Boosting foundations and algorithms

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Schapire, Robert E

2012-01-01

Boosting is an approach to machine learning based on the idea of creating a highly accurate predictor by combining many weak and inaccurate "rules of thumb." A remarkably rich theory has evolved around boosting, with connections to a range of topics, including statistics, game theory, convex optimization, and information geometry. Boosting algorithms have also enjoyed practical success in such fields as biology, vision, and speech processing. At various times in its history, boosting has been perceived as mysterious, controversial, even paradoxical.

Added value of dedicated axillary hybrid 18F-FDG PET/MRI for improved axillary nodal staging in clinically node-positive breast cancer patients. A feasibility study

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Nijnatten, Thiemo J.A. van; Goorts, B. [Maastricht University Medical Center+, Department of Radiology and Nuclear Medicine (Netherlands); Maastricht University Medical Center+, Department of Surgery, Maastricht (Netherlands); Maastricht University Medical Center+, GROW - School for Oncology and Developmental Biology, Maastricht (Netherlands); Voeoe, S.; Wildberger, J.E. [Maastricht University Medical Center+, Department of Radiology and Nuclear Medicine (Netherlands); Boer, M. de [Maastricht University Medical Center+, GROW - School for Oncology and Developmental Biology, Maastricht (Netherlands); Maastricht University Medical Center+, Division of Internal Medicine, Department of Medical Oncology, Maastricht (Netherlands); Kooreman, L.F.S. [Maastricht University Medical Center+, GROW - School for Oncology and Developmental Biology, Maastricht (Netherlands); Maastricht University Medical Center+, Department of Pathology, Maastricht (Netherlands); Heuts, E.M. [Maastricht University Medical Center+, Department of Surgery, Maastricht (Netherlands); Mottaghy, F.M. [Maastricht University Medical Center+, Department of Radiology and Nuclear Medicine (Netherlands); RWTH Aachen University, Department of Nuclear Medicine, University Hospital, Aachen (Germany); Lobbes, M.B.I. [Maastricht University Medical Center+, Department of Radiology and Nuclear Medicine (Netherlands); Maastricht University Medical Center+, GROW - School for Oncology and Developmental Biology, Maastricht (Netherlands); Smidt, M.L. [Maastricht University Medical Center+, Department of Surgery, Maastricht (Netherlands); Maastricht University Medical Center+, GROW - School for Oncology and Developmental Biology, Maastricht (Netherlands)

2018-02-15

To investigate the feasibility and potential added value of dedicated axillary 18F-FDG hybrid PET/MRI, compared to standard imaging modalities (i.e. ultrasound [US], MRI and PET/CT), for axillary nodal staging in clinically node-positive breast cancer. Twelve patients with clinically node-positive breast cancer underwent axillary US and dedicated axillary hybrid 18F-FDG PET/MRI. Nine of the 12 patients also underwent whole-body PET/CT. Maximum standardized uptake values (SUVmax) were measured for the primary breast tumor and the most FDG-avid axillary lymph node. A positive axillary lymph node on dedicated axillary hybrid PET/MRI was defined as a moderate to very intense FDG-avid lymph node. The diagnostic performance of dedicated axillary hybrid PET/MRI was calculated by comparing quantitative and its qualitative measurements to results of axillary US, MRI and PET/CT. The number of suspicious axillary lymph nodes was subdivided as follows: N0 (0 nodes), N1 (1-3 nodes), N2 (4-9 nodes) and N3 (≥ 10 nodes). According to dedicated axillary hybrid PET/MRI findings, seven patients were diagnosed with N1, four with N2 and one with N3. With regard to mean SUVmax, there was no significant difference in the primary tumor (9.0 [±5.0] vs. 8.6 [±5.7], p = 0.678) or the most FDG-avid axillary lymph node (7.8 [±5.3] vs. 7.7 [±4.3], p = 0.767) between dedicated axillary PET/MRI and PET/CT. Compared to standard imaging modalities, dedicated axillary hybrid PET/MRI resulted in changes in nodal status as follows: 40% compared to US, 75% compared to T2-weighted MRI, 40% compared to contrast-enhanced MRI, and 22% compared to PET/CT. Adding dedicated axillary 18F-FDG hybrid PET/MRI to diagnostic work-up may improve the diagnostic performance of axillary nodal staging in clinically node-positive breast cancer patients. (orig.)

Added value of dedicated axillary hybrid 18F-FDG PET/MRI for improved axillary nodal staging in clinically node-positive breast cancer patients. A feasibility study

International Nuclear Information System (INIS)

Nijnatten, Thiemo J.A. van; Goorts, B.; Voeoe, S.; Wildberger, J.E.; Boer, M. de; Kooreman, L.F.S.; Heuts, E.M.; Mottaghy, F.M.; Lobbes, M.B.I.; Smidt, M.L.

2018-01-01

To investigate the feasibility and potential added value of dedicated axillary 18F-FDG hybrid PET/MRI, compared to standard imaging modalities (i.e. ultrasound [US], MRI and PET/CT), for axillary nodal staging in clinically node-positive breast cancer. Twelve patients with clinically node-positive breast cancer underwent axillary US and dedicated axillary hybrid 18F-FDG PET/MRI. Nine of the 12 patients also underwent whole-body PET/CT. Maximum standardized uptake values (SUVmax) were measured for the primary breast tumor and the most FDG-avid axillary lymph node. A positive axillary lymph node on dedicated axillary hybrid PET/MRI was defined as a moderate to very intense FDG-avid lymph node. The diagnostic performance of dedicated axillary hybrid PET/MRI was calculated by comparing quantitative and its qualitative measurements to results of axillary US, MRI and PET/CT. The number of suspicious axillary lymph nodes was subdivided as follows: N0 (0 nodes), N1 (1-3 nodes), N2 (4-9 nodes) and N3 (≥ 10 nodes). According to dedicated axillary hybrid PET/MRI findings, seven patients were diagnosed with N1, four with N2 and one with N3. With regard to mean SUVmax, there was no significant difference in the primary tumor (9.0 [±5.0] vs. 8.6 [±5.7], p = 0.678) or the most FDG-avid axillary lymph node (7.8 [±5.3] vs. 7.7 [±4.3], p = 0.767) between dedicated axillary PET/MRI and PET/CT. Compared to standard imaging modalities, dedicated axillary hybrid PET/MRI resulted in changes in nodal status as follows: 40% compared to US, 75% compared to T2-weighted MRI, 40% compared to contrast-enhanced MRI, and 22% compared to PET/CT. Adding dedicated axillary 18F-FDG hybrid PET/MRI to diagnostic work-up may improve the diagnostic performance of axillary nodal staging in clinically node-positive breast cancer patients. (orig.)

Postoperative peri-axillary seroma following axillary artery cannulation for surgical treatment of acute type A aortic dissection

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Katsanos Konstantinos

2010-05-01

Full Text Available Abstract The arterial cannulation site for optimal tissue perfusion and cerebral protection during cardiopulmonary bypass (CPB for surgical treatment of acute type A aortic dissection remains controversial. Right axillary artery cannulation confers significant advantages, because it provides antegrade arterial perfusion during cardiopulmonary bypass, and allows continuous antegrade cerebral perfusion during hypothermic circulatory arrest, thereby minimizing global cerebral ischemia. However, right axillary artery cannulation has been associated with serious complications, including problems with systemic perfusion during cardiopulmonary bypass, problems with postoperative patency of the artery due to stenosis, thrombosis or dissection, and brachial plexus injury. We herein present the case of a 36-year-old Caucasian man with known Marfan syndrome and acute type A aortic dissection, who had direct right axillary artery cannulation for surgery of the ascending aorta. Postoperatively, the patient developed an axillary perigraft seroma. As this complication has, not, to our knowledge, been reported before in cardiothoracic surgery, we describe this unusual complication and discuss conservative and surgical treatment options.

Harmonic scalpel versus electrocautery in axillary dissection in carcinoma breast

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Nawaz, A.; Khan, A.; Mansoor, R.; Butt, U.I.

2015-01-01

To compare the results between harmonics scalpel and electrocautery use in axillary dissection for carcinoma breast. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Surgery, Services Hospital, Lahore, from December 2013 to June 2014. Methodology: Eighty patients fulfilling the inclusion criteria were selected and equally divided in two groups. Axillary dissection for carcinoma breast was performed by using the harmonic scalpel in one group and by using electrocautery in the other group. Total mean axillary drain output and frequency of axillary numbness were noted in both groups and compared. Results: All the patients were females with mean age of 53.52 ± 9.8. Mean axillary drain output in harmonic scalpel group was 167.75 ± 43.90 as compared to 310.00 ± 60.09 in electrocautery group while only 12.5% of patients were positive for axillary numbness in harmonic scalpel group as compared to 100% of patients who were positive for electrocautery group. Conclusion: Use of harmonic scalpel in axillary dissection resulted in decreased total mean axillary drain output and lowered frequency of axillary numbness when compared to utilizing electrocautery. (author)

Routine use of standard breast MRI compared to axillary ultrasound for differentiating between no, limited and advanced axillary nodal disease in newly diagnosed breast cancer patients

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Nijnatten, T.J.A. van, E-mail: Thiemovn@gmail.com [Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht (Netherlands); Department of Surgery, Maastricht University Medical Center+, Maastricht (Netherlands); GROW – School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht (Netherlands); Ploumen, E.H. [Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht (Netherlands); Department of Surgery, Maastricht University Medical Center+, Maastricht (Netherlands); Schipper, RJ. [Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht (Netherlands); Department of Surgery, Maastricht University Medical Center+, Maastricht (Netherlands); GROW – School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht (Netherlands); Department of Surgery, Catharina Hospital, Eindhoven (Netherlands); Goorts, B. [Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht (Netherlands); Department of Surgery, Maastricht University Medical Center+, Maastricht (Netherlands); GROW – School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht (Netherlands); Andriessen, E.H. [Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht (Netherlands); Department of Surgery, Maastricht University Medical Center+, Maastricht (Netherlands); Vanwetswinkel, S.; Schavemaker, M. [Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht (Netherlands); Nelemans, P. [Department of Epidemiology, Maastricht University Medical Center+, Maastricht (Netherlands); Vries, B. de [Department of Pathology, Zuyderland Hospital, Heerlen (Netherlands); and others

2016-12-15

Objectives: To compare standard breast MRI to dedicated axillary ultrasound (with or without tissue sampling) for differentiating between no, limited and advanced axillary nodal disease in breast cancer patients. Methods: All patients who underwent breast MRI and dedicated axillary ultrasound between 2009 and 2014 were eligible. Exclusion criteria were recurrent disease, neoadjuvant systemic therapy and not receiving completion axillary lymph node dissection after positive sentinel lymph node biopsy (SLNB). Two radiologists independently reassessed all MRI exams. Axillary ultrasound findings were retrospectively collected. Probability of advanced axillary nodal disease (pN2-3) given clinically node negative (cN0) or limited (cN1) findings was calculated, with corresponding negative predictive value (NPV) to exclude pN2-3 and positive predictive value (PPV) to identify axillary nodal disease. Histopathology served as gold standard. Results: A total of 377 cases resulted in 81.4% no, 14.4% limited and 4.2% advanced axillary nodal disease at final histopathology. Probability of pN2-3 given cN0 for breast MRI and axillary ultrasound was 0.7–0.9% versus 1.5% and probability of pN2-3 given cN1 was 11.6–15.4% versus 29.0%. When cN1 on breast MRI was observed, PPV to identify positive axillary nodal disease was 50.7% and 59.0%. Conclusions: Evaluation of axillary nodal status on standard breast MRI is comparable to dedicated axillary ultrasound in breast cancer patients. In patients who underwent preoperative standard breast MRI, axillary ultrasound is only required in case of suspicious nodal findings on MRI.

Motivating quantum field theory: the boosted particle in a box

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Vutha, Amar C

2013-01-01

It is a maxim often stated, yet rarely illustrated, that the combination of special relativity and quantum mechanics necessarily leads to quantum field theory. An elementary illustration is provided using the familiar particle in a box, boosted to relativistic speeds. It is shown that quantum fluctuations of momentum lead to energy fluctuations, which are inexplicable without a framework that endows the vacuum with dynamical degrees of freedom and allows particle creation/annihilation. (letters and comments)

Muscular Variations During Axillary Dissection: A Clinical Study in ...

African Journals Online (AJOL)

muscle and the coracoid process, without interruption by any type of tendinous fibres. The axillary arch muscle crossed anteriorly over the axillary vein [Figure 1]. The mastectomy along with axillary dissection was completed uneventfully. There was left sided absence of pectoralis major and minor muscles in a 45 years old ...

Comparison of rectal and axillary temperatures in dogs and cats.

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Goic, Joana B; Reineke, Erica L; Drobatz, Kenneth J

2014-05-15

To compare rectal versus axillary temperatures in dogs and cats. Prospective observational study. 94 dogs and 31 cats. Paired axillary and rectal temperatures were measured in random order with a standardized method. Animal signalment, initial complaint, blood pressure, blood lactate concentration, and variables associated with vascular perfusion and coat were evaluated for associations with axillary and rectal temperatures. Axillary temperature was positively correlated with rectal temperature (ρ = 0.75 in both species). Median axillary temperature (38.4°C [101.1°F] in dogs, and 38.4°C [101.2°F] in cats) was significantly different from median rectal temperature in dogs (38.9°C [102.0°F]) but not in cats (38.6°C [101.5°F]). Median rectal-axillary gradient (difference) was 0.4°C (0.7°F; range, -1.3° to 2.3°C [-2.4° to 4.1°F]) in dogs and 0.17°C (0.3°F; range -1.1° to 1.6°C [-1.9° to 3°F]) in cats. Sensitivity and specificity for detection of hyperthermia with axillary temperature were 57% and 100%, respectively, in dogs and 33% and 100%, respectively, in cats; sensitivity and specificity for detection of hypothermia were 86% and 87%, respectively, in dogs and 80% and 96%, respectively, in cats. Body weight (ρ = 0.514) and body condition score (ρ = 0.431) were correlated with rectal-axillary gradient in cats. Although axillary and rectal temperatures were correlated in dogs and cats, a large gradient was present between rectal temperature and axillary temperature, suggesting that axillary temperature should not be used as a substitute for rectal temperature.

Partial axillary dissection in early breast cancer

African Journals Online (AJOL)

Tarek Abdel Halim El-Fayoumi

ORIGINAL ARTICLE. Partial axillary dissection in early breast cancer. Tarek Abdel Halim El-Fayoumi *. Department of General Surgery, Faculty of Medicine, Alexandria University, Egypt. Received 16 October 2012; accepted 7 January 2013. Available online 7 March 2013. KEYWORDS. Breast cancer;. Axillary lymph nodes.

The accuracy of electron-boost fields in the radiation therapy of early breast cancer after lumpectomy

International Nuclear Information System (INIS)

Yakar, D.; Bower, D.; Kambouris, A.

1989-01-01

Electron boost fields used in the radiotherapy of early breast cancer may be set up either clinically (on the basis of lumpectomy scar location and other clinical data) or on location of surgical clips shown by simulation films. A comparison of these two methods has been conducted on 27 patients. In 13 patients, the clinical set up was good (margin around the clips > 1.5 cm); in four, marginal (margin = 0.5-1.5 cm) and in 10, unacceptable (< 0.5 cm margin). The authors concluded that placement of surgical clips at the margins of the tumor bed and simulation of the electron boost fields is necessary to ensure geographic miss

Axillary Hodgkin's disease in manual workers.

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Andrieu, J M; Weh, H J; Teillet, F; Asselain, B

1979-01-01

Between 1965 and 1974, 16 patients were clinically staged as having unique axillary localizations of Hodgkin's disease. Sex ratio (4.3), mean age (40.8 years) and professional occupations (12 out of the 16 patients were engaged in manual work) were significantly different from that of all patients observed during the same period. These facts lead us to suppose the existence of a link between manual work and initial axillary localizations.

Posttraumatic True Aneurysm of the Axillary Artery Following Blunt Trauma

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Tugrul Goncu

2010-01-01

Full Text Available The majority of the axillary artery aneurysm cases arise as pseudoaneurysms secondary to blunt or iatrogenic trauma. Isolated traumatic true axillary artery aneurysm is a relatively unusual disorder and generally occurs with repetitive blunt trauma. A 22-year-old female patient with distal axillary artery true aneurysm due to simple blunt axillothoracic trauma is presented. The aneurysm was excised with subpectoral-axillary approach and saphenous vein graft interposition was applied. Long-term follow-up with the patient was uneventful.

The clinical value of 99mTc-MIBI imaging for axillary lymph node metastasis of breast cancer

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Song Bangkun; Yang Jisheng; Shen Dawei; Zuo Lei; Jiang Ling; Zhou Ya

2001-01-01

Objective: To observe the clinical value of 99m Tc-MIBI imaging for axillary lymph node metastasis of breast cancer. Methods: 56 patients with breast cancer proven by pathology were imaged with 99m Tc-MIBI. Images were taken at 5, 30, 60 minutes. The axillary area of affected side was included in imaging field. Results: The primary foci in 55 cases were positive and one case was negative in uptake. Of the 56 cases, 35 had histologically proven axillary lymph node metastases. MIBI uptake was seen in 30 cases and negative in 5 cases. The sensitivity was 85.7% (30/35 cases). In 21 cases who had no metastasis, 3 cases showed false positive uptake and 18 cases were true negative, making the specificity 85.7%. In the case who had negative imaging for primary focus, which was non-palpable, had an enlarged axillary lymphatic node. Positive MIBI uptake of the node area was seen in this case. Conclusion: 99m Tc-MIBI imaging is valuable for the diagnosis of axillary nodal metastasis of breast cancer. Even though there is no palpable primary focus, if there is an enlarged axillary lymphatic node and positive MIBI uptake, metastasis should be considered

Targeted intraoperative radiotherapy (TARGIT) yields very low recurrence rates when given as a boost

International Nuclear Information System (INIS)

Vaidya, Jayant S.; Baum, Michael; Tobias, Jeffrey S.; Massarut, Samuele; Wenz, Frederik; Murphy, Olive; Hilaris, Basil; Houghton, Joan B.Sc.; Saunders, Christobel; Corica, Tammy; Roncadin, Mario; Kraus-Tiefenbacher, Uta; Melchaert, Frank; Keshtgar, Mohammed; Sainsbury, Richard; Douek, Michael; Harrison, Elly; Thompson, Alastair; Joseph, David

2006-01-01

Purpose: Patients undergoing breast-conserving surgery were offered boost radiotherapy with targeted intraoperative radiotherapy (TARGIT) using the Intrabeam system to test the feasibility, safety, and efficacy of the new approach. Methods and Materials: We treated 302 cancers in 301 unselected patients. This was not a low-risk group. One-third of patients (98/301) were younger than 51 years of age. More than half of the tumors (172, 57%) were between 1 cm and 2 cm, and one-fifth (62, 21%) were >2 cm; 29% (86) had a Grade 3 tumor and, in 29% (87), axillary lymph nodes contained metastasis. After primary surgery, 20 Gy was delivered intraoperatively to the surface of the tumor bed, followed by external-beam radiotherapy (EBRT), but excluding the usual boost. Results: The treatment was well tolerated. The follow-up ranged from 3 to 80 months (164 and 90 patients completed 2 and 3 years follow-up, respectively). Four patients (1.3%) had local recurrence. The Kaplan-Meier estimate of local recurrence is 2.6% (SE = 1.7) at 5 years. This compares favorably with the 4.3% recurrence rate in boosted patients from the EORTC boost study, in which only 8.1% patients were node-positive, as opposed to 29% in our series. Conclusion: Targeted intraoperative radiotherapy combined with EBRT results in a low local recurrence rate. This could be attributed to both accurate targeting and timeliness of the treatment. These data support the need for a randomized trial to test whether the TARGIT boost is superior to conventional external boost, especially in high-risk women

Axillary lymph nodes and arm lymphatic drainage pathways are spared during routine complete axillary clearance in majority of women undergoing breast cancer surgery.

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Szuba, A; Chachaj, Z; Koba-Wszedybylb, M; Hawro, R; Jasinski, R; Tarkowski, R; Szewczyk, K; Bebenek, M; Forgacz, J; Jodkowska, A; Jedrzejuk, D; Janczak, D; Mrozinska, M; Pilch, U; Wozniewski, M

2011-09-01

Alterations in axillary lymph nodes (ALNs) after complete axillary lymph node dissection (ALND) in comparison to the preoperative status were evaluated using lymphoscintigraphy performed preoperatively and 1-6 weeks after surgery in 30 women with a new diagnosis of unilateral, invasive breast carcinoma. Analysis of lymphoscintigrams revealed that ALNs after surgery were present in 26 of 30 examined women. In comparison to preoperative status, they were visualized in the same location (12 women), in the same and additionally in different locations (9 women), or only in different locations (4 women). No lymph nodes were visualized in one woman and lymphocoele were in 4 women. Thus, after ALND, a variable number of axillary lymph nodes remain and were visualized on lymphoscintigraphy in the majority of women. The classical ALND, therefore, does not allow complete dissection and removal of axillary nodes with total disruption of axillary lymphatic pathways, accounting in part for the variable incidence and severity of lymphedema after the procedure.

Presentation of Axillary Metastases from Occult Breast Carcinoma

Institute of Scientific and Technical Information of China (English)

Xin Wang

2007-01-01

Axillary presentation from occult breast cancer is uncommon and continues to be a diagnostic and therapeutic challenge to physicians.Once the diagnosis of adenocarcinoma metastatic to an axillary lymph node has been confirmed,a preoperative workup should be done.The current experience is based on several relatively small retrospective reviews and case reports.It is difficult to determine the best management of occult breast cancer.However,treatmenl of axillary Iymph node dissection is recommended for local control and complete staging information.Treatment of breast should be a choice between breast conservation with whole-breast radiotherapy and mastectomy.Adjuvant systemic treatment should be offered.

Muscular variations during axillary dissection: A clinical study in fifty patients

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Upasna

2015-01-01

Methods: The anatomy of axilla regarding muscular variations was studied in 50 patients who had an axillary dissection for the staging and treatment of invasive primary breast cancer over one year. Results: In a period of one year, two patients (4% with axillary arch and one patient (2% with absent pectoralis major and minor muscles among fifty patients undergoing axillary surgery for breast cancer were identified. Conclusions: Axillary arch when present should always be identified and formally divided to allow adequate exposure of axillary contents, in order to achieve a complete lymphatic dissection. Complete absence of pectoralis major and minor muscles precludes the insertion of breast implants and worsens the prognosis of breast cancer.

Axillary nerve injury associated with sports.

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Lee, Sangkook; Saetia, Kriangsak; Saha, Suparna; Kline, David G; Kim, Daniel H

2011-11-01

The aim of this retrospective study was to present and investigate axillary nerve injuries associated with sports. This study retrospectively reviewed 26 axillary nerve injuries associated with sports between the years 1985 and 2010. Preoperative status of the axillary nerve was evaluated by using the Louisiana State University Health Science Center (LSUHSC) grading system published by the senior authors. Intraoperative nerve action potential recordings were performed to check nerve conduction and assess the possibility of resection. Neurolysis, suture, and nerve grafts were used for the surgical repair of the injured nerves. In 9 patients with partial loss of function and 3 with complete loss, neurolysis based on nerve action potential recordings was the primary treatment. Two patients with complete loss of function were treated with resection and suturing and 12 with resection and nerve grafting. The minimum follow-up period was 16 months (mean 20 months). The injuries were associated with the following sports: skiing (12 cases), football (5), rugby (2), baseball (2), ice hockey (2), soccer (1), weightlifting (1), and wrestling (1). Functional recovery was excellent. Neurolysis was performed in 9 cases, resulting in an average functional recovery of LSUHSC Grade 4.2. Recovery with graft repairs averaged LSUHSC Grade 3 or better in 11 of 12 cases Surgical repair can restore useful deltoid function in patients with sports-associated axillary nerve injuries, even in cases of severe stretch-contusion injury.

Correction of accessory axillary breast tissue without visible scar.

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Kim, Young Soo

2004-01-01

Various methods for correction of accessory axillary breast tissue have been proposed, including simple excision, diamond-shaped excision, a Y-V technique, and lipoplasty. We present an effective method for correction of a prominent axillary mound that combines lipoplasty with excision of accessory breast tissue along the axillary transverse line. Preoperative markings included an incision within the natural wrinkle line in the axillary fold, and demarcation of areas in which lipoplasty and excision were to be performed. After lipoplasty, deep dissection was performed to isolate and remove accessory breast tissue and excess fat tissue. A compression dressing was applied for 1 to 2 weeks postoperatively, and the patient was instructed to wear a sports bra for 1 to 2 months after removal of the dressing. We treated 7 patients using this procedure between October 1999 and March 2003. No major postoperative complications were detected and recurrence was not noted during the follow-up periods. Aesthetic results were satisfactory. We believe that a procedure that combines lipoplasty and excision provides numerous advantages as a surgical option in treating a prominent axillary mound. The main advantage is that the final scar is laid in the natural axillary fold, rendering scars less conspicuous and eliminating the need to remove excess skin. The one disadvantage was that elevation of the skin flap via small, remote incisions initially produced surgical difficulties, but these were overcome with experience.

