear Information System (INIS)

    Choi, Y. Y.; Moon, D. H.; Ryu, J. S.; Yang, S. H.; Lee, H. K.; Lee, J. H.; Kim, J. S.; Kim, K. A.

    1997-01-01

    Cerebral vascular reserve can be assessed by development of collateral channels (DCC) on cerebral angiography(CA) or vasoreactivity (VR) on acetazolamide-enhanced brain SPECT (ACZ-SPECT). The purpose of this study was to compare Tc-99m ECD ACZ-SPECT with CA in the evaluation of vascular reserve in patients (pts) with cerebrovascular disease(CVD). Twenty seven patients with CVD, including TIA (n=13), infarction (n=11) and asymptomatic pts (AS, n=3), underwent CA and ACZ-SPECT. Basal and ACZ-SPECT was obtained consecutively, and image subtraction was performed. On CA, degree of DCC was scored 0-3 (0: normal, 3: poor) according to parenchymal staining on delayed film. In ACZ-SPECT, decrease of VR was graded 0-3 (0: normal, 3: more than 30% decrease). The correlation between degree of stenosis, DCC and VR were analyzed. 1) Variable degree of VR or DCC was observed in totally occluded or stenotic cerebral arterial territories. 2) In arterial territories with poor DCC, ACZ-SPECT showed poor VR. However, in 5 out of 11 TIA or AS with good DCC, poor VR was observed. These data suggests that 1) cerebral hemodynamic status cannot be assessed by the degree of stenosis on CA alone. 2) DCC may overestimate the cerebral vascular reserve in patients with TIA or AS. 3) ACZ-SPECT plays a complementary role to CA for evaluation of cerebral hemodynamic status in pts with CVD

  6. A Phase II Trial of 17-Allylamino-17-Demethoxygeldanamycin (17-AAG) in Patients with Hormone-Refractory Metastatic Prostate Cancer

    Science.gov (United States)

    Heath, Elisabeth I.; Hillman, David W.; Vaishampayan, Ulka; Sheng, Shijie; Sarkar, Fazlul; Harper, Felicity; Gaskins, Melvin; Pitot, Henry C.; Tan, Winston; Ivy, S. Percy; Pili, Roberto; Carducci, Michael A.; Liu, Glenn

    2011-01-01

    Purpose 17-Allylamino-17-Demethoxygeldanamycin (17-AAG) is a benzoquinone ansamycin antibiotic with anti-proliferative activity in several mouse xenograft models including prostate cancer models. A two-stage phase II study was conducted to assess the activity and toxicity profile of 17-AAG administered to patients with metastatic, hormone-refractory prostate cancer. Experimental Design Patients with at least one prior systemic therapy and a rising PSA were eligible. Patients received 17-AAG at a dose of 300 mg/m2 IV weekly for three out of four weeks. The primary objective was to assess the PSA response. Secondary objectives were to determine overall survival, to assess toxicity, to measure IL-6, IL-8 and maspin levels and quality of life. Results Fifteen eligible patients were enrolled. The median age was 68 years and the median PSA was 261 ng/mL. Patients received 17-AAG for a median number of 2 cycles. Severe adverse events included: grade 3 fatigue (4 pts), grade 3 lymphopenia (2 pts) and grade 3 back pain (2 pts). The median PSA progression free survival was 1.8 months (95% CI: 1.3–3.4 months). The six-month overall survival was 71% (95% CI: 52%–100%). Conclusion 17-AAG did not show any activity with regards to PSA response. Due to insufficient PSA response, enrollment was stopped at end of first stage per study design. The most significant severe toxicity was grade 3 fatigue. Further evaluation of 17-AAG at a dose of 300 mg/m2 IV weekly as a single agent in patients with metastatic, hormone-refractory prostate cancer who received at least one prior systemic therapy is not warranted. PMID:19047126

  7. Effects of low upper shelf fracture toughness on reactor vessel integrity during pressurized thermal shock events

    International Nuclear Information System (INIS)

    Bamford, W.H.; Heinecke, C.C.; Balkey, K.R.

    1988-01-01

    For the past decade, significant attention has been focused on the subject of nuclear rector vessel integrity during pressurized thermal shock (PTS) events. The issue of low upper shelf fracture toughness at operating temperatures has been a consideration for some reactor vessel materials since the early 1970's. Deterministic and probabilistic fracture mechanics sensitivity studies have been completed to evaluate the interaction between the PTS and lower upper shelf toughness issues that result from neutron embrittlement of the critical beltline region materials. This paper presents the results of these studies to show the interdependency of these fracture considerations in certain instances and to identify parameters that need to be carefully treated in reactor vessel integrity evaluations for these subjects. This issue is of great importance to those vessels which have low upper shelf toughness, both for demonstrating safety during the original design life and in life extension assessments

  8. Using consumer perspectives to inform the cultural adaptation of psychological treatments for depression: a mixed methods study from South Asia.

    Science.gov (United States)

    Aggarwal, Neil Krishan; Balaji, Madhumitha; Kumar, Shuba; Mohanraj, Rani; Rahman, Atif; Verdeli, Helena; Araya, Ricardo; Jordans, M J D; Chowdhary, Neerja; Patel, Vikram

    2014-07-01

    Integrating consumer perspectives in developing and adapting psychological treatments (PTs) can enhance their acceptability in diverse cultural contexts. To describe the explanatory models (EMs) of depression in South Asia with the goal of informing the content of culturally appropriate PTs for this region. Two methods were used: a systematic review of published literature on the EMs of depression in South Asia; and in-depth interviews with persons with depression and family caregivers in two sites in India. Findings from both were analysed independently and then triangulated. There were 19 studies meeting our inclusion criteria. Interviews were conducted with 27 patients and 10 caregivers. Findings were grouped under four broad categories: illness descriptions, perceived impact, causal beliefs and self-help forms of coping. Depression was characterised predominantly by somatic complaints, stress, low mood, and negative and ruminative thoughts. Patients experienced disturbances in interpersonal relationships occupational functioning, and stigma. Negative life events, particularly relationship difficulties, were perceived as the main cause. Patients mostly engaged in distracting activities, religious practices, and received support from family and friends to cope with the illness. The primary data are entirely from India but the studies from the literature review covering South Asia are consistent with these findings. This study also does not include literature in local languages or explore how consumer perspectives change over time. EMs can inform cultural adaptations to PTs for depression in South Asia by defining target outcomes, content for psycho-education, and culturally appropriate treatment strategies. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  9. Aspen Delineation - Lassen National Forest [ds372

    Data.gov (United States)

    California Natural Resource Agency — The database represents delineations of aspen stands associated with stand assessment data (LASSEN_NF_EAGLELAKE_PTS) collected in aspen stands in the in the Eagle...

  10. EFFECACY OF PULSE-THERAPY WIHT GLUCOCORTICOSTEROIDS AND METHOTREXATE IN PATIENTS WITH RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    N YU Lashina

    2000-01-01

    Full Text Available Summary Aim of study: Comparative study of clinical efficacy and tolerability of pulse-therapy (PT by glucocorticosteroids and methotrexate in RA pts and frequency of side effects and aggravations. Material and methods: 31 pts with seropositive RA (M:F=4:27 with disease activity 2-3 were examined. 16 pts had pulse-therapy by dexaven in dosage of 2 mg/kg of weight for 3 consecutive days, 15 pts of the 2nd group had methypred in classic dose of1000 mg No3. After PT on the 7th and 30th day pts had PT by methotrexate 100 mg and dexaven 16 mg. Therapy effect was evaluated after PT, in a month, 6 month and a year. During examination the following parameters were registered: severity of arthralgia, morning stiffness duration, grip strength, number of inflamedjoints, Ritchie's, Li, Landsbery indices, extra-articular manifestations. ESR, hemoglobin content, leukocytes, fibrinogen, seromucoid, C-reactive protein, CIC, RF were determined. Results: After PT in both groups arthralgia, morning stiffness, number of inflamed joints considerably subsided. Dynamics of medial indices of activity decreased by 2-3 times. Side effects after the procedures were minimal and were stopped without additional treatment.

  11. The role of anxiety sensitivity in the relationship between posttraumatic stress symptoms and negative outcomes in trauma-exposed adults.

    Science.gov (United States)

    Kugler, Brittany B; Phares, Vicky; Salloum, Alison; Storch, Eric A

    2016-01-01

    The development of posttraumatic stress symptoms (PTSs) following a trauma is related to impairment, diminished quality of life, and physical health issues. Yet it is not clear why some trauma-exposed individuals experience negative outcomes while others do not. The purpose of this study was to determine the role of several influential factors related to PTS severity and negative outcomes. One hundred and twenty-two trauma-exposed adults were administered the following self-report measures: the Posttraumatic Stress Disorder Checklist-Civilian, the Trauma History Questionnaire-Short, the Anxiety Sensitivity Index-3, Depression and Anxiety Stress Scale 21, Sheehan Disability Scale, World Health Organization Quality of Life-BREF, and an abbreviated Patient Health Questionnaire. PTS severity was positively correlated with depressive symptom severity (r = 0.54, p effects were found for PTS severity (β = -0.38, p life. No interaction was found between PTS severity and AS with any negative outcome. PTS severity mediated the relationship between AS and physical health issues (0.05; 95% CI: 0.02-0.08). This study helps clarify the role of various factors in the relationship between trauma and negative outcomes. Clinical and research implications are discussed.

  12. Lung scintigraphy with Tc-99m-MIBI in diagnosis of active tuberculosis

    International Nuclear Information System (INIS)

    Raziei, G.; Fotouhi, F.; Masjedi, M.R.; Neshandar, E.

    2002-01-01

    Tuberculosis is highly contagious infection and one of the most important health problems in the world today, particularly in our country. Routine diagnostic procedures are sometimes unable to differentiated active from inactive cases particularly in elderly. Children, immunomedics patients, Chronic cases with recurrent actuate infection and in the patients unable to provide sputum for microbiological studies. Several radiopharmaceuticals have been used in the evaluation of active pulmonary TB. In this study Tc 99 m-MIBI lung scan was performed using a single head ADAC gamma camera. 62 patients including 34 APTB 915 male and 19 female) and 28 IPTB 99 male and 19 female) underwent six minutes anterior and posterior chest images 20 and minutes after injection of 10 mCi (370 MBq) of Tc 99 m-MIBI. Visual grading was generated by comparing uptake of lesion with neck soft tissue (sternoleidomastoid muscle) and myocardium. For semiquantitative analysis, regions of interest were draw over the lesion (L), non lesion (NL) and neck soft tissue (SCM) and mean count value of ROIs as well as L/NL, L/SCM values were obtained. Results: From 34 patients with APTB, 4 PTS had normal lung uptake (11.7%), 14 PTs+(41, 2%), 14 PTs++41.2%) and 2 PTS +++ (5.9%), therefore 30 PTs of APTB were positive in scintigraphy (88.2%). From 28 patients with IPTB 21 PTs had normal lung uptake (75%), 6 PTs+ (21.4%) and one PT ++ (3.5%). In the semi quantitative study L/NL ratio is calculated for + about 1.35 +/-0.15 and below from this range is considered with normal limit. The sensitivity, specificity, accuracy, PPV and NPV were 88.2% 75%, 82.2%, 81.1% and 84% respectively. From 100 CXR lesion in APTB, 60 had compatible positive scan and from 86 CXR lesions in IPTB 9 had compatible positive scan, where as incompatible positive findings were 12 and 2 respectively. This study indicates Tc 99 m - MIBI lung scan can be used as a reliable complementary study in diagnosis of APTB and differentiating from

  13. Hegemonic Masculinity in Sport Education: Case Studies of Experienced In-Service Teachers with Teaching Orientations

    Science.gov (United States)

    Chen, YuChun; Curtner-Smith, Matthew

    2013-01-01

    Research has revealed that while pre-service teachers (PTs) with coaching orientations reinforce sexism and masculine bias, those with teaching orientations combat and reject it. The purpose of this study was to examine four sport education (SE) seasons taught by two experienced in-service teachers for the presence or absence of sexism and…

  14. Role of fluconazole in the long-term suppressive therapy of fungal infections in patients with artificial implants.

    Science.gov (United States)

    Penk, A; Pittrow, L

    1999-12-01

    With the increased use of artificial implants the management of related infections has become an important challenge. Normally an infected implant would be removed. In many cases this might be contraindicated and drug treatment remains as the only alternative. As microbiological eradication is often impossible, especially in fungal infections at artificial implants (FIAI) long-term suppressive therapy might be required. The objective of this study was to determine the therapeutic value of fluconazole (F) in the management of FIAI. Clinical data of 56 patients (pts) with proven or suspected fungal infections and artificial implants (FIAI) subsequently treated with F were analyzed retrospectively. FIAI caused by species with intrinsic resistance to F have been excluded from the study. The following implants were involved: prosthetic valve endocarditis (PVE) 25 pts (44.6%), intraocular lenses (IL) 9 pts (16.1%), ventriculoperitoneal shunts (VPS) 6 pts (10.7%), knee prostheses (KP) 5 pts (8.9%), biliary stents (BS) 4 pts (7.1 %), venous access devices (VAS) 3 pts (5.4%), urinary stents (US) 2 pts (3.6%), breast implant and pacemaker 1 patient (1.8%) each. Underlying diseases were valve insufficiency (in PVE), cataract surgery (in IL), prematurity in newborns (in VPS), arthrosis (in KP), biliary obstruction (in BS), cystic fibrosis (in VAS), and obstructive renal calculi (in US). Candida species (C. spp.) were the most frequently detected causative agents with C. parapsilosis as the leading cause (n = 19; 33.9%). Furthermore C. albicans (n = 15; 26.8%), C. spp. and fungi not further specified (n = 8; 14.3%), C. tropicalis (n = 3; 5.4%), C. glabrata (n = 3; 5.4%), and C. lusitaniae (n = 1; 1.8%) were identified. Acremonium kiliense has been detected in 4 pts (7.1%), Cryptococcus neoformans in 2 pts (3.6 %). Histoplasma capsulatum was identified in 1 patient (1.8%). The maximum duration of treatment with F was lifelong with a maximum recorded duration of 4,5 years. The

  15. [Fear of childbirth among nulliparous women: Relations with pain during delivery, post-traumatic stress symptoms, and postpartum depressive symptoms].