Axillary arthrotomography of the glenoid labrum

International Nuclear Information System (INIS)

Kleinman, P.K.; Kanzaria, P.K.; Goss, T.P.; Pappas, A.M.

1984-01-01

In a study of 67 shoulders evaluated by axillary arthrotomography, tears of the glenoid labrum were accurately detected in all 26 surgically confirmed cases. One false-positive case was identified in the five patients without labral tears; there were no false-negative cases. Only 40% of the patients had clinical evidence of subluxation or dislocation. Axillary arthrotomography provides important information about the integrity of the labrum that may be helpful in planning surgery for patients without clinical subluxation or dislocation but with pain, clicking, or vague shoulder discomfort secondary to labral pathology (functional instability)

Characterization of Staphylococcus and Corynebacterium clusters in the human axillary region.

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Chris Callewaert

Full Text Available The skin microbial community is regarded as essential for human health and well-being, but likewise plays an important role in the formation of body odor in, for instance, the axillae. Few molecular-based research was done on the axillary microbiome. This study typified the axillary microbiome of a group of 53 healthy subjects. A profound view was obtained of the interpersonal, intrapersonal and temporal diversity of the human axillary microbiota. Denaturing gradient gel electrophoresis (DGGE and next generation sequencing on 16S rRNA gene region were combined and used as extent to each other. Two important clusters were characterized, where Staphylococcus and Corynebacterium species were the abundant species. Females predominantly clustered within the Staphylococcus cluster (87%, n = 17, whereas males clustered more in the Corynebacterium cluster (39%, n = 36. The axillary microbiota was unique to each individual. Left-right asymmetry occurred in about half of the human population. For the first time, an elaborate study was performed on the dynamics of the axillary microbiome. A relatively stable axillary microbiome was noticed, although a few subjects evolved towards another stable community. The deodorant usage had a proportional linear influence on the species diversity of the axillary microbiome.

Potential bud bank responses to apical meristem damage and environmental variables: matching or complementing axillary meristems?

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Klimešová, Jitka; Malíková, Lenka; Rosenthal, Jonathan; Šmilauer, Petr

2014-01-01

Soil nutrients, dormant axillary meristem availability, and competition can influence plant tolerance to damage. However, the role of potential bud banks (adventitious meristems initiated only after injury) is not known. Examining Central European field populations of 22 species of short-lived monocarpic herbs exposed to various sources of damage, we hypothesized that: (1) with increasing injury severity, the number of axillary branches would decrease, due to axillary meristem limitation, whereas the number of adventitious shoots (typically induced by severe injury) would increase; (2) favorable environmental conditions would allow intact plants to branch more, resulting in stronger axillary meristem limitation than in unfavorable conditions; and (3) consequently, adventitious sprouting would be better enabled in favorable than unfavorable conditions. We found strong support for the first hypothesis, only limited support for the second, and none for the third. Our results imply that whereas soil nutrients and competition marginally influence plant tolerance to damage, potential bud banks enable plants to overcome meristem limitation from severe damage, and therefore better tolerate it. All the significant effects were found in intraspecific comparisons, whereas interspecific differences were not found. Monocarpic plants with potential bud banks therefore represent a distinct strategy occupying a narrow environmental niche. The disturbance regime typical for this niche remains to be examined, as do the costs associated with the banks of adventitious and axillary reserve meristems.

Potential bud bank responses to apical meristem damage and environmental variables: matching or complementing axillary meristems?

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Jitka Klimešová

Full Text Available Soil nutrients, dormant axillary meristem availability, and competition can influence plant tolerance to damage. However, the role of potential bud banks (adventitious meristems initiated only after injury is not known. Examining Central European field populations of 22 species of short-lived monocarpic herbs exposed to various sources of damage, we hypothesized that: (1 with increasing injury severity, the number of axillary branches would decrease, due to axillary meristem limitation, whereas the number of adventitious shoots (typically induced by severe injury would increase; (2 favorable environmental conditions would allow intact plants to branch more, resulting in stronger axillary meristem limitation than in unfavorable conditions; and (3 consequently, adventitious sprouting would be better enabled in favorable than unfavorable conditions. We found strong support for the first hypothesis, only limited support for the second, and none for the third. Our results imply that whereas soil nutrients and competition marginally influence plant tolerance to damage, potential bud banks enable plants to overcome meristem limitation from severe damage, and therefore better tolerate it. All the significant effects were found in intraspecific comparisons, whereas interspecific differences were not found. Monocarpic plants with potential bud banks therefore represent a distinct strategy occupying a narrow environmental niche. The disturbance regime typical for this niche remains to be examined, as do the costs associated with the banks of adventitious and axillary reserve meristems.

Axillary artery injury secondary to inferior shoulder dislocation.

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Plaga, Brad R; Looby, Peter; Feldhaus, Steven J; Kreutzmann, Karl; Babb, Aaron

2010-11-01

Dislocation injuries of the glenohumeral joint are common in the general public and generally are corrected without complication. One serious complication with shoulder dislocations, or the subsequent reduction, is a lesion to the axillary artery. This specific complication is most frequently seen in the elderly population, where vascular structures have become less flexible. Also, these injuries are most common in association with anterior dislocations of the shoulder. To bring awareness to the possibility of axillary artery injury with inferior dislocation of the shoulder, the treatment options, and a review. We report a 15-year-old male athlete who inferiorly dislocated his shoulder during wrestling practice. The injury was reduced at the scene with manual traction and the patient was transferred to our clinic for evaluation. The patient was determined to have a pseudoaneurysm of the axillary artery, and the history and treatment of the illness are presented. Axillary artery injuries secondary to shoulder dislocations are rare, especially in the young athlete, and proper recognition and treatment offer patients a full recovery. Copyright © 2010. Published by Elsevier Inc.

Radiotherapy without boost in the tumor bed after conserving surgery in the treatment of early breast cancer

International Nuclear Information System (INIS)

Parvanova, V.; Pandova, V.

1998-01-01

The aim of this study is to analyse satisfactory local control and breast preservation with particular emphasis on the importance of the microscopic negative margin in patients who not receiving tumor bed boost therapy. Authors analysed 122 consecutive patients with breast cancer in pathological stages I and II, who were treated with quadrantectomy at full axillary dissection between 1992 and 1997. The median follow up was 34 months. The radiation treatment was started 60 - 80 day in 14 patients (11.5%) with high risk for metastases, because they underwent chemotherapy. The patients were treated with external beam radiation therapy on the entire breast to a mean total dose of 48.8 Gy. A boost to a tumor bed was not delivered. Only patients with follow-up period above 24 months were evaluated for the purpose of analysis of cosmetic results. Analyzed variables were: age, size, lymph node status, two-field versus three-field technique, operating scare. The major goal of breast conserving therapy is the preservation of cosmetically acceptable breast without local relapses in all patients of our study. A 43 years old patient with liver metastases and any regional and local relapses was dead 27 months after the radiotherapy. A single significant factor impairing excellent cosmetic outcome in our study is the surgical scar. The very high percent (51) of excellent cosmetic results and low percent of post radiotherapy injury is due to precise for breast conserving therapy, the prevailing number of young patients and precise CT and dosimetric planning on three level of treatment volume (author)

Impact and evaluation of the use of tri-dimensional over bi-dimensional plan for the breast and axillary lymph node irradiation with tangential fields for conservative breast cancer treatment

International Nuclear Information System (INIS)

Pellizzon, Antonio Cassio Assis; Boccaletti Karina; Belletti Fernanda

2011-01-01

A comparative study of dose distribution delivered to the anatomically defined breast, axillary levels I-III, supra clavicle nodal, cardiac and left lung volumes treated by standard tangent fields using conventional technique, planned by either two dimensional (2D) or tri-dimensional (3D) radiotherapy treatment-plan was performed to determine if the dosimetry for the breast, regional lymph nodes and normal tissues at risk can be improved. Material And Methods: Data of the charts and images of 10 consecutive patients who underwent breast-conserving surgery for left-sided breast cancer and received post-operative RT at the Department of Radiation Oncology, Hospital A.C. Camargo, Sao Paulo, Brazil were reviewed and re-planned. All sets of images used for the study were saved separately and no modification was performed to the initial programmed plan for each patient. For 2D irradiation plans, two opposed fields to treat the breast volume were used and one appositional field was used to treat the supra clavicle nodes. After 2D dosimetric planning, a second 3D treatment plan, with CT tomography at 5-mm intervals in the same position as predetermined in the 2D simulation, was used for plan dose coverage comparison. Results: The breast CTV dose coverage evaluated by the D85%, D90% and D100% presented statically significant differences favoring the 3D plan (p = 0.017; 0.011 and 0.005), with correlation indexes ranging from 42.6% to 57.2%. The same was observed for the supra clavicle nodes (p = 0.003; < 0.001 and 0.045) with correlation indexes ranging from 19.4% to 37.4%. For the axillary levels, a statistical significant difference on dose coverage was observed only for the axillary level III D100%, p 0.001 and correlation index of 72.5%. For the cardiac area there was a statistical significant difference between the maximum and median given, p 0.002 and p = 0.01, favoring the 3D plan. Conclusion: The use of 3D plan is necessary to include not only the breast but also the

Axillary Phlebography; An analysis of 33 cases of healthy person

International Nuclear Information System (INIS)

Kim, Chu Wan

1974-01-01

It has been well established that axillary phlebography is excellent method in diagnosis of the primary and secondary thrombotic conditions of axillary vein. But the evaluation of veins of axilla is often difficult due to individual variation of veins and to various methods of venography. Axillary phlebographies were made in thirty-three normal Korean adults by modified bolus technique and various measurements and consideration were done for the evaluation of normal anatomical variations. Results were as follows; 1. Axillary vein was visualized satisfactory in 32 cases among 33 cases, basilic vein in 28 cases, and cephalic vein and brachial vein in 15 cases. 2. Bifid basilic vein was observed in 4 cases and trifid basilic vein in 1 case. Anastomosis between cephalic and brachial vein was observed in 5 case. In 1 case, anastomotic site of median cubital vein with basilic vein is more proximal than usual. 3. Average diameter of axillary vein were 9 mm (7-11 mm) in male and 8 mm (5-10 mm) in female at axillary border of scapula and 14 mm (11-18 mm) in male and 13 mm (11-15 mm) in female at midportion of first rib. 4. Streaming and dilution of contrast media, and deformities by valve action were observed in many cases, which may be mistaken as abnormality

To boost or not boost in radiotherapy

International Nuclear Information System (INIS)

Maciejewski, B.; Suwinski, R.; Withers, H.R.; Fowler, J.; Fijuth, J.

2004-01-01

The aim of this paper it to analyse and discuss standard definition of the 'boost' procedure in relation to clinical results and new forms of the boost designed on physical and radiobiological bases. Seventeen sets of clinical data including over 5000 cases cancer with different tumour stages and locations and treated with various forms of 'boost' method have been subtracted from literature. Effectiveness of boost is analyzed regarding its place in combined treatment, timing and subvolume involved. Radiobiological parameter of D10 and normalization method for biologically equivalent doses and dose intensity are used to simulated cold and not subvolumes (hills and dales) and its influence of effectiveness on the boost delivery. Sequential and concomitant boost using external irradiation, although commonly used, offers LTC benefit lower than expected. Brachytherapy, intraoperative irradiation and concurrent chemotherapy boost methods appear more effective. Conformal radiotherapy, with or without dose-intensity modulation, allows heterogeneous increase in dose intensity within the target volume and can be used to integrate the 'boost dose' into baseline treatment (Simultaneous Integrated Boost and SIB). Analysis of interrelationships between boost-dose; boost volume and its timing shows that a TCP benefit from boosting can be expected when a relatively large part of the target volume is involved. Increase in boost dose above 1.2-1.3 of baseline dose using 'standard' methods does not substantially further increase the achieved TCP benefit unless hypoxic cells are a problem. Any small uncertainties in treatment planning can ruin all potential beneficial effect of the boost. For example, a 50% dose deficit in a very small (e.g. 1%) volume of target can decrease TCP to zero. Therefore boost benefits should be carefully weighed against any risk of cold spots in the target volume. Pros and cons in discussion of the role of boost in radiotherapy lead to the important

Blunt traumatic axillary artery truncation, in the absence of associated fracture.

Science.gov (United States)

Bokser, Emily; Caputo, William; Hahn, Barry; Greenstein, Josh

2018-02-01

Axillary artery injuries can be associated with both proximal humeral fractures (Naouli et al., 2016; Ng et al., 2016) [1,2] as well as shoulder dislocations (Leclerc et al., 2017; Karnes et al., 2016) [3,4]. We report a rare case of an isolated axillary artery truncation following blunt trauma without any associated fracture or dislocation. A 58-year-old male presented to the emergency department for evaluation after falling on his outstretched right arm. The patient was found to have an absent right radial pulse with decreased sensation to the right arm. Point of care ultrasound showed findings suspicious for traumatic axillary artery injury, and X-rays did not demonstrate any fracture. Computed tomography with angiography confirmed axillary artery truncation with active extravasation. The patient underwent successful vascular repair with an axillary artery bypass. Although extremity injuries are common in emergency departments, emergency physicians need to recognize the risk for vascular injuries, even without associated fracture or dislocation. Copyright © 2017 Elsevier Inc. All rights reserved.

In vitro PROLIFERATION ABILITY OF AXILLARY BUDS IN Musa spp

African Journals Online (AJOL)

AISA

The proliferation rate of Axillary and apical buds and other growth parameters ... types of buds after four to five sub cultures in all the varieties except for CRBP 39 where the axillary bud exhibits ..... propagation, conservation and exchange.

Axillary radiotherapy in conservative surgery for early-stage breast cancer (stage I and II).

Science.gov (United States)

García Novoa, Alejandra; Acea Nebril, Benigno; Díaz, Inma; Builes Ramírez, Sergio; Varela, Cristina; Cereijo, Carmen; Mosquera Oses, Joaquín; López Calviño, Beatriz; Seoane Pillado, María Teresa

2016-01-01

Several clinical studies analyze axillary treatment in women with early-stage breast cancer because of changes in the indication for axillary lymph node dissection. The aim of the study is to analyze the impact of axillary radiotherapy in disease-free and overall survival in women with early breast cancer treated with lumpectomy. Retrospective study in women with initial stages of breast carcinoma treated by lumpectomy. A comparative analysis of high-risk women with axillary lymph node involvement who received axillary radiotherapy with the group of women with low risk without radiotherapy was performed. Logistic regression was used to determine factors influencing survival and lymphedema onset. A total of 541 women were included in the study: 384 patients (71%) without axillary lymph node involvement and 157 women (29%) with 1-3 axillary lymph node involvement. Patients with axillary radiotherapy had a higher number of metastatic lymph node compared to non-irradiated (1.6±0.7 vs. 1.4±0.6, P=.02). The group of women with axillary lymph node involvement and radiotherapy showed an overall and disease-free survival at 10 years similar to that obtained in patients without irradiation (89.7% and 77.2%, respectively). 3 lymph nodes involved multiplied by more than 7 times the risk of death (HR=7.20; 95% CI: 1.36 to 38.12). The multivariate analysis showed axillary lymph node dissection as the only variable associated with the development of lymphedema. The incidence of axillary relapse on stage I and II breast cancer is rare. In these patients axillary radiotherapy does not improve overall survival, but contributes to regional control in those patients with risk factors. Copyright © 2016 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

A systematic review of microwave-based therapy for axillary hyperhidrosis.

Science.gov (United States)

Hsu, Tzu-Herng; Chen, Yu-Tsung; Tu, Yu-Kang; Li, Chien-Nien

2017-10-01

To systematically analyse the literature on the use of the microwave-based device for subdermal thermolysis of the axilla and its efficacy for the treatment of axillary hyperhidrosis. A systematic review was conducted using PubMed, Embase, SCOPUS and Cochrane databases on 2 June 2016. The inclusion criteria including: (1) studies with human subjects, (2) full-text articles published in English, (3) a microwave-based device used to treat axillary hyperhidrosis and (4) trials that precisely evaluated axillary hyperhidrosis. Exclusion criteria were the following: (1) studies that did not fit the inclusion criteria mentioned above and (2) case reports and reviews. We reviewed five clinical trials and 189 patients, all of which were published between 2012 and 2016. There was one randomized controlled trial, one retrospective study and the remainder were prospective studies. Although all of the studies were conducted with a small sample size, the results indicated that microwave-based device treatment of axillary hyperhidrosis had long-term efficacy with mild adverse effects. In addition, most patients were satisfied with the outcomes in these studies. Microwave-based device treatment may be an effective alternative treatment for axillary hyperhidrosis. However, further investigation is necessary to determine its long-term efficacy and safety.

Effect of temperature on development and growth potential of axillary buds in roses

NARCIS (Netherlands)

Marcelis-van Acker, C.A.M.

1995-01-01

The effect of temperature during axillary bud formation on axillary bud development and subsequent shoot growth was investigated. Growth potential of the axillary buds was studied either in situ, by pruning the parent shoot above the bud, or in isolation, by grafting the bud or by culturing the bud

Quark and gluon production from a boost-invariantly expanding color electric field

Science.gov (United States)

Taya, Hidetoshi

2017-07-01

Particle production from an expanding classical color electromagnetic field is extensively studied, motivated by the early stage dynamics of ultrarelativistic heavy ion collisions. We develop a formalism at one-loop order to compute the particle spectra by canonically quantizing quark, gluon, and ghost fluctuations under the presence of such an expanding classical color background field; the canonical quantization is done in the τ -η coordinates in order to take into account manifestly the expanding geometry. As a demonstration, we model the expanding classical color background field by a boost-invariantly expanding homogeneous color electric field with lifetime T , for which we obtain analytically the quark and gluon production spectra by solving the equations of motion of QCD nonperturbatively with respect to the color electric field. In this paper we study (i) the finite lifetime effect, which is found to modify significantly the particle spectra from those expected from the Schwinger formula; (ii) the difference between the quark and gluon production; and (iii) the quark mass dependence of the production spectra. Implications of these results to ultrarelativistic heavy ion collisions are also discussed.

Axillary web syndrome following sentinel node biopsy for breast cancer.

Science.gov (United States)

Nieves Maldonado, S M; Pubul Núñez, V; Argibay Vázquez, S; Macías Cortiñas, M; Ruibal Morell, Á

2016-01-01

A 49 year-old woman diagnosed with infiltrating lobular breast carcinoma, underwent a right mastectomy and sentinel node biopsy (SLNB). The resected sentinel lymph nodes were negative for malignancy, with an axillary lymphadenectomy not being performed. In the early post-operative period, the patient reported an axillary skin tension sensation, associated with a painful palpable cord. These are typical manifestations of axillary web syndrome (AWS), a poorly known axillary surgery complication, from both invasive and conservative interventions. By presenting this case we want to focus the attention on a pathological condition, for which its incidence may be underestimated by not including it in SLNB studies. It is important for nuclear medicine physicians to be aware of AWS as a more common complication than infection, seroma, or lymphoedema, and to discuss this possible event with the patient who is consenting to the procedure. Copyright © 2016 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

Energy expenditure during ambulation with ortho crutches and axillary crutches.

Science.gov (United States)

Hinton, C A; Cullen, K E

1982-06-01

Thirteen normal male college students were studied during unassisted ambulation and nonweight-bearing ambulation with Ortho crutches and axillary crutches to determine energy expenditure. Subjects walked at self-selected velocities. Energy expenditure was determined by analyzing expired air collected by a calorimeter. Heart rate was monitored by telemetry. During the first 2.5 minutes of walking, heart rate and energy expenditure were significantly greater for ambulation with axillary crutches than with Ortho crutches. After 11.5 minutes of walking, no difference in energy cost was found between crutch types; however, heart rate increased significantly (p less than .01) during ambulation with axillary crutches. Differences in energy cost and heart rate were attributed to increased upper extremity work performed when using axillary crutches. We concluded that during nonweight-bearing ambulation for short periods of time or over a short distance, the Ortho crutch is less taxing in terms of energy cost and heart rate demands.

Indications for axillary ultrasound use in breast cancer patients.

Science.gov (United States)

Joh, Jennifer E; Han, Gang; Kiluk, John V; Laronga, Christine; Khakpour, Nazanin; Lee, M Catherine

2012-12-01

Axillary ultrasound has been adopted for preoperative planning in breast cancer. Our objective was to determine features predictive of abnormal AUS and/or positive axillary node needle biopsy (NBx). Single-institution database of breast cancer patients identified patients with preoperative AUS. Patient characteristics and outcomes were correlated with AUS and NBx. Significant features were identified using univariable and multivariable analysis and correlative statistics. Three hundred thirteen breast cancers were evaluated. Abnormal AUS was demonstrated in 250 cases (80%). Node needle biopsy was performed in 247 cases (79%). Sensitivity and specificity was 93% and 48% for AUS and 86% and 100% for NBx, respectively. Palpable axillary adenopathy was significant in logistic regression model (P AUS and NBx (P AUS. Copyright © 2012 Elsevier Inc. All rights reserved.

Quality of Life in Women Undergoing Breast Irradiation in a Randomized, Controlled Clinical Trial Evaluating Different Tumor Bed Boost Fractionations

International Nuclear Information System (INIS)

Finkel, Morgan A.; Cooper, Benjamin T.; Li, Xiaochun; Fenton-Kerimian, Maria; Goldberg, Judith D.; Formenti, Silvia C.

2016-01-01

Purpose: To identify differences in breast cancer patient-reported quality of life (QOL) between 2 radiation tumor bed boost dose regimens. Methods and Materials: Four hundred patients with stage 0, I, or II breast cancer who underwent segmental mastectomy with sentinel node biopsy and/or axillary node dissection were treated with either a daily or weekly boost. Patients were treated prone to 40.5 Gy/15 fractions to the whole breast, 5 days per week. Patients were randomized to a concomitant daily boost to the tumor bed of 0.5 Gy, or a weekly boost of 2 Gy on Friday. Patients completed 6 validated QOL survey instruments at baseline, last week of treatment (3 weeks), 45-60 days from the completion of radiation treatment, and at 2-year follow-up. Results: There were no statistically significance differences in responses to the 6 QOL instruments between the daily and weekly radiation boost regimens, even after adjustment for important covariates. However, several changes in responses over time occurred in both arms, including worsening functional status, cosmetic status, and breast-specific pain at the end of treatment as compared with before and 45 to 60 days after the conclusion of treatment. Conclusions: Whole-breast, prone intensity modulated radiation has similar outcomes in QOL measures whether given with a daily or weekly boost. This trial has generated the foundation for a current study of weekly versus daily radiation boost in women with early breast cancer in which 3-dimensional conformal radiation is allowed as a prospective stratification factor.

Quality of Life in Women Undergoing Breast Irradiation in a Randomized, Controlled Clinical Trial Evaluating Different Tumor Bed Boost Fractionations

Energy Technology Data Exchange (ETDEWEB)

Finkel, Morgan A.; Cooper, Benjamin T. [Department of Radiation Oncology, New York University School of Medicine, New York, New York (United States); Li, Xiaochun [Division of Biostatistics, Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, New York (United States); Fenton-Kerimian, Maria [Department of Radiation Oncology, New York University School of Medicine, New York, New York (United States); Goldberg, Judith D. [Division of Biostatistics, Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, New York (United States); Formenti, Silvia C., E-mail: formenti@med.cornell.edu [Department of Radiation Oncology, New York University School of Medicine, New York, New York (United States)

2016-06-01

Purpose: To identify differences in breast cancer patient-reported quality of life (QOL) between 2 radiation tumor bed boost dose regimens. Methods and Materials: Four hundred patients with stage 0, I, or II breast cancer who underwent segmental mastectomy with sentinel node biopsy and/or axillary node dissection were treated with either a daily or weekly boost. Patients were treated prone to 40.5 Gy/15 fractions to the whole breast, 5 days per week. Patients were randomized to a concomitant daily boost to the tumor bed of 0.5 Gy, or a weekly boost of 2 Gy on Friday. Patients completed 6 validated QOL survey instruments at baseline, last week of treatment (3 weeks), 45-60 days from the completion of radiation treatment, and at 2-year follow-up. Results: There were no statistically significance differences in responses to the 6 QOL instruments between the daily and weekly radiation boost regimens, even after adjustment for important covariates. However, several changes in responses over time occurred in both arms, including worsening functional status, cosmetic status, and breast-specific pain at the end of treatment as compared with before and 45 to 60 days after the conclusion of treatment. Conclusions: Whole-breast, prone intensity modulated radiation has similar outcomes in QOL measures whether given with a daily or weekly boost. This trial has generated the foundation for a current study of weekly versus daily radiation boost in women with early breast cancer in which 3-dimensional conformal radiation is allowed as a prospective stratification factor.

Obesity predisposes to increased drainage following axillary node clearance: a prospective audit.

OpenAIRE

Banerjee, D.; Williams, E. V.; Ilott, J.; Monypenny, I. J.; Webster, D. J.

2001-01-01

BACKGROUND: Whilst sentinel node biopsy is being evaluated for optimising treatment of the axilla, axillary dissection remains the gold standard. Seroma formation, a common sequel to axillary dissection, has been shown to be associated with an increased incidence of wound infection, delayed healing, and lymphoedema. This study was conducted to evaluate the possible contributory role of obesity in axillary drainage following lymphatic dissection. PATIENTS AND METHODS: This study comprised a pr...

Usefulness of effective field theory for boosted Higgs production

Energy Technology Data Exchange (ETDEWEB)

Dawson, S. [Brookhaven National Lab. (BNL), Upton, NY (United States); Lewis, I. M. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Zeng, Mao [Stony Brook Univ., Stony Brook, NY (United States)

2015-04-07

The Higgs + jet channel at the LHC is sensitive to the effects of new physics both in the total rate and in the transverse momentum distribution at high _pT. We examine the production process using an effective field theory (EFT) language and discussing the possibility of determining the nature of the underlying high-scale physics from boosted Higgs production. The effects of heavy color triplet scalars and top partner fermions with TeV scale masses are considered as examples and Higgs-gluon couplings of dimension-5 and dimension-7 are included in the EFT. As a byproduct of our study, we examine the region of validity of the EFT. Dimension-7 contributions in realistic new physics models give effects in the high _pT tail of the Higgs signal which are so tiny that they are likely to be unobservable.

Primary infiltrating ductal carcinoma of the axillary breast with metastasis to the contralateral chest wall

Directory of Open Access Journals (Sweden)

Li-Min Sun

2013-06-01

Full Text Available Primary infiltrating ductal carcinoma of the axillary breast is rare and has a high frequency of lymph node (LN involvement. We report a woman with primary infiltrating ductal carcinoma arising from the right axillary breast with metastasis to the contralateral chest wall. Excisional biopsy of the left chest wall nodule and the right axillary mass was carried out and both showed invasive ductal carcinomas histologically. The lesion of the right axillary mass arose from the breast tissue, rather than the LN. Further surgery proved the right axillary LN metastasis. After further review, a primary infiltrating ductal carcinoma of the right axillary breast with metastasis to axillary LNs and contralateral chest wall was diagnosed. The patient also received chemotherapy and radiation and there was no evidence of tumor recurrence after treatment. The present report demonstrated a rare case with uncommon manifestation. Lesions of uncertain origin around the periphery of the breast should be suspected for breast carcinoma.

SOME ASPECTS OF THE ANATOMY OF AXILLARY LYMPH NODES

Directory of Open Access Journals (Sweden)

A. I. Shvedavchenko

2009-01-01

Full Text Available The paper concisely reviews the classifications of axillary lymph nodes (LN and considers various approaches to their formation. The authors identify the axillary lymph chain consisting of lateral, central, and apical groups of nodes through which lymph outflows into the overlying lymph collectors, as well as of subscapular and medial groups of nodes from where lymph makes its way into the auxil- lary lymph chain.

Cytokinins and polar transport of auxin in axillary pea buds

Directory of Open Access Journals (Sweden)

Petr Kalousek

2010-01-01

Full Text Available The influence of cytokinin on auxin transport during release of axillary buds from apical dominance was studied. Expression of auxin-carrier coding genes PsAUX1 (AUXIN RESISTANT 1 and PsPIN1 (PIN-FORMED 1 was explored in axillary buds of the 2nd node of 7-day pea plants (Pisum sativum L. cv. Vladan after decapitation or after exogenous application of benzyladenine (6-benzylaminopurine onto axillary buds of intact plants. Localization of the PsPIN1 protein, the key factor for polar transport of auxin in axillary buds, was visualised by immunohistochemistry. After exogenous application of cytokinin the expression of PsAUX1 and PsPIN1 rapidly increased with a simultaneous rapid decrease in PsDRM1 and PsAD1 expression – genes related to bud dormancy. The same changes in expression were observed after decapitation, however they were markedly slower. The PsPIN1 auxin efflux carrier in the inhibited axillary buds of intact plants was localised in a non-polar manner. After exogenous application of cytokinin gradual polarisation of the PsPIN1 protein occurred on the basal pole of polar auxin transport competent cells. Despite the fact that direct auxin application to buds of intact plants led to an increase in PsAUX1 and PsPIN1 expression, the buds remained dormant (non-growing what was accompanied by persistent expression of the dormancy markers PsDRM1 and PsAD1. The results indicate a possible effect of cytokinins on biosynthesis, and/or transport of auxin in axillary buds and they highlight the importance of auxin-cytokinin crosstalk in the regulation of bud outgrowth after breaking of apical dominance.

Partial lower axillary dissection for patients with clinically node-negative breast cancer.

Science.gov (United States)

Kodama, H; Mise, K; Kan, N

2012-01-01

To evaluate retrospectively the outcomes of partial lower axillary lymph node dissection caudal to the intercostobrachial nerve in patients with clinically node-negative (N(0)) breast cancer. Numbers of dissected and metastatic nodes, overall and disease-free survival rates, postoperative complication rates, and axillary recurrence were compared between patients who underwent breast cancer surgery with partial axillary node dissection (n = 1043) and historical controls who underwent conventional dissection (n = 1084). The 5-year overall and disease-free survival rates were 95.6% and 89.7%, and 94.9% and 88.4%, respectively, in the partial dissection and conventional dissection groups; the differences were not significant. Mean duration of surgery (41.6 min versus 60.9 min), intraoperative blood loss (28.0 ml versus 51.3 ml), volume of lymphatic drainage at 2 weeks postoperatively (488 ml versus 836 ml), and persistent arm lymphoedema (0.0% versus 11.8%) were significantly different between the partial and conventional dissection groups, respectively. Partial axillary lymph node dissection was associated with similar survival rates (but lower postoperative complication rates) compared with conventional axillary dissection and is recommended in patients with N(0) breast cancer.

Primary breast lymphoma presenting as non-healing axillary abscess.

Science.gov (United States)

Anele, Chukwuemeka; Phan, Yih Chyn; Wong, Suanne; Poddar, Anil

2015-10-07

A 67-year-old woman with non-insulin dependent diabetes mellitus with a history consistent with a right axillary abscess, presented to her general practitioner (GP). A diagnosis of folliculitis was made and the GP started a course of flucloxacillin. Despite antibiotics, the patient's symptoms worsened and the abscess increased in size. This prompted her GP to perform an incision and drainage procedure of the abscess. The practice nurse subsequently oversaw the follow-up care of the wound. Two months after the incision and drainage, and after regular wound dressing, the patient was referred to the acute surgical team with a complicated, non-healing right axillary abscess cavity and associated generalised right breast cellulitis. There was no history of breast symptoms prior to the onset of the axillary abscess. The patient underwent wound debridement, washout and application of negative pressure vacuum therapy. Biopsies revealed primary breast lymphoma (B-cell). She underwent radical chemotherapy and is currently in remission. 2015 BMJ Publishing Group Ltd.

Biomechanical study on axillary crutches during single-leg swing-through gait.

Science.gov (United States)

Goh, J C; Toh, S L; Bose, K

1986-08-01

This paper describes a kinetic and kinematic study on axillary crutches during one-leg swing-through gait. The primary objective is to evaluate the interplay of forces at the crutch and body interfaces and to relate them in the understanding of problems associated with the use of axillary crutches. Ten normal adult male subjects with simulated left leg impairment participated in the study. For data acquisition, the VICON kinematic system, a Kistler force plate and an instrumented crutch (with force transducers at the two upper struts close to the axillary bar and one near the crutch tip) were used. Results showed that the peak ground reaction force on the weight-bearing leg during lower limb stance increased by 21.6 percent bodyweight. The peak reaction force transmitted to the arm during crutch stance was 44.4 percent bodyweight. These increased loadings could be detrimental to patients with unsound weight-bearing leg and upper extremities respectively. When the crutches were used incorrectly, 34 percent bodyweight was carried by the underarm. This could cause undue pressure over the neurovascular structures at the axillary region.

Radiographer-led breast boost localisation – A service evaluation study

International Nuclear Information System (INIS)

Smith, S.; Comins, C.

2015-01-01

A radiation boost to the tumour bed as part of breast conserving therapy reduces the rate of local recurrence. Radiographer-led planning for tangential field radiotherapy has been the practice at our centre since 2007. The transition from conventional simulation to computed tomography (CT) and virtual simulation enhanced the radiographer's role in the breast planning process. Electron boost mark ups continued to be marked up freehand by doctors using available imaging to determine tumour bed. The paper reports on a service evaluation undertaken to establish a change in practice for electron breast boosts to be simulated using the virtual simulator by suitably trained radiographers. The retrospective simulation of ten patients confirmed the consistency of radiographer tumour bed localisation, followed by the prospective simulation of ten patients' boost fields. The introduction of a radiographer-led planning breast boost service has given greater autonomy and job satisfaction to individuals as well as resulting in a cost effective use of available resources. - Highlights: • A service evaluation study was undertaken to train a radiographer to perform breast boost planning. • Retrospective breast boost planning established proposed technique was workable. • Prospective planning by radiographer proved their competence. • Introduction of new technique provided job satisfaction and service improvement

FULL ELECTROMAGNETIC FEL SIMULATION VIA THE LORENTZ-BOOSTED FRAME TRANSFORMATION

International Nuclear Information System (INIS)

Fawley, William; Vay, Jean-Luc

2010-01-01

Numerical electromagnetic simulation of some systems containing charged particles with highly relativistic directed motion can by speeded up by orders of magnitude by choice of the proper Lorentz-boosted frame. A particularly good application for calculation in a boosted frame isthat of short wavelength free-electron lasers (FELs) where a high energy electron beam with small fractional energy spread interacts with a static magnetic undulator. In the optimal boost frame (i.e., the ponderomotive rest frame), the red-shifted FEL radiation and blue-shifted undulator field have identical wavelengths and the number of required longitudinal grid cells and time-steps for fully electromagnetic simulation (relative to the laboratory frame) decrease by factors of gamma 2 each. In theory, boosted frame EM codes permit direct study of FEL problems for which the eikonal approximation for propagation of the radiation field and wiggler-period-averaging for the particle-field interaction may be suspect. We have adapted the WARP code to apply this method to several electromagnetic FEL problems including spontaneous emission, strong exponential gain in a seeded, single pass amplifier configuration, and emission from e-beams in undulators with multiple harmonic components. WARP has a standard relativistic macroparticle mover and a fully 3-D electromagnetic field solver. We discuss our boosted frame results and compare with those obtained using the 'standard' eikonal FEL simulation approach.

Comparison of the effect of diode laser versus intense pulsed light in axillary hair removal.

Science.gov (United States)

Ormiga, Patricia; Ishida, Cleide Eiko; Boechat, Alvaro; Ramos-E-Silva, Marcia

2014-10-01

Devices such as diode laser and intense pulsed light (IPL) are in constant development aiming at permanent hair removal, but there are few comparative studies between these technologies. The objective was to comparatively assess axillary hair removal performed by diode laser and IPL and to obtain parameters of referred pain and evolution response for each method. A comparative prospective, double-blind, and randomized study of axillary hair removal performed by the diode laser and IPL was conducted in 21 females. Six sessions were held with application of the diode laser in one axilla and the IPL in the other, with intervals of 30 days and follow-up of 6 months after the last session. Clinical photographs and digital dermoscopy for hair counts in predefined and fixed fields of the treated areas were performed before, 2 weeks after the sixth session, and 6 months after the end of treatment. A questionnaire to assess the pain was applied. The number of hair shafts was significantly reduced with the diode laser and IPL. The diode laser was more effective, although more painful than the IPL. No serious, adverse, or permanent effects were observed with both technologies. Both diode laser and the IPL are effective, safe, and able to produce lasting results in axillary hair removal.

Comparison of rectal, tympanic membrane and axillary temperature measurement methods in dogs.

Science.gov (United States)

Lamb, V; McBrearty, A R

2013-11-30

The aim of this study was to compare axillary and tympanic membrane (TM) temperature measurements to rectal temperature in a large group of clinical canine patients. We also sought to ascertain whether certain factors affected the differences between the measurements and to compare the ease of measurement. Axillary temperatures were easy to obtain but tended to be lower than rectal readings (median difference 0.6°C). In 54.7 per cent of dogs there was a difference of >0.5°C between the two readings. Weight, coat length, body condition score and breed size were significantly associated with the difference between the rectal and axillary temperature. TM temperatures were more similar to rectal temperatures (median difference 0°C) but in 25 per cent of dogs, there was a difference of >0.5°C between rectal and TM readings. TM measurements were less well tolerated than axillary measurements. None of the factors assessed were associated with the difference between the rectal and TM temperature. As a difference of >0.5°C has previously been described as unacceptable for different methods of temperature measurement, neither axillary nor TM temperatures are interchangeable with rectal temperatures for the measurement of body temperature.

Higgs boson creation in laser-boosted lepton collisions

International Nuclear Information System (INIS)

Müller, Sarah J.; Keitel, Christoph H.; Müller, Carsten

2014-01-01

Electroweak processes in high-energy lepton collisions are considered in a situation where the incident center-of-mass energy lies below the reaction threshold, but is boosted to the required level by subsequent laser acceleration. Within the framework of laser-dressed quantum field theory, we study the laser-boosted process ℓ + ℓ − →HZ 0 in detail and specify the technical demands needed for its experimental realization. Further, we outline possible qualitative differences to field-free processes regarding the detection of the produced Higgs bosons.

Single incision thoracoscopic sympathectomy for palmar and axillary hyperhidrosis

Directory of Open Access Journals (Sweden)

Aram Baram

2014-02-01

Full Text Available Background: Primary hyperhidrosis is characterized by excessive sweating beyond physiological needs. It is a common disease (incidence 2.8% that causes intense discomfort for patients. In the last decade, advantages of Single-Incision Thoracoscopic Sympathectomy have become clear, particularly in decreasing morbidity of sympathectomy. Patients and methods: From January 2010 to December 2012, 39 patients (29 females and 10 males with primary palmar or axillary hyperhidrosis were treated by thoracoscopic sympathectomy. The age ranged from 18 to 40 years with a mean of 26.28 years. We used single incision thoracoscopic electrocoagulation through 10 mm incision for thoracic sympathetic chain (T2–T4. Results: The mean follow-up was 23.6 ± 14.2 months (range = 4–24 months. A total of 97.42% of patients were satisfied with the results. A total of 72.5% of patients had cure, one patient (2.5% and another patient (2.5% presented with recurrent axillary hyperhidrosis. The morbidity was 10.2% with no mortality. Percentage of compensatory sweating and gustatory sweating were 5.1% (p = .353 and 2.5% (p = .552, respectively. The result of sympathectomy in patients with both palmar and axillary hyperhidrosis was significantly better (17, 43.58% compared to palmar type (14, 35.89% or axillary type (7, 17.94%. Conclusion: Thoracoscopic sympathectomy is a simple, safe, and cost-effective therapy with good results and low complications.

Comparison of axillary and rectal temperatures for healthy Beagles in a temperature- and humidity-controlled environment.

Science.gov (United States)

Mathis, Justin C; Campbell, Vicki L

2015-07-01

To compare axillary and rectal temperature measurements obtained with a digital thermometer for Beagles in a temperature- and humidity-controlled environment. 26 healthy Beagles (17 sexually intact males and 9 sexually intact females). Dogs were maintained in a temperature- and humidity-controlled environment for 56 days before rectal and axillary temperatures were measured. Axillary and rectal temperatures were obtained in triplicate for each dog by use of a single commercially available manufacturer-calibrated digital thermometer. Mean rectal and axillary temperatures of Beagles maintained in a temperature- and humidity-controlled environment were significantly different, with a median ± SD difference of 1.4° ± 0.15°C (range, 0.7° to 2.1°C). Mean rectal and axillary temperatures were 38.7°C (range, 37.6° to 39.5°C) and 37.2°C (range, 36.6° to 38.3°C), respectively. Results of this study indicated that the historical reference of a 0.55°C gradient between rectal and axillary temperatures that has been clinically used for veterinary patients was inaccurate for healthy Beagles in a temperature- and humidity-controlled environment. Rectal and axillary temperatures can be measured in veterinary patients. Reliable interpretation of axillary temperatures may accommodate patient comfort and reduce patient anxiety when serial measurement of temperatures is necessary. Further clinical studies will be needed.

An imaging evaluation of the simultaneously integrated boost breast radiotherapy technique

Energy Technology Data Exchange (ETDEWEB)

Turley, Jessica; Claridge Mackonis, Elizabeth [Department of Radiation Oncology, Royal Prince Alfred Hospital, Camperdown, New South Wales (Australia)

2015-09-15

To evaluate in-field megavoltage (MV) imaging of simultaneously integrated boost (SIB) breast fields to determine its feasibility in treatment verification for the SIB breast radiotherapy technique, and to assess whether the current-imaging protocol and treatment margins are sufficient. For nine patients undergoing SIB breast radiotherapy, in-field MV images of the SIB fields were acquired on days that regular treatment verification imaging was performed. The in-field images were matched offline according to the scar wire on digitally reconstructed radiographs. The offline image correction results were then applied to a margin recipe formula to calculate safe margins that account for random and systematic uncertainties in the position of the boost volume when an offline correction protocol has been applied. After offline assessment of the acquired images, 96% were within the tolerance set in the current department-imaging protocol. Retrospectively performing the maximum position deviations on the Eclipse™ treatment planning system demonstrated that the clinical target volume (CTV) boost received a minimum dose difference of 0.4% and a maximum dose difference of 1.4% less than planned. Furthermore, applying our results to the Van Herk margin formula to ensure that 90% of patients receive 95% of the prescribed dose, the calculated CTV margins were comparable to the current departmental procedure used. Based on the in-field boost images acquired and the feasible application of these results to the margin formula the current CTV-planning target volume margins used are appropriate for the accurate treatment of the SIB boost volume without additional imaging.

An imaging evaluation of the simultaneously integrated boost breast radiotherapy technique

International Nuclear Information System (INIS)

Turley, Jessica; Claridge Mackonis, Elizabeth

2015-01-01

To evaluate in-field megavoltage (MV) imaging of simultaneously integrated boost (SIB) breast fields to determine its feasibility in treatment verification for the SIB breast radiotherapy technique, and to assess whether the current-imaging protocol and treatment margins are sufficient. For nine patients undergoing SIB breast radiotherapy, in-field MV images of the SIB fields were acquired on days that regular treatment verification imaging was performed. The in-field images were matched offline according to the scar wire on digitally reconstructed radiographs. The offline image correction results were then applied to a margin recipe formula to calculate safe margins that account for random and systematic uncertainties in the position of the boost volume when an offline correction protocol has been applied. After offline assessment of the acquired images, 96% were within the tolerance set in the current department-imaging protocol. Retrospectively performing the maximum position deviations on the Eclipse™ treatment planning system demonstrated that the clinical target volume (CTV) boost received a minimum dose difference of 0.4% and a maximum dose difference of 1.4% less than planned. Furthermore, applying our results to the Van Herk margin formula to ensure that 90% of patients receive 95% of the prescribed dose, the calculated CTV margins were comparable to the current departmental procedure used. Based on the in-field boost images acquired and the feasible application of these results to the margin formula the current CTV-planning target volume margins used are appropriate for the accurate treatment of the SIB boost volume without additional imaging

Value of FNAC in abnormal axillary lymph nodes with non specific mammograms

Directory of Open Access Journals (Sweden)

Rania S.M. Ibrahim

2018-06-01

Conclusions: FNAC was a good cytological predictor in the majority of patients with abnormal lymph nodes and nonspecific mammography. FNAC is cost effective in assessing axillary lymph node status especially in limited resource setting like in our developing country. FNAC is preferred diagnostic tool in all cases of abnormal axillary lymph adenopathy.

Axillary Lymph Node Evaluation Utilizing Convolutional Neural Networks Using MRI Dataset.

Science.gov (United States)

Ha, Richard; Chang, Peter; Karcich, Jenika; Mutasa, Simukayi; Fardanesh, Reza; Wynn, Ralph T; Liu, Michael Z; Jambawalikar, Sachin

2018-04-25

The aim of this study is to evaluate the role of convolutional neural network (CNN) in predicting axillary lymph node metastasis, using a breast MRI dataset. An institutional review board (IRB)-approved retrospective review of our database from 1/2013 to 6/2016 identified 275 axillary lymph nodes for this study. Biopsy-proven 133 metastatic axillary lymph nodes and 142 negative control lymph nodes were identified based on benign biopsies (100) and from healthy MRI screening patients (42) with at least 3 years of negative follow-up. For each breast MRI, axillary lymph node was identified on first T1 post contrast dynamic images and underwent 3D segmentation using an open source software platform 3D Slicer. A 32 × 32 patch was then extracted from the center slice of the segmented tumor data. A CNN was designed for lymph node prediction based on each of these cropped images. The CNN consisted of seven convolutional layers and max-pooling layers with 50% dropout applied in the linear layer. In addition, data augmentation and L2 regularization were performed to limit overfitting. Training was implemented using the Adam optimizer, an algorithm for first-order gradient-based optimization of stochastic objective functions, based on adaptive estimates of lower-order moments. Code for this study was written in Python using the TensorFlow module (1.0.0). Experiments and CNN training were done on a Linux workstation with NVIDIA GTX 1070 Pascal GPU. Two class axillary lymph node metastasis prediction models were evaluated. For each lymph node, a final softmax score threshold of 0.5 was used for classification. Based on this, CNN achieved a mean five-fold cross-validation accuracy of 84.3%. It is feasible for current deep CNN architectures to be trained to predict likelihood of axillary lymph node metastasis. Larger dataset will likely improve our prediction model and can potentially be a non-invasive alternative to core needle biopsy and even sentinel lymph node

Three-level boost converter with zero voltage transition

Directory of Open Access Journals (Sweden)

Kuo-Ing Hwu

2017-06-01

Full Text Available As compared with the traditional boost converter, the three-level boost converter possesses several advantages, such as lower switch voltage stresses and lower inductor current ripple. To improve the efficiency, this paper proposes a zero voltage transition (ZVT three-level boost converter. With the proposed ZVT circuit, the switches can achieve soft switching. Moreover, by using the voltage balance control, the output voltage can be equally across the output capacitors. In this study, the effectiveness of the proposed topology is verified by the experimental results based on the field-programmable gate array control.

Rapid on-site evaluation of axillary fine-needle aspiration cytology in breast cancer.

LENUS (Irish Health Repository)

O'Leary, D P

2012-06-01

Axillary ultrasonography (AUS) and fine-needle aspiration cytology (FNAC) can establish axillary lymph node status before surgery, although this technique is hampered by poor adequacy rates. To achieve consistently high rates of FNAC adequacy, rapid on-site evaluation (ROSE) of FNAC samples was introduced.

Axillary iodine-131 accumulation due to perspiration

International Nuclear Information System (INIS)

Camponovo, E.J.; Goyer, P.F.; Silverman, E.D.; Kistler, A.M.; Yudt, W.M.

1989-01-01

A case of spurious axillary uptake of I-131 proven to be caused by perspiration is presented. False-positive localizations of radioiodine, both pathologic and physiologic, are reviewed to avoid confusion of these entities with functioning thyroid carcinoma metastases

Self-taught axillary vein access without venography for pacemaker implantation: prospective randomized comparison with the cephalic vein access.

Science.gov (United States)

Squara, Fabien; Tomi, Julien; Scarlatti, Didier; Theodore, Guillaume; Moceri, Pamela; Ferrari, Emile

2017-12-01

Axillary vein access for pacemaker implantation is uncommon in many centres because of the lack of training in this technique. We assessed whether the introduction of the axillary vein technique was safe and efficient as compared with cephalic vein access, in a centre where no operators had any previous experience in axillary vein puncture. Patients undergoing pacemaker implantation were randomized to axillary or cephalic vein access. All three operators had no experience nor training in axillary vein puncture, and self-learned the technique by reading a published review. Axillary vein puncture was fluoroscopy-guided without contrast venography. Cephalic access was performed by dissection of delto-pectoral groove. Venous access success, venous access duration (from skin incision to guidewire or lead in superior vena cava), procedure duration, X-ray exposure, and peri-procedural (1 month) complications were recorded. results We randomized 74 consecutive patients to axillary (n = 37) or cephalic vein access (n = 37). Axillary vein was successfully accessed in 30/37 (81.1%) patients vs. 28/37 (75.7%) of cephalic veins (P = 0.57). Venous access time was shorter in axillary group than in cephalic group [5.7 (4.4-8.3) vs. 12.2 (10.5-14.8) min, P < 0.001], as well as procedure duration [34.8 (30.6-38.4) vs. 42.0 (39.1-46.6) min, P = 0.043]. X-ray exposure and peri-procedural overall complications were comparable in both groups. Axillary puncture was safe and faster than cephalic access even for the five first procedures performed by each operator. Self-taught axillary vein puncture for pacemaker implantation seems immediately safe and faster than cephalic vein access, when performed by electrophysiologists trained to pacemaker implantation but not to axillary vein puncture. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For Permissions, please email: journals.permissions@oup.com.