    Science.gov (United States)

    Gosselin, P; Chabot, K; Béland, M; Goulet-Gervais, L; Morin, A J S

    2016-04-01

    Fear of childbirth is common in women who are pregnant with their first child and is associated with important consequences such as abortions and miscarriages. Twenty percent of nulliparous women seem to exhibit a mild or moderate fear, while 6% present an excessive and irrational fear known as tocophobia. Tocophobia is suggested to be associated with many negative consequences such as postpartum depression (PPD) and Post-traumatic stress (PTS). However, there is little empirical evidence to support these relationships. Recently, Fairbrother and Woody (2007) did not observe a link between the fear of childbirth and symptoms of PPD and PTS in nulliparous women. Some results, near the significance level, could be explained by a lack of statistical power. The present study focused on the link between the fear of childbirth and the process of delivery, the perception of pain, PPD and PTS. More specifically, it aimed to test three hypotheses: (i) fear of childbirth will be linked to the process of delivery, especially regarding the perception of pain, the use of anaesthesia and the use of Caesarean section; (ii) a high level of fear of childbirth will be associated with more negative postpartum consequences (namely PPD/PTS symptoms); (iii) the process of delivery and pain will also be related to post-delivery symptoms. Mediation effects were tested. Data from a longitudinal study were used to meet the hypotheses. A total of 176 nulliparous pregnant women responded to questionnaires at two time measurements (during pregnancy and at 5weeks postpartum). Fear of childbirth is related to the perception of pain at birth among women delivering vaginally, in the absence of anaesthesia. It is also linked to symptoms of PPD and PTS, regardless of whether or not anaesthesia was used. Fear of childbirth also appears to be strongly associated to symptoms of PTS in women who have experienced an unplanned caesarean section. Thus, symptoms of postpartum PTS could play a mediating role

  16. Shame and guilt in the aftermath of terror: the Utøya Island study.

    Science.gov (United States)

    Aakvaag, Helene Flood; Thoresen, Siri; Wentzel-Larsen, Tore; Røysamb, Espen; Dyb, Grete

    2014-10-01

    In recent years, there has been increased interest in trauma-related shame and guilt and their relationship to mental health. Little is known, however, about shame and guilt following mass traumas, such as terrorism. This study investigates the potential associations of trauma-related shame and guilt with posttraumatic stress (PTS) reactions after the terrorist attack of July 22, 2011 on Utøya Island in Norway. Interviews were conducted with 325 of the 490 survivors 4 to 5 months after the event. Multiple linear regression analyses were employed to investigate associations. In the month previous to the interview, 44.1% (n = 143) of participants had experienced at least some guilt for what happened during the attack, and 30.5% (n = 99) had experienced at least some shame. Shame and guilt were both uniquely associated with PTS reactions after adjusting for terror exposure, gender, and other potential confounders (frequent shame: B = 0.54, frequent guilt: B = 0.33). We concluded that trauma-related shame and guilt are related to mental health after mass trauma. Copyright © 2014 International Society for Traumatic Stress Studies.

  17. Probabilistic fracture mechanics analysis of reactor vessels with low upper-shelf fracture toughness

    International Nuclear Information System (INIS)

    Yoon, K.K.

    1993-01-01

    A class of submerged-arc welds used in fabricating early reactor vessels has relatively high copper contents. Studies have shown that when such vessels are irradiated, the copper contributes to lowering the Charpy upper-shelf energy level. To address this concern, 10CFR50, Appendix G requires a fracture mechanics analysis to demonstrate an adequate margin of safety for continued service. The B and W Owners Group (B and WOG) has been accumulating J-resistance fracture toughness data for these weld metals. Based on a mathematical model derived from this B and WOG data base, the first Appendix G analysis was performed. Another important issue affecting reactor vessel integrity is pressurized thermal shock (PIS) transients. In the early 1980s, probabilistic fracture mechanics analyses were performed on a reactor vessel to determine the probability of failure under postulated accident scenarios. Results of such analyses were used by the Nuclear Regulatory Commission (NRC) to establish the screening criteria for assessing reactor vessel integrity under PTS transient loads. This paper addresses the effect of low upper-shelf toughness on the probability of failure of reactor vessels under PTS loads. Probabilistic fracture mechanics codes were modified to include the low upper-shelf toughness model used in a reference and a series of analyses was performed using plant-specific material conditions and realistic PTS scenarios. The results indicate that low upper-shelf toughness has an insignificant effect on the probability of reactor vessel failures. This is mostly due to PTS transients being susceptible to crack initiation at low temperatures and not affected by upper-shelf fracture toughness

  18. Silent ischemia in patients after the acute myocardial infarction

    International Nuclear Information System (INIS)

    Samarzija, M.

    1991-01-01

    The purpose of this study was to determine the frequency and importance of silent ischemia in patients (pts) after acute myocardial infarction (AMI) as well as to establish diagnostic and prognostic values of exercise stress test (EST), Holter (H) monitoring and thallium-201 (Tl) scintigraphy. All the tests were performed 2-4 months following the AMI. The criterion for diagnostic myocardial ischemia on EST and H is 1 mm or more of horizontal or down-sloping ST depression. Additional criteria for Holter imply that the ischemic episode should last one minute and be separated from other episodes by at least one minute. Planar thallium images were performed 5-10 minutes after the stress test; the delayed images were obtained after 3-6 hours. Visual and quantitative methods were employed in the analysis of Tl-scintigraphy. Scintigraphy was considered positive if exercise-induced perfusion defects showed redistribution. The study included 74 asymptomatic patients after the AMI. The patients were divided into two groups by results of quantitative Tl-scintigraphy: Group I - 44 pts with silent ischemia, Group II - 30 pts without ischemia. In Group I, out of 44 pts, 9 had a positive exercise stress test, 4 showed a painless ST depression on Holter and 7 had both tests positive, whereas 24 pts had only scintigraphy positive. In Group II one patient had positive EST and H. Sensitivity and specificity were determined by results of coronary arteriography performed on 33 pts: EST (Se=40%, Sp=80%), H (Se=21%, Sp=100%) and scintigraphy (Se=93%, Sp=80%). During the follow-up period lasting at least 12 months, in Group I 3 pts died, 1 developed a new myocardial infarction and 15 pts had painful ischemic occurrences. In Group II only 3 pts developed symptoms of angina pectoris. Tl-scintigraphy was the only non-invasive test showing significant correlation with the follow-up outcomes. The diagnostic and prognostic superiority of Tl-scintigraphy justifies its value as an initial

  19. Silent ischemia in patients after uncomplicated myocardial infarction

    International Nuclear Information System (INIS)

    Samarzija, M.; Tezak, S.

    1994-01-01

    The purpose of this study was to determine the frequency and importance of silent ischemia in patients (pts) after the acute myocardial infarction (A MI) as well as to establish diagnostic and prognostic value of exercise stress test (EST), Holter (H) monitoring and thallium-201 (Tl) scintigraphy. All the three tests were performed 2-4 months following the AMI. The criterion for diagnosing myocardial ischemia on EST and H is 1 mm or more of horizontal or down-sloping ST depression. Additional criteria for Holter imply the ischemic episode should last one minute and be separated from other episodes by at least one minute. Planar thallium images were performed 5-10 minute after the stress test; the delayed images were obtained after 3-6 hours. Visual and quantitative methods were employed in the analysis of TI-scintigraphy. Scintigraphy was considered positive if exercise- induced perfusion defects showed redistribution. The study included 74 asymptomatic patients after the AMI. The patients were divided into two groups by results of quantitative Tl-scintigraphy: Group I - 44 pts with silent ischemia, Group II - 30 pts without ischemia. In Group I, out of 44 pts, 9 had a positive exercise stress, 4 showed a painless ST depression on Holter and 7 had both tests positive, whereas 24 pts had only scintigraphy positive. In Group II one patient had positive EST and H. Sensitivity and specificity were determined by results of coronary arteriography performed on 33 pts: EST (Se=40%, Sp=80%), H (Se=219, Sp=100%) and scintigraphy (Se=93%, Sp =80%). During the follow-up period lasting at least 12 months, in Group I 3 pts died, 1 developed a new myocardial infarction and 15 pts had painful ischemic occurrences. In Group II only 3 pts developed symptoms of angina pectoris. Tl-scintigraphy was the only non-invasive test showing significant correlation with the follow-up outcomes. The diagnostic and prognostic superiority of Tl-scintigraphy justifies its value as the initial

  20. Definitive treatment of anal canal carcinoma with radiotherapy: Adverse impact of a pre-radiation resection. A retrospective study of 57 patients treated with curative intent

    International Nuclear Information System (INIS)

    Coquard, R.; Cenni, J.C.; Artru, P.; Lledo, G.; Chalabreysse, P.; Queneau, P.E.; Taieb, S.; Alessio, A.

    2009-01-01

    Purpose To describe retrospectively the overall survival, the cancer specific survival and the tumor control in an homogeneous series of patients with epidermoid carcinoma of the anal canal treated with definitive radiotherapy; to assess the impact of brachytherapy, chemotherapy and pre-radiotherapy resection on the risk of recurrence. Patients and methods From 1997 to 2007, 57 patients (pts) presenting with an epidermoid carcinoma of the anal canal (T1: 14, T2: 33, T3-4: 10, N0: 31, N1: 19, N2: 3, N3: 4, M0: 57) were treated with definitive radiotherapy by the same radiation oncologist. The treatment included an external beam irradiation (E.B.R.T.) given to the posterior pelvis (45 Gy/25 fractions) and, six weeks later, a boost delivered with interstitial brachytherapy (37/57) or external beam irradiation (20/57). Twelve pts had undergone a surgical resection of the tumour before radiotherapy. A belly board was used for E.B.R.T. in 13 pts. A concurrent platinum based chemotherapy was done in 42 pts. The mean follow-up was 57 months. Results The overall survival rate at 5 years was 89% with a cause specific survival of 96%. Five patients recurred (5-year rate: 12%: four had local relapse (5-year rate: 8%), four had groin recurrence, and distant metastases were seen in two. In univariate analysis, the risk of relapse was higher in patients who had undergone a pre-radiation excision (p = 0.018), in those who did not receive chemotherapy (p = 0.076) and in those who were irradiated on a belly board (p = 0.049). In multivariate analysis, a pre-radiotherapy resection (p = 0.084) had an inverse impact on the tumour control reaching the level of statistical significance and the use of a belly board was of marginal influence (p = 0.13). Conclusion Radiotherapy and chemo radiation with cisplatin-based chemotherapy cure a vast majority of patients with epidermoid carcinoma of the anal canal. Therapeutic factors that may interfere with the definition of the target volume and

  1. Chemo-radiotherapy plus hyperthermia in locally advanced cervical cancer: preliminary results of an institutional phase II study

    International Nuclear Information System (INIS)

    Gabbani, M.; Marciai, N.; Maluta, S.; Griso, C.; Merlin, F.; Cassandrini, P.; Giudici, S.; Franchi, M.; Zanini, L.

    2005-01-01

    Full text: Radiotherapy given concurrently with a cisplatin-based regimen has shown a benefit in patients with locally advanced cervical cancer so becoming the new standard treatment according to EBM criteria. Addition of hyperthermia to radiotherapy has also been proved to yield an advantage in survival and local control in pts affected by recurrent and local advanced cervical cancer in the Dutch Phase III trial so that the Consensus Forum of Kadota (Osaha June 2004) included cervical cancer among tumors treatable with hyperthermia. In our institutional multidisciplinary team a pilot study has been designed in order to evaluate feasibility, outcome and toxicity of tri-modality treatment in pts with locally advanced cervical cancer in our daily practice. Since January 2003 to now eight patients affected by cervical cancer with stage IB2 through IVA N0-N+ pelvic or paraaortic were entered the study. Six patients were treated at initial diagnosis and two patients after chemotherapy which had achieved stable disease. Treatment regimen consisted in 5 courses of weekly chemotherapy (cisplatin 40 mg/mq) with concurrent external radiotherapy to a total dose of 64-66 Gy on CTV1 and 45 Gy on para-aortic nodes plus boost in pts with enlarged nodes identified by imaging. Five weekly sessions of hyperthermia were performed by using BSD 2000 system and sigma 60 applicator. No significant toxicity occurred and all of the patients completed tri-modality treatment in accordance with the study protocol. Seven pts experienced a complete clinical remission and one patient a partial remission as defined by clinical and imaging examinations. After four months from the end of the treatment a patient with Stage IIB bulky tumor plus one pelvic positive node who was in complete remission (Clinical examination, MRI and TAC-PET three months from the end of the treatment were negative for evidence of disease) developed a bleeding recto-vaginal fistula plus central pelvic necrosis for which an

  2. Posttraumatic Stress, Coping Flexibility, and Risky Drinking Among Trauma-Exposed Male and Female College Students: The Mediating Effect of Delay of Gratification.

    Science.gov (United States)

    Boyraz, Güler; Cherry, Megan L; Cherry, Marcus A; Aarstad-Martin, Samantha; Cloud, Cody; Shamp, Lindsey M

    2018-02-23

    The co-occurence of posttraumatic stress (PTS) and risky drinking has been demonstrated in diverse populations, including college students. However, the mechanisms underlying this co-occurrence, as well as the protective factors that may reduce risky drinking among trauma-exposed college students have yet to be fully understood in the literature. The present study builds upon self-regulation theories and previous empirical work to determine whether the effects of PTS and coping flexibility on risky drinking were mediated by delay of gratification among trauma-exposed college students. In addition, the potential moderating effect of gender on these relationships was examined. Participants included 624 trauma-exposed college students (68.4% female) attending a public university in the southeast region of the United States. Data were collected through an online survey. The hypothesized model was examined using a multigroup structural equation modeling approach. As hypothesized, PTS had a significant, positive indirect effect on risky drinking through delay of gratification; however, the effect of PTS on delay of gratification was stronger for males than for females. Results also indicated that the indirect effect of coping flexibility on risky drinking through delay of gratification was significant and negative for males and females. Conclusions/Importance: The findings of this study suggest that delay of gratification might be an important mechanism underlying the co-occurrence of PTS and risky drinking. In addition, our results highlight the potential benefits of coping flexibility for college students coping with PTS.

  3. Rumination and posttraumatic stress symptoms in trauma-exposed adults: a systematic review and meta-analysis.

    Science.gov (United States)

    Szabo, Yvette Z; Warnecke, Ashlee J; Newton, Tamara L; Valentine, Jeffrey C

    2017-07-01

    Rumination is a correlate of increased posttraumatic stress (PTS) symptoms. This study quantitatively reviewed the literature on rumination and PTS symptoms in trauma-exposed adults, extending prior research by using an inclusive definition of trauma, addressing PTS symptom clusters, and conducting moderator analyses. Searches were conducted in PsycINFO, PubMed, PILOTS, EBSCO Psychology and Behavioral Sciences Collection, Google Scholar, and Dissertation Abstracts. Sixty-four unique samples from 59 articles were included. Results showed a moderate, positive relationship between rumination and PTS symptoms (r = .50, p < .001). This was not moderated by time since trauma, gender, prior trauma history, Criterion A congruence of events, type of rumination or PTS symptom measure, or sample setting. However, trauma-focused rumination yielded smaller effect sizes than trait rumination. The association between rumination and intrusive re-experiencing was stronger than that between rumination and avoidance (t (13) = 9.18, p < .001), or rumination and hyperarousal (t (9) = 2.70, p = .022). Results confirm that rumination is associated with increased PTS symptoms. Future research should identify mechanisms underlying this association and their potential specificity by symptoms cluster, as well as further examine the potential moderating roles of gender and prior trauma history.

  4. "If it's not Iron it's Iron f*cking biggest Ironman": personal trainers's views on health norms, orthorexia and deviant behaviours.