Improving bladder cancer treatment with radiotherapy using separate intensity modulated radiotherapy plans for boost and elective fields

Energy Technology Data Exchange (ETDEWEB)

Van Rooijen, D.; Van de Kamer, J.; Hulshof, M.; Koning, C.; Bel, A. [Department of Radiation Oncology, Academic Medical Center, Amsterdam (Netherlands)

2010-06-01

The aim of this study is to investigate to what extent IMRT can decrease the dose to the organs at risk in bladder cancer treatment compared with conformal treatment while making separate treatment plans for the elective field and the boost. Special attention is paid to sparing small intestines. Twenty patients who were treated with the field-in-field technique (FiF) were re-planned with intensity modulated radiotherapy (IMRT) using five and seven beams, respectively. Separate treatment plans were made for the elective field (including the pelvic lymph nodes) and the boost, which enables position correction for bone and tumour separately. The prescribed dose was 40 Gy to the elective field and 55 or 60 Gy to the planning target volume (PTV). For bladder and rectum, V{sub 45}Gy and V{sub 55}Gy were compared, and for small intestines, V{sub 25}Gy and V{sub 40}Gy. The dose distribution with IMRT conformed better to the shape of the target. There was no significant difference between the techniques in dose to the healthy bladder. The median V{sub 40}Gy of the small intestines decreased from 114 to 66 cc (P = 0.001) with five beam IMRT, and to 55 cc (P = 0.001) with seven beam IMRT compared with FiF. V{sub 45}Gy for rectum decreased from 34.2% to 17.5% (P = 0.004) for both five and seven beam plans, while V{sub 55}Gy for rectum remained the same. With IMRT, a statistically significant dose decrease to the small intestines can be achieved while covering both tumour and elective PTV adequately.

Improving bladder cancer treatment with radiotherapy using separate intensity modulated radiotherapy plans for boost and elective fields

International Nuclear Information System (INIS)

Van Rooijen, D.; Van de Kamer, J.; Hulshof, M.; Koning, C.; Bel, A.

2010-01-01

The aim of this study is to investigate to what extent IMRT can decrease the dose to the organs at risk in bladder cancer treatment compared with conformal treatment while making separate treatment plans for the elective field and the boost. Special attention is paid to sparing small intestines. Twenty patients who were treated with the field-in-field technique (FiF) were re-planned with intensity modulated radiotherapy (IMRT) using five and seven beams, respectively. Separate treatment plans were made for the elective field (including the pelvic lymph nodes) and the boost, which enables position correction for bone and tumour separately. The prescribed dose was 40 Gy to the elective field and 55 or 60 Gy to the planning target volume (PTV). For bladder and rectum, V 45 Gy and V 55 Gy were compared, and for small intestines, V 25 Gy and V 40 Gy. The dose distribution with IMRT conformed better to the shape of the target. There was no significant difference between the techniques in dose to the healthy bladder. The median V 40 Gy of the small intestines decreased from 114 to 66 cc (P = 0.001) with five beam IMRT, and to 55 cc (P = 0.001) with seven beam IMRT compared with FiF. V 45 Gy for rectum decreased from 34.2% to 17.5% (P = 0.004) for both five and seven beam plans, while V 55 Gy for rectum remained the same. With IMRT, a statistically significant dose decrease to the small intestines can be achieved while covering both tumour and elective PTV adequately.

Pretreatment axillary ultrasonography and core biopsy in patients with suspected breast cancer: Diagnostic accuracy and impact on management

Energy Technology Data Exchange (ETDEWEB)

Garcia-Ortega, Maria Jose, E-mail: rserranogan@telefonica.net [Breast Imaging Center, Radiology Department, Hospital Universitario Reina Sofia, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain); Alvarez Benito, Marina, E-mail: marinaalvarezbenito@telefonica.net [Breast Imaging Center, Radiology Department, Hospital Universitario Reina Sofia, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain); Fuentes Vahamonde, Elena, E-mail: elena.fuentes.sspa@juntadeandalucia.es [Pathology Department, Hospital Universitario Reina Sofia, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain); Rioja Torres, Pilar, E-mail: priojat@yahoo.es [Clinical Management Unit, Department of General and Digestive Surgery, Hospital Universitario Reina Sofia, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain); Benitez Velasco, Ana, E-mail: abvelazco@yahoo.es [Nuclear Medicine Department, Hospital Universitario Reina Sofia, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain); Martinez Paredes, Maria, E-mail: mariaparedes@uco.es [Radiology and Physical Medicine Area, University of Cordoba Medical School, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain)

2011-07-15

Preoperative diagnosis of axillary metastases in breast cancer patients enables treatment planning. We aimed to evaluate the diagnostic accuracy of axillary ultrasonography and percutaneous biopsy, both alone and in combination, in detecting axillary metastases in patients with breast cancer and to assess the impact of these techniques on the patients' management. Materials and methods: Retrospective study of consecutive patients with suspected breast cancer examined between October 2006 and December 2008. The diagnosis of a primary tumor was histologically confirmed in all patients. All patients underwent axillary ultrasonography and percutaneous core biopsy (14G) of suspicious lymph nodes. We evaluated the morphological characteristics of the lymph nodes by ultrasonography. We calculated the diagnostic accuracy of ultrasonography and of core biopsy, and assessed the impact of these techniques on patients' treatment. Results: We evaluated 675 axillary regions and performed 291 core biopsies of axillary lymph nodes in 662 patients. In 650 patients, breast cancer was histologically confirmed and in 12 patients malignant tumors in other locations were confirmed. The sensitivity and specificity of axillary ultrasonography were 63.2% and 88.7%, respectively. The absence of a fatty hilum within the lymph node was the ultrasonographic finding with the highest positive predictive value for malignancy (93.1%). The sensitivity and specificity of axillary core biopsy were 69.1% and 100%, respectively. Sentinel lymph node biopsy was avoided in 33% of initial candidates and immediate breast reconstruction was undertaken in 35.1% of the patients with mastectomy and negative axillary core biopsy. Conclusions: Ultrasonography and axillary core biopsy enable adequate pretreatment staging in patients with breast cancer and has a positive impact on their management.

Bilateral axillary artery aneurysms after Bentall procedure in Marfan syndrome.

Science.gov (United States)

Haruki, Takashi; Ito, Hiroshi; Sakata, Kensuke; Kobayashi, Yurio

2015-11-01

A man with Marfan syndrome underwent a Bentall procedure for annuloaortic ectasia and severe aortic regurgitation at 43 years of age. Twenty-eight years after the Bentall procedure, he developed bilateral axillary artery aneurysms (length × diameter: right: 80 × 39 mm; left: 103 × 45 mm). Aneurysmectomy and reconstruction of the axillary artery were performed using an artificial vascular graft. Histological examination revealed cystic medial necrosis. The postoperative course was uneventful, but long-term follow-up is necessary. © The Author(s) 2014.

Ontogeny of axillary buds and shoots in roses: Leaf initiation and pith development.

NARCIS (Netherlands)

Marcelis-van Acker, C.A.M.

1994-01-01

The ontogeny of an axillary bud (in the middle region of a shoot) from initiation up to flowering of the subsequent shoot was studied. The first secondary buds appeared in the axillary bud (primary bud) when the leaf subtending the primary bud unfolded. By that time, the primary bud contained seven

Ultrasound-guided axillary nerve block for ED incision and drainage of deltoid abscess.

Science.gov (United States)

Lyons, Claire; Herring, Andrew A

2017-07-01

Deltoid abscesses are common and painful, often a consequence of injection drug use and seen frequently in emergency departments (EDs). The required incision and drainage can be completed successfully with effective pain relief using a peripheral nerve block. The brachial plexus nerve block works well, however it is technically complex with a low, but potentially serious, risk of complications such as phrenic nerve paralysis. Selective blockade of the axillary nerve eliminates the risks associated with a brachial plexus block, while providing more specific anesthesia for the deltoid region. Our initial experience suggests that the axillary nerve block (ANB) is a technically simple, safe, and effective way to manage the pain of deltoid abscesses and the necessary incision and drainage (I&D). The block involves using ultrasound guidance to inject a 20mL bolus of local anesthetic into the quadrangular space surrounding the axillary nerve (inferior to the posterolateral aspect of the acromion, near the overlap of the long head of triceps brachii and teres minor). Once injected the local will anesthetize the axillary nerve resulting in analgesia of the cutaneous area of the lateral shoulder and the deeper tissues including the deltoid muscle. Further research will clarify questions about the volume and concentration of local anesthetic, the role of injected adjuncts, and expected duration of analgesia and anesthesia. Herein we present a description of an axillary nerve block successfully used for deltoid abscess I&D in the ED. Copyright © 2017 Elsevier Inc. All rights reserved.

Ultrasound-guided core biopsy: an effective method of detecting axillary nodal metastases.

LENUS (Irish Health Repository)

Solon, Jacqueline G

2012-02-01

BACKGROUND: Axillary nodal status is an important prognostic predictor in patients with breast cancer. This study evaluated the sensitivity and specificity of ultrasound-guided core biopsy (Ax US-CB) at detecting axillary nodal metastases in patients with primary breast cancer, thereby determining how often sentinel lymph node biopsy could be avoided in node positive patients. STUDY DESIGN: Records of patients presenting to a breast unit between January 2007 and June 2010 were reviewed retrospectively. Patients who underwent axillary ultrasonography with or without preoperative core biopsy were identified. Sensitivity, specificity, positive predictive value, and negative predictive value for ultrasonography and percutaneous biopsy were evaluated. RESULTS: Records of 718 patients were reviewed, with 445 fulfilling inclusion criteria. Forty-seven percent (n = 210\\/445) had nodal metastases, with 110 detected by Ax US-CB (sensitivity 52.4%, specificity 100%, positive predictive value 100%, negative predictive value 70.1%). Axillary ultrasonography without biopsy had sensitivity and specificity of 54.3% and 97%, respectively. Lymphovascular invasion was an independent predictor of nodal metastases (sensitivity 60.8%, specificity 80%). Ultrasound-guided core biopsy detected more than half of all nodal metastases, sparing more than one-quarter of all breast cancer patients an unnecessary sentinel lymph node biopsy. CONCLUSIONS: Axillary ultrasonography, when combined with core biopsy, is a valuable component of the management of patients with primary breast cancer. Its ability to definitively identify nodal metastases before surgical intervention can greatly facilitate a patient\\'s preoperative integrated treatment plan. In this regard, we believe our study adds considerably to the increasing data, which indicate the benefit of Ax US-CB in the preoperative detection of nodal metastases.

Sentinel node detection in pre-operative axillary staging.

Science.gov (United States)

Trifirò, Giuseppe; Viale, Giuseppe; Gentilini, Oreste; Travaini, Laura Lavinia; Paganelli, Giovanni

2004-06-01

The concept of sentinel lymph node biopsy in breast cancer surgery is based on the fact that the tumour drains in a logical way via the lymphatic system, from the first to upper levels. Since axillary node dissection does not improve the prognosis of patients with breast cancer, sentinel lymph node biopsy might replace complete axillary dissection for staging of the axilla in clinically N0 patients. Sentinel lymph node biopsy would represent a significant advantage as a minimally invasive procedure, considering that about 70% of patients are found to be free from metastatic disease, yet axillary node dissection can lead to significant morbidity. Subdermal or peritumoural injection of small aliquots (and very low activity) of radiotracer is preferred to intratumoural administration, and (99m)Tc-labelled colloids with most of the particles in the 100-200 nm size range would be ideal for radioguided sentinel node biopsy in breast cancer. The success rate of radioguidance in localising the sentinel lymph node in breast cancer surgery is about 97% in institutions where a high number of procedures are performed, and the success rate of lymphoscintigraphy in sentinel node detection is about 100%. The sentinel lymph node should be processed for intraoperative frozen section examination in its entirety, based on conventional histopathology and, when necessary, immune staining with anti-cytokeratin antibody. Nowadays, lymphoscintigraphy is a useful procedure in patients with different clinical evidence of breast cancer.

A comparative study of thoracoscopic sympathicotomy versus local surgical treatment for axillary hyperhidrosis

DEFF Research Database (Denmark)

Heidemann, Erik; Licht, Peter B

2013-01-01

Axillary hyperhidrosis affects approximately 1.4% of the population. Medical management is often frustrating, and the response generally transient. Surgical methods include thoracoscopic sympathectomy or sympathicotomy and local axillary surgery such as suction-curettage or en-bloc skin resection....... Many case series with retrospective follow-up are available in the literature, but no comparative studies between surgical techniques have been published....

Nipple adenoma arising from axillary accessory breast: a case report

Directory of Open Access Journals (Sweden)

Shioi Yoshihiro

2012-11-01

Full Text Available Abstract Nipple adenoma is a relatively rare benign breast neoplasm, and cases of the disease arising from the axillary accessory breast have very seldom been reported in the English literature. We report a case of nipple adenoma arising from axillary accessory breast including clinical and pathological findings. An 82-year-old woman presented with the complaint of a small painful mass in the right axilla. Physical examination confirmed a well-defined eczematous crusted mass that was 8 mm in size. The diagnosis of nipple adenoma was made from an excisional specimen on the basis of characteristic histological findings. Microscopic structural features included a compact proliferation of small tubules lined by epithelial and myoepithelial cells, and the merging of glandular epithelial cells of the adenoma into squamous epithelial cells in the superficial epidermal layer. Because clinically nipple adenoma may resemble Paget’s disease and pathologically can be misinterpreted as tubular carcinoma, the correct identification of nipple adenoma is an important factor in the differential diagnosis for axillary tumor neoplasms. Virtual slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1186821489769063

[Comparison of body temperatures in children measured using 3 different thermometers: tympanic, skin and digital axillary].

Science.gov (United States)

Padilla-Raygoza, Nicolás; Ruiz-Paloalto, M Laura; Díaz-Guerrero, Rosalina; Olvera-Villanueva, Georgina; Maldonado, Angélica; Raygoza-Mendoza, María Del Pilar

2014-01-01

To compare body temperature measurements using tympanic, skin and digital axillary thermometers. Hospitalized or outpatient children from the General Hospital Celaya, ISSSTE Hospital Clinic and General Hospital No. 4 IMSS, and the pediatric private service in Celaya, Guanajuato, from 1 day of life until 16 years old, were recruited over a one month period, after their parents signed the consent form. The order of each institution was selected by simple randomization. Body temperatures were measured in triplicate using tympanic, skin and digital axillary thermometers. The sample consisted of 554 children. The Pearson r between the tympanic and digital axillary thermometers was 0.57 to 0.65, with a positive linear relationship (P<.05); between the skin and the digital axillary thermometers, it was between 0.47 and 0.52 with a positive linearrelationship (P<.05). The intra-observer Kappa for the tympanic thermometer was 0.86, and for the inter-observer was 0.77; for the skin thermometer it was 0.82 and 0.67, respectively, and for the digital axillary thermometer it was 0.86 for intra-observer reliability and 0.78 for inter -observer reliability. Tympanic and axillary thermometers showed better precision in measuring the body temperature in children than skin thermometers. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Definition of postlumpectomy tumor bed for radiotherapy boost field planning: CT versus surgical clips

International Nuclear Information System (INIS)

Goldberg, Hadassah; Prosnitz, Robert G.; Olson, John A.; Marks, Lawrence B.

2005-01-01

Purpose: To compare the location and extent of the tumor bed as defined by surgical clips and computed tomography (CT) scans, after lumpectomy, for electron boost planning as part of breast radiotherapy. Methods and Materials: Planning CT images of 31 operated breasts in 30 patients who underwent lumpectomy were reviewed. One or more clips were placed in the lumpectomy cavity. Serial CT images were used to measure the depth and transverse and longitudinal dimensions. The area and geometric center of the tumor bed were defined by the clips and CT. Results: The CT and clip measurements were identical for the maximal tumor depth in 27 of 30 patients. The CT bed extended beyond the clips by 0-7 mm medially in the transverse/longitudinal extent (multiclip patients). The median distance between the geometric centers in the coronal plane for the tumor bed center was larger for patients with single clips than for those with multiple clips (p 2 . The CT bed was more readily visible in patients with a shorter interval between surgery and radiotherapy. Conclusion: The maximal depth of the tumor bed was similar using the two methods. The extent and centers of the clip-and CT-determined beds differed significantly. This may indicate an underestimation of the tumor bed as defined by clips only and justifies integration of CT information in boost field planning

Axillary lymph nodes siliconoma in a woman with intracapsular implant rupture

International Nuclear Information System (INIS)

Plachkov, I.; Cvetankov, K.; Hadjidekov, G.

2013-01-01

Full text: Introduction: Siliconoma, or silicone granuloma is the migration of silicon particles in the axillary lymph nodes, muscle and other non- ruptured or intact silicone implant. The latter is a relatively rare finding, and usually occurs in patients with extracapsular rupture of silicone prosthesis and has a typical ultrasound image. We present a case of a young woman with bilateral silicone prostheses placed 5 years ago, where in the right axilla are enlarged, structurally altered lymph nodes in the clinical and ultrasonography studies. Subsequent magnetic resonance examination shows intracapsular rupture ipsilateral silicone prosthesis and migration of silicon particles in the axillary lymph nodes. What you will learn: In this case we present twenty-three year old woman who reported pain and ‘swelling’ in the right axilla. The patient is with bilateral silicone prosthesis, she is not febrile and not reported other illness. After physical examination enlarged and tender lymph nodes in the right axilla was found. Several structurally altered and enlarged lymph nodes were visualized by ultrasound. These lymph nodes are hypoechogenic with obliterated fatty hilus. Due to the suspicion of silicone ‘extravasation’ in axillary lymph nodes, a magnetic resonance study of both mammary glands was performed. The images show intracapsular rupture of the right prosthesis without reliable data on silicone gel outside the fibrous capsule. Discussion: Siliconoma is a complication after plastic surgery of the breast and can affect both the axillary lymph nodes, and other lymphatic chains and also muscle and lung. Most frequently it occurs at damage of the extracapsular silicone prostheses. More rarely siliconoma occurs in siliconoma intracapsular damage, as in the presented case or in a silicone gel microbleed. Conclusion: The presence of siliconoma in axillary lymph nodes is relatively rare complication in plastic surgery of the breast. Methods of imaging diagnostic

Axillary fine needle aspiration cytology for pre-operative staging of patients with screen-detected invasive breast carcinoma.

LENUS (Irish Health Repository)

Hayes, Brian D

2012-02-01

INTRODUCTION: Fine needle aspiration cytology (FNAC) of radiologically abnormal axillary lymph nodes in patients with breast cancer can identify patients suitable for primary axillary clearance (AC) rather than sentinel node biopsy, enabling surgical axillary staging by a single operation. This study assessed the accuracy of FNAC in predicting positive axillary lymph nodes. METHODS: 161 patients with screen-detected invasive carcinoma and who had pre-operative FNAC of a radiologically abnormal axillary lymph node were identified from two screening units, The axillary FNAC reports were correlated with sentinel node biopsy and AC reports, and sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were calculated. RESULTS: FNAC had a moderate sensitivity (66.3%) and NPV (71.8%), and a high specificity (98.7%) and PPV (98.3%). Most patients (86%) had a single axillary operation. The sensitivity was highest in grade 3 (81.8%) and ductal type (77.8%) tumours. The sensitivity was lower in tumours of special type (34.8%), grade 1 tumours (50%) and those without lymphovascular invasion (LVI) (55.9%). The NPV was highest in pT1 (86.7%) and in grade 1 (84.5%) tumours, and lowest (44%) in tumours with LVI. The PPV was 100% in grade 1 and 3 tumours, stage pT2 and pT3 tumours and those without LVI, and was high (>96%) in all other groups. In lymph-node-positive patients, the mean number of lymph nodes involved was higher in the case of a positive (6.4) than negative FNAC (4.4). CONCLUSIONS: FNAC of ultrasonically abnormal axillary lymph nodes achieved surgical staging by a single operation in most patients with screen-detected invasive breast carcinoma, with moderate sensitivity and high specificity.

Development and growth potential of axillary buds in roses as affected by bud age.

NARCIS (Netherlands)

Marcelis-van Acker, C.A.M.

1994-01-01

The effect of axillary bud age on the development and potential for growth of the bud into a shoot was studied in roses. Age of the buds occupying a similar position on the plant varied from 'subtending leaf just unfolded' up to 1 year later. With increasing age of the axillary bud its dry mass,

Multi-detector row CT in the assessment of axillary lymph node metastasis in breast cancer

International Nuclear Information System (INIS)

Murakami, Shogo

2003-01-01

The purpose of this study is to evaluate the diagnostic capability instead of clinical efficacy of multi-detector row CT (MDCT) in the assessment of axillary lymph node metastasis in breast cancer. MDCT was performed in 63 patients with breast cancer, and multiplanar reformation (MPR) and volume rendering (VR) images were reconstructed for the evaluation of bilateral axillary lymph nodes. Two hundred sixty eight lymph nodes were depicted with MDCT, and correlation with pathological findings was performed. The short axis length of lymph node was measured on MPR image, and the shape of the nodes was analyzed with the pathological results statistically. The diagnostic criteria on size and shape of lymph node metastasis were discussed Dynamic study with contrast media was also performed, and the CT value ratios (CTVR) of the lymph nodes and breast tumors were calculated. No relevance of axillary lymph node metastasis was noted to the pathological types of breast cancer. The average short axis length of the ipsilateral axillary nodes was 8.9 mm±3.8 (SD) while that of the contralateral nodes was 4.9 mm±1.1 (SD) showing significant difference. More than 6.5 mm in short length of the lymph node was thought to be an effective criterion for positive metastasis, and its sensitivity was 96%. Soybean-shape lymph node was statistically common in metastasis, while non-metastatic nodes were commonly demonstrated as letter ''c'' shape or ring-like shape. Statistical relevance was obtained between the CTVR of axillary lymph nodes and that of breast tumors, suggesting clinical usefulness of dynamic study using contrast media in the evaluation of lymph node metastasis. With MPR and VR images using MDCT, more accurate morphological evaluation of axillary lymph nodes was possible. When soybean-shape node with more than 6.5 mm in short axis is depicted in the axillar region on MDCT metastasis should be the consideration. Comparison with the contralateral side as a control in coronal

Sentinel node biopsy before neoadjuvant chemotherapy spares breast cancer patients axillary lymph node dissection.

Science.gov (United States)

van Rijk, Maartje C; Nieweg, Omgo E; Rutgers, Emiel J T; Oldenburg, Hester S A; Olmos, Renato Valdés; Hoefnagel, Cornelis A; Kroon, Bin B R

2006-04-01

Neoadjuvant chemotherapy in breast cancer patients is a valuable method to determine the efficacy of chemotherapy and potentially downsize the primary tumor, which facilitates breast-conserving therapy. In 18 studies published about sentinel node biopsy after neoadjuvant chemotherapy, the sentinel node was identified in on average 89%, and the false-negative rate was on average 10%. Because of these mediocre results, no author dares to omit axillary clearance just yet. In our institute, sentinel lymph node biopsy is performed before neoadjuvant chemotherapy. The aim of this study was to evaluate our experience with this approach. Sentinel node biopsy was performed before neoadjuvant chemotherapy in 25 T2N0 patients by using lymphoscintigraphy, a gamma ray detection probe, and patent blue dye. Axillary lymph node dissection was performed after chemotherapy if the sentinel node contained metastases. Ten patients had a tumor-positive axillary sentinel node, and one patient had an involved lateral intramammary node. Four patients had additional involved nodes in the completion lymph node dissection specimen. The other 14 patients (56%) had a tumor-negative sentinel node and did not undergo axillary lymph node dissection. No recurrences have been observed after a median follow-up of 18 months. Fourteen (56%) of the 25 patients were spared axillary lymph node dissection when the sentinel node was found to be disease free. Performing sentinel node biopsy before neoadjuvant chemotherapy seems successful and reliable in patients with T2N0 breast cancer.