    Science.gov (United States)

    Håman, Linn; Lindgren, Eva-Carin; Prell, Hillevi

    2017-12-01

    Orthorexia nervosa (ON) describes a pathological obsession with healthy eating to avoid ill health. In the Swedish context, ON is also understood in terms of unhealthy exercise. Fitness gyms are popular health-promoting places, but exercise-related problems, disordered eating and ON-like behaviour are increasing. Personal trainers (PTs) play an important role in detecting unhealthy behaviours. The aim of the present study was to illuminate PTs' understandings of healthy and unhealthy exercise and eating behaviours in relation to orthorexia nervosa in a fitness gym context. Five focus groups with 14 PTs were conducted. These were analysed using interpretative qualitative content analysis and Becker's model "Kinds of Deviance." In contrast to PTs' health norms (practicing balanced behaviours and contributing to well-being), ON was expressed mainly in terms of exercise behaviour and as being excessive and in total control. The PTs maintain that extreme behaviours are legitimized by an aggressive exercise trend in society and that they fear to falsely accuse clients of being pathological. Certain sport contexts (bodybuilding, fitness competitions and elite sports) and specific groups (fitness professionals) contribute to complicating PTs' negotiations due to a competition, performance and/or profession norm, making it difficult to determine whether or not to intervene.

  5. Fitness for purpose of pharmacy technician education and training: The case of Great Britain.

    Science.gov (United States)

    Schafheutle, Ellen I; Jee, Samuel D; Willis, Sarah C

    To enable pharmacists to become increasingly patient-centered, clinical professionals, they need to work with suitably trained and competent support staff; pharmacy technicians (PTs) may be the most appropriate to take on additional roles and responsibilities. However, clarity on PT roles, particularly in community pharmacy, is lacking, and pharmacists may be reluctant to delegate due to concerns over PTs' competence. This paper aims to explore the fitness for purpose of PT education and training in Great Britain. A mixed methods study was conducted in 2013-14. Semi-structured interviews were undertaken with face-to-face and distance education providers; and different types of community (n = 16) and hospital pharmacy (n = 15) employers. Interviews explored views on education delivery, work-based learning and assessment, and quality assurance; they were transcribed verbatim and analyzed thematically. Interviews informed a questionnaire that was piloted and distributed (with reminders) to all 1457 recently registered PTs. Survey data were analyzed using SPSS v20, employing comparative statistics (Mann-Whitney U, Chi-Square). University ethics approval was obtained. Staff in 17 Further Education (FE) colleges, 6 distance providers, 16 community pharmacies and 15 NHS organizations were interviewed. Participants from different sectors, education providers and employing organizations questioned whether standards met current practice requirements. Certain topics were considered as redundant or over-taught whereas others, such as professionalism (attitudes, behaviors), were perceived to be lacking. Hospital interviewees felt that PT education and training lacked clinical detail, whereas many community interviewees felt that requirements for PTs were more advanced than required. Various comments suggested that PTs' roles in community pharmacy were not clearly defined or sufficiently different from other support staff. In order to define appropriate and up

  6. The usefulness of hepatobiliary scan in insulin dependent diabetic patients (IDDM)

    International Nuclear Information System (INIS)

    Taddei, G.; Carletto, M.; Santaniello, B.; Curti, G.; Villa, G.; Altrinetti, V.; Tommasi, L.; Piccardo, A.; Gianiorio, F.

    2002-01-01

    Aim:The purpose of the study is to point out morpho-functional alterations of intra-extrahepatic biliary tract in IDDM patients and to verify any possible correlation between the seriousness of such disorders and the presence of autonomic neuropathy. Material and method: there have been studied 47 pts. (20 females and 27 males), average age 35.(yrs (range 18-73) with normal blood levels of HbA1C (2.5-4.6%), fructosamine (285 mmol/l), fasting glycemia between 120 and 140 mg/dl. The average duration of the illness was 14.53 yrs. (range 3-31); The daily intensive treatment of insulin was 38 U/I p.day (average dose). No pt. showed any clinical, instrumental or laboratory signs referring to hepatobiliary pathology; 1 pt. had undergone cholecystectomy. All pts. have been submitted to a hepatobiliary scan after i.v. injection of 5 mCi of Tc-99m DIDA using a large-field gamma-camera (SP-6 Elscint). The presence autonomic neuropathy was evaluated according to Ewing's parameters. The statistical analysis was performed with Man-Whitney's U test. Results: a mild delay in the visualization of the intrahepatic biliary ducts was observed in 3 pts. The dismission of the radiotracer from the gallbladder was normal in 3 pts, in 2 of them there was a mild delay while in the remainders such abnormality was very significant. The presence of radioactivity in the bowel was delayed in 7 pts. Duodena-gastric backflow was observed in 10 pts. The statistical analysis showed a good correlation between score of neuropathy and duodena-gastric backflow (p<0.01) and between score of neuropathy and delayed dismission of the radiotracer from the gallbladder (p<0.003). Conclusion: hepatobiliary scan seems to give a good contribution to the study of autonomic neuropathy of gastroenteric apparatus in IDDM pts. in absence of comparative studies on the subject

  7. Prognostic impact of serum CYFRA 21–1 in patients with advanced lung adenocarcinoma: a retrospective study

    International Nuclear Information System (INIS)

    Ono, Akira; Nakajima, Takashi; Endo, Masahiro; Yamamoto, Nobuyuki; Takahashi, Toshiaki; Mori, Keita; Akamatsu, Hiroaki; Shukuya, Takehito; Taira, Tetsuhiko; Kenmotsu, Hirotsugu; Naito, Tateaki; Murakami, Haruyasu

    2013-01-01

    Serum CYFRA 21–1 is one of the most important serum markers in the diagnosis of non-small cell lung cancer (NSCLC), especially squamous-cell carcinoma. However, it remains unknown whether pretreatment serum CYFRA 21–1 values (PCV) may also have prognostic implications in patients with advanced lung adenocarcinoma. We retrospectively reviewed the data of 284 patients (pts) who were diagnosed as having advanced lung adenocarcinoma and had received initial therapy. Of the study subjects, 121 pts (43%) had activating epidermal growth factor receptor (EGFR) mutations (Mt+), while the remaining 163 pts (57%) had wild-type EGFR (Mt-). Univariate analysis identified gender (male/ female), ECOG performance status (PS) (0-1/ ≥2), PCV (<2.2 ng/ml/ ≥2.2 ng/ml), EGFR mutation status (Mt+/ Mt-), pretreatment serum CEA values (<5.0 ng/ml/ ≥5.0 ng/ml), smoking history (yes/ no) and EGFR-TKI treatment (yes/ no) as prognostic factors (p = .008, p < .0001, p < .0001, p < .0001, p = .036, p = .0012, p < .0001 respectively). Cox's multivariate regression analysis identified PCV < 2.2ng/ml as the only factor significantly associated with prolonged survival (p < .0001, hazard ratio: 0.43, 95% CI 0.31-0.59), after adjustments for PS (p < .0001), EGFR mutation status (p = .0069), date of start of initial therapy (p = .07), gender (p = .75), serum CEA level (p = .63), smoking history (p = .39) and EGFR-TKI treatment (p = .20). Furthermore, pts with Mt+ and PCV of <2.2 ng/ml had a more favorable prognosis than those with Mt+ and PCV of ≥2.2 ng/ml (MST: 67.0 vs. 21.0 months, p < .0001), and patients with Mt- and PCV of <2.2 ng/ml had a more favorable prognosis than those with Mt- and PCV of ≥2.2 ng/ml (MST: 24.1 vs. 10.2 months, p < .0001). PCV may be a potential independent prognostic factor in both Mt+ and Mt- patients with advanced lung adenocarcinoma

  8. Evaluation of the theory-based Quality Improvement in Physical Therapy (QUIP) programme: a one-group, pre-test post-test pilot study.

    Science.gov (United States)

    Rutten, Geert M; Harting, Janneke; Bartholomew, L Kay; Schlief, Angelique; Oostendorp, Rob A B; de Vries, Nanne K

    2013-05-25

    Guideline adherence in physical therapy is far from optimal, which has consequences for the effectiveness and efficiency of physical therapy care. Programmes to enhance guideline adherence have, so far, been relatively ineffective. We systematically developed a theory-based Quality Improvement in Physical Therapy (QUIP) programme aimed at the individual performance level (practicing physiotherapists; PTs) and the practice organization level (practice quality manager; PQM). The aim of the study was to pilot test the multilevel QUIP programme's effectiveness and the fidelity, acceptability and feasibility of its implementation. A one-group, pre-test, post-test pilot study (N = 8 practices; N = 32 PTs, 8 of whom were also PQMs) done between September and December 2009. Guideline adherence was measured using clinical vignettes that addressed 12 quality indicators reflecting the guidelines' main recommendations. Determinants of adherence were measured using quantitative methods (questionnaires). Delivery of the programme and management changes were assessed using qualitative methods (observations, group interviews, and document analyses). Changes in adherence and determinants were tested in the paired samples T-tests and expressed in effect sizes (Cohen's d). Overall adherence did not change (3.1%; p = .138). Adherence to three quality indicators improved (8%, 24%, 43%; .000 ≤ p ≤ .023). Adherence to one quality indicator decreased (-15.7%; p = .004). Scores on various determinants of individual performance improved and favourable changes at practice organizational level were observed. Improvements were associated with the programme's multilevel approach, collective goal setting, and the application of self-regulation; unfavourable findings with programme deficits. The one-group pre-test post-test design limits the internal validity of the study, the self-selected sample its external validity. The QUIP programme has the potential to change physical

  9. Streptococcus pneumoniae Cell-Wall-Localized Phosphoenolpyruvate Protein Phosphotransferase Can Function as an Adhesin: Identification of Its Host Target Molecules and Evaluation of Its Potential as a Vaccine.

    Directory of Open Access Journals (Sweden)

    Yaffa Mizrachi Nebenzahl

    Full Text Available In Streptococcus pneumonia, phosphoenolpyruvate protein phosphotransferase (PtsA is an intracellular protein of the monosaccharide phosphotransferase systems. Biochemical and immunostaining methods were applied to show that PtsA also localizes to the bacterial cell-wall. Thus, it was suspected that PtsA has functions other than its main cytoplasmic enzymatic role. Indeed, recombinant PtsA and anti-rPtsA antiserum were shown to inhibit adhesion of S. pneumoniae to cultured human lung adenocarcinoma A549 cells. Screening of a combinatorial peptide library expressed in a filamentous phage with rPtsA identified epitopes that were capable of inhibiting S. pneumoniae adhesion to A549 cells. The insert peptides in the phages were sequenced, and homologous sequences were found in human BMPER, multimerin1, protocadherin19, integrinβ4, epsin1 and collagen type VIIα1 proteins, all of which can be found in A549 cells except the latter. Six peptides, synthesized according to the homologous sequences in the human proteins, specifically bound rPtsA in the micromolar range and significantly inhibited pneumococcal adhesion in vitro to lung- and tracheal-derived cell lines. In addition, the tested peptides inhibited lung colonization after intranasal inoculation of mice with S. pneumoniae. Immunization with rPtsA protected the mice against a sublethal intranasal and a lethal intravenous pneumococcal challenge. In addition, mouse anti rPtsA antiserum reduced bacterial virulence in the intravenous inoculation mouse model. These findings showed that the surface-localized PtsA functions as an adhesin, PtsA binding peptides derived from its putative target molecules can be considered for future development of therapeutics, and rPtsA should be regarded as a candidate for vaccine development.

  10. Final report for DOE grant FG02-06ER15805

    Energy Technology Data Exchange (ETDEWEB)

    Gage, Daniel

    2012-05-31

    DOE funding was used to investigate the role of the phosphotransferase system (PTS) in the symbiotic, nodulating bacterium Sinorhizobium meliloti. This system is well studied in several bacterial species. However, it's organization and function in S. meliloti is substantially different than in the those other, well-studied bacteria. The S. meliloti PTS, through our DOE-funded work, has become a model for how this important signal transduction system works in the a-proteobacteria. We have found that the PTS is relatively simple, used for only signal transduction and not transport, and is involved in regulation of carbon metabolism in response to carbon availability and nitrogen availability.

  11. A multi-institutional outcome and prognostic factor analysis of radiosurgery (RS) for resectable single brain metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Auchter, RM; Lamond, JP; Alexander, E; Buatti, JM; Chappell, RJ; Friedman, W; Kinsella, TJ; Levin, AB; Noyes, WR; Schultz, C; Loeffler, JS; Mehta, MP

    1995-07-01

    PURPOSE: Recent randomized trials comparing resection of single brain metastasis (BM) in selected patients (pts) followed by whole brain radiotherapy (WBRT) to WBRT alone demonstrated statistically significant survival advantage for surgery (Patchell, 1990 and Noordijk, 1994). This multi-institutional retrospective study was performed in similar pts who were treated with RS and WBRT to provide a baseline for comparison for a future randomized trial. MATERIALS AND METHODS: The RS databases of four institutions were reviewed to identify all pts who met the following criteria: single BM; age > 18; surgically resectable lesion; independently functional (KPS {>=} 70); non-radiosensitive histology (small cell, lymphoma, myeloma, germ cell excluded); no prior cranial surgery or WBRT. 122 of 533 pts with BM treated with RS met these criteria. Pts were categorized by: (a) status of the primary: 'absent' = complete resection, 26 pts; 'controlled' locally controlled with radiotherapy or chemotherapy, 70 pts; 'under treatment' = undergoing radiotherapy, 15 pts; 'active' = no definitive or successful treatment of the primary, 11 pts; (b) status of non-CNS metastasis: present=64 pts, absent=58 pts; (c) age: median=61, range 23-83; (d) KPS : KPS 70/80/90/100=20/26/44/32 pts; (e) histology: lung=58, melanoma=16, breast=13, renal=12,colon=9, other=10, unknown primary=4; (f) time from primary to BM: median=12 months, range=1-252 months; (g) gender: male=64, female=58; (h) tumor volume: median=2.68 cc, range=0.13-27.2 cc. RS was performed with a linear accelerator based technique (peripheral dose 10-27 Gy, median 17 Gy). WBRT was performed in all but 5 pts who refused it (range 25 - 40 Gy, median 37.5 Gy). RESULTS: The potential median follow-up for all pts is 123 weeks (wks). The overall local response rate is 59% (complete response = 25%, partial response = 34%). In field progression occurred in 17 patients (14%), with overall local control of 86%. Local control was highest for

  12. The Impact of Affective Constraints on Shaping Environmental Literacy: Model Testing Using Mediator and Moderator Variables

    Science.gov (United States)

    Öztürk, Nilay; Teksöz, Gaye

    2016-01-01

    The aims of this study were; first to investigate the mediating effects of pre-service teachers' (PTs) attitude toward environment on the relationship between their environmental concern and environmental responsibility, and second, to explore the moderating effect of gender on the relationships between; PTs' environmental concern and…

  13. Total pelvic exenteration: the Albert Einstein College of Medicine/Montefiore Medical Center Experience (1987 to 2003).