Predicting axillary lymph node metastasis from kinetic statistics of DCE-MRI breast images

Science.gov (United States)

Ashraf, Ahmed B.; Lin, Lilie; Gavenonis, Sara C.; Mies, Carolyn; Xanthopoulos, Eric; Kontos, Despina

2012-03-01

The presence of axillary lymph node metastases is the most important prognostic factor in breast cancer and can influence the selection of adjuvant therapy, both chemotherapy and radiotherapy. In this work we present a set of kinetic statistics derived from DCE-MRI for predicting axillary node status. Breast DCE-MRI images from 69 women with known nodal status were analyzed retrospectively under HIPAA and IRB approval. Axillary lymph nodes were positive in 12 patients while 57 patients had no axillary lymph node involvement. Kinetic curves for each pixel were computed and a pixel-wise map of time-to-peak (TTP) was obtained. Pixels were first partitioned according to the similarity of their kinetic behavior, based on TTP values. For every kinetic curve, the following pixel-wise features were computed: peak enhancement (PE), wash-in-slope (WIS), wash-out-slope (WOS). Partition-wise statistics for every feature map were calculated, resulting in a total of 21 kinetic statistic features. ANOVA analysis was done to select features that differ significantly between node positive and node negative women. Using the computed kinetic statistic features a leave-one-out SVM classifier was learned that performs with AUC=0.77 under the ROC curve, outperforming the conventional kinetic measures, including maximum peak enhancement (MPE) and signal enhancement ratio (SER), (AUCs of 0.61 and 0.57 respectively). These findings suggest that our DCE-MRI kinetic statistic features can be used to improve the prediction of axillary node status in breast cancer patients. Such features could ultimately be used as imaging biomarkers to guide personalized treatment choices for women diagnosed with breast cancer.

LDA boost classification: boosting by topics

Science.gov (United States)

Lei, La; Qiao, Guo; Qimin, Cao; Qitao, Li

2012-12-01

AdaBoost is an efficacious classification algorithm especially in text categorization (TC) tasks. The methodology of setting up a classifier committee and voting on the documents for classification can achieve high categorization precision. However, traditional Vector Space Model can easily lead to the curse of dimensionality and feature sparsity problems; so it affects classification performance seriously. This article proposed a novel classification algorithm called LDABoost based on boosting ideology which uses Latent Dirichlet Allocation (LDA) to modeling the feature space. Instead of using words or phrase, LDABoost use latent topics as the features. In this way, the feature dimension is significantly reduced. Improved Naïve Bayes (NB) is designed as the weaker classifier which keeps the efficiency advantage of classic NB algorithm and has higher precision. Moreover, a two-stage iterative weighted method called Cute Integration in this article is proposed for improving the accuracy by integrating weak classifiers into strong classifier in a more rational way. Mutual Information is used as metrics of weights allocation. The voting information and the categorization decision made by basis classifiers are fully utilized for generating the strong classifier. Experimental results reveals LDABoost making categorization in a low-dimensional space, it has higher accuracy than traditional AdaBoost algorithms and many other classic classification algorithms. Moreover, its runtime consumption is lower than different versions of AdaBoost, TC algorithms based on support vector machine and Neural Networks.

Boost.Unicode

OpenAIRE

Wien, Erik; Gigstad, Lars Erik

2005-01-01

The project has resulted in a Unicode string library for C++ that abstracts away the complexity of working with Unicode text. The idea behind the project originated from the Boost community's developer mailings lists, and is developed with inclusion into the Boost library collection in mind.

Secondary node analysis as an indicator for axillary lymphadenectomy in breast cancer patients.

Science.gov (United States)

Cremades, Manel; Torres, Mireia; Solà, Montse; Navinés, Jordi; Pascual, Icíar; Mariscal, Antonio; Caballero, Albert; Castellà, Eva; Luna, Miguel Ángel; Julián, Joan Francesc

2017-11-01

Currently, there is no agreement regarding if it would be necessary to perform an axillary lymph node dissection (ALND) in patients who have macrometastases in the sentinel lymph node (SLN). We studied the utility of the secondary node analysis (SN), defined as the following node after the SLN in an anatomical and lymphatic pathway, as a sign of malignant axillary involvement. An observational, retrospective and multicentre study was designed to assess the utility of the SN as a sign of axillary involvement. Among 2273 patients with breast cancer, a valid sample of 283 was obtained representing those who had the SN studied. Main endpoints of our study were: the SLN, the SN and the ALND histological pattern. Sensitivity, specificity and precision of the test were also calculated. SN test, in cases with positive SLN, has a sensitivity of 61.1%, a specificity of 78.7%, a positive predictive value of 45.8% and a negative predictive value of 87.3% with a precision of 74.7%. The study of the SN together with the technique of the SLN allows a more precise staging of the axillary involvement, in patients with breast cancer, than just the SLN technique. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

High-dose simultaneously integrated breast boost using intensity-modulated radiotherapy and inverse optimization

International Nuclear Information System (INIS)

Hurkmans, Coen W.; Meijer, Gert J.; Vliet-Vroegindeweij, Corine van; Sangen, Maurice J. van der; Cassee, Jorien

2006-01-01

Purpose: Recently a Phase III randomized trial has started comparing a boost of 16 Gy as part of whole-breast irradiation to a high boost of 26 Gy in young women. Our main aim was to develop an efficient simultaneously integrated boost (SIB) technique for the high-dose arm of the trial. Methods and Materials: Treatment planning was performed for 5 left-sided and 5 right-sided tumors. A tangential field intensity-modulated radiotherapy technique added to a sequentially planned 3-field boost (SEQ) was compared with a simultaneously planned technique (SIB) using inverse optimization. Normalized total dose (NTD)-corrected dose volume histogram parameters were calculated and compared. Results: The intended NTD was produced by 31 fractions of 1.66 Gy to the whole breast and 2.38 Gy to the boost volume. The average volume of the PTV-breast and PTV-boost receiving more than 95% of the prescribed dose was 97% or more for both techniques. Also, the mean lung dose and mean heart dose did not differ much between the techniques, with on average 3.5 Gy and 2.6 Gy for the SEQ and 3.8 Gy and 2.6 Gy for the SIB, respectively. However, the SIB resulted in a significantly more conformal irradiation of the PTV-boost. The volume of the PTV-breast, excluding the PTV-boost, receiving a dose higher than 95% of the boost dose could be reduced considerably using the SIB as compared with the SEQ from 129 cc (range, 48-262 cc) to 58 cc (range, 30-102 cc). Conclusions: A high-dose simultaneously integrated breast boost technique has been developed. The unwanted excessive dose to the breast was significantly reduced

An estimation of the minimum effective anesthetic volume of 2% lidocaine in ultrasound-guided axillary brachial plexus block.

LENUS (Irish Health Repository)

O'Donnell, Brian D

2009-07-01

Ultrasound guidance facilitates precise needle and injectate placement, increasing axillary block success rates, reducing onset times, and permitting local anesthetic dose reduction. The minimum effective volume of local anesthetic in ultrasound-guided axillary brachial plexus block is unknown. The authors performed a study to estimate the minimum effective anesthetic volume of 2% lidocaine with 1:200,000 epinephrine (2% LidoEpi) in ultrasound-guided axillary brachial plexus block.

Benefits of ambulatory axillary intra-aortic balloon pump for circulatory support as bridge to heart transplant.

Science.gov (United States)

Umakanthan, Ramanan; Hoff, Steven J; Solenkova, Natalia; Wigger, Mark A; Keebler, Mary E; Lenneman, Andrew; Leacche, Marzia; Disalvo, Thomas G; Ooi, Henry; Naftilan, Allen J; Byrne, John G; Ahmad, Rashid M

2012-05-01

Axillary intra-aortic balloon pump therapy has been described as a bridge to transplant. Advantages over femoral intra-aortic balloon pump therapy include reduced incidence of infection and enhanced patient mobility. We identified the patients who would benefit most from this therapy while awaiting heart transplantation. We conducted a single-center, retrospective observational study to evaluate outcomes from axillary intra-aortic balloon pump therapy. These included hemodynamic parameters, duration of support, and success in bridging to transplant. We selected patients on the basis of history of sternotomy, elevated panel-reactive antibody, and small body habitus. Patients were made to ambulate aggressively beginning on postoperative day 1. Between September 2007 and September 2010, 18 patients underwent axillary intra-aortic balloon pump therapy. All patients had the devices placed through the left axillary artery with a Hemashield side graft (Boston Scientific, Natick, Mass). Before axillary placement, patients underwent femoral placement to demonstrate hemodynamic benefit. Duration of support ranged from 5 to 63 days (median = 19 days). There was marked improvement in ambulatory potential and hemodynamic parameters, with minimal blood transfusion requirements. There were no device-related infections. Some 72% of the patients (13/18) were successfully bridged to transplantation. Axillary intra-aortic balloon pump therapy provides excellent support for selected patients as a bridge to transplant. The majority of the patients were successfully bridged to transplant and discharged. Although this therapy has been described in previous studies, this is the largest series to incorporate a regimen of aggressive ambulation with daily measurements of distances walked. Copyright © 2012. Published by Mosby, Inc.

Boost breaking in the EFT of inflation

Energy Technology Data Exchange (ETDEWEB)

Delacrétaz, Luca V.; Senatore, Leonardo [Stanford Institute for Theoretical Physics, Stanford University, Stanford, CA 94305 (United States); Noumi, Toshifumi, E-mail: lvd@stanford.edu, E-mail: tnoumi@phys.sci.kobe-u.ac.jp, E-mail: senatore@stanford.edu [Jockey Club Institute for Advanced Study, Hong Kong University of Science and Technology (Hong Kong)

2017-02-01

If time-translations are spontaneously broken, so are boosts. This symmetry breaking pattern can be non-linearly realized by either just the Goldstone boson of time translations, or by four Goldstone bosons associated with time translations and boosts. In this paper we extend the Effective Field Theory of Multifield Inflation to consider the case in which the additional Goldstone bosons associated with boosts are light and coupled to the Goldstone boson of time translations. The symmetry breaking pattern forces a coupling to curvature so that the mass of the additional Goldstone bosons is predicted to be equal to √2 H in the vast majority of the parameter space where they are light. This pattern therefore offers a natural way of generating self-interacting particles with Hubble mass during inflation. After constructing the general effective Lagrangian, we study how these particles mix and interact with the curvature fluctuations, generating potentially detectable non-Gaussian signals.

Short course radiotherapy with simultaneous integrated boost for stage I-II breast cancer, early toxicities of a randomized clinical trial

Science.gov (United States)

2012-01-01

Background TomoBreast is a unicenter, non-blinded randomized trial comparing conventional radiotherapy (CR) vs. hypofractionated Tomotherapy (TT) for post-operative treatment of breast cancer. The purpose of the trial is to compare whether TT can reduce heart and pulmonary toxicity. We evaluate early toxicities. Methods The trial started inclusion in May 2007 and reached its recruitment in August 2011. Women with stage T1-3N0M0 or T1-2N1M0 breast cancer completely resected by tumorectomy (BCS) or by mastectomy (MA) who consented to participate were randomized, according to a prescribed computer-generated randomization schedule, between control arm of CR 25x2 Gy/5 weeks by tangential fields on breast/chest wall, plus supraclavicular-axillary field if node-positive, and sequential boost 8x2 Gy/2 weeks if BCS (cumulative dose 66 Gy/7 weeks), versus experimental TT arm of 15x2.8 Gy/3 weeks, including nodal areas if node-positive and simultaneous integrated boost of 0.6 Gy if BCS (cumulative dose 51 Gy/3 weeks). Outcomes evaluated were the pulmonary and heart function. Comparison of proportions used one-sided Fisher's exact test. Results By May 2010, 70 patients were randomized and had more than 1 year of follow-up. Out of 69 evaluable cases, 32 were assigned to CR (21 BCS, 11 MA), 37 to TT (20 BCS, 17 MA). Skin toxicity of grade ≥1 at 2 years was 60% in CR, vs. 30% in TT arm. Heart function showed no significant difference for left ventricular ejection fraction at 2 years, CR 4.8% vs. TT 4.6%. Pulmonary function tests at 2 years showed grade ≥1 decline of FEV1 in 21% of CR, vs. 15% of TT and decline of DLco in 29% of CR, vs. 7% of TT (P = 0.05). Conclusions There were no unexpected severe toxicities. Short course radiotherapy of the breast with simultaneous integrated boost over 3 weeks proved feasible without excess toxicities. Pulmonary tests showed a slight trend in favor of Tomotherapy, which will need confirmation with longer

Technological evolution of axillary lymph nodes: Radiological visualisation in breast cancer patients

International Nuclear Information System (INIS)

Eglitis, J.; Krumins, V.; Stengrevics, A.; Berzins, A.; Vevere, I.; Storozenko, G.

2004-01-01

Full text: In patients with breast cancer, detection of axillary lymph node spread has a great prognostic significance. Visualisation of lymphatic glands is attracting attention of radiologists since long. Lymphogram usually shows 4-9 lymph glands as compared to 8 to 50 identified during surgical intervention. Lymphography is a laborious and complicated process requiring specific skills. Likewise, the evaluation and interpretation of results depends upon the experience of the specialist. We evaluated 234 breast cancer patients and found that lymphograms of these patients initially detected 1-2 central axillary lymph nodes followed by others. During surgical intervention, the total number of lymphatic glands removed from these patients was 3,241 of which only 2,693 (83.1%) were seen on lymphography. On further evaluation it was found that the largest groups of lymphatic nodes were seen in the following pattern (i) central axillary (ii) subclavicular (iii) lateral, with central axillary lymph nodes being the biggest (1.5 - 2 cm) and subclavicular the smallest (0.2 - 0.5 cm). Sternal lymph nodes receive lymph from medial quadrants of the breast and / or if the axillary lymph nodes are obstructed by metastases. The results of lymphography and post-operative examination matched in 71.7-75 % of cases. False positivity was seen in 19.2 % and false negative 9.1 % instances. As this method was not sufficiently selective and specific, its relative upsurge receded backwards and was forgotten. The last decade of the twentieth century saw a sentinel node (SN) concept. In advanced countries, the possibility to detect breast cancer of up to 1 cm diameter corresponding to T1A category, when the axillary lymph nodes still are not involved in malignant growth, accounts about 50%. Hence the search of lymphatic spread vis-a-vis sentinel node detection has gained more importance. Earlier, SN detection involved colour contrast methods, which was reasonably sensitive and specific in

Traumatiske laesioner af a. axillaris og a. brachialis

DEFF Research Database (Denmark)

Bitsch, M; Hensler, M K; Schroeder, T V

1994-01-01

During af six year period 16 patients were treated for an axillary or brachial artery trauma. The vascular injury was caused by fracture in nine cases, contusion in four and penetrating injury in three. Concomitant nerve or tendon lesion occurred in five cases. Five of the 16 events were industri...

Boost.Asio C++ network programming

CERN Document Server

Torjo, John

2013-01-01

What you want is an easy level of abstraction, which is just what this book provides in conjunction with Boost.Asio. Switching to Boost.Asio is just a few extra #include directives away, with the help of this practical and engaging guide.This book is great for developers that need to do network programming, who don't want to delve into the complicated issues of a raw networking API. You should be familiar with core Boost concepts, such as smart pointers and shared_from_this, resource classes (noncopyable), functors and boost::bind, boost mutexes, and the boost date/time library. Readers should

Is axillary sonographic staging less accurate in invasive lobular breast cancer than in ductal breast cancer?

Science.gov (United States)

Sankaye, Prashant; Chhatani, Sharmila; Porter, Gareth; Steel, Jim; Doyle, Sarah

2014-10-01

The purpose of this study was to determine whether axillary sonography is less accurate in invasive lobular breast cancer than in ductal breast cancer. Patients with invasive breast cancer were retrospectively identified from histologic records from 2010 to 2012. Staging axillary sonograms from 96 patients with primary breast cancer in each of 2 subgroups, invasive lobular carcinoma (ILC) and invasive ductal carcinoma (IDC), were reviewed. Preoperative sonographically guided 14-gauge core biopsy was performed on morphologically abnormal lymph nodes. Thirty-one of 96 patients (32%) in each subgroup were node positive on final postoperative histopathologic analysis. Axillary staging sensitivity was 17 of 31 patients (54%) in the IDC subgroup and 15 of 31(48%) in the ILC subgroup. Further analysis of the data showed no statistically significant differences between these subgroups. We found that there was no statistically significant difference in the accuracy of axillary sonographic staging between ILC and IDC. © 2014 by the American Institute of Ultrasound in Medicine.

Nomogram for prediction of level 2 axillary lymph node metastasis in proven level 1 node-positive breast cancer patients.

Science.gov (United States)

Jiang, Yanlin; Xu, Hong; Zhang, Hao; Ou, Xunyan; Xu, Zhen; Ai, Liping; Sun, Lisha; Liu, Caigang

2017-09-22

The current management of the axilla in level 1 node-positive breast cancer patients is axillary lymph node dissection regardless of the status of the level 2 axillary lymph nodes. The goal of this study was to develop a nomogram predicting the probability of level 2 axillary lymph node metastasis (L-2-ALNM) in patients with level 1 axillary node-positive breast cancer. We reviewed the records of 974 patients with pathology-confirmed level 1 node-positive breast cancer between 2010 and 2014 at the Liaoning Cancer Hospital and Institute. The patients were randomized 1:1 and divided into a modeling group and a validation group. Clinical and pathological features of the patients were assessed with uni- and multivariate logistic regression. A nomogram based on independent predictors for the L-2-ALNM identified by multivariate logistic regression was constructed. Independent predictors of L-2-ALNM by the multivariate logistic regression analysis included tumor size, Ki-67 status, histological grade, and number of positive level 1 axillary lymph nodes. The areas under the receiver operating characteristic curve of the modeling set and the validation set were 0.828 and 0.816, respectively. The false-negative rates of the L-2-ALNM nomogram were 1.82% and 7.41% for the predicted probability cut-off points of level 1 axillary lymph node metastasis. Patients with a low probability of L-2-ALNM could be spared level 2 axillary lymph node dissection, thereby reducing postoperative morbidity.

Diet-boosting foods

Science.gov (United States)

Obesity - diet-boosting foods; Overweight - diet-boosting foods ... Low-fat and nonfat milk, yogurt, and cottage cheese are healthy sources of calcium, vitamin D , and potassium. Unlike sweetened drinks with extra calories, milk ...

CT planning of boost irradiation in radiotherapy of breast cancer after conservative surgery

International Nuclear Information System (INIS)

Messer, Peter M.; Kirikuta, Ion C.; Bratengeier, Klaus; Flentje, Michael

1997-01-01

Background and purpose: A study was performed to compare the accuracy of clinical treatment set-up and CT planning of boost irradiation in radiotherapy of breast cancer. Material and methods: Between September 1993 and October 1994, 45 women who underwent breast conserving surgery and irradiation containing a boost to the tumour bed were investigated. Prospective evaluation of CT planning of the boost was carried out. The target volume/boost field, electron energy and treatment set-up had been defined on the basis of clinical examination, initial and postsurgical mammograms by one radiotherapist. Next, a planning CT was performed in treatment position and a CT-based treatment plan was calculated according to a target volume defined by another radiotherapist. The clinical treatment set-up was imported into our computer planning system and the resulting isodose plots were compared with those from CT planning and reviewed critically. Results: The clinically defined treatment set-up had to be modified in 80% of the patients. Most discrepancies observed were related to the size of the boost field itself and the chosen electron energy. Minor changes had to be made with respect to angle of table and gantry. Conclusions: Critical review of the isodose plots from both methods showed clear advantages for CT planning. Guidelines for target definition in CT planning of boost irradiation and subgroups of patients benefiting from this technique are described

SemiBoost: boosting for semi-supervised learning.

Science.gov (United States)

Mallapragada, Pavan Kumar; Jin, Rong; Jain, Anil K; Liu, Yi

2009-11-01

Semi-supervised learning has attracted a significant amount of attention in pattern recognition and machine learning. Most previous studies have focused on designing special algorithms to effectively exploit the unlabeled data in conjunction with labeled data. Our goal is to improve the classification accuracy of any given supervised learning algorithm by using the available unlabeled examples. We call this as the Semi-supervised improvement problem, to distinguish the proposed approach from the existing approaches. We design a metasemi-supervised learning algorithm that wraps around the underlying supervised algorithm and improves its performance using unlabeled data. This problem is particularly important when we need to train a supervised learning algorithm with a limited number of labeled examples and a multitude of unlabeled examples. We present a boosting framework for semi-supervised learning, termed as SemiBoost. The key advantages of the proposed semi-supervised learning approach are: 1) performance improvement of any supervised learning algorithm with a multitude of unlabeled data, 2) efficient computation by the iterative boosting algorithm, and 3) exploiting both manifold and cluster assumption in training classification models. An empirical study on 16 different data sets and text categorization demonstrates that the proposed framework improves the performance of several commonly used supervised learning algorithms, given a large number of unlabeled examples. We also show that the performance of the proposed algorithm, SemiBoost, is comparable to the state-of-the-art semi-supervised learning algorithms.

Novel Axillary Approach for Brachial Plexus in Robotic Surgery: A Cadaveric Experiment

Directory of Open Access Journals (Sweden)

Cihangir Tetik

2014-01-01

Full Text Available Brachial plexus surgery using the da Vinci surgical robot is a new procedure. Although the supraclavicular approach is a well known described and used procedure for robotic surgery, axillary approach was unknown for brachial plexus surgery. A cadaveric study was planned to evaluate the robotic axillary approach for brachial plexus surgery. Our results showed that robotic surgery is a very useful method and should be used routinely for brachial plexus surgery and particularly for thoracic outlet syndrome. However, we emphasize that new instruments should be designed and further studies are needed to evaluate in vivo results.

Robust boosting via convex optimization

Science.gov (United States)

Rätsch, Gunnar

2001-12-01

In this work we consider statistical learning problems. A learning machine aims to extract information from a set of training examples such that it is able to predict the associated label on unseen examples. We consider the case where the resulting classification or regression rule is a combination of simple rules - also called base hypotheses. The so-called boosting algorithms iteratively find a weighted linear combination of base hypotheses that predict well on unseen data. We address the following issues: o The statistical learning theory framework for analyzing boosting methods. We study learning theoretic guarantees on the prediction performance on unseen examples. Recently, large margin classification techniques emerged as a practical result of the theory of generalization, in particular Boosting and Support Vector Machines. A large margin implies a good generalization performance. Hence, we analyze how large the margins in boosting are and find an improved algorithm that is able to generate the maximum margin solution. o How can boosting methods be related to mathematical optimization techniques? To analyze the properties of the resulting classification or regression rule, it is of high importance to understand whether and under which conditions boosting converges. We show that boosting can be used to solve large scale constrained optimization problems, whose solutions are well characterizable. To show this, we relate boosting methods to methods known from mathematical optimization, and derive convergence guarantees for a quite general family of boosting algorithms. o How to make Boosting noise robust? One of the problems of current boosting techniques is that they are sensitive to noise in the training sample. In order to make boosting robust, we transfer the soft margin idea from support vector learning to boosting. We develop theoretically motivated regularized algorithms that exhibit a high noise robustness. o How to adapt boosting to regression problems

Studies on topical antiperspirant control of axillary hyperhidrosis.

Science.gov (United States)

Shelley, W B; Hurley, H J

1975-01-01

Axillary hyperhidrotics is reviewed from the standpoint of anatomical factors, physiological mechanisms and the history of methods of control. Anhydrous aluminum chloride and anhydrous zirconium tetrachloride are shown to be superior topical agents for partial control of axillary sweating when applied as a powder or in anhydrous nonreactive vehicles. Complete anhidrosis as demonstrated by sustained garment armpit dryness could be achieved in hyperhidrotics within 48 hours by the following trinary antiperspirant system: (1) a saturated solution of aluminum chloride hexahydrate or zirconyl chloride in absolute ethanol or isopropyl alcohol, (2) application to the dry axilla at times of sleep or other prolonged non-sweating period, (3) water vapor occlusion of area for 6 to 8 hours by means of Saran wrap. The hypothesis is presented that metallic antiperspirants act by reflux entrance into the terminal intraepidermal eccrine duct, slowly combining with the intraductal keratin, to produce a fibrillar contraction (super contraction) of keratin and hence functional closure, not histologically evident. This altered keratin is shed weeks later, with the consequent return of ductal patency and sweating.

Prospective evaluation of fluorodeoxyglucose positron emission tomography/computed tomography scan (FDG-PET/CT) for axillary staging in breast cancer

International Nuclear Information System (INIS)

Yamaguchi, Masahide; Noguchi, Akinori; Tani, Naoki

2008-01-01

Seventy-two patients from 2005 October to 2007 February with operative breast cancer underwent fluorodeoxyglucose positron emission tomography/computed tomography scan (FDG-PET/CT) of chest and body, ultrasound scan (US) and enhanced computed tomography scan (CT) followed by sentinel lymph node biopsy (SLNB) and axillary lymph node dissection (ALND). The results of PET/CT were compared with histopathological diagnosis of SLNB and ALND. Sensitivity, specificity and accuracy of PET/CT for detection of axillary lymph node metastases were 61%, 96% and 88%, respectively. Seven false-negative and two false-positive of PET/CT results were found. In patients with false-negative of PET/CT results there are two skin-invasive breast cancer patients and axillary lymph node metastases were detected in three patients with US, in one with CT and in four with SLNB. In clinical method for diagnosis of axillary lymph node metastases SLNB should be recommended because sensitivity of PET/CT for early breast cancer patients were low and positive diagnosis of axillary lymph node metastases with PET needs more than 1 cm size of lesion. PET/CT is useful for not-early breast cancer patients. To decide the operation of axillary lymph node disection needs total diagnosis of US, CT, SLNB and clinical findings. (author)

Assessment of axillary temperature for the evaluation of normal body temperature of healthy young adults at rest in a thermoneutral environment.

Science.gov (United States)

Marui, Shuri; Misawa, Ayaka; Tanaka, Yuki; Nagashima, Kei

2017-02-22

The aims of this study were to (1) evaluate whether recently introduced methods of measuring axillary temperature are reliable, (2) examine if individuals know their baseline body temperature based on an actual measurement, and (3) assess the factors affecting axillary temperature and reevaluate the meaning of the axillary temperature. Subjects were healthy young men and women (n = 76 and n = 65, respectively). Three measurements were obtained: (1) axillary temperature using a digital thermometer in a predictive mode requiring 10 s (T ax-10 s ), (2) axillary temperature using a digital thermometer in a standard mode requiring 10 min (T ax-10 min ), and (3) tympanic membrane temperature continuously measured by infrared thermometry (T ty ). The subjects answered questions about eating and exercise habits, sleep and menstrual cycles, and thermoregulation and reported what they believed their regular body temperature to be (T reg ). T reg , T ax-10 s , T ax-10 min , and T ty were 36.2 ± 0.4, 36.4 ± 0.5, 36.5 ± 0.4, and 36.8 ± 0.3 °C (mean ± SD), respectively. There were correlations between T ty and T ax-10 min , T ty and T ax-10 s , and T ax-10 min and T ax-10 s (r = .62, r = .46, and r = .59, respectively, P body mass indices and irregular menstrual cycles. Modern devices for measuring axillary temperature may have changed the range of body temperature that is recognized as normal. Core body temperature variations estimated by tympanic measurements were smaller than those estimated by axillary measurements. This variation of axillary temperature may be due to changes in the measurement methods introduced by modern devices and techniques. However, axillary temperature values correlated well with those of tympanic measurements, suggesting that the technique may reliably report an individual's state of health. It is important for individuals to know their baseline axillary temperature to evaluate subsequent

Small-field fractionated radiotherapy with or without stereotactic boost for vestibular schwannoma

International Nuclear Information System (INIS)

Kagei, K.; Shirato, H.; Suzuki, K.; Isu, T.; Sawamura, Y.; Sakamoto, T.; Fukuda, S.; Nishioka, T.; Hashimoto, S.; Miyasaka, K.

1999-01-01

Purpose: To assess the efficacy and toxicity of small-field fractionated radiotherapy with or without stereotactic boost (SB) for vestibular schwannomas.Methods and materials: Thirty-nine patients with vestibular schwannoma were treated with irradiation between March 1991 and February 1996. Extra-meatal tumor diameters were under 30 mm. Thirty-three patients received small-field fractionated radiotherapy followed by SB. Basic dose schedule was 44 Gy in 22 fractions over 5 1/2 weeks plus 4 Gy in one session. Six patients received small-field fractionated radiotherapy only (40-44 Gy in 20-22 fractions over 5-5 1/2 weeks or 36 Gy in 20 fractions over 5 weeks).< Results: Follow-up ranged from 6 to 69 months (median, 24 months). Tumors decreased in size in 13 cases (33%), were unchanged in 25 (64%), and increased in one (3%). The actuarial 2-year tumor control rate was 97%. Fifteen patients had useful hearing (Gardner-Robertson class 1-2) and 25 patients had testable hearing (class 1-4) before irradiation. The 2-year actuarial rates of useful hearing preservation (free of deterioration from class 1-2 to class 3-5) were 78%. The 2-year actuarial rates of any testable hearing preservation (free of deterioration from class 1-4 to class 5) were 96%. No permanent facial and trigeminal neuropathy developed after irradiation. The 2-year actuarial incidences of facial and trigeminal neuropathies were 8% and 16%, respectively.Conclusions: Small-field fractionated radiotherapy with or without SB provides excellent short-term local control and a relatively low incidence of complications for vestibular schwannoma, although further follow-up is necessary to evaluate the long-term results. (Copyright (c) 1999 Elsevier Science B.V., Amsterdam. All rights reserved.)

Role of Tulipa gesneriana TEOSINTE BRANCHED1 (TgTB1) in the control of axillary bud outgrowth in bulbs.

Science.gov (United States)

Moreno-Pachon, Natalia M; Mutimawurugo, Marie-Chantal; Heynen, Eveline; Sergeeva, Lidiya; Benders, Anne; Blilou, Ikram; Hilhorst, Henk W M; Immink, Richard G H

2018-06-01

Tulip vegetative reproduction. Tulips reproduce asexually by the outgrowth of their axillary meristems located in the axil of each bulb scale. The number of axillary meristems in one bulb is low, and not all of them grow out during the yearly growth cycle of the bulb. Since the degree of axillary bud outgrowth in tulip determines the success of their vegetative propagation, this study aimed at understanding the mechanism controlling the differential axillary bud activity. We used a combined physiological and "bottom-up" molecular approach to shed light on this process and found that first two inner located buds do not seem to experience dormancy during the growth cycle, while mid-located buds enter dormancy by the end of the growing season. Dormancy was assessed by weight increase and TgTB1 expression levels, a conserved TCP transcription factor and well-known master integrator of environmental and endogenous signals influencing axillary meristem outgrowth in plants. We showed that TgTB1 expression in tulip bulbs can be modulated by sucrose, cytokinin and strigolactone, just as it has been reported for other species. However, the limited growth of mid-located buds, even when their TgTB1 expression is downregulated, points at other factors, probably physical, inhibiting their growth. We conclude that the time of axillary bud initiation determines the degree of dormancy and the sink strength of the bud. Thus, development, apical dominance, sink strength, hormonal cross-talk, expression of TgTB1 and other possibly physical but unidentified players, all converge to determine the growth capacity of tulip axillary buds.

Consumption of garlic positively affects hedonic perception of axillary body odour.

Science.gov (United States)

Fialová, Jitka; Roberts, S Craig; Havlíček, Jan

2016-02-01

Beneficial health properties of garlic, as well as its most common adverse effect - distinctive breath odour - are well-known. In contrast, analogous research on the effect of garlic on axillary odour is currently missing. Here, in three studies varying in the amount and nature of garlic provided (raw garlic in study 1 and 2, garlic capsules in study 3), we tested the effect of garlic consumption on the quality of axillary odour. A balanced within-subject experimental design was used. In total, 42 male odour donors were allocated to either a "garlic" or "non-garlic" condition, after which they wore axillary pads for 12 h to collect body odour. One week later, the conditions were reversed. Odour samples were then judged for their pleasantness, attractiveness, masculinity and intensity by 82 women. We found no significant differences in ratings of any characteristics in study 1. However, the odour of donors after an increased garlic dosage was assessed as significantly more pleasant, attractive and less intense (study 2), and more attractive and less intense in study 3. Our results indicate that garlic consumption may have positive effects on perceived body odour hedonicity, perhaps due to its health effects (e.g., antioxidant properties, antimicrobial activity). Copyright © 2015 Elsevier Ltd. All rights reserved.

Clinical utility of routine pre-operative axillary ultrasound and fine needle aspiration cytology in patient selection for sentinel lymph node biopsy.

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Rattay, T; Muttalib, M; Khalifa, E; Duncan, A; Parker, S J

2012-04-01

In patients with operable breast cancer, pre-operative evaluation of the axilla may be of use in the selection of appropriate axillary surgery. Pre-operative axillary ultrasound (US) and fine needle aspiration cytology (FNAC) assessments have become routine practice in many breast units, although the evidence base is still gathering. This study assessed the clinical utility of US+/-FNAC in patient selection for either axillary node clearance (ANC) or sentinel lymph node biopsy (SLNB) in patients undergoing surgery for operable breast cancer. Over a two-year period, 348 patients with a clinically negative axilla underwent axillary US. 67 patients with suspicious nodes on US also underwent FNAC. The sensitivity and specificity of axillary investigations to determine nodal involvement were 56% (confidence interval: 47-64%) and 90% (84-93%) for US alone, and 76% (61-87%) and 100% (65-100%) for FNAC combined with US, respectively. With a positive US, the post-test probability was 78%. A negative US carried a post-test probability of 25%. When FNAC was positive, the post-test probability was greater than unity. A negative FNAC yielded a post-test probability of 52%. All patients with positive FNAC and most patients with suspicious US were listed for axillary node clearance (ANC) after consideration at the multi-disciplinary team (MDT) meeting. With pre-operative axillary US+/-FNAC, 20% of patients were saved a potential second axillary procedure, facilitating a reduction in the overall re-operation rate to 12%. In this study, a positive pre-operative US+/-FNAC directs patients towards ANC. When the result is negative, other clinico-pathological factors need to be taken into account in the selection of the appropriate axillary procedure. Copyright © 2011 Elsevier Ltd. All rights reserved.

Computed tomography image of the mediastinal and axillary lymph nodes in clinically sound Rottweilers

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Ana Carolina B. Fonseca Pinto

2013-03-01

Full Text Available Trough computed tomography (CT, it is possible to evaluate lymph nodes in detail and to detect changes in these structures earlier than with radiographs and ultrasound. Lack of information in the veterinary literature directed the focus of this report to normal aspects of the axillary and mediastinal lymph nodes of adult dogs on CT imaging. A CT scan of 15 normal adult male and female Rottweilers was done. To define them as clinically sound, anamnesis, physical examination, complete blood count, renal and hepatic biochemistry, ECG, and thoracic radiographs were performed. After the intravenous injection of hydrosoluble ionic iodine contrast medium contiguous 10mm in thickness thoracic transverse images were obtained with an axial scanner. In the obtained images mediastinal and axillary lymph nodes were sought and when found measured in their smallest diameter and their attenuation was compared to musculature. Mean and standard deviation of: age, weight, body length and the smallest diameter of the axillary and mediastinal lymph nodes were determined. Mean and standard deviation of parameters: age 3.87±2.03 years, weight 41.13±5.12, and body length 89.61±2.63cm. Axillary lymph nodes were seen in 60% of the animals, mean of the smallest diameter was 3.58mm with a standard deviation of 2.02 and a minimum value of 1mm and a maximum value of 7mm. From 13 observed lymph nodes 61.53% were hypopodense when compared with musculature, and 30.77% were isodense. Mediastinal lymph nodes were identified in 73.33% of the dogs; mean measure of the smallest diameter was 4.71mm with a standard deviation of 2.61mm and a minimum value of 1mm, and a maximum value of 8mm. From 14 observed lymph nodes 85.71% were isodense when compared with musculature and 14.28% were hypodense. The results show that it is possible to visualize axillary and mediastinal lymph nodes in adult clinically sound Rottweilers with CT using a slice thickness and interval of 10mm. The

Partial axillary dissection in early breast cancer | El-Fayoumi ...

African Journals Online (AJOL)

... of later clinical involvement of the axilla and at establishing a sound basis for adjuvant treatment planning axillary dissection is an important operative procedure. ... Methods: Eighteen patients underwent modified radical mastectomy, while the other two patients who were fulfilling the criteria for conservative breast surgery ...

Successful Completion of the Pilot Phase of a Randomized Controlled Trial Comparing Sentinel Lymph Node Biopsy to No Further Axillary Staging in Patients with Clinical T1-T2 N0 Breast Cancer and Normal Axillary Ultrasound.

Science.gov (United States)

Cyr, Amy E; Tucker, Natalia; Ademuyiwa, Foluso; Margenthaler, Julie A; Aft, Rebecca L; Eberlein, Timothy J; Appleton, Catherine M; Zoberi, Imran; Thomas, Maria A; Gao, Feng; Gillanders, William E

2016-08-01

Axillary surgery is not considered therapeutic in patients with clinical T1-T2 N0 breast cancer. The importance of axillary staging is eroding in an era in which tumor biology, as defined by biomarker and gene expression profile, is increasingly important in medical decision making. We hypothesized that axillary ultrasound (AUS) is a noninvasive alternative to sentinel lymph node biopsy (SLNB), and AUS could replace SLNB without compromising patient care. Patients with clinical T1-T2 N0 breast cancer and normal AUS were eligible for enrollment. Subjects were randomized to no further axillary staging (arm 1) vs SLNB (arm 2). Descriptive statistics were used to describe the results of the pilot phase of the randomized controlled trial. Sixty-eight subjects were enrolled in the pilot phase of the trial (34 subjects in arm 1, no further staging; 32 subjects in arm 2, SLNB; and 2 subjects voluntarily withdrew from the trial). The median age was 61 years (range 40 to 80 years) in arm 1 and 59 years (range 31 to 81 years) in arm 2, and there were no significant clinical or pathologic differences between the arms. Median follow-up was 17 months (range 1 to 32 months). The negative predictive value (NPV) of AUS for identification of clinically significant axillary disease (>2.0 mm) was 96.9%. No axillary recurrences have been observed in either arm. Successful completion of the pilot phase of the randomized controlled trial confirms the feasibility of the study design, and provides prospective evidence supporting the ability of AUS to exclude clinically significant disease in the axilla. The results provide strong support for a phase 2 randomized controlled trial. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Comparison between minimal right vertical infra-axillary thoracotomy and standard median sternotomy for repair of atrial septal defects

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Hafize Yaliniz

2015-10-01

Conclusion: Minimal right vertical infra-axillary thoracotomy can be performed with favorable cosmetic and clinical results for atrial septal defects closure. Infra-axillary thoracotomy provides a good alternative to standard median sternotomy for patients with atrial septal defects.

Correlation between obesity and fat-infiltrated axillary lymph nodes visualized on mammography.

Science.gov (United States)

diFlorio Alexander, Roberta M; Haider, Steffen J; MacKenzie, Todd; Goodrich, Martha E; Weiss, Julie; Onega, Tracy

2018-01-05

Using screening mammography, this study investigated the association between obesity and axillary lymph node (LN) size and morphology. We conducted a retrospective review of 188 females who underwent screening mammography at an academic medical centre. Length and width of the LN and hilum were measured in the largest, mammographically visible axillary node. The hilo-cortical ratio (HCR) was calculated as the hilar width divided by the cortical width. Measurements were performed by a board certified breast radiologist and a resident radiology physician. Inter-rater agreement was assessed with Pearson correlation coefficient. We performed multivariable regression analysis for associations of LN measurements with body mass index (BMI), breast density and age. There was a strong association between BMI and LN dimensions, hilum dimensions and HCR (p < 0.001 for all metrics). There was no significant change in cortex width with increasing BMI (p = 0.15). Increases in LN length and width were found with increasing BMI [0.6 mm increase in length per unit BMI, 95% CI (0.4-0.8), p < 0.001 and0.3 mm increase in width per unit BMI, 95% CI(0.2-0.4), p < 0.001, respectively]. Inter-rater reliability for lymph node and hilum measurements was 0.57-0.72. We found a highly significant association between increasing BMI and axillary LN dimensions independent of age and breast density with strong interobserver agreement. The increase in LN size was driven by expansion of the LN hilum secondary to fat infiltration. Advances in knowledge: This preliminary work determined a relationship between fat infiltrated axillary lymph nodes and obesity.

Lymphedema of the arm and breast in irradiated breast cancer patients: risks in an era of dramatically changing axillary surgery.

Science.gov (United States)

Goffman, Thomas E; Laronga, Christine; Wilson, Lori; Elkins, David

2004-01-01

The purpose of this study was to assess risk for lymphedema of the breast and arm in radiotherapy patients in an era of less extensive axillary surgery. Breast cancer patients treated for cure were reviewed, with a minimum follow-up of 1.5 years from the end of treatment. Clinical, surgical, and radiation-related variables were tested for statistical association with arm and breast lymphedema using regression analyses, t-tests, and chi-squared analyses. Between January 1998 and June 2001, 240 women received radiation for localized breast cancer in our center. The incidence of lymphedema of the ipsilateral breast, arm, and combined (breast and arm) was 9.6%, 7.6%, and 1.8%, respectively, with a median follow-up of 27 months. For breast edema, t-test and multivariate analysis showed body mass index (BMI) to be significant (p = 0.043, p = 0.0038), as was chi-squared and multivariate testing for site of tumor in the breast (p = 0.0043, p = 0.0035). For arm edema, t-test and multivariate analyses showed the number of nodes removed to be significant (p = 0.0040, p = 0.0458); the size of the tumor was also significant by multivariate analyses (p = 0.0027). Tumor size appeared significant because a number of very large cancers failed locally and caused cancer-related obstructive lymphedema. In our center, even modern, limited level 1-2 axillary dissection and tangential irradiation carries the risk of arm lymphedema that would argue in favor of sentinel node biopsy. For breast edema, disruption of draining lymphatics by surgery and radiation with boost to the upper outer quadrant increased risk, especially for the obese. Fortunately both breast and arm edema benefited from manual lymphatic drainage.

Horizontal right axillary minithoracotomy: aesthetic and effective option for atrial and ventricular septal defect repair in infants and toddlers

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Luciana da Fonseca da Silva

2014-04-01

Full Text Available Introduction: Congenital heart defects treatment shows progressive reduction in morbidity and mortality, however, the scar, resulting from ventricular (VSD and atrial septal defect (ASD repair, may cause discomfort. Right axillary minithoracotomy approach, by avoiding the breast growth region, is an option for correction of these defects that may provide better aesthetic results at low cost. Since October 2011, we have been using this technique for repairing VSD and ASD defects as well as associated defects. Objectives: To evaluate the efficacy of this method in children undergoing correction of VSD and ASD, to compare perioperative clinical outcomes with those repaired by median sternotomy, and to evaluate the aesthetic result. Methods: Perioperative clinical data of 25 patients submitted to axillary thoracotomy were compared with data from a paired group of 25 patients with similar heart defects repaired by median sternotomy, from October 2011 to August 2012. Results: Axillary approach was possible even in infants. There was no mortality and the main perioperative variables were similar in both groups, except for lower use of blood products in the axillary group (6/25 vs. control (13/25, with statistical difference (P =0.04. The VSD size varied from 7 to 15 mm in axillary group. Cannulation of the aorta and vena cavae was performed through the main incision, whose size ranged from 3 to 5 cm in the axillary group, with excellent aesthetic results. Conclusion: The axillary thoracotomy was effective, allowing for a heart defect repair similar to the median sternotomy, with more satisfactory aesthetic results and reduced blood transfusion, and it can be safely used in infants.

Origin and distribution of the axillary nerve in the giant anteater (Myrmecophaga tridactyla

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Daniela Cristina de Oliveira Silva

2012-09-01

Full Text Available The giant anteater (Myrmecophaga tridactyla, a mammal belonging to the order Xenarthra and family Myrmecophagidae, is an endangered species. For this reason, additional knowledge about its anatomy is of interest, especially the forelimb, which plays important roles in feeding and defense. The goal of this study was to learn more about the origin and distribution of the axillary nerve of Myrmecophaga tridactyla by studying two individuals (one male and one female that belong to the Research Laboratory of Wild Animals (UFU. The study material consisted of corpses fixed and preserved in 10% aqueous formalin solution. Dissection of the material followed standard procedures. In both animals, the axillary nerve was found in the ventral branch of the sixth cervical (C6 and seventh (C7 spinal nerve. This nerve showed symmetry in relation to its position in the two specimens and branched into the teres major, teres minor and deltoid muscles. In both specimens the axillary nerve originated in the cranial cutaneous branch of the lower leg.

presence of axillary bud and application of plant growth hormones

African Journals Online (AJOL)

D. alata)- were grown in pots in the greenhouse. Half the cuttings bore axillary buds and half had none. The cuttings were sprayed with a factorial combination of indole acetic acid (IAA), benzyladenine (BA) and giberellic acid (GA3). Cuttings ...

Staging primary breast cancer. Are there tumour pathological features that correlate with a false-negative axillary ultrasound?

International Nuclear Information System (INIS)

Johnson, S.; Brown, S.; Porter, G.; Steel, J.; Paisley, K.; Watkins, R.; Holgate, C.

2011-01-01

Aim: To investigate whether the histopathological characteristics of primary breast cancer tumours could predict the likelihood of false-negative axillary ultrasound. Materials and methods: Screening and symptomatic patients were identified from pathology records and imaging and pathology records reviewed. True and false-negative axillary staging ultrasound groups were compared statistically in terms of tumour size, pathological type and grade, lymphovascular invasion, and oestrogen receptor (ER) status. Results: Of 155 women with normal ultrasounds, 45 (29%) were node positive at axillary surgery. Breast tumour size was significantly different with the average size smaller in the true-negative group: 21 versus 30 mm (p < 0.02). The histological type varied significantly between the groups, with more lobular carcinomas in the false-negative group [6/110 (5%) versus 6/45 (13%), p < 0.001]. The false-negative group was also more likely to show lymphovascular invasion in the breast [6/110 (5%) versus 14/45 (31%), p < 0.001]. There was no significant difference in tumour grade or ER status. Conclusion: The present study has found significant differences in tumour characteristics between women with true-negative and false-negative axillary staging ultrasound in terms of size, primary tumour histological type and presence of lymphovascular invasion. In particular, axillary ultrasound in primary lobular carcinoma may be less accurate and a negative result is more likely to be spurious than with primary ductal carcinomas.

Validation of the methods of cosmetic assessment after breast-conserving therapy in the EORTC 'boost versus no boost' trial

International Nuclear Information System (INIS)

Vrieling, Conny; Collette, Laurence; Bartelink, Ellen; Borger, Jacques H.; Brenninkmeyer, Stefan J.; Horiot, Jean-Claude; Pierart, Marianne; Poortmans, Philip M.; Struikmans, Henk; Schueren, Emmanuel van der; Dongen, Joop A. van; Limbergen, Erik van; Bartelink, Harry

1999-01-01

Purpose: To evaluate both qualitative and quantitative scoring methods for the cosmetic result after breast-conserving therapy (BCT), and to compare the usefulness and reliability of these methods. Methods and Materials: In EORTC trial 22881/10882, stage I and II breast cancer patients were treated with tumorectomy and axillary dissection. A total of 5318 patients were randomized between no boost and a boost of 16 Gy following whole-breast irradiation of 50 Gy. The cosmetic result was assessed for 731 patients in two ways. A panel scored the qualitative appearance of the breast using photographs taken after surgery and 3 years later. Digitizer measurements of the displacement of the nipple were also made using these photographs in order to calculate the breast retraction assessment (BRA). The cosmetic results after 3-year follow-up were used to analyze the correlation between the panel evaluation and digitizer measurements. Results: For the panel evaluation the intraobserver agreement for the global cosmetic score as measured by the simple Kappa statistic was 0.42, considered moderate agreement. The multiple Kappa statistic for interobserver agreement for the global cosmetic score was 0.28, considered fair agreement. The specific cosmetic items scored by the panel were all significantly related to the global cosmetic score; breast size and shape influenced the global score most. For the digitizer measurements, the standard deviation from the average value of 30.0 mm was 2.3 mm (7.7%) for the intraobserver variability and 2.6 mm (8.7%) for the interobserver variability. The two methods were significantly, though moderately, correlated; some items scored by the panel were only correlated to the digitizer measurements if the tumor was not located in the inferior quadrant of the breast. Conclusions: The intra- and interobserver variability of the digitizer evaluation of cosmesis was smaller than that of the panel evaluation. However, there are some treatment sequelae

Merkel cell carcinoma with axillary metastasis; a case report of a rare disease

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Serdar Culcu

2018-04-01

Full Text Available Merkel cell carcinoma is a rare primer neuroendocrine carcinoma of the skin. It is an extremely aggressive tumor. This rare carcinoma is seen with high local and regional recurrence ratios and distant metastasis. We report that a 64 years old female patient who had undergo an excision in another center because of a mass on 4 cm proximal of her right elbow had been diagnosed with Merkel cell carcinoma with positive surgical margins. She was treated with wide re-excision and axillary dissection at our clinic. Keywords: Merkel cell carcinoma, Skin, Axillary metastasis

Harmonic focus versus electrocautery in axillary lymph node dissection for breast cancer: a randomized clinical study.