    Science.gov (United States)

    Goldberg, Gary L; Sukumvanich, Paniti; Einstein, Mark H; Smith, Harriet O; Anderson, Patrick S; Fields, Abbie L

    2006-05-01

    To review the trends, modifications and results of 103 consecutive total pelvic exenterations (TPE) performed at the Montefiore Medical Center and Albert Einstein College of Medicine from 1987 to 2003. All patients who underwent TPE from January 1987 to December 2003 were included. The medical record, complications, follow-up, clinical status and demographic information were entered in a database. The procedure performed, the method of urinary diversion, colonic diversion, pelvic floor support and vaginal reconstruction were documented. Surviving patients were surveyed regarding their satisfaction with the urinary diversion, the vaginal reconstruction and their sexual function since the surgery. 103 pts were identified. Indications for TPE were recurrent cancers of the cervix (95), endometrium (2), colon and rectum (5), vulva (1). Overall 5-year survival was 47%. 5-year survival for pts with recurrent cervix cancer was 48%. Six pts (6%) recurred >5 years after the TPE. 14 pts (14%) had ureteral anastomotic leaks (no difference between ileal conduit 9/65 (14%) versus 5/38 (13%) continent conduit (P = 0.92). 34 pts (89%) with continent conduits were "continent." 14 pts (17%) had wound complications. 4 pts (4%) had parastomal hernias. 5/11 (46%) pts who had a low rectal reanastomosis developed recurrence in the pelvis. 21/39 (54%) of pts with continent conduits would choose an ileal conduit if they had the option again. Long-term renal function was similar in pts with ileal and continent conduits. Mesh of any type for pelvic floor reconstruction is associated with infection and bowel/urinary fistulas. VRAM flaps for neovagina fill the pelvic dead space, reduce the risk of fistulas and 20/36 pts (55%) are sexually active. Our overall 5-year survival is encouraging, and modifications in surgical technique have improved the reconstructive phase. Low rectal anastomoses at TPE adversely affects survival. Many of our pts with continent urinary diversions would not choose

  14. Re-irradiation of adenoid cystic carcinoma: Analysis and evaluation of outcome in 52 consecutive patients treated with raster-scanned carbon ion therapy

    International Nuclear Information System (INIS)

    Jensen, Alexandra D.; Poulakis, Melanie; Nikoghosyan, Anna V.; Chaudhri, Naved; Uhl, Matthias; Münter, Marc W.; Herfarth, Klaus K.; Debus, Jürgen

    2015-01-01

    Background: Treatment of local relapse in adenoid cystic carcinoma (ACC) following prior radiation remains a challenge: without the possibility of surgical salvage patients face the choice between palliative chemotherapy and re-irradiation. Chemotherapy yields response rates around 30% and application of tumouricidal doses is difficult due to proximity of critical structures. Carbon ion therapy (C12) is a promising method to minimize side-effects and maximize re-treatment dose in this indication. We describe our initial results for re-irradiation in heavily pre-treated ACC patients. Methods: Patients treated with carbon ion therapy between 04/2010 and 05/2013 (N = 52 pts, median age: 54 a) were retrospectively evaluated regarding toxicity (NCI CTC v.4), tumour response (RECIST) and control rates. 48 pts (92.3%) received carbon ions only, 4 pts received IMRT plus C12. Results: 4 pts were treated following R1-resection, 43 pts for inoperable local relapse. Most common tumour sites were paranasal sinus (36.5%), parotid (19.2%), and base of skull (17.3%). Pts received a median dose of 51 GyE C12/63 Gy BED and cumulative dose of 128 Gy BED [67–182 Gy] after a median RT-interval of 61 months. Median target volume was 93 ml [9–618 ml]. No higher-grade (>°II) acute reactions were observed, 7 pts showed blood–brain-barrier changes (°I/II: 8 pts; °III: 2 pts), 1 pt corneal ulceration, xerophthalmia 7 pts, °IV bleeding 1 pt, tissue necrosis 2 pts, otherwise no significant late reactions. Objective response rate (CR/PR) was 56.6%. With a median follow-up of 14 months [1–39 months] local control and distant control at 1a are 70.3% and 72.6% respectively. Of the 18 pts with local relapse, 13 pts have recurred in-field, 1 pt at the field edge, 3 pts out of field, and one in the dose gradient. Conclusion: Despite high applied doses, C12 re-irradiation shows moderate side-effects, response rates even in these heavily pre-treated patients are encouraging and present a

  15. Xenon-133 determination of muscle blood flow: Use in evaluating cardioactive drugs

    International Nuclear Information System (INIS)

    Wexler, J.P.; Davis, L.; Mancini, D.; Chadwick, B.; Le Jemtel, T.

    1985-01-01

    Cardioactive drugs may effect both the central and peripheral circulatory systems. The effects on the central and peripheral circulatory systems of chronic Captorpril therapy in 7 pts with severe congestive heart failure (CHF) were evaluated simultaneously. Skeletal muscle blood flow (SMBF) determined using 133-Xe washout and a Cd/Te detector, oxygen consumption (VO/sub 2/), and radial artery and femoral vein O/sub 2/ concentration difference (A-V) were determined at rest and peak upright bicycle exercise before (BT) and after (AT) 6-12 weeks of Captopril therapy. In CI pts there was a significant increase in VO/sub 2/ and SMBF AT vs BT. In contrast, in CNC pts there was no change in VO/sub 2/ and a significant decrease in SMBF AT vs BT. In pts with severe CHF who are CI, there is an apparent fall in peripheral vascular resistance (PVR). In contrast, in CNC pts there is an increase in PVR. This study demonstrates that SMBF determines using 133-Xe is an important method for determining the effects of cardioactive drugs

  16. Optimization in optical systems revisited: Beyond genetic algorithms

    Science.gov (United States)

    Gagnon, Denis; Dumont, Joey; Dubé, Louis

    2013-05-01

    Designing integrated photonic devices such as waveguides, beam-splitters and beam-shapers often requires optimization of a cost function over a large solution space. Metaheuristics - algorithms based on empirical rules for exploring the solution space - are specifically tailored to those problems. One of the most widely used metaheuristics is the standard genetic algorithm (SGA), based on the evolution of a population of candidate solutions. However, the stochastic nature of the SGA sometimes prevents access to the optimal solution. Our goal is to show that a parallel tabu search (PTS) algorithm is more suited to optimization problems in general, and to photonics in particular. PTS is based on several search processes using a pool of diversified initial solutions. To assess the performance of both algorithms (SGA and PTS), we consider an integrated photonics design problem, the generation of arbitrary beam profiles using a two-dimensional waveguide-based dielectric structure. The authors acknowledge financial support from the Natural Sciences and Engineering Research Council of Canada (NSERC).

  17. Valutazione analitica e applicazione clinica di un metodo Real Time PCR per il dosaggio della carica virale di Epstein-Barr virus

    Directory of Open Access Journals (Sweden)

    Maria Teresa Bortolin

    2004-03-01

    Full Text Available We assessed the performance of a Real Time PCR assay to be used for EBV viremia evaluation in clinical specimens. Sensitivity and intra-/interassay reproducibility were evaluated by using DNA serial dilutions from the Namalwa cell line. EBV DNA was analyzed in serum samples from 39 patients (pts with undifferentiated type nasopharyngeal carcinoma (UCNT, from 5 infectious mononucleosis (IM pts and from 18 healthy donors. Results obtained by Real Time PCR were compared with those obtained by quantitative competitive (QC-PCR assay.We thereafter measured the dynamics of EBV DNA load in 5 HIV-seropositive (HIV+ and 9 HIV-seronegative (HIV-, as controls pts with lymphoma, treated with high-dose chemotherapy (HCT followed by autologus stem-cell transplantation (ASCT. We found a sensitivity of 100% at 10 EBV copies. The Spearman correlation for both the intra- and the interassay reproducibility was statistically significant (r=0.99; p20 copies/reaction and >30% for EBV viral loads <20 copies/reaction. No EBV DNA was detected in healthy donors. Higher EBV DNA loads were found by Real Time PCR (range 1173-46328 copies/ml than by QC-PCR (range 450-5000 copies/ml (p<0.05. 54% of UCNT and 100% of IM pts were EBV DNA positive. Two HIV+(40% and 2 HIV-(22% pts with lymphoma had detectable EBV viremia during the follow-up. The Real Time PCR is a suitable technique for high-throughput screening and frequent monitoring of patients at risk for developing EBV-associated diseases.

  18. Therapy-related acute myeloid leukemia and myelodysplastic syndrome: a clinical and morphologic study of 65 cases

    International Nuclear Information System (INIS)

    Michels, S.D.; McKenna, R.W.; Arthur, D.C.; Brunning, R.D.

    1985-01-01

    This study consists of 65 patients (pts) who developed a myelodysplastic syndrome (MDS) (39 pts) or acute myeloid leukemia (AML) (26 pts) following chemotherapy and/or radiotherapy; the interval from the onset of therapy to bone marrow abnormality ranged from 11 to 192 months (median, 58). Thirty-three patients had been previously treated for lymphoproliferative diseases, 29 for carcinoma, and three for a nonneoplastic disorder. Approximately 30% of the cases presenting in the MDS phase evolved to AML in one to 12 months (median, 3.5). The AML in 49% of the cases was not readily classified according to French-American-British (FAB) criteria; the primary difficulty in classification related to the involvement of multiple cell lines. Among the cases that could be classified, all FAB types were represented except for M1; M2 was the most frequent type. Clonal chromosome abnormalities were found in marrow specimens from 22 of 24 (92%) patients studied with G banding; 11 had abnormalities of chromosomes 5 and/or 7. The median survival for all patients was four months with no significant difference between those treated and not treated with antileukemic therapy. The median survival was three months for the patients presenting with AML, six months for the patients with AML following an MDS, and four months for the patients with an MDS that did not evolve to AML. The findings in the present study suggest that there are three stages of therapy-related panmyelosis: (1) pancytopenia with associated myelodysplastic changes, (2) a frank MDS, and (3) overt AML. Many patients will present in the stage of overt AML that differs from de novo AML primarily by the high incidence of trilineage involvement, difficulty in classification, frequent cytogenetic abnormalities, and poor response to antileukemic therapy

  19. [Interest of tricuspid annular displacement (TAD) in evaluation of right ventricular ejection fraction].

    Science.gov (United States)

    Hugues, T; Ducreux, D; Bertora, D; Berthier, F; Lemoigne, F; Padovani, B; Gibelin, P

    2010-04-01

    The ultrasound assessment of RV structure and function is often sub-optimal. The range of excursions of the mitral or tricuspid annulus measured in millimetre by 2D or TM-mode in centimetre per second by DTI-mode echocardiography has been shown to reflect the systolic function of both ventricles. We studied a new technique based on a tissue tracking algorithm that is ultrasound beam angle independent for automated detection of tricuspid annular displacement (TAD) (QLAB, Philips Medical Imaging). Twenty-six patients (pts) referred for magnetic resonance imaging (MRI) and 44 control subjects underwent a complete transthoracic echocardiography. MRI of the right ventricular ejection fraction (RVEF) was correlated by linear regression with TAD. Sixteen pts (61.5%) exhibited right ventricular systolic dysfunction (MRI RVEFTAD (R(2)=0,65; pTAD TAD values exceeding this cut-off point (mean: 16.9+/-1.64mm; range: 13.3 to 24.8mm). Negative correlation was found between TAD and age (R(2)=0,36; pTAD with MRI RVEF. TAD is a simple, rapid, and non-invasive tool for right ventricular systolic function assessment.

  20. A study on probabilistic fracture mechanics for nuclear pressure vessels and piping

    International Nuclear Information System (INIS)

    Yagawa, Genki; Yoshimura, Shinobu

    1997-01-01

    This paper describes some recent research activities on probabilistic fracture mechanics (PFM) for nuclear pressure vessels and piping (PV and P) performed by the RC111 research committee of the Japan Society of Mechanical Engineers (JSME) under a subcontract of the Japan Atomic Energy Research Institute (JAERI). To establish standard procedures for evaluating failure probabilities of nuclear PV and P, we have set up the following three kinds of PFM round-robin problems on: (a) primary piping under normal operating conditions, (b) aged reactor pressure vessel (RPV) under normal and upset operating conditions, and (c) aged RPV under pressurised thermal shock (PTS) events. The basic problems of the last one are chosen from some US benchmark problems such as EPRI (Electric Power Research Institute) and US NRC (Nuclear Regulatory Commission) joint PTS benchmark problems. This paper summarizes some sensitivity studies on the three kinds of problems mainly varying material properties such as flow stress, fracture toughness, fatigue crack growth rate, Cu content. Employed in this study are the PFM computer codes developed in Japan and USA. Failure probabilities of nuclear PV and P are quantitatively discussed in detail. (author)

  1. Unraveling the evolutionary history of the phosphoryl-transfer chain of the phosphoenolpyruvate:phosphotransferase system through phylogenetic analyses and genome context

    Directory of Open Access Journals (Sweden)

    Zúñiga Manuel

    2008-05-01

    Full Text Available Abstract Background The phosphoenolpyruvate phosphotransferase system (PTS plays a major role in sugar transport and in the regulation of essential physiological processes in many bacteria. The PTS couples solute transport to its phosphorylation at the expense of phosphoenolpyruvate (PEP and it consists of general cytoplasmic phosphoryl transfer proteins and specific enzyme II complexes which catalyze the uptake and phosphorylation of solutes. Previous studies have suggested that the evolution of the constituents of the enzyme II complexes has been driven largely by horizontal gene transfer whereas vertical inheritance has been prevalent in the general phosphoryl transfer proteins in some bacterial groups. The aim of this work is to test this hypothesis by studying the evolution of the phosphoryl transfer proteins of the PTS. Results We have analyzed the evolutionary history of the PTS phosphoryl transfer chain (PTS-ptc components in 222 complete genomes by combining phylogenetic methods and analysis of genomic context. Phylogenetic analyses alone were not conclusive for the deepest nodes but when complemented with analyses of genomic context and functional information, the main evolutionary trends of this system could be depicted. Conclusion The PTS-ptc evolved in bacteria after the divergence of early lineages such as Aquificales, Thermotogales and Thermus/Deinococcus. The subsequent evolutionary history of the PTS-ptc varied in different bacterial lineages: vertical inheritance and lineage-specific gene losses mainly explain the current situation in Actinobacteria and Firmicutes whereas horizontal gene transfer (HGT also played a major role in Proteobacteria. Most remarkably, we have identified a HGT event from Firmicutes or Fusobacteria to the last common ancestor of the Enterobacteriaceae, Pasteurellaceae, Shewanellaceae and Vibrionaceae. This transfer led to extensive changes in the metabolic and regulatory networks of these bacteria

  2. Extension of radiotherapy (involved field vs subtotal nodal) after short-term chemotherapy in early-stage Hodgkin's disease (ESHD)

    International Nuclear Information System (INIS)

    Zanini, M.; Bonfante, V.; Soncini, F.; Di Russo, A.; Santoro, A.; Viviani, S.; Devizzi, L.; Gasparini, M.; Tesoro, Tess J.D.; Valagussa, P.; Bonadonna, G.

    1995-01-01

    Aims of this study were to avoid staging laparotomy, to improve the results of radiotherapy (RT) alone by a combined modality approach, to evaluate the optimal extent of RT after short-term chemotherapy (CT) and to reduce the long-term toxicity in patients cured for ESHD. From (2(90)) to (1(95)), 110 consecutive patients with clinical stage I (bulky and/or B), IIA, IIA bulky and IIEA entered a randomized trial comparing subtotal nodal irradiation (STNI) vs involved field radiotherapy (IFRT), both after short-term chemotherapy (ABVD for 4 cycles). The doses of RT were 30 Gy to uninvolved and 36 Gy to involved sites, respectively. With a median follow-up of 38 mos., the main results in 96 evaluable patients (stage I: 13 pts., stage II: 83 pts., median age 28 yrs., range 17-64) are as reported below. Most patients achieved complete remission (CR) after CT (92%), while 8 partial responders attained CR with RT (IFRT 5 pts., STNI 3 pts.). Four stage II patients relapsed (IFRT 2, pts., STNI 2 pts.), mainly in extranodal or not irradiated sites. Up-to-date the most remarkable toxicities include: acute myocardial infarction (1%), aspecific EKG changes (5%), reductions in pulmonary function tests (most mild and/or transient) in 45%, subclinical or clinical hypothyroidism 26% (only in pts. irradiated to the neck), 3 cases of azoospermia in 23 evaluable patients (13%) and transient amenorreha in(1(44)) patients. No second malignancies have been so far observed. The results of this study seem to indicate that 4 courses of ABVD plus RT are an effective treatment in clinical ESHD, with moderate long-term toxicities. In almost 10% of patients RT changed partial into complete remission. Should these results be confirmed on a longer follow-up, IFRT will definitely replace STNI in a combined modality treatment

  3. High-dose rate intra-operative radiation therapy for local advanced and recurrent colorectal cancer

    International Nuclear Information System (INIS)

    Harrison, L.B.; Mychalczak, B.; Enker, W.; Anderson, L.; Cohen, A.E.; Minsky, B.

    1996-01-01

    In an effort to improve the local control for advanced and recurrent cancers of the rectum, we have integrated high-dose rate intra-operative radiation therapy (HDR-IORT) into the treatment program. Between 11/92 and 10/95, 47 patients (pts) were treated. There were 26 males and 21 females whose ages ranged from 30-80 (median = 62) years. There were 19 pts with primary unresectable rectal cancer, and 28 pts who were treated for recurrent rectal cancer. Histology was adenocarcinoma - 45 pts, squamous cancer - 2 pts. The range of follow-up is 1-34 months (median = 14 months). The majority of primary unresectable pts received pre-operative radiation therapy (4500-5040 cGy) with chemotherapy (5-FU with Leucovorin) 4-6 weeks later, they underwent resection + HDR-IORT (1200 cGy). For the 28 pts with recurrent cancer, the majority received surgery and HDR-IORT alone because they had received prior RT. For the pts with primary unresectable disease, actuarial 2-year local control was 77%, actuarial distant metastasis-free survival was 71%, disease free survival was 66%, and overall survival was 84%. For those pts with recurrent disease, actuarial 2-year local control rate was 65%, distant metastasis-free survival was 65%, disease free survival was 47%, and overall survival was 61%. Complications occurred in 36%. There were no cases where the anatomical distribution of disease, or technical limitations prevented the adequate delivery of HDR-IORT. We conclude that this technique was most versatile, and enabled all appropriate pts to receive IORT. The preliminary data in terms of local control are encouraging, even for the poor prognostic sub-group of pts with recurrent cancer

  4. Follow-up of rheumatic carditis using 67Ga-citrate imaging

    International Nuclear Information System (INIS)

    Calegaro, J.U.M.; Bae, S.H.; Prado, E.S.; Gomes, E.F.

    2002-01-01

    Aim: This study reports the follow -up of 25 patients (pts) with rheumatic carditis (9 male, 16 females; 4-29 years, mean 12,12) using 67-gallium citrate. Materials and Methods: the pts were divided in 2 groups: I- first attack (7pts, 2 males, with a mean follow-up of 5,65 years); II- recurrence (18 pts, 7 males, with a mean follow-up of 5,27 years).Images of the thorax and semi quantitative indexes were obtained 72 hours after intravenous injection of 37-74 MBq (1-2 mCi) of 67-gallium citrate, using a LFOV scintillation camera. 67-gallium uptake in the cardiac area was graded as mild, moderate or severe using the tracer uptake in the lung as a reference (normal up to 130%). Results: all pts in group I (2 severe, 2 moderate, and 3 mild carditis) had normal gallium uptake in up to 9 weeks after the institution of cortico therapy, with a better outcome in follow-up.In group II, 8 pts presented moderately active carditis (2 had good and 6 had a poor outcome) and 10 mildly active carditis (7 had good and 3 had poor outcome). The evolution of the disease was better in 8 pts that the reduction of 67- gallium uptake to normal limits occurred in up to 9 weeks, than in 9 pts that the scintigraphy was only normal after 10 weeks of therapy. Conclusion: normal gallium uptake in up to 9 weeks of treatment seems to be a good predictor of evolution in rheumatic carditis first attack or recurrence; in recurrence, reduction of 67-gallium uptake only after 10 weeks or increasing uptake seems to be worse predictors

  5. Results of a TcTUs-optimized radioiodine therapy of multifocal and disseminated functional thyroid autonomy

    International Nuclear Information System (INIS)

    Dunkelmann, S.; Endlicher, D.; Prillwitz, A.; Rudolph, F.; Groth, P.; Schuemichen, C.

    1999-01-01

    Aim: The presented study prospectively evaluates the efficacy of optimized radioiodine therapy in patients (pts) with multifocal (MFA) and disseminated (DISA) autonomy. The target dose was related to the total thyroid volume and was increased in moderate and nonlinear increments for 150 to 300 Gy dependent on the pretherapeutic Tc-99m pertechnetate thyroid uptake under suppression (TcTUs). Patients with focal autonomy were treated with a target dose independent of TcTUs and were used as control group. Methods: The data of 641 pts (518 women, 123 men) were evaluated, 466 pts with MFA or DISA and 175 pts with focal autonomy. In pts with MFA and DISA the target dose was increased in four steps: TcTUs 3-6%: 200 Gy, >6-12%: 250 Gy and >12%: 300 Gy. In pts with focal autonomy a fixed target dose of 300 or 400 Gy was applied. The radioactivity to be administered was calculated using a modified Marinelli formula. The follow-up examination was performed at the earliest after four, on average after eight months. Normalization of TSH was the only criterion for successful therapy. Results: The success rate in pts with latent or manifest hyperthyroidism in focal autonomy was 91.5%, thereby was not successful in 5.1% and hypothyroidism occurred in 3.4%. The average success rate in pts with MFA and DISA was 91.5%, therapy failed in 7.5% and a very low rate of 1% with hypothyroidism was seen. Conclusion: The presented optimized therapy concept with calculated, nonlinear increase of the target dose according to the TcTUs-level guaranteed even in MFA and DISA a high success rate comparable to that in focal autonomy along with a very low rate of hypothyroidism. (orig.) [de

  6. Interfraction interval does not affect survival of patients with non-small cell lung cancer treated with hyperfractionated radiotherapy with/without chemotherapy: a multivariate analysis of 682 RTOG patients

    International Nuclear Information System (INIS)

    Werner-Wasik, Maria; Scott, Charles; Graham, Mary L.; Smith, Colum; Byhardt, Roger W.; Roach, Mack; Andras, E. James

    1997-01-01

    OBJECTIVE: Radiobiologic considerations led to the choice of a 4-6 hr as an optimal interfraction interval (IFI) in hyperfractionated radiation therapy (HFX RT). Recently it was suggested (Jeremic, '95) that a shorter IFI (4.5-5.0 hr vs. 5.5-6.0) was associated with an improved survival in patients (pts) with locally advanced/inoperable non-small cell lung cancer (LA-NSCLC) treated with a concurrent chemotherapy (CT)-HFX RT or HFX RT alone. Our analysis was therefore undertaken to verify this hypothesis in a larger patient population. METHODS: Records of patients treated with HFX RT with/without CT on 5 RTOG studies were reviewed retrospectively and an actual IFI, defined as a mean of all daily IFIs, was calculated. RT dose was 1.2 Gy BID to 69.6 Gy. CT included cisplatin and either oral etoposide or vinblastine. The relationship between the length of IFI and the median survival time (MST), overall survival (OS) and incidence of esophagitis was investigated using log rank and Cox analyses. RESULTS: Pts with a LA-NSCLC were treated in 2 HFX RT only studies (n=927) and in 3 CT-HFX RT studies (n=209). Pt characteristics was as follows: Stage IIIA, 52%; Stage IIIB, 37%; males, 72%; older than 60 yr, 64%; Karnofsky Performance Status (KPS) of > 70, 84%; weight loss of >5%, 31% of pts. In 682 pts eligible for this analysis, a full dose of RT (69.6 Gy +/- 10%) was delivered and at least 90% of all daily IFIs were available. Six percent of all pts (n=42) are alive. The HFX RT studies recommended an IFI of 4-6 hr and CT-HFX RT studies, an IFI of at least 6 hr. The actual mean IFI was as follows: 4-4.9 hr in 51% of pts; 5-5.9 hr in 17%; 6-6.9 in 28% and 7-8 hr in 4%. MST and incidence of esophagitis by mean IFI are as follows: In multivariate analysis, however, only no weight loss, use of CT, low nodal stage and good KPS, but not IFI (4-6 hr vs. 6-8 hr) were associated with an improved survival for all pts (p values: <0.0001; <0.0001; 0.02; 0.0001 and 0.55, respectively), as

  7. Characterization of Mathematics Instructional Practises for Prospective Elementary Teachers with Varying Levels of Self-Efficacy in Classroom Management and Mathematics Teaching

    Science.gov (United States)

    Lee, Carrie W.; Walkowiak, Temple A.; Nietfeld, John L.

    2017-01-01

    The purpose of this study was to investigate the relationship between prospective teachers' (PTs) instructional practises and their efficacy beliefs in classroom management and mathematics teaching. A sequential, explanatory mixed-methods design was employed. Results from efficacy surveys, implemented with 54 PTs were linked to a sample of…

  8. Preliminary development of an integrated approach to the evaluation of pressurized thermal shock as applied to the Oconee Unit 1 Nuclear Power Plant

    Energy Technology Data Exchange (ETDEWEB)

    Burns, T J; Cheverton, R D; Flanagan, G F; White, J D; Ball, D G; Lamonica, L B; Olson, R

    1986-05-01

    An evaluation of the risk to the Oconee-1 nuclear plant due to pressurized thermal shock (PTS) has been Completed by Oak Ridge National Laboratory (ORNL). This evaluaion was part of a Nuclear Regulatory Commission (NRC) program designed to study the PTS risk to three nuclear plants: Oconee-1, a Babcock and Wilco reactor plant owned and operated by Duke Power Company; Calvert Cliffs-1, a Combustion Engineering reactor plant owned and operated by Baltimore Gas and Electric company; and H.B. Robinson-2, a Westinghouse reactor plant owned and operated by Carolina Power and Light Company. Studies of Calvert Cliffs-1 and H.B. Robinson-2 are still underway. The specific objectives of the Oconee-1 study were to: (1) provide a best estimate of the probability of a through-the-wall crack (TWC) occurring in the reactor pressure vessel as a result of PTS; (2) determine dominant accident sequences, plant features, operator and control actions and uncertainty in the PTS risk; and (3) evaluate effectiveness of potential corrective measures.

  9. The Validity and Reliability Study of Turkish Version of the Sentiments, Attitudes, and Concerns about Inclusive Education Scale

    Science.gov (United States)

    Cansiz, Nurcan; Cansiz, Mustafa

    2018-01-01

    The purpose of this study is to translate and adapt the Sentiments Attitudes and Concerns about Inclusive Education Scale (SACIE) for use in the Turkish context. For this purpose, translated version of SACIE was administered to 304 and 368 preservice teachers (PTs) to perform exploratory and confirmatory factor analysis respectively. The result of…

  10. Sampling of suspended particulate matter using particle traps in the Rhône River: Relevance and representativeness for the monitoring of contaminants.

    Science.gov (United States)

    Masson, M; Angot, H; Le Bescond, C; Launay, M; Dabrin, A; Miège, C; Le Coz, J; Coquery, M

    2018-05-10

    Monitoring hydrophobic contaminants in surface freshwaters requires measuring contaminant concentrations in the particulate fraction (sediment or suspended particulate matter, SPM) of the water column. Particle traps (PTs) have been recently developed to sample SPM as cost-efficient, easy to operate and time-integrative tools. But the representativeness of SPM collected with PTs is not fully understood, notably in terms of grain size distribution and particulate organic carbon (POC) content, which could both skew particulate contaminant concentrations. The aim of this study was to evaluate the representativeness of SPM characteristics (i.e. grain size distribution and POC content) and associated contaminants (i.e. polychlorinated biphenyls, PCBs; mercury, Hg) in samples collected in a large river using PTs for differing hydrological conditions. Samples collected using PTs (n = 74) were compared with samples collected during the same time period by continuous flow centrifugation (CFC). The grain size distribution of PT samples shifted with increasing water discharge: the proportion of very fine silts (2-6 μm) decreased while that of coarse silts (27-74 μm) increased. Regardless of water discharge, POC contents were different likely due to integration by PT of high POC-content phytoplankton blooms or low POC-content flood events. Differences in PCBs and Hg concentrations were usually within the range of analytical uncertainties and could not be related to grain size or POC content shifts. Occasional Hg-enriched inputs may have led to higher Hg concentrations in a few PT samples (n = 4) which highlights the time-integrative capacity of the PTs. The differences of annual Hg and PCB fluxes calculated either from PT samples or CFC samples were generally below 20%. Despite some inherent limitations (e.g. grain size distribution bias), our findings suggest that PT sampling is a valuable technique to assess reliable spatial and temporal trends of particulate

  11. What do physiotherapists and manual handling advisors consider the safest lifting posture, and do back beliefs influence their choice?

    Science.gov (United States)

    Nolan, David; O'Sullivan, Kieran; Stephenson, John; O'Sullivan, Peter; Lucock, Michael

    2018-02-01

    It is commonly believed lifting is dangerous and the back should be straight during lifting. These beliefs may arise from healthcare professionals, yet no study has evaluated the lifting and back beliefs of manual handling advisors (MHAs) and physiotherapists (PTs). To evaluate (i) what lifting technique MHAs and PTs perceive as safest, and why, and (ii) the back pain beliefs of MHAs and PTs. Data was collected via an electronic survey. Participants selected the safest lifting posture from four options: two with a straight back and two with a more rounded back, with justification. Back beliefs were collected via the Back-Pain Attitudes Questionnaire (Back-PAQ). Relationships were investigated using multiple linear and logistic regression models. 400 PTs and MHAs completed the survey. 75% of PTs and 91% of MHAs chose a straight lifting posture as safest, mostly on the basis that it avoided rounding of the back. MHAs scored significantly higher than PTs on the Back-PAQ instrument (mean difference = 33.9), indicating more negative back beliefs. Those who chose the straight back position had significantly more negative back beliefs (mean 81.9, SD 22.7) than those who chose a round back lift (mean 61.7, SD 21.1). Avoiding rounding the back while lifting is a common belief in PTs and MHAs, despite the lack of evidence that any specific spinal posture is a risk factor for low back pain. MHAs, and those who perceived a straight back position as safest, had significantly more negative back beliefs. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Analysis of the thermal balance characteristics for multiple-connected piezoelectric transformers.