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He, Qingqing; Zhuang, Dayong; Zheng, Luming; Fan, Ziyi; Zhou, Peng; Zhu, Jian; Lv, Zhen; Chai, Jixin; Cao, Lei

2012-12-01

Electrocautery has been proven to be associated with prolonged serous drainage that might result in several complications in patients requiring axillary lymph node dissection for breast cancer. We proposed that the Harmonic Focus might outperform electrocautery in axillary lymph node dissection, resulting in shorter operative times and reduced postoperative complications. One hundred twenty-eight women with confirmed T1-3 N1-2 breast cancer were randomly assigned to undergo mastectomy or breast-conserving surgery with axillary dissection by using Harmonic Focus or electrocautery. Sixty-four has surgery with Harmonic Focus (group A) and 64 with electrocautery (group B) by the same surgical team. Operative time, blood loss, total drainage volume and days, incidence of seroma, hematoma, pain score, and flap necrosis were recorded. Using Harmonic Focus significantly diminished operative time, blood loss, total drainage volume, days of stay, and visual analogue scale as compared with traditional electrocautery. There was no statistical difference between the 2 groups regarding seroma, hematoma, and flap necrosis. Axillary lymph node dissection using Harmonic Focus is feasible, safe, and a more comfortable design for the surgeon. Copyright © 2012 Elsevier Inc. All rights reserved.

[Isolated traumatic injuries of the axillary nerve. Radial nerve transfer in four cases and literatura review].

Science.gov (United States)

Domínguez-Páez, Miguel; Socolovsky, Mariano; Di Masi, Gilda; Arráez-Sánchez, Miguel Ángel

2012-11-01

To analyze the results of an initial series of four cases of traumatic injuries of the axillary nerve, treated by a nerve transfer from the triceps long branch of the radial nerve. An extensive analysis of the literature has also been made. Four patients aged between 21 and 42 years old presenting an isolated traumatic palsy of the axillary nerve were operated between January 2007 and June 2010. All cases were treated by nerve transfer six to eight months after the trauma. The results of these cases are analyzed, the same as the axillary nerve injuries series presented in the literature from 1982. One year after the surgery, all patients improved their abduction a mean of 70° (range 30 to 120°), showing a M4 in the British Medical Council Scale. No patient complained of triceps weakness after the procedure. These results are similar to those published employing primary grafting for the axillary nerve. Isolated injuries of the axillary nerve should be treated with surgery when spontaneous recovery is not verified 6 months after the trauma. Primary repair with grafts is the most popular surgical technique, with a rate of success of approximately 90%. The preliminary results of a nerve transfer employing the long triceps branch are similar, and a definite comparison of both techniques with a bigger number of cases should be done in the future. Copyright © 2012 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

Evaluation of axillary dose coverage following whole breast radiotherapy: Variation with the breast volume and shape

International Nuclear Information System (INIS)

Aguiar, Artur; Gomes Pereira, Helena; Azevedo, Isabel; Gomes, Luciano

2015-01-01

Objective: To evaluate the axillary dose coverage in patients treated with tridimensional whole breast radiotherapy (3D-WBRT), according to the breast volume and shape in treatment position. Background: Several studies have demonstrated an insufficient dose contribution to the axillary levels, using 3D-WBRT, remaining unclear whether the breast volume and shape can influence it. Materials and methods: We retrospectively delineated the axillary levels on planning CT-images of 100 patients, treated with 3D-WBRT along 2012 in our institution. To estimate the shape we established an anatomic CT-based interval, defined as the Thoracic Extent (TE). The breast volume matched its CTV. Mean dose levels and V95 (volume receiving at least 95% of the prescribed dose) were evaluated. Results: Mean axillary level I (A1), II (A2) and III (A3) volume was 56.1 cc, 16.5 cc and 18.9 cc, respectively, and mean doses were 43.9 Gy, 38.6 Gy and 19.5 Gy. For breast volumes of <800 cc, 800–999 cc, 1000–1199 cc and >1200 cc, mean A1 V95 was 38%, 51%, 61.2% and 57.2% whereas median A2 V95 was 8.3%, 13.4%, 19.4% and 28% respectively. Regarding shape, where the breast relative position to the TE was categorized in intervals between 31% and 40%, 41% and 50%, 51% and 60%, and 61% and 70%, mean A1 V95 was 38.7%, 43.1%, 51.1% and 77.3% whereas mean A2 V95 was 6.1%, 11.2%, 17.1% and 37% respectively. Conclusions: We observed inadequate dose coverage to all axillary levels, even after applying a sub-analysis accounting for different breast volumes and shapes. Although higher doses were associated with the more voluminous and pendulous breasts, axillary coverage with 3D-WBRT seems to be inefficient, regardless of the breast morphology

Distribution-Specific Agnostic Boosting

OpenAIRE

Feldman, Vitaly

2009-01-01

We consider the problem of boosting the accuracy of weak learning algorithms in the agnostic learning framework of Haussler (1992) and Kearns et al. (1992). Known algorithms for this problem (Ben-David et al., 2001; Gavinsky, 2002; Kalai et al., 2008) follow the same strategy as boosting algorithms in the PAC model: the weak learner is executed on the same target function but over different distributions on the domain. We demonstrate boosting algorithms for the agnostic learning framework tha...

Comparison of the diagnostic value of FDG-PET/CT and axillary ultrasound for the detection of lymph node metastases in breast cancer patients

International Nuclear Information System (INIS)

Riegger, Carolin; Heusner, Till A.; Koeninger, Angela; Kimmig, Rainer; Hartung, Verena; Bockisch, Andreas; Otterbach, Friedrich; Forsting, Michael; Antoch, Gerald

2012-01-01

Background. FDG-PET/CT is increasingly being used for breast cancer staging. Its diagnostic accuracy in comparison to ultrasound as the standard non-invasive imaging modality for the evaluation of axillary lymph nodes has yet not been evaluated. Purpose. To retrospectively compare the diagnostic value of full-dose, intravenously contrast-enhanced FDG-PET/CT and ultrasound for the detection of lymph node metastases in breast cancer patients. Material and Methods. Ninety patients (one patient with a bilateral carcinoma) (89 women, one man; mean age, 55.5 ± 16.6 years) suffering from primary breast cancer underwent whole-body FDG-PET/CT and axillary ultrasound. The ipsilateral axillary fossa (n = 91) was evaluated for metastatic spread. The sensitivity, specificity, the positive predictive value (PPV), negative predictive value (NPV), and accuracy of both methods were calculated. The sensitivity and accuracy were statistically compared using the McNemar Test (P <0.05). Analyses were made on a patient basis. The number of patients with extra-axillary locoregional lymph node metastases exclusively detected by FDG-PET/CT was evaluated. For axillary lymph node metastases histopathology served as the reference standard. Results. The sensitivity, specificity, PPV, NPV, and accuracy of FDG-PET/CT for the detection of axillary lymph node metastases were 54%, 89%, 77%, 74%, and 75%, respectively. For ultrasound it was 38%, 78%, 54%, 65%, and 62%, respectively. FDG-PET/CT was significantly more accurate than ultrasound for the detection of axillary lymph node metastases (P = 0.019). There was no statistically significant difference between the sensitivity of both modalities (P = 0.0578). FDG-PET/CT detected extra-axillary locoregional lymph node metastases in seven patients (8%) that had not been detected by another imaging modality. Conclusion. Though more accurate compared to ultrasound for evaluating the axillary lymph node status FDG-PET/CT is only as sensitive as

Use of ropivacain and lidocaine for axillary plexus blockade ...

African Journals Online (AJOL)

Use of ropivacain and lidocaine for axillary plexus blockade. ... of the juvenile anatomy, psychological barriers, time constraints on block ... children in the age group of 2 to 10 years and undergoing short upper limb surgery. ... Browse By Category · Browse Alphabetically · Browse By Country · List All Titles · Free To Read ...

Feasibility study of axillary reverse mapping lymphoscintigraphy in carcinoma breast: A concept toward preventing lymphedema

International Nuclear Information System (INIS)

Gandhi, Sunny J.; Satish, C.; Sundaram, Palaniswamy Shanmuga; Subramanyam, Padma; Vijaykumar, D. K.

2016-01-01

In the surgery of breast cancer, axillary reverse mapping (ARM) is the identification and preservation of arm draining lymph node (ARM node) during an axillary dissection. The assumption is that the ARM node is different from node draining breast and is unlikely to be involved even in the patients with axillary nodal metastases. If we can identify and preserve ARM node using lymphoscintigraphy; morbidity of lymphedema, as seen with axillary dissection, may be avoided. Pathologically proven 50 breast cancer patients undergoing initial surgery (cTx-4, cN0-2, and Mx-0) were included in this study. Less than 37 MBq, 0.5 ml in equally divided doses of filtered 99mTc sulfur colloid was injected intradermally into the second and third web spaces. ARM nodes in the axilla were identified with the help of Gamma Probe intraoperatively; however, their location was noted with the reference to specific anatomical landmarks and sent for histopathological examination after excision. The ARM node was successfully identified in 47/50 cases (sensitivity - 94%). In 40 out of 47 cases (85%), the location of the ARM node was found to lateral to the subscapular pedicle, above the second intercostobrachial nerve and just below the axillary vein. Of the 47 patients in whom ARM node/s were identified, metastasis was noted in 5 of them (10%). Four out of these 5 patients had the pN3 disease. ARM node exists, and it is feasible to identify ARM node using radio isotope technique with an excellent sensitivity. ARM node seems to have a fairly constant location in more than 80% cases. It is involved with metastasis (10% cases) only when there are multiple lymph nodal metastases in the axilla

Contemporary management of subclavian and axillary artery injuries-A Western Trauma Association multicenter review.

Science.gov (United States)

Waller, Christine J; Cogbill, Thomas H; Kallies, Kara J; Ramirez, Luis D; Cardenas, Justin M; Todd, S Rob; Chapman, Kayla J; Beckman, Marshall A; Sperry, Jason L; Anto, Vincent P; Eriksson, Evert A; Leon, Stuart M; Anand, Rahul J; Pearlstein, Maura; Capano-Wehrle, Lisa; Cothren Burlew, Clay; Fox, Charles J; Cullinane, Daniel C; Roberts, Jennifer C; Harrison, Paul B; Berg, Gina M; Haan, James M; Lightwine, Kelly

2017-12-01

Subclavian and axillary artery injuries are uncommon. In addition to many open vascular repairs, endovascular techniques are used for definitive repair or vascular control of these anatomically challenging injuries. The aim of this study was to determine the relative roles of endovascular and open techniques in the management of subclavian and axillary artery injuries comparing hospital outcomes, and long-term limb viability. A multicenter, retrospective review of patients with subclavian or axillary artery injuries from January 1, 2004, to December 31, 2014, was completed at 11 participating Western Trauma Association institutions. Statistical analysis included χ, t-tests, and Cochran-Armitage trend tests. A p value less than 0.05 was significant. Two hundred twenty-three patients were included; mean age was 36 years, 84% were men. An increase in computed tomography angiography and decrease in conventional angiography was observed over time (p = 0.018). There were 120 subclavian and 119 axillary artery injuries. Procedure type was associated with injury grade (p < 0.001). Open operations were performed in 135 (61%) patients, including 93% of greater than 50% circumference lacerations and 83% of vessel transections. Endovascular repairs were performed in 38 (17%) patients; most frequently for pseudoaneurysms. Fourteen (6%) patients underwent a hybrid procedure. Use of endovascular versus open procedures did not increase over the duration of the study (p = 0.248). In-hospital mortality rate was 10%. Graft or stent thrombosis occurred in 7% and graft or stent infection occurred in 3% of patients. Mean follow-up was 1.6 ± 2.4 years (n = 150). Limb salvage was achieved in 216 (97%) patients. The management of subclavian and axillary artery injuries still requires a wide variety of open exposures and procedures, especially for the control of active hemorrhage from more than 50% vessel lacerations and transections. Endovascular repairs were used most often for

Comparison of posterior fossa and tumor bed boost in medulloblastoma.

Science.gov (United States)

Paulino, A C; Saw, C B; Wen, B C

2000-10-01

To quantify the difference between the area of brain irradiated using the posterior fossa boost (PFB) and tumor bed boost (TBB) in medulloblastoma, we studied 15 simulation radiographs of patients treated in our institution from 1990 and 1999. The PFB was compared with the TBB, which was defined as the tumor bed plus 2-cm margin as demonstrated by postoperative magnetic resonance imaging. The PFB field treated a mean area of 9.43 cm2 more brain than the TBB. In 3 patients (20%), the area of the brain in the TBB was larger than the PFB. In 11 patients (73.3%), the PFB field had more than 10% more brain than the TBB. The cochlea was in the PFB and TBB field in all patients. In more than two thirds of patients, the area of brain irradiated with the PFB was at least 10% greater than the TBB. Future studies are needed to determine whether the TBB can replace the PFB in patients with medulloblastoma.

Axillary artery to left anterior descending coronary artery bypass with an externally stented graft: a technical report

Directory of Open Access Journals (Sweden)

Salvador Loris

2008-02-01

Full Text Available Abstract With the proliferation of minimally invasive cardiac surgery a number of alternative inflow sites for coronary artery bypass grafting have been utilized, especially in higher risk patients. The use of axillary-coronary artery bypass is a safe and effective alternative especially in the case of patients requiring redo coronary revascularization. However, the length and convoluted course of the axillary-coronary vein graft makes is susceptible to twisting, trauma and neointimal hyperplasia. We therefore report a case of an axillary-coronary artery bypass in a high risk patient in which a Dacron conduit was used to externally support and protect the vein graft to the left anterior descending artery. Surgical technique and considerations are presented and discussed.

Quantifying the number of lymph nodes identified in one-stage versus two-stage axillary dissection in breast cancer

DEFF Research Database (Denmark)

Damgaard, Olaf E; Jensen, Maj-Britt; Kroman, Niels

2013-01-01

To establish whether a different number of lymph nodes is identified in a delayed versus an immediate axillary lymph node dissection (ALND) in breast cancer patients.......To establish whether a different number of lymph nodes is identified in a delayed versus an immediate axillary lymph node dissection (ALND) in breast cancer patients....

Technique for axillary radiotherapy using computer-assisted planning for high-risk skin cancerΤ

International Nuclear Information System (INIS)

Fogarty, G.B.; Martin, J.M.; Fay, M.; Ainslie J; Cassumbhoy, R.

2007-01-01

High-risk skin cancer arising on the upper limb or trunk can cause axillary nodal metastases. Previous studies have shown that axillary radiotherapy improves regional control. There is little published work on technique. Technique standardization is important in quality assurance and comparison of results especially for trials. Our technique, planned with CT assistance, is presented. To assess efficacy, an audit of patients treated in our institution over a 15-month period was conducted. Of 24 patients treated, 13 were treated with radical intent, 11 with this technique. With a follow up of over 2 years, the technique had more than a 90% (10/11) regional control in this radical group. Both of the radical patients who were not treated according to the technique had regional failure. One case of late toxicity was found, of asymptomatic lymphoedema in a radically treated patient. This technique for axillary radiotherapy for regional control of skin cancer is acceptable in terms of disease control and toxicity as validated by audit at 2 years

Sentinel Node Biopsy Alone versus Completion Axillary Node Dissection in Node Positive Breast Cancer: Systematic Review and Meta-Analysis

Directory of Open Access Journals (Sweden)

Rachna Ram

2014-01-01

Full Text Available Introduction. There has been recent interest in validity of completion axillary node dissection after a positive sentinel node. This systematic review aims to ascertain if sentinel lymph node dissection alone was noninferior to axillary lymph node dissection for breast cancer patients who have a positive sentinel node. Method. A systematic review of the electronic databases Embase, MEDLINE, and Cochrane Register of Controlled Trials was carried out. Only randomised trials that had patients with positive sentinel node as the study sample were included in the meta-analysis using the reported hazard ratios with a fixed effect model. Results. Three randomised controlled trials and five retrospective studies were identified. The pooled effect for overall survival was HR 0.94, 95% CI [0.79, 1.19], and for disease free survival was HR 0.83, 95% CI [0.60, 1.14]. The reported rates for locoregional recurrence were similar in both groups. The surgical morbidity was found to be significantly more in patients who had underwent axillary dissection. Conclusion. Amongst patients with micrometastasis in the sentinel node, no further axillary dissection is necessary. For patients with macrometastasis in the sentinel node, it is reasonable to consider omitting axillary dissection to avoid the morbidity of the procedure.

Gradient Boosting Machines, A Tutorial

Directory of Open Access Journals (Sweden)

Alexey eNatekin

2013-12-01

Full Text Available Gradient boosting machines are a family of powerful machine-learning techniques that have shown considerable success in a wide range of practical applications. They are highly customizable to the particular needs of the application, like being learned with respect to different loss functions. This article gives a tutorial introduction into the methodology of gradient boosting methods. A theoretical information is complemented with many descriptive examples and illustrations which cover all the stages of the gradient boosting model design. Considerations on handling the model complexity are discussed. A set of practical examples of gradient boosting applications are presented and comprehensively analyzed.

The surgical importance of an axillary arch in sentinel node biopsy.

LENUS (Irish Health Repository)

Ridgway, P F

2011-03-01

When Carl Langer described the aberrant axillary arch in 1846 its relevance in sentinel node biopsy (SNB) surgery could not have been contemplated. The authors define an incidence and elucidate relevance of the arch in SNB of the axilla.

A case of recurrent metastasis in the supraclavicular and axillary lymph nodes and vertebrae following irradiation and paclitaxel plus bevacizumab administration

International Nuclear Information System (INIS)

Nishiyama, Yasuyuki; Nishimura, Reiki; Ohsako, Tomofumi; Tashima, Rumiko; Nakano, Masahiro; Fujisue, Mamiko

2013-01-01

A 48-year-old woman with invasive ductal carcinoma of the left breast underwent breast-conserving surgery and axillary dissection; 19 months after surgery, she developed local recurrence. Subsequently, she underwent mastectomy and received endocrine therapy and chemotherapy. At 47 years of age, she developed pleural metastasis, which directly invaded the vertebrae as well as the right supraclavicular and right axillary lymph nodes. In addition, liver metastasis was observed. To avoid acute transverse myelopathy, the patient received radiation therapy to the vertebrae and the right supraclavicular and right axillary lymph nodes followed by paclitaxel plus bevacizumab administration. After 2 courses of paclitaxel plus bevacizumab, we observed a remarkable shrinkage of the vertebral tumor, and skin necrosis was observed in the right supraclavicular and right axillary region; in contrast, the liver metastasis had increased in size. After discontinuation of the combination therapy, the patient died of blood loss from the axillary skin defect. This wound healing complication might have arisen because of the synergistic effects of paclitaxel plus bevacizumab and irradiation. (author)

Substructure of Highly Boosted Massive Jets

Energy Technology Data Exchange (ETDEWEB)

Alon, Raz [Weizmann Inst. of Science, Rehovot (Israel)

2012-10-01

Modern particle accelerators enable researchers to study new high energy frontiers which have never been explored before. This realm opens possibilities to further examine known fields such as Quantum Chromodynamics. In addition, it allows searching for new physics and setting new limits on the existence of such. This study examined the substructure of highly boosted massive jets measured by the CDF II detector. Events from 1.96 TeV proton-antiproton collisions at the Fermilab Tevatron Collider were collected out of a total integrated luminosity of 5.95 fb$^{-1}$. They were selected to have at least one jet with transverse momentum above 400 GeV/c. The jet mass, angularity, and planar flow were measured and compared with predictions of perturbative Quantum Chromodynamics, and were found to be consistent with the theory. A search for boosted top quarks was conducted and resulted in an upper limit on the production cross section of such top quarks.

The sensitivity of pre-operative axillary staging in breast cancer: comparison of invasive lobular and ductal carcinoma.

Science.gov (United States)

Topps, A; Clay, V; Absar, M; Howe, M; Lim, Y; Johnson, R; Bundred, N

2014-07-01

Axillary ultrasound (AUS) with fine-needle aspiration (FNA) biopsy of abnormal lymph nodes is important for pre-operative staging and planning the surgical management of the axilla. Invasive lobular carcinoma (ILC) metastases are thought to be difficult to detect because the cells are small and on cytology resemble lymphocytes. To investigate this we directly compared the sensitivity of pre-operative axillary staging between ILC and invasive ductal carcinoma (IDC). Consecutive patients that presented in a single breast unit with pure IDC between April 2005 and December 2006 and pure ILC between January 2008 and December 2012 were retrospectively identified from pathology records. Pre-operative axillary ultrasound and FNA biopsy results were compared with post-operative histopathology from the sentinel node biopsy (SNB) or axillary lymph node dissection (ALND). A total of 275 and 142 axillae were identified in the IDC and ILC groups respectively. In the node positive patients there was no significant difference in the sensitivity of AUS (IDC vs. ILC; 58.7% vs. 52.8%). However, there was a significant difference in the sensitivity of ultrasound-guided FNA biopsy of abnormal nodes (IDC vs. ILC; 98.4% vs. 53.6%; p < 0.001). AUS has comparative sensitivities between IDC and ILC populations. In contrast, FNA biopsy of abnormal axillary nodes is clearly less sensitive in the ILC group. In these patients, who have abnormal AUS, we suggest that a core biopsy is required to improve the pre-operative staging and prevent unnecessary surgical procedures. Copyright © 2014 Elsevier Ltd. All rights reserved.

Dosimetric comparison of intensity-modulated, conformal, and four-field pelvic radiotherapy boost plans for gynecologic cancer: a retrospective planning study

International Nuclear Information System (INIS)

Chan, Philip; Yeo, Inhwan; Perkins, Gregory; Fyles, Anthony; Milosevic, Michael

2006-01-01

To evaluate intensity-modulated radiation therapy (IMRT) as an alternative to conformal radiotherapy (CRT) or 4-field box boost (4FB) in women with gynecologic malignancies who are unsuitable for brachytherapy for technical or medical reasons. Dosimetric and toxicity information was analyzed for 12 patients with cervical (8), endometrial (2) or vaginal (2) cancer previously treated with external beam pelvic radiotherapy and a CRT boost. Optimized IMRT boost treatment plans were then developed for each of the 12 patients and compared to CRT and 4FB plans. The plans were compared in terms of dose conformality and critical normal tissue avoidance. The median planning target volume (PTV) was 151 cm 3 (range 58–512 cm 3 ). The median overlap of the contoured rectum with the PTV was 15 (1–56) %, and 11 (4–35) % for the bladder. Two of the 12 patients, both with large PTVs and large overlap of the contoured rectum and PTV, developed grade 3 rectal bleeding. The dose conformity was significantly improved with IMRT over CRT and 4FB (p ≤ 0.001 for both). IMRT also yielded an overall improvement in the rectal and bladder dose-volume distributions relative to CRT and 4FB. The volume of rectum that received the highest doses (>66% of the prescription) was reduced by 22% (p < 0.001) with IMRT relative to 4FB, and the bladder volume was reduced by 19% (p < 0.001). This was at the expense of an increase in the volume of these organs receiving doses in the lowest range (<33%). These results indicate that IMRT can improve target coverage and reduce dose to critical structures in gynecologic patients receiving an external beam radiotherapy boost. This dosimetric advantage will be integrated with other patient and treatment-specific factors, particularly internal tumor movement during fractionated radiotherapy, in the context of a future image-guided radiation therapy study

Impact of axillary nodal metastases on lymphatic mapping and sentinel lymph node identification rate in patients with early stage breast cancer

International Nuclear Information System (INIS)

Pelosi, Ettore; Ala, Ada; Bussone, Riccardo; Bello, Marilena; Douroukas, Anastasios; Varetto, Teresio; Migliaretti, Giuseppe; Berardengo, Ester; Bisi, Gianni

2005-01-01

The aim of this study was to define the impact of the presence of axillary nodal metastases on lymphatic mapping and sentinel lymph node (SLN) identification rate in patients with early breast cancer. Two hundred and forty-six lymphatic mapping procedures were performed with both labelled nanocolloid and blue dye, followed by SLN biopsy and/or complete axillary dissection. The following parameters were recorded: patient's age, tumour laterality and location, tumour size, tumour histology, tumour stage, tumour grade, lymphovascular invasion, radiotracer injection site (subdermal-peritumoural/peri-areolar), SLN visualisation at lymphoscintigraphy, SLN metastases (presence/absence, size) and other axillary metastases (presence/absence, number). Discriminant analysis was used to analyse the data. SLNs were identified by labelled nanocolloid alone in 94.7% of tumours, by blue dye alone in 93.5% and by the combined technique in 99.2%. Discriminant analysis showed the gamma probe SLN identification rate to be significantly limited by the presence of axillary nodal metastases. In particular, the size of SLN metastases and the number of other axillary metastases were the most important variables in reducing the gamma probe SLN identification rate (p=0.004 and p=0.002, respectively). On the other hand, high tumour grade was the only parameter limiting the blue dye SLN identification rate. The accuracy of lymphatic mapping with labelled nanocolloid is limited by the presence of axillary nodal metastases, and particularly by the degree of SLN tumoural invasion and the presence and number of other axillary nodal metastases. Neither of these elements seems to interfere with the blue dye identification rate. The combination of the two tracers maximises the SLN identification rate. (orig.)