    Science.gov (United States)

    Park, Joung-Hu; Cho, Bo-Hyung; Choi, Sung-Jin; Lee, Sang-Min

    2009-08-01

    Because the amount of power that a piezoelectric transformer (PT) can handle is limited, multiple connections of PTs are necessary for the power-capacity improvement of PT-applications. In the connection, thermal imbalance between the PTs should be prevented to avoid the thermal runaway of each PT. The thermal balance of the multiple-connected PTs is dominantly affected by the electrothermal characteristics of individual PTs. In this paper, the thermal balance of both parallel-parallel and parallel-series connections are analyzed by electrical model parameters. For quantitative analysis, the thermal-balance effects are estimated by the simulation of the mechanical loss ratio between the PTs. The analysis results show that with PTs of similar characteristics, the parallel-series connection has better thermal balance characteristics due to the reduced mechanical loss of the higher temperature PT. For experimental verification of the analysis, a hardware-prototype test of a Cs-Lp type 40 W adapter system with radial-vibration mode PTs has been performed.

  13. Low energy helium-neon laser prevents oral mucositis after high-dose chemo-radiotherapy: results of a double-blind randomized trial

    International Nuclear Information System (INIS)

    Cowen, Didier; Tardieu, Corinne; Resbeut, Michel; Hannoun-Levi, Jean-Michel; Alzieu, Claude; Schubert, Marc; Franquin, Jean-Claude

    1996-01-01

    Purpose: To evaluate the efficiency of Helium-Neon (He-Ne) laser in the prevention of oral mucositis (OM) induced by high dose chemoradiotherapy before bone marrow transplantation (BMT). Methods and materials: Between 1993 and 1995, 30 consecutive patients (pts) receiving an autologous peripheral stem-cell or bone marrow transplant (BMT) after high dose chemoradiotherapy were randomized to receive or not prophylactic laser applications to the oral mucosa. Chemotherapy consisted of cyclophosphamide, 60 mg/kg intravenously (IV) on day (d)-5 and d-4 in 27 cases, or melphalan 140 mg/kg IV on d-4 in 3 cases. Total body irradiation consisted of 12 Gy midplane dose in six fractions and 3 days. He-Ne laser (632.8 nm wavelength, power 60 mW) applications were performed daily from d-5 to d-1 on 5 anatomic sites of the oral mucosa. Oral examination was performed daily from d0 to d+20. Mucositis was scored according to an oral exam guide with a 16 items scale of which 4 were assessed by the pts themselves. Mean daily scores of pain, ability to swallow and saliva production were measured. A daily mucositis index (DMI) and a cumulative score of oral mucositis (CSOM) were established. Requirement for narcotics and parenteral nutrition were measured. Validation of the grading scale was carried out using the Cronbach alpha coefficient for the internal validation and the test-retest correlation coefficient for the reproducibility analysis. The U Mann Whitney test was used to test for differences among groups. Patients were assigned to either laser treatment (L+) or sham-treatment (L-) by computer blocked randomization. Results: No pt was excluded for failure to complete the laser application protocol. Laser applications were well tolerated and no side effects were reported. The items were highly interrelated as well as the index considered as a whole: over 21 days, α = 0.97. Reproducibility analysis between the nurses in charge with the oral examination showed a significant

  14. The preferred walk to run transition speed in actual lunar gravity.

    Science.gov (United States)

    De Witt, John K; Edwards, W Brent; Scott-Pandorf, Melissa M; Norcross, Jason R; Gernhardt, Michael L

    2014-09-15

    Quantifying the preferred transition speed (PTS) from walking to running has provided insight into the underlying mechanics of locomotion. The dynamic similarity hypothesis suggests that the PTS should occur at the same Froude number across gravitational environments. In normal Earth gravity, the PTS occurs at a Froude number of 0.5 in adult humans, but previous reports found the PTS occurred at Froude numbers greater than 0.5 in simulated lunar gravity. Our purpose was to (1) determine the Froude number at the PTS in actual lunar gravity during parabolic flight and (2) compare it with the Froude number at the PTS in simulated lunar gravity during overhead suspension. We observed that Froude numbers at the PTS in actual lunar gravity (1.39±0.45) and simulated lunar gravity (1.11±0.26) were much greater than 0.5. Froude numbers at the PTS above 1.0 suggest that the use of the inverted pendulum model may not necessarily be valid in actual lunar gravity and that earlier findings in simulated reduced gravity are more accurate than previously thought. © 2014. Published by The Company of Biologists Ltd.

  15. The influence of chemistry concentration on the fracture risk of a reactor pressure vessel subjected to pressurized thermal shocks

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Pin-Chiun [Institute of Nuclear Engineering and Science, National Tsing-Hua University, Hsinchu 30013, Taiwan, ROC (China); Chou, Hsoung-Wei, E-mail: hwchou@iner.gov.tw [Institute of Nuclear Energy Research, Taoyuan 32546, Taiwan, ROC (China); Ferng, Yuh-Ming [Institute of Nuclear Engineering and Science, National Tsing-Hua University, Hsinchu 30013, Taiwan, ROC (China)

    2016-02-15

    Highlights: • Probabilistic fracture mechanics method was used to analyze a reactor pressure vessel. • Effects of copper and nickel contents on RPV fracture probability under PTS were investigated and discussed. • Representative PTS transients of Beaver Valley nuclear power plant were utilized. • The range of copper and nickel contents of the RPV materials were suggested. • With different embrittlement levels the dominated PTS category is different. - Abstract: The radiation embrittlement behavior of reactor pressure vessel shell is influenced by the chemistry concentration of metal materials. This paper aims to study the effects of copper and nickel content variations on the fracture risk of pressurized water reactor (PWR) pressure vessel subjected to pressurized thermal shock (PTS) transients. The probabilistic fracture mechanics (PFM) code, FAVOR, which was developed by the Oak Ridge National Laboratory in the United States, is employed to perform the analyses. A Taiwan domestic PWR pressure vessel assumed with varied copper and nickel contents of beltline region welds and plates is investigated in the study. Some PTS transients analyzed from Beaver Valley Unit 1 for establishing the U.S. NRC's new PTS rule are applied as the loading condition. It is found that the content variation of copper and nickel will significantly affect the radiation embrittlement and the fracture probability of PWR pressure vessels. The results can be regarded as the risk incremental factors for comparison with the safety regulation requirements on vessel degradation as well as a reference for the operation of PWR plants in Taiwan.

  16. Preschool Teachers' Perspectives on Teaching as a Profession and Pedagogical Change

    Science.gov (United States)

    Maskit, Ditza; Firstater, Esther

    2016-01-01

    This study examines the associations between preschool teachers' (PTs) perceptions of teaching as a profession and attitudes toward pedagogical changes, in relation to their seniority and their work setting--public sector or private sector. Participants were 105 preschool teachers, who filled out three measures: (1) PTs' perceptions of teaching as…

  17. Transglycosylation reactions of Bacillus stearothermophilus maltogenic amylase with acarbose and various acceptors

    International Nuclear Information System (INIS)

    Hwa Park, K.; Jeong Kim, M.; Seob Lee, H.; Kim, D.; Soo Han, N.; Robyt, J.F.

    1998-01-01

    It was observed that Bacillus stearothermophilus maltogenic amylase cleaved the first glycosidic bond of acarbose to produce glucose and a pseudotrisaccharide (PTS) that was transferred to C-6 of the glucose to give an α-(1-6) glycosidic linkage and the formation of isoacarbose. The addition of a number of different carbohydrates to the digest gave transfer products in which PTS was primarily attached α-(1-6) to d-glucose, d-mannose, d-galactose, and methyl α-d-glucopyranoside. With d-fructopyranose and d-xylopyranose, PTS was linked α-(1-5) and α-(1-4), respectively. PTS was primarily transferred to C-6 of the nonreducing residue of maltose, cellobiose, lactose, and gentiobiose. Lesser amounts of α-(1-3) and/or α-(1-4) transfer products were also observed for these carbohydrate acceptors. The major transfer product to sucrose gave PTS linked α-(1-4) to the glucose residue. α,α-Trehalose gave two major products with PTS linked α-(1-6) and α-(1-4). Maltitol gave two major products with PTS linked α-(1-6) and α-(1-4) to the glucopyranose residue. Raffinose gave two major products with PTS linked α-(1-6) and α-(1-4) to the d-galactopyranose residue. Maltotriose gave two major products with PTS linked α-(1-6) and α-(1-4) to the nonreducing end glucopyranose residue. Xylitol gave PTS linked α-(1-5) as the major product and d-glucitol gave PTS linked α-(1-6) as the only product. The structures of the transfer products were determined using thin layer-chromatography, high-performance ion chromatography, enzyme hydrolysis, methylation analysis and 13 C NMR spectroscopy. The best acceptor was gentiobiose, followed closely by maltose and cellobiose, and the weakest acceptor was d-glucitol. (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

  18. Transglycosylation reactions of Bacillus stearothermophilus maltogenic amylase with acarbose and various acceptors

    Energy Technology Data Exchange (ETDEWEB)

    Hwa Park, K; Jeong Kim, M; Seob Lee, H; Kim, D [Department of Food Science and Technology and Research Center for New Bio-Materials in Agriculture, Seoul National University, Suwon (Korea, Republic of); Soo Han, N; Robyt, J F [Laboratory for Carbohydrate Chemistry and Enzymology, Department of Biochemistry and Biophysics, Iowa State University, Ames, IA (United States)

    1998-12-15

    It was observed that Bacillus stearothermophilus maltogenic amylase cleaved the first glycosidic bond of acarbose to produce glucose and a pseudotrisaccharide (PTS) that was transferred to C-6 of the glucose to give an {alpha}-(1-6) glycosidic linkage and the formation of isoacarbose. The addition of a number of different carbohydrates to the digest gave transfer products in which PTS was primarily attached {alpha}-(1-6) to d-glucose, d-mannose, d-galactose, and methyl {alpha}-d-glucopyranoside. With d-fructopyranose and d-xylopyranose, PTS was linked {alpha}-(1-5) and {alpha}-(1-4), respectively. PTS was primarily transferred to C-6 of the nonreducing residue of maltose, cellobiose, lactose, and gentiobiose. Lesser amounts of {alpha}-(1-3) and/or {alpha}-(1-4) transfer products were also observed for these carbohydrate acceptors. The major transfer product to sucrose gave PTS linked {alpha}-(1-4) to the glucose residue. {alpha},{alpha}-Trehalose gave two major products with PTS linked {alpha}-(1-6) and {alpha}-(1-4). Maltitol gave two major products with PTS linked {alpha}-(1-6) and {alpha}-(1-4) to the glucopyranose residue. Raffinose gave two major products with PTS linked {alpha}-(1-6) and {alpha}-(1-4) to the d-galactopyranose residue. Maltotriose gave two major products with PTS linked {alpha}-(1-6) and {alpha}-(1-4) to the nonreducing end glucopyranose residue. Xylitol gave PTS linked {alpha}-(1-5) as the major product and d-glucitol gave PTS linked {alpha}-(1-6) as the only product. The structures of the transfer products were determined using thin layer-chromatography, high-performance ion chromatography, enzyme hydrolysis, methylation analysis and {sup 13}C NMR spectroscopy. The best acceptor was gentiobiose, followed closely by maltose and cellobiose, and the weakest acceptor was d-glucitol. (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

  19. Contamination by persistent toxic substances in surface sediment of urban rivers in Chaohu City, China.

    Science.gov (United States)

    Li, Feipeng; Zhang, Haiping; Meng, Xiangzhou; Chen, Ling; Yin, Daqiang

    2012-01-01

    The concentration and spatial distribution of persistent toxic substances (PTS) in the river sediment in Chaohu City, China were investigated. A total of nine surface sediments were collected and the selected PTS pollutants including six heavy metals and nineteen polybrominated diphenyl ethers (PBDEs) were analyzed. The mean heavy metal concentrations (in mg/kg, dry weight) ranged within 0.18-1.53 (Hg), 50.08-200.18 (Cu), 118.70-313.65 (Zn), 50.77-310.85 (Cr), 37.12-92.72 (Pb) and 13.29-197.24 (As), and Cu, Zn and As have been regarded as the main metal pollutants. The levels of PBDEs (1.2-12.1 ng/g) and BDE-209 (2.4-30.5 ng/g) were at the middle level of the global range. BDE-209 was the predominant congener (67.0%-85.7%), which agrees with the fact that technical deca-BDE mixtures are the dominant PBDE formulation in China. The relative high level of PTS pollutants in the western part of the city is probably owing to the intensive agricultural activities and lack of sewerage system there. The ecological risk assessment with the sediment quality guidelines (SOGs) indicates that the urban river sediments in the city have been heavily contaminated by heavy metals with probable ecotoxicological impacts on freshwater organisms and the main toxic pollutants are Hg and As. The results of current study imply that the city, and perhaps many other small cities in China as well, requires immediate pollution control measures with emphasis on not only conventional organic pollutants but also on PTS such as heavy metals and PBDEs.

  20. The inclusion of weld residual stress in fracture margin assessments of embrittled nuclear reactor pressure vessels

    International Nuclear Information System (INIS)

    Dickson, T.L.; Bass, B.R.; McAfee, W.J.

    1998-01-01

    Analyses were performed to determine the impact of weld residual stresses in a reactor pressure vessel (RPV) on (1) the generation of pressure temperature (P-T) curves required for maintaining specified fracture prevention margins during nuclear plant startup and shutdown, and (2) the conditional probability of vessel failure due to pressurized thermal shock (PTS) loading. The through wall residual stress distribution in an axially oriented weld was derived using measurements taken from a shell segment of a canceled RPV and finite element thermal stress analyses. The P-T curve derived from the best estimate load analysis and a t / 8 deep flaw, based on K Ic , was less limiting than the one derived from the current methodology prescribed in the ASME Boiler and Pressure Vessel Code. The inclusion of the weld residual stresses increased the conditional probability of cleavage fracture due to PTS loading by a factor ranging from 2 to 4

  1. Risk factors for avascular osteonecrosis in children with malignant tumors after thermochemotherapy

    International Nuclear Information System (INIS)

    Balzer, S.; Wessalowski, R.; Mils, O.; Schneider, D.; Bernbeck, B.; Goebel, U.; Jaeger, M.; Krauspe, R.

    2005-01-01

    Full text: In children with locally advanced malignant tumors or recurrences after first-line treatment, loco-regional deep hyperthermia (RHT) at temperatures between 42-44 o C and platinum-based chemotherapy ± radiotherapy were administered in order to facilitate complete surgical resection. Growing understanding and clinical experience with RHT techniques disclosed an increasing number of children achieving a long-term remission. Therefore, we have also to focus on risk factors for late sequelae. Based on the current data available, in our patient population the most important and severe complication after RHT is avascular osteonecrosis of the femoral head. Although this complication can also be found after chemo- and/or radiotherapy alone, RHT may also be a risk factor for this complication. Aseptic ON in children and adolescents in caused by an interruption of the capital femoris epiphysis blood supply. Most children present with mild or intermittent pain in the anterior thight and a limb. The pertinent early physical findings include antalgic gait; muscle spasm with mild restriction of motion, especially abduction and internal rotation. In order to determine whether RHT contributes to development of ON in our patient population, we compared different treatment parameters in children and adults. In this analysis 72 patients aged between 1 - 72 years (median 16,1 years) with pelvic malignancies were included. Twenty-four patients were male and 48 female. RHT was performed with 3 annular phased array applicators constructed in the same way (Sigma-30, -40 and -60, BSD 2000, Medical Corporation, Salt Lake City, Utah, USA). The number of heat sessions per patient was 2-30. Frequencies ranged between 87-140 MHz. Maximum power supply ranged between 130-1300 Watts (W). Five different age groups were assigned: 1-5 years (22 pts), 6-10 years (6 pts), 11-15 years (7 pts), 16-20 years (9 pts), > 20 years (27 pts). The number of heat sessions was subdivided in the

  2. Kinetic and Mechanistic Studies of Oxidation of an Antiallergic Drug with Bromamine-T in Acid and Alkaline Media

    International Nuclear Information System (INIS)

    Puttaswamy; Anu Sukhdev

    2012-01-01

    Cetrizine dihydrochloride (CTZH) is widely used as an anti-allergic drug. Sodium N-bromo-p-toluenesulfonamide or bromamine-T (BAT) is the bromine analogue of chloramine-T (CAT) and is found to be a better oxidizing agent than CAT. In the present research, the kinetics of oxidation of CTZH with BAT in acid and alkaline media was studied at 313 K. The experimental rate laws obtained are: -d[BAT]/dt = k[BAT] [CTZH] 0.80 [H + ] -0.48 in acid medium and -d[BAT]/dt = k[BAT][CTZH] 0.48 [OH - ] 0.52 [PTS] -0.40 in alkaline medium where PTS is p-toluenesulfonamide. Activation parameters and reaction constants were evaluated. The solvent isotope effect was studied using D 2 O. The dielectric effect is positive. The stoichiometry of the reaction was found to be 1:1 and the oxidation products were identified as 4-chlorobenzophenone and (2-piperazin-1-yl-ethoxy)-acetic acid in both media. The rate of oxidation of CTZH is faster in acid medium. Suitable mechanisms and related rate laws have been worked out

  3. Adenocarcinoma of the endometrium treated with combined irradiation and surgery: study of 437 patients; Adenocarcinome de l'endometre traite par association radiochirurgicale: a propos de 437 cas

    Energy Technology Data Exchange (ETDEWEB)

    Touboul, E.; Belkacemi, Y.; Deniaud-Alexandre, E.; Ganansia, V.; Schlienger, M. [Hopital Tenon, Service d' Oncologie-Radiotherapie, 75 - Paris (France); Buffat, L. [Hopital Tenon, Service de Biostatistique, Centre des Tumeurs, 75 - Paris (France); Lefranc, J.P.; Blondon, J. [Groupe Hospitalier Pitie-Salpetriere, Service de Chirurgie Gynecologique, 75 - Paris (France); Lhuillier, P. [Centre Hospitalier de Fontainebleau, Service de Gynecologie Obstetrique, 77 - Fontainebleau (France); Uzan, S. [Hopital Tenon, Service de Gynecologie Obstetrique, Centre des Tumeurs, 75 - Paris (France); Jannet, D.; Milliez, J. [Hopital Saint Antoine, Service de Gynecologie Obstetrique, 75 - Paris (France); Uzan, M. [Hopital Jean Verdier, Service de Gynecologie Obstetrique, 93 - Bondy (France); Antoine, M. [Hopital Tenon, Service d' Anatomopathologie, 75 - Paris (France); Ginesty, C. [Groupe Hospitalier Pitie-Salpetriere, Service d' Anatomopathologie, 75 - Paris (France); Jamali, M. [Hopital Saint Antoine, Service d' Anatomopathologie, 75 - Paris (France)

    2001-08-01

    To identify prognostic actors and treatment toxicity in a series of operable endometrial adenocarcinomas. Between November 1971 and October 1992, 437 patients (pts) with endometrial carcinoma, staged according to the 1988 FIGO staging system, underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy without (n = 140) or with (n = 297) pelvic lymph node dissection. The chronology of RT was not randomized and depended on the usual practices of the surgical teams. Group I: 79 pts received preoperative utero-vaginal brachytherapy (mean total dose [MD]: 57 Gy). Group II: 358 pts received postoperative RT (196 pts received vaginal brachytherapy alone [MD: 50 Gy], 158 pts had external beam pelvis RT [EPRT] [MD: 46 Gy over 5 weeks] followed by vaginal brachytherapy [MD: 17 Gy], and 4 pts had EPRT alone [MD: 46 Gy over 5 weeks]). The mean follow-up was 128 months. The 10-year disease-free survival rate was 86%. From 57 recurrences, 12 were isolated loco-regionally. Multivariate analysis showed that independent factors decreasing the probability of disease-free survival were: histologic type (clear cell carcinoma, p = 0.038), largest histologic tumor diameter > 3 cm (p = 0.015), histologic grade (p = 0.008), myometrial invasion > 1/2 (p 0.0055), and 1988 FIGO staging system (p= 9.10{sup -8}). In group II, the addition of EPRT did not seem to improve locoregional control. The postoperative complication rate was 7%. The independent factors increasing the risk of postoperative complications were FIGO stage (p = 0.02) and pelvic lymph node dissection (p = 0.011). The 10-year rate for grade 3 and 4 late radiation complications according to the LENT-SOMA scoring system was 3.1 %. EPRT independently increased the 10-year rate for grade 3 and 4 late radiation complications (R.R.: 5.6, p = 0.0096). EPRT increases the risk of late radiation complications. After surgical and histopathologic staging with pelvic lymph node dissection, in a subgroup of intermediate risk

  4. Anatomic ligament consolidation of the superior acromioclavicular ligament and the coracoclavicular ligament complex after acute arthroscopically assisted double coracoclavicular bundle stabilization.

    Science.gov (United States)

    Jobmann, S; Buckup, J; Colcuc, C; Roessler, P P; Zimmermann, E; Schüttler, K F; Hoffmann, R; Welsch, F; Stein, T

    2017-09-18

    The consolidation of the acromioclavicular (AC) and coracoclavicular (CC) ligament complex after arthroscopically assisted stabilization of acute acromioclavicular joint (ACJ) separation is still under consideration. Fifty-five consecutive patients after arthroscopically assisted double-CC-bundle stabilization within 14 days after acute high-grade ACJ separation were studied prospectively. All patients were clinically analysed preoperatively (FU0) and post-operatively (FU1 = 6 months; FU2 = 12 months). The structural MRI assessments were performed at FU0 (injured ACJ) and at FU2 bilateral (radiologic control group) and assessed separately the ligament thickness and length at defined regions for the conoid, trapezoid and the superior AC ligament. Thirty-seven patients were assessed after 6.5 months and after 16.0 months. The 16-month MRI analysis revealed for all patients continuous ligament healing for the CC-complex and the superior AC ligament with in the average hypertrophic consolidation compared to the control side. Separate conoid and trapezoid strands (double-strand configuration) were detected in 27 of 37 (73%) patients, and a single-strand configuration was detected in 10 of 37 (27%) patients; both configurations showed similar CCD data. The ligament healing was not influenced by the point of surgery, age at surgery and heterotopic ossification. The clinical outcome was increased (FU0-FU2): Rowe, 47.7-97.0 pts.; TAFT, 3.9-10.6 pts.; NAS pain , 8.9-1.4 pts. (all P < 0.05). The arthroscopically assisted double-CC-bundle stabilization within 14 days after acute high-grade ACJ separation showed 16 months after surgery sufficient consolidations of the AC and double-CC ligament complex in 73%. III, Case series.

  5. Evaluation of creep-fatigue crack growth for large-scale FBR reactor vessel and NDE assessment

    Energy Technology Data Exchange (ETDEWEB)

    Joo, Young Sang; Kim, Jong Bum; Kim, Seok Hun; Yoo, Bong

    2001-03-01

    Creep fatigue crack growth contributes to the failure of FRB reactor vessels in high temperature condition. In the design stage of reactor vessel, crack growth evaluation is very important to ensure the structural safety and setup the in-service inspection strategy. In this study, creep-fatigue crack growth evaluation has been performed for the semi-elliptical surface cracks subjected to thermal loading. The thermal stress analysis of a large-scale FBR reactor vessel has been carried out for the load conditions. The distributions of axial, radial, hoop, and Von Mises stresses were obtained for the loading conditions. At the maximum point of the axial and hoop stress, the longitudinal and circumferential surface cracks (i.e. PTS crack, NDE short crack and shallow long crack) were postulated. Using the maximum and minimum values of stresses, the creep-fatigue crack growth of the proposed cracks was simulated. The crack growth rate of circumferential cracks becomes greater than that of longitudinal cracks. The total crack growth of the largest PTS crack is very small after 427 cycles. The structural integrity of a large-scale reactor can be maintained for the plant life. The crack depth growth of the shallow long crack is faster than that of the NDE short crack. In the ISI of the large-scale FBR reactor vessel, the ultrasonic inspection is beneficial to detect the shallow circumferential cracks.

  6. Post-Traumatic Stress Disorder (PDQ)

    Science.gov (United States)

    ... stress (PTS) is a lot like post-traumatic stress disorder (PTSD) but not as severe. Patients have a ... PTS) are a lot like symptoms of other stress-related disorders. PTS has many of the same symptoms as ...

  7. Attractiveness of employment sectors for physical therapists in Ontario, Canada (1999-2007: implication for the long term care sector

    Directory of Open Access Journals (Sweden)

    Landry Michel D

    2012-05-01

    Full Text Available Abstract Background Recruiting and retaining health professions remains a high priority for health system planners. Different employment sectors may vary in their appeal to providers. We used the concepts of inflow and stickiness to assess the relative attractiveness of sectors for physical therapists (PTs in Ontario, Canada. Inflow was defined as the percentage of PTs working in a sector who were not there the previous year. Stickiness was defined as the transition probability that a physical therapist will remain in a given employment sector year-to-year. Methods A longitudinal dataset of registered PTs in Ontario (1999-2007 was created, and primary employment sector was categorized as ‘hospital’, ‘community’, ‘long term care’ (LTC or ‘other.’ Inflow and stickiness values were then calculated for each sector, and trends were analyzed. Results There were 5003 PTs in 1999, which grew to 6064 by 2007, representing a 21.2% absolute growth. Inflow grew across all sectors, but the LTC sector had the highest inflow of 32.0%. PTs practicing in hospitals had the highest stickiness, with 87.4% of those who worked in this sector remaining year-to-year. The community and other employment sectors had stickiness values of 78.2% and 86.8% respectively, while the LTC sector had the lowest stickiness of 73.4%. Conclusion Among all employment sectors, LTC had highest inflow but lowest stickiness. Given expected increases in demand for services, understanding provider transitional probabilities and employment preferences may provide a useful policy and planning tool in developing a sustainable health human resource base across all employment sectors.

  8. Attractiveness of employment sectors for physical therapists in Ontario, Canada (1999-2007): implication for the long term care sector

    Science.gov (United States)

    2012-01-01

    Background Recruiting and retaining health professions remains a high priority for health system planners. Different employment sectors may vary in their appeal to providers. We used the concepts of inflow and stickiness to assess the relative attractiveness of sectors for physical therapists (PTs) in Ontario, Canada. Inflow was defined as the percentage of PTs working in a sector who were not there the previous year. Stickiness was defined as the transition probability that a physical therapist will remain in a given employment sector year-to-year. Methods A longitudinal dataset of registered PTs in Ontario (1999-2007) was created, and primary employment sector was categorized as ‘hospital’, ‘community’, ‘long term care’ (LTC) or ‘other.’ Inflow and stickiness values were then calculated for each sector, and trends were analyzed. Results There were 5003 PTs in 1999, which grew to 6064 by 2007, representing a 21.2% absolute growth. Inflow grew across all sectors, but the LTC sector had the highest inflow of 32.0%. PTs practicing in hospitals had the highest stickiness, with 87.4% of those who worked in this sector remaining year-to-year. The community and other employment sectors had stickiness values of 78.2% and 86.8% respectively, while the LTC sector had the lowest stickiness of 73.4%. Conclusion Among all employment sectors, LTC had highest inflow but lowest stickiness. Given expected increases in demand for services, understanding provider transitional probabilities and employment preferences may provide a useful policy and planning tool in developing a sustainable health human resource base across all employment sectors. PMID:22643111

  9. The value of exercise radionuclide ventriculography in risk stratification after coronary arterial bypass grafting

    International Nuclear Information System (INIS)

    Iskandrian, A.S.; Hakki, A.H.; Goel, I.P.; Mundth, E.D.; Kane, S.; Schenk, C.

    1985-01-01

    Cardiac events after coronary artery bypass surgery (CABG) may be related to left ventricular (LV) function, residual coronary artery diseases (CAD), graft occlusion, and progression of CAD. This study examined the value of rest and exercise (EX) radionuclide ventriculography (RNV) done 3-6 mos after CABG in risk stratification in 212 pts. There were 185 men and 27 women, aged 57 +- 8 years (mean +- SD). During a followup period of up to 4 years, (15 +- 10 months), there were 23 cardiac events; 13 pts died of cardiac causes and 20 had non-fatal acute myocardial infarctions. The pts with and without events did not differ in: clinical presentation after CABG (most were asymptomatic), medications and ECG findings at rest and EX. The pts with events had lower EX systolic blood pressure (p < 0.01); resting LV ejection fraction (EF) (p = 0.002), and EX EF (40 +- 18% vs 54 +- 16%, p = 0.002). The change in EF (rest to EX) was not significantly different (l.6 +- 8.2%, vs 2.1 +- 9.2%). Survival analysis (Cox model) identified the EX EF as the best predictor of death and total events (X/sup 2/ = 4.3 and 2.4, p = 0.04 and 0.07 respectively). Actuarial life table analysis showed that the risk increased as the EX EF decreased when pts were grouped into EX EF ≥ 50, 30-49, and <30%, (p < 0.001, Mantel-Cox). Thus, EX RNA is useful in risk stratification after CABG. The EX LVEF is an important descriptor that categorizes pts into different risks groups. The pts at high risk probably require more aggressive followup and continued medical therapy

  10. Does remnant from differentiated thyroid micro-carcinoma patients really not be treated with Iodine-131 ablation?

    International Nuclear Information System (INIS)

    D'Antuono, F.; Gallicchio, R.; Venetucci, A.; Giacomobono, S.; Tempone, A.; Di Leo, A.; Storto, G.; Nardelli, A.; Pellegrino, T.; Gattozzi, D.

    2015-01-01

    Full text of publication follows. Aim: Remnant ablation by radioiodine is generally not recommended in patients presenting uni- or multifocal cancer <1 cm, without other higher risk features. We retrospectively studied low-risk patients (pts) with differentiated thyroid cancer (DTC) less than 1 cm recruited for radioiodine therapy (RAI). Methods: 91 pts (79 women, age 49.4 ± 10 years) with DTC were recruited for RAI. Pts underwent pre-therapy ultrasonography (US), those with suspected/ambiguous lymph-nodes were excluded and proposed for cytology. Treated pts underwent post-therapeutic whole body scan (WBSt) completed by neck/chest SPECT-CT, when necessary (e.g. evidence of uptake outside of thyroid bed). A target lesion on SPECT-CT was defined as an identifiable lymph-nodal site presenting a matched significant iodine uptake. Patients were followed up for 13 ± 2 months thereafter. Results: All pts/cancers were pT1. Mean histological diameter was (0.66 ± 0.25) cm. Six patients were excluded because of clear nodal involvement at US. Thirty (35%) out of 85 pts had suspicious WBSt as per lymph-nodal involvement which was confirmed at the following SPECT-CT acquisition in most part of pts (25/30; 83 %). Overall detected target lesions was 34, ten (29%) had interim positive fine needle cytology. Conclusions: a significant part of low risk DTC patients, for whom RAI is not recommended, presents an incidental evidence of lymph-nodal involvement at WBSt confirmed by SPECT-CT, when performed. Such setting would have not been treated by I-131. Indications for RAI in DTC low risk patients could be revised at least considering a different dimensional cut-off for the primary lesion. (authors)

  11. Extending laboratory automation to the wards: effect of an innovative pneumatic tube system on diagnostic samples and transport time.