Impact of axillary nodal metastases on lymphatic mapping and sentinel lymph node identification rate in patients with early stage breast cancer

Energy Technology Data Exchange (ETDEWEB)

Pelosi, Ettore [Ospedale S. Giovanni Battista, S.C.D.U. Medicina Nucleare 2, Turin (Italy); Universita Torino, Dottorato di Ricerca Radioimmunolocalizzazione dei Tumori Umani, Turin (Italy); Ala, Ada; Bussone, Riccardo [Ospedale S. Giovanni Battista, Reparto di Chirurgia Oncologica 10, Turin (Italy); Bello, Marilena; Douroukas, Anastasios; Varetto, Teresio [Ospedale S. Giovanni Battista, S.C.D.U. Medicina Nucleare 2, Turin (Italy); Migliaretti, Giuseppe [Universita di Torino, Dipartimento di Sanita Pubblica e Microbiologia, Turin (Italy); Berardengo, Ester [Ospedale S. Giovanni Battista, Servizio di Anatomia Patologica 4, Turin (Italy); Bisi, Gianni [Ospedale S. Giovanni Battista, S.C.D.U. Medicina Nucleare 2, Turin (Italy); Universita di Torino, Dipartimento di Medicina Interna, SCDU Medicina Nucleare 2, Turin (Italy)

2005-08-01

The aim of this study was to define the impact of the presence of axillary nodal metastases on lymphatic mapping and sentinel lymph node (SLN) identification rate in patients with early breast cancer. Two hundred and forty-six lymphatic mapping procedures were performed with both labelled nanocolloid and blue dye, followed by SLN biopsy and/or complete axillary dissection. The following parameters were recorded: patient's age, tumour laterality and location, tumour size, tumour histology, tumour stage, tumour grade, lymphovascular invasion, radiotracer injection site (subdermal-peritumoural/peri-areolar), SLN visualisation at lymphoscintigraphy, SLN metastases (presence/absence, size) and other axillary metastases (presence/absence, number). Discriminant analysis was used to analyse the data. SLNs were identified by labelled nanocolloid alone in 94.7% of tumours, by blue dye alone in 93.5% and by the combined technique in 99.2%. Discriminant analysis showed the gamma probe SLN identification rate to be significantly limited by the presence of axillary nodal metastases. In particular, the size of SLN metastases and the number of other axillary metastases were the most important variables in reducing the gamma probe SLN identification rate (p=0.004 and p=0.002, respectively). On the other hand, high tumour grade was the only parameter limiting the blue dye SLN identification rate. The accuracy of lymphatic mapping with labelled nanocolloid is limited by the presence of axillary nodal metastases, and particularly by the degree of SLN tumoural invasion and the presence and number of other axillary nodal metastases. Neither of these elements seems to interfere with the blue dye identification rate. The combination of the two tracers maximises the SLN identification rate. (orig.)

Ten-year results of accelerated hypofractionated adjuvant whole-breast radiation with concomitant boost to the lumpectomy cavity after conserving surgery for early breast cancer.

Science.gov (United States)

Cante, Domenico; Petrucci, Edoardo; Sciacero, Piera; Piva, Cristina; Ferrario, Silvia; Bagnera, Silvia; Patania, Sebastiano; Mondini, Guido; Pasquino, Massimo; Casanova Borca, Valeria; Vellani, Giorgio; La Porta, Maria Rosa; Franco, Pierfrancesco

2017-09-01

Accelerated hypofractionated whole-breast radiotherapy (WBRT) is considered a standard therapeutic option for early breast cancer (EBC) in the postoperative setting after breast conservation (BCS). A boost to the lumpectomy cavity may further increase local control. We herein report on the 10-year results of a series of EBC patients treated after BCS with hypofractionated WBRT with a concomitant photon boost to the surgical bed over 4 weeks. Between 2005 and 2007, 178 EBC patients were treated with a basic course of radiotherapy consisting of 45 Gy to the whole breast in 20 fractions (2.25 Gy daily) with an additional boost dose of 0.25 Gy delivered concomitantly to the lumpectomy cavity, for an additional dose of 5 Gy. Median follow-up period was 117 months. At 10-year, overall, cancer-specific, disease-free survival and local control were 92.2% (95% CI 88.7-93.4%), 99.2% (95% CI 96.7-99.7%), 95.5% (95% CI 91.2-97.2%) and 97.3% (95% CI 94.5-98.9%), respectively. Only eight patients recurred. Four in-breast recurrences, two axillary node relapses and two metastatic localizations were observed. Fourteen patients died during the observation period due to other causes while breast cancer-related deaths were eight. At last follow-up, ≥G2 fibrosis and telangiectasia were seen in 7% and 5% of patients. No major lung and heart toxicities were observed. Cosmetic results were excellent/good in 87.8% of patients and fair/poor in 12.2%. Hypofractionated WBRT with concomitant boost to the lumpectomy cavity after BCS in EBC led to consistent clinical results at 10 years. Hence, it can be considered a valid treatment option in this setting.

Robust loss functions for boosting.

Science.gov (United States)

Kanamori, Takafumi; Takenouchi, Takashi; Eguchi, Shinto; Murata, Noboru

2007-08-01

Boosting is known as a gradient descent algorithm over loss functions. It is often pointed out that the typical boosting algorithm, Adaboost, is highly affected by outliers. In this letter, loss functions for robust boosting are studied. Based on the concept of robust statistics, we propose a transformation of loss functions that makes boosting algorithms robust against extreme outliers. Next, the truncation of loss functions is applied to contamination models that describe the occurrence of mislabels near decision boundaries. Numerical experiments illustrate that the proposed loss functions derived from the contamination models are useful for handling highly noisy data in comparison with other loss functions.

Breast-axillary complex in HIV/AIDS patients | Eni | Nigerian Journal ...

African Journals Online (AJOL)

This is a report of three cases seen and managed by the authors. : Three adult female patients presented with progressively increasing axillary and ipsilateral breast swellings. They also had associated fevers and weight loss. Their main concern had been development of breast cancer. One of the patients was a known ...

Ultrasound-Guided Single-Injection Infraclavicular Block Versus Ultrasound-Guided Double-Injection Axillary Block: A Noninferiority Randomized Controlled Trial.

Science.gov (United States)

Boivin, Ariane; Nadeau, Marie-Josée; Dion, Nicolas; Lévesque, Simon; Nicole, Pierre C; Turgeon, Alexis F

2016-01-01

Single-injection ultrasound-guided infraclavicular block is a simple, reliable, and effective technique. A simplified double-injection ultrasound-guided axillary block technique with a high success rate recently has been described. It has the advantage of being performed in a superficial and compressible location, with a potentially improved safety profile. However, its effectiveness in comparison with single-injection infraclavicular block has not been established. We hypothesized that the double-injection ultrasound-guided axillary block would show rates of complete sensory block at 30 minutes noninferior to the single-injection ultrasound-guided infraclavicular block. After approval by our research ethics committee and written informed consent, adults undergoing distal upper arm surgery were randomized to either group I, ultrasound-guided single-injection infraclavicular block, or group A, ultrasound-guided double-injection axillary block. In group I, 30 mL of 1.5% mepivacaine was injected posterior to the axillary artery. In group A, 25 mL of 1.5% mepivacaine was injected posteromedial to the axillary artery, after which 5 mL was injected around the musculocutaneous nerve. Primary outcome was the rate of complete sensory block at 30 minutes. Secondary outcomes were the onset of sensory and motor blocks, surgical success rates, performance times, and incidence of complications. All outcomes were assessed by a blinded investigator. The noninferiority of the double-injection ultrasound-guided axillary block was considered if the limits of the 90% confidence intervals (CIs) were within a 10% margin of the rate of complete sensory block of the infraclavicular block. At 30 minutes, the rate of complete sensory block was 79% in group A (90% CI, 71%-85%) compared with 91% in group I (90% CI, 85%-95%); the upper limit of CI of group A is thus included in the established noninferiority margin of 10%. The rate of complete sensory block was lower in group A (proportion

Breast and Axillary Lymph Nodes Metastasis five years after Radical ...

African Journals Online (AJOL)

Breast is an uncommon and rare site for metastasis. Primary and secondary tumors of the breast need to be differentiated as management is different. We present a 67 year old female patient with two breast lumps and an axillary lymph node, 5 years after nephrectomy for Renal Cell Carcinoma (RCC). Mammogram report ...

Deep Incremental Boosting

OpenAIRE

Mosca, Alan; Magoulas, George D

2017-01-01

This paper introduces Deep Incremental Boosting, a new technique derived from AdaBoost, specifically adapted to work with Deep Learning methods, that reduces the required training time and improves generalisation. We draw inspiration from Transfer of Learning approaches to reduce the start-up time to training each incremental Ensemble member. We show a set of experiments that outlines some preliminary results on some common Deep Learning datasets and discuss the potential improvements Deep In...

[Selective biopsy of the sentinel lymph node in breast cancer: without axillary recurrences after a mean follow-up of 4.5 years].

Science.gov (United States)

Bañuelos Andrío, Luis; Rodríguez Caravaca, Gil; Argüelles Pintos, Miguel; Mitjavilla Casanova, Mercedes

2014-01-01

To analyze the rate of axillary recurrences (AR) in patients with early breast cancer who had not undergone an axillary node dissection (ALND) because of a negative sentinel lymph node biopsy (SLNB). The study includes 173 patients operated on for breast cancer and selective node biopsy. In 32 patients the SLNB was positive and undergone subsequent ALND. We followed up 141 patients with negative SLNB without LDN, with a median follow up of 55 months (range 74-36). The detection rate of SLN was of 99.42%. After a median follow-up of 4.5 years, there were no axillary recurrences. Two patients developed local recurrence, other two patients developed distant metastases and four patients developed a metachronous tumor. Four patients died, none of them because of breast cancer. The results obtained support the SLNB as an accurate technique in the axillary stratification of patients with breast cancer, offering in the cases of negative SLNB a safe axillary control after 4.5 year follow-up. Copyright © 2013 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

A Phase I Dose Escalation Study of Hypofractionated IMRT Field-in-Field Boost for Newly Diagnosed Glioblastoma Multiforme

Energy Technology Data Exchange (ETDEWEB)

Monjazeb, Arta M., E-mail: arta.monjazeb@ucdmc.ucdavis.edu [U.C. Davis School of Medicine, Department of Radiation Oncology, Sacramento, CA (United States); Ayala, Deandra; Jensen, Courtney [Radiation Oncology, Wake Forest University Health Sciences, Winston-Salem, NC (United States); Case, L. Douglas [Biostatistical Sciences, Wake Forest University Health Sciences, Winston-Salem, NC (United States); Bourland, J. Daniel; Ellis, Thomas L. [Neurosurgery, Wake Forest University Health Sciences, Winston-Salem, NC (United States); McMullen, Kevin P.; Chan, Michael D. [Radiation Oncology, Wake Forest University Health Sciences, Winston-Salem, NC (United States); Tatter, Stephen B. [Neurosurgery, Wake Forest University Health Sciences, Winston-Salem, NC (United States); Lesser, Glen J. [Hematology Oncology, Wake Forest University Health Sciences, Winston-Salem, NC (United States); Shaw, Edward G. [Radiation Oncology, Wake Forest University Health Sciences, Winston-Salem, NC (United States)

2012-02-01

Objectives: To describe the results of a Phase I dose escalation trial for newly diagnosed glioblastoma multiforme (GBM) using a hypofractionated concurrent intensity-modulated radiotherapy (IMRT) boost. Methods: Twenty-one patients were enrolled between April 1999 and August 2003. Radiotherapy consisted of daily fractions of 1.8 Gy with a concurrent boost of 0.7 Gy (total 2.5 Gy daily) to a total dose of 70, 75, or 80 Gy. Concurrent chemotherapy was not permitted. Seven patients were enrolled at each dose and dose limiting toxicities were defined as irreversible Grade 3 or any Grade 4-5 acute neurotoxicity attributable to radiotherapy. Results: All patients experienced Grade 1 or 2 acute toxicities. Acutely, 8 patients experienced Grade 3 and 1 patient experienced Grade 3 and 4 toxicities. Of these, only two reversible cases of otitis media were attributable to radiotherapy. No dose-limiting toxicities were encountered. Only 2 patients experienced Grade 3 delayed toxicity and there was no delayed Grade 4 toxicity. Eleven patients requiring repeat resection or biopsy were found to have viable tumor and radiation changes with no cases of radionecrosis alone. Median overall and progression-free survival for this cohort were 13.6 and 6.5 months, respectively. One- and 2-year survival rates were 57% and 19%. At recurrence, 15 patients received chemotherapy, 9 underwent resection, and 5 received radiotherapy. Conclusions: Using a hypofractionated concurrent IMRT boost, we were able to safely treat patients to 80 Gy without any dose-limiting toxicity. Given that local failure still remains the predominant pattern for GBM patients, a trial of dose escalation with IMRT and temozolomide is warranted.

A Phase I Dose Escalation Study of Hypofractionated IMRT Field-in-Field Boost for Newly Diagnosed Glioblastoma Multiforme

International Nuclear Information System (INIS)

Monjazeb, Arta M.; Ayala, Deandra; Jensen, Courtney; Case, L. Douglas; Bourland, J. Daniel; Ellis, Thomas L.; McMullen, Kevin P.; Chan, Michael D.; Tatter, Stephen B.; Lesser, Glen J.; Shaw, Edward G.

2012-01-01

Objectives: To describe the results of a Phase I dose escalation trial for newly diagnosed glioblastoma multiforme (GBM) using a hypofractionated concurrent intensity-modulated radiotherapy (IMRT) boost. Methods: Twenty-one patients were enrolled between April 1999 and August 2003. Radiotherapy consisted of daily fractions of 1.8 Gy with a concurrent boost of 0.7 Gy (total 2.5 Gy daily) to a total dose of 70, 75, or 80 Gy. Concurrent chemotherapy was not permitted. Seven patients were enrolled at each dose and dose limiting toxicities were defined as irreversible Grade 3 or any Grade 4–5 acute neurotoxicity attributable to radiotherapy. Results: All patients experienced Grade 1 or 2 acute toxicities. Acutely, 8 patients experienced Grade 3 and 1 patient experienced Grade 3 and 4 toxicities. Of these, only two reversible cases of otitis media were attributable to radiotherapy. No dose-limiting toxicities were encountered. Only 2 patients experienced Grade 3 delayed toxicity and there was no delayed Grade 4 toxicity. Eleven patients requiring repeat resection or biopsy were found to have viable tumor and radiation changes with no cases of radionecrosis alone. Median overall and progression-free survival for this cohort were 13.6 and 6.5 months, respectively. One- and 2-year survival rates were 57% and 19%. At recurrence, 15 patients received chemotherapy, 9 underwent resection, and 5 received radiotherapy. Conclusions: Using a hypofractionated concurrent IMRT boost, we were able to safely treat patients to 80 Gy without any dose-limiting toxicity. Given that local failure still remains the predominant pattern for GBM patients, a trial of dose escalation with IMRT and temozolomide is warranted.

Comparison of peripheral nerve stimulator versus ultrasonography guided axillary block using multiple injection technique.

Science.gov (United States)

Kumar, Alok; Sharma, Dk; Sibi, Maj E; Datta, Barun; Gogoi, Biraj

2014-01-01

The established methods of nerve location were based on either proper motor response on nerve stimulation (NS) or ultrasound guidance. In this prospective, randomised, observer-blinded study, we compared ultrasound guidance with NS for axillary brachial plexus block using 0.5% bupivacaine with the multiple injection techniques. A total of 120 patients receiving axillary brachial plexus block with 0.5% bupivacaine, using a multiple injection technique, were randomly allocated to receive either NS (group NS, n = 60), or ultrasound guidance (group US, n = 60) for nerve location. A blinded observer recorded the onset of sensory and motor blocks, skin punctures, needle redirections, procedure-related pain and patient satisfaction. The median (range) number of skin punctures were 2 (2-4) in group US and 3 (2-5) in group NS (P =0.27). Insufficient block was observed in three patient (5%) of group US and four patients (6.67%) of group NS (P > =0.35). Patient acceptance was similarly good in the two groups. Multiple injection axillary blocks with ultrasound guidance provided similar success rates and comparable incidence of complications as compared with NS guidance with 20 ml 0.5% bupivacaine.

Comparison of peripheral nerve stimulator versus ultrasonography guided axillary block using multiple injection technique

Directory of Open Access Journals (Sweden)

Alok Kumar

2014-01-01

Full Text Available Background: The established methods of nerve location were based on either proper motor response on nerve stimulation (NS or ultrasound guidance. In this prospective, randomised, observer-blinded study, we compared ultrasound guidance with NS for axillary brachial plexus block using 0.5% bupivacaine with the multiple injection techniques. Methods : A total of 120 patients receiving axillary brachial plexus block with 0.5% bupivacaine, using a multiple injection technique, were randomly allocated to receive either NS (group NS, n = 60, or ultrasound guidance (group US, n = 60 for nerve location. A blinded observer recorded the onset of sensory and motor blocks, skin punctures, needle redirections, procedure-related pain and patient satisfaction. Results: The median (range number of skin punctures were 2 (2-4 in group US and 3 (2-5 in group NS (P =0.27. Insufficient block was observed in three patient (5% of group US and four patients (6.67% of group NS (P > =0.35. Patient acceptance was similarly good in the two groups. Conclusion: Multiple injection axillary blocks with ultrasound guidance provided similar success rates and comparable incidence of complications as compared with NS guidance with 20 ml 0.5% bupivacaine.

False-positive axillary lymph node on F-18 FDG PET/CT due to moxibustion therapy

Energy Technology Data Exchange (ETDEWEB)

Jeong, Shin Young; Lee, Sang Woo; Ahn, Byeong Cheol; Lee, Jae Tae [Kyungpook National University Hospital, Daegu (Korea, Republic of); Seo, Ji Hyoung [Inje University Haeundae Paik Hospital, Busan (Korea, Republic of)

2010-12-15

A 30-year-old female was diagnosed with papillary thyroid cancer and underwent total thyroidectomy and high-dose radioiodine ablation. F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for recurrence detection of thyroid carcinoma was performed at 3 years after total thyroidectomy. Moxibustion is a traditional Chinese medicine therapy using moxa or the mugwort herb. Moxibustion is the burning of a small, thimble-sized, smoldering plug of dried leaves such as moxa or mugwort on the skin at an acupuncture point. Acupuncture and moxibustion induce hyperemia and a local inflammatory reaction. Complications associated with moxibustion such as skin bums or infection of the site have been reported previously. False-positive FDG uptake in PET may result from inflammation, infection, and variations in physiological uptake. In the present case, the hypermetabolic axillary lymph node disappeared without any treatment. Well-known of false-positive FDG uptake in axillary lymph noes such as arthritis of the upper extremity, extravasation of injected FDG, and vaccination were not found. Thus, left axillary lymph node uptake was

False-positive axillary lymph node on F-18 FDG PET/CT due to moxibustion therapy

International Nuclear Information System (INIS)

Jeong, Shin Young; Lee, Sang Woo; Ahn, Byeong Cheol; Lee, Jae Tae; Seo, Ji Hyoung

2010-01-01

A 30-year-old female was diagnosed with papillary thyroid cancer and underwent total thyroidectomy and high-dose radioiodine ablation. F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for recurrence detection of thyroid carcinoma was performed at 3 years after total thyroidectomy. Moxibustion is a traditional Chinese medicine therapy using moxa or the mugwort herb. Moxibustion is the burning of a small, thimble-sized, smoldering plug of dried leaves such as moxa or mugwort on the skin at an acupuncture point. Acupuncture and moxibustion induce hyperemia and a local inflammatory reaction. Complications associated with moxibustion such as skin bums or infection of the site have been reported previously. False-positive FDG uptake in PET may result from inflammation, infection, and variations in physiological uptake. In the present case, the hypermetabolic axillary lymph node disappeared without any treatment. Well-known of false-positive FDG uptake in axillary lymph noes such as arthritis of the upper extremity, extravasation of injected FDG, and vaccination were not found. Thus, left axillary lymph node uptake was

A case study of an axillary artery pseudoaneurysm following anterior dislocation of the glenohumeral joint: A rare presentation on plain film radiographs

International Nuclear Information System (INIS)

Whittam, Katie; Hardy, Maryann

2007-01-01

Axillary pseudoaneurysm is a rare but important complication of anterior glenohumeral joint dislocation. Diagnosis of axillary pseudoaneurysm is predominantly undertaken following clinical examination but where diagnosis is uncertain, Doppler ultrasound is the imaging examination of choice to confirm diagnosis. In this case study, the initial clinical signs of axillary pseudoaneurysm were masked by the presenting trauma and, although findings indicative of pseudoaneurysm were present on late plain film images, they were not immediately recognised. Misdiagnosis or delayed diagnosis of axillary pseudoaneurysm may result in upper limb morbidity or patient mortality. Consequently, the prompt and accurate identification of an axillary pseudoaneurysm on plain film radiographs, although rare, is essential. Yet for inexperienced film readers, correctly identifying an axillary pseudoaneurysm can be difficult due to its apparent similarity to other pathologies. This article will highlight the differences in radiological appearances between a pseudoaneurysm and a gleno-humeral joint effusion to raise radiographer awareness of the risks and clinical signs of an axillary pseudoaneurysm post gleno-humeral joint dislocation and discuss the difficulties encountered in its diagnosis. Finally, this review will evaluate current diagnostic practices in comparison with best practice, as identified in the literature [Fitzgerald JF, Keates J. False aneurysm as a late complication of anterior shoulder dislocation. Ann Surg 1975;6:785-6; Drury JK, Scullion JE. Vascular complications of anterior dislocation of the shoulder. Br J Surg 1980;67(8):579-81. Waxman DL, France MP, Douglas T, Harryman I. Late lateral displacement of the humeral head after closed reduction of dislocation: a sign of vascular injury. J Bone Joint Surg 1996;78(6):907-10

Permanent pace maker implantation through axillary vein approach

International Nuclear Information System (INIS)

Shah, B.; Hussain, C.; Awan, Z.A.

2017-01-01

Device implantation is an integral part of interventional cardiology particularly electrophysiology. In this study, we are going to share our experience of device implantation technique at electrophysiology department Hayatabad Medical Complex, Peshawar. Methods: the study was conducted from June 2011 to December 2015. Axillary vein was used to implant the devices but in some cases when this rout was not convenient due to any reason then subclavian vein was entered through the Seldinger technique. Fluoroscopy time was less than 10 minutes and total procedure time was not more than 45 minutes. Electric cautery was used only in two cases. Pressure dressing was used in a few cases. Results: Total numbers of permanent pacemakers (PPM) remain 800 during the study period. There were 450 single chamber pacemakers and 350 dual chambers pacemakers. No case of any major bleeding was documented and in very few cases there was mild ooze from the procedure site after the operation which was tackled with pressure dressing. Four cases of pneumothorax were noted during the study period and in three cases chest intubation were done and one patient was kept on conservative management. Patient were followed after one month of discharge from the hospital and then yearly. Eight cases of lead dislodgment were documented during the study period. Conclusion: Axillary vein approach for implantation of permanent pacemakers is a safe and less time-consuming technique. (author)

Diversification in the South American Pampas: the genetic and morphological variation of the widespread Petunia axillaris complex (Solanaceae).

Science.gov (United States)

Turchetto, Caroline; Fagundes, Nelson J R; Segatto, Ana L A; Kuhlemeier, Cris; Solís Neffa, Viviana G; Speranza, Pablo R; Bonatto, Sandro L; Freitas, Loreta B

2014-02-01

Understanding the spatiotemporal distribution of genetic variation and the ways in which this distribution is connected to the ecological context of natural populations is fundamental for understanding the nature and mode of intraspecific and, ultimately, interspecific differentiation. The Petunia axillaris complex is endemic to the grasslands of southern South America and includes three subspecies: P. a. axillaris, P. a. parodii and P. a. subandina. These subspecies are traditionally delimited based on both geography and floral morphology, although the latter is highly variable. Here, we determined the patterns of genetic (nuclear and cpDNA), morphological and ecological (bioclimatic) variation of a large number of P. axillaris populations and found that they are mostly coincident with subspecies delimitation. The nuclear data suggest that the subspecies are likely independent evolutionary units, and their morphological differences may be associated with local adaptations to diverse climatic and/or edaphic conditions and population isolation. The demographic dynamics over time estimated by skyline