    Science.gov (United States)

    Suchsland, Juliane; Winter, Theresa; Greiser, Anne; Streichert, Thomas; Otto, Benjamin; Mayerle, Julia; Runge, Sören; Kallner, Anders; Nauck, Matthias; Petersmann, Astrid

    2017-02-01

    The innovative pneumatic tube system (iPTS) transports one sample at a time without the use of cartridges and allows rapid sending of samples directly into the bulk loader of a laboratory automation system (LAS). We investigated effects of the iPTS on samples and turn-around time (TAT). During transport, a mini data logger recorded the accelerations in three dimensions and reported them in arbitrary area under the curve (AUC) units. In addition representative quantities of clinical chemistry, hematology and coagulation were measured and compared in 20 blood sample pairs transported by iPTS and courier. Samples transported by iPTS were brought to the laboratory (300 m) within 30 s without adverse effects on the samples. The information retrieved from the data logger showed a median AUC of 7 and 310 arbitrary units for courier and iPTS transport, respectively. This is considerably below the reported limit for noticeable hemolysis of 500 arbitrary units. iPTS reduces TAT by reducing the hands-on time and a fast transport. No differences in the measurement results were found for any of the investigated 36 analytes between courier and iPTS transport. Based on these findings the iPTS was cleared for clinical use in our hospital.

  12. Characterization of mathematics instructional practises for prospective elementary teachers with varying levels of self-efficacy in classroom management and mathematics teaching

    Science.gov (United States)

    Lee, Carrie W.; Walkowiak, Temple A.; Nietfeld, John L.

    2017-03-01

    The purpose of this study was to investigate the relationship between prospective teachers' (PTs) instructional practises and their efficacy beliefs in classroom management and mathematics teaching. A sequential, explanatory mixed-methods design was employed. Results from efficacy surveys, implemented with 54 PTs were linked to a sample of teachers' instructional practises during the qualitative phase. In this phase, video-recorded lessons were analysed based on tasks, representations, discourse, and classroom management. Findings indicate that PTs with higher levels of mathematics teaching efficacy taught lessons characterised by tasks of higher cognitive demand, extended student explanations, student-to-student discourse, and explicit connections between representations. Classroom management efficacy seems to bear influence on the utilised grouping structures. These findings support explicit attention to PTs' mathematics teaching and classroom management efficacy throughout teacher preparation and a need for formative feedback to inform development of beliefs about teaching practises.

  13. Implications of Posttraumatic Stress Among Military-Affiliated and Civilian Students

    Science.gov (United States)

    Barry, Adam E.; Whiteman, Shawn D.; MacDermid Wadsworth, Shelley M.

    2012-01-01

    Objectives Determine whether posttraumatic stress symptoms (PTS) are associated with problem drinking and alcohol-related consequences, as well as academic correlates among military-affiliated and civilian students. Participants Final sample (n = 248) included 78 combat exposed student service members/veterans, 53 non-combat exposed student service members/veterans, 38 ROTC students, and 79 civilian students. Method Self-report data was collected spring 2011 via a web-based survey measuring PTS, problem drinking, alcohol-related consequences, GPA, educational self-efficacy, academic amotivation and persistence. Results Military students exposed to combat-related trauma reported significantly greater PTS symptoms than other military and civilian groups. PTS symptoms were associated with problem drinking and alcohol-related consequences for all groups, yet unrelated to academic correlates among those exposed to combat-related trauma. Conclusions This study adds to the scant literature base exploring the unique characteristics of student service members/veterans in higher education. PMID:23157198

  14. Structural analysis of NPP components and structures

    International Nuclear Information System (INIS)

    Saarenheimo, A.; Keinaenen, H.; Talja, H.

    1998-01-01

    Capabilities for effective structural integrity assessment have been created and extended in several important cases. In the paper presented applications deal with pressurised thermal shock loading, PTS, and severe dynamic loading cases of containment, reinforced concrete structures and piping components. Hydrogen combustion within the containment is considered in some severe accident scenarios. Can a steel containment withstand the postulated hydrogen detonation loads and still maintain its integrity? This is the topic of Chapter 2. The following Chapter 3 deals with a reinforced concrete floor subjected to jet impingement caused by a postulated rupture of a near-by high-energy pipe and Chapter 4 deals with dynamic loading resistance of the pipe lines under postulated pressure transients due to water hammer. The reliability of the structural integrity analysing methods and capabilities which have been developed for application in NPP component assessment, shall be evaluated and verified. The resources available within the RATU2 programme alone cannot allow performing of the large scale experiments needed for that purpose. Thus, the verification of the PTS analysis capabilities has been conducted by participation in international co-operative programmes. Participation to the European Network for Evaluating Steel Components (NESC) is the topic of a parallel paper in this symposium. The results obtained in two other international programmes are summarised in Chapters 5 and 6 of this paper, where PTS tests with a model vessel and benchmark assessment of a RPV nozzle integrity are described. (author)

  15. Effects of feed additives on ileal mucosa-associated microbiota composition of broiler chickens.

    Science.gov (United States)

    Ruiz, R; Peinado, M J; Aranda-Olmedo, I; Abecia, L; Suárez-Pereira, E; Ortiz Mellet, C; García Fernández, J M; Rubio, L A

    2015-07-01

    The effects of dietary supplementation with 2 recently developed feed additives on the composition of the mucosa-associated microbiota of the ileum were studied in growing broiler chickens. A total of 48 male 1-d-old broiler chickens of the Cobb 500 strain were distributed in 4 treatments with 2 replicates of 6 birds each. The 2 additives tested were a di-d-fructose dianhydride–enriched caramel (FC) and the garlic derivative propyl propane thiosulfonate (PTS-O). Dietary treatments were a control (commercial diet with no additive), INU (20 g inulin/kg diet), CAR (20 g FC/kg diet), and GAR (90 mgPTS-O/kg diet). As a result of this study, inulin supplementation resulted in lower (P Eubacterium rectale log10 number of copies respect to controls. Higher (P spp. revealed the presence of Bifidobacterium longum, Bifidobacterium pseudolongum, and Bifidobacterium pseudocatenulatum in samples from chickens fed the control and the PTS-O–supplemented diet. Bifidobacterium longum was exclusively found in poultry fed the control diet, whereas B. pseudocatenulatum was found only in poultry fed the PTS-O–supplemented diet. This study showed that both PTS-O and FC were able to modulate the composition of the ileal mucosa-associated microbiota of growing broiler chickens. Finally, in addition to B. pseudolongum, the presence of B. longum and B. pseudocatenulatum, species not previously described in intestinal samples of broilers, was also demonstrated.

  16. Phase II trial of combined surgical resection, intraoperative high dose rate brachytherapy (IORT), and external beam radiation therapy (EBRT) for malignant pleural mesothelioma (MPM)

    International Nuclear Information System (INIS)

    Raben, A.; Rusch, V.; Mychalczak, B.; Schupak, K.; Ginsburg, R.; Burt, M.; Bains, M.; Harrison, L.B.

    1996-01-01

    The purpose of this study was to determine the feasibility of combining extrapleural pneumonectomy (EPP) or pleurectomy/decortication (PD), IORT and postoperative EBRT to treat MPM. From (3(94)) through (9(94)), 16 patients (pts) were enrolled on this trial; 2 females and 14 males with a median age of 59 (range: 45 - 75). Eligibility criteria included biopsy proven MPM, no evidence of T4 or N3 disease by exam/CT scan, no evidence of metastatic disease, no previous treatment, and a Karnofsky performance status of ≥ 80%. Pts with pulmonary function tests permitting EPP, underwent EPP and IORT (15 Gy prescribed to a depth of 5 mm in tissue to the mediastinum, diaphragm and chestwall) with postoperative EBRT (54 Gy to entire hemithorax, surgical scar and surgical drain site). Pts ineligible for EPP due to marginal pulmonary function underwent PD and IORT (15 Gy to mediastinum, diaphragm and chestwall), with EBRT (54 Gy to entire hemithorax with customized lung blocking). The median surgical procedure time, median IORT time and median overall operating time was 554 minutes, 240 minutes and 649 minutes respectively. The median dose of EBRT was 50.4 Gy (range 50-54 Gy). The median follow-up time is 8 months (range: 3 - 17 months). Four of 16 pts had unresectable disease at the time of surgery and were taken off study. Eight pts underwent EPP/IORT and 4 patients underwent PD/IORT. A complete resection of all gross disease was obtained in 11pts. One pt had a single focus of gross residual disease (less than 5 mm in size) left behind. The overall actuarial local control at 1 year for resected patients is 66%. The crude local control rate and distant control rate for pts undergoing EPP was 75% and 50% respectively. The crude local control rate and distant control rate for PD pts was 50% and 75%. The overall distant metastasis rate at 1 year was 42%. The overall complication rate was 58% ((7(12))). Of the 8 pts undergoing EPP and IORT, 1 patient developed postoperative acute

  17. Polyaniline assisted by TiO2:SnO2 nanoparticles as a hydrogen gas sensor at environmental conditions

    Science.gov (United States)

    Nasirian, Shahruz; Milani Moghaddam, Hossain

    2015-02-01

    In the present research, polyaniline assisted by TiO2:SnO2 nanoparticles was synthesized and deposited onto an epoxy glass substrate with Cu-interdigited electrodes for gas sensing application. To examine the efficiency of the polyaniline/TiO2:SnO2 nanocomposite (PTS) as a hydrogen (H2) gas sensor, its nature, stability, response, recovery/response time have been studied with a special focus on its ability to work at environmental conditions. H2 gas sensing results demonstrated that a PTS sensor with 20 and 10 wt% of anatase-TiO2 and SnO2 nanoparticles, respectively, has the best response time (75 s) with a recovery time of 117 s at environmental conditions. The highest (lowest) response (recovery time) was 6.18 (46 s) in PTS sensor with 30 and 15 wt% of anatase- (rutile-)TiO2 and SnO2 nanoparticles, respectively, at 0.8 vol.% H2 gas. Further, the H2 gas sensing mechanism of PTS sensor has also been studied.

  18. A survey of treatment approaches of malignant ascites in Germany and Austria.

    Science.gov (United States)

    Jehn, C F; Küpferling, S; Oskay-Özcelik, G; Lüftner, D

    2015-07-01

    Malignant ascites (MA) is a common manifestation of advanced cancer. Currently, there are no evidence-based guidelines for the management of MA. We conducted a survey with physicians throughout Germany and Austria, to get an overview of current approaches and opinions in the treatment of MA. One hundred and twenty-eight medical oncologists (MO), gastroenterologists (GE), and gynecologists (GYN) completed an electronic questionnaire consisting of 33 questions. Ninety percent of the physicians were from Germany and 10% from Austria; 48% of those were MO, 30% were GYN, and 14% were GE. Most physicians treated an average of 34 patients (pts)/year with MA. Twenty-six percent of these pts suffered from ovarian, 20% from pancreatic, 17% from gastric, and 14% from colorectal cancer. The majority of the physicians associated MA with poor prognosis (92%) and significant reduction in quality of life (87%). One third felt that MA was a contraindication for full dosing of systemic chemotherapy. Paracentesis (PC) was performed in 70% of pts with symptom relieve and quality of life being the main reasons. Almost half of the pts required 3-5 PC, 50% even more than 5 PC during the course of their disease. Only 15% of pts needed multiple PC per week; the majority (79%) needed the procedure either once a week or every 14 days. In 61% of pts, 3-5 L of ascites fluid was drained. Only in 8%, 5 L and more were removed. Volume substitution with IV albumin was performed in 40% of pts. Most pts (55%) had to stay 1-3 h in a healthcare facility for the procedure. However, 21% had to stay ≥1 day. While almost all physicians (89%) performed a PC at some point in the treatment of MA, 75% felt that a systemic chemotherapy and 55% thought a concomitant diuretic therapy were a necessary adjunct. Seven percent of the pts received a targeted treatment with catumaxomab. Repeated PC is the main pillar of treatment of MA; its effect is only temporary and requires significant hospital resources

  19. Two-dimensional speckle tracking echocardiography prognostic parameters in patients after acute myocardial infarction.

    Science.gov (United States)

    Haberka, Maciej; Liszka, Jerzy; Kozyra, Andrzej; Finik, Maciej; Gąsior, Zbigniew

    2015-03-01

    The aim of the study was to evaluate the left ventricle (LV) function with speckle tracking echocardiography (STE) and to assess its relation to prognosis in patients after acute myocardial infarction (AMI). Sixty-three patients (F/M = 16/47 pts; 62.33 ± 11.85 years old) with AMI (NSTEMI/STEMI 24/39 pts) and successful percutaneous coronary intervention (PCI) with stent implantation (thrombolysis in myocardial infarction; TIMI 3 flow) were enrolled in this study. All patients underwent baseline two-dimensional conventional echocardiography and STE 3 days (baseline) and 30 days after PCI. All patients were followed up for cardiovascular clinical endpoints, major adverse cardiovascular endpoint (MACE), and functional status (Canadian Cardiovascular Society and New York Heart Association). During the follow-up (31.9 ± 5.1 months), there were 3 cardiovascular deaths, 15 patients had AMI, 2 patients had cerebral infarction, 24 patients reached the MACE. Baseline LV torsion (P = 0.035), but none of the other strain parameters were associated with the time to first unplanned cardiovascular hospitalization. Univariate analysis showed that baseline longitudinal two-chamber and four-chamber strain (sLa2 0 and sLa4 0) and the same parameters obtained 30 days after the AMI together with transverse four-chamber strain (sLa2 30, sLa4 30, and sTa4 30) were significantly associated with combined endpoint (MACE). The strongest association in the univariate analysis was found for the baseline sLa2. However, in multivariable analysis only a left ventricular remodeling (LVR - 27% pts) was significantly associated with MACE and strain parameters were not associated with the combined endpoint. The assessment of LV function with STE may improve cardiovascular risk prediction in postmyocardial infarction patients. © 2014, Wiley Periodicals, Inc.

  20. Origem Anómala da Artéria Coronária Esquerda a Partir da Artéria Pulmonar

    OpenAIRE

    Kaku, S; Pinto, MF; Magalhães, M; Fragata, J; Sousa Ramos, JM; Nunes, MA; Trigo, C; Borges, A

    1995-01-01

    OBJECTIVE: To assess the frequency and severity of the anomalous origin of the left coronary artery (ALCA) from the pulmonary artery (PA). DESIGN OF THE STUDY: Prospective study of case series between March 1991 and December 1994. SETTING: Referral-based Paediatric Cardiology Department of a Tertiary Care Center. PATIENTS AND METHODS: Five consecutive patients (pts) with anomalous origin of the LCA from the PA; there were three infants aged 4 months and two children one 8 year and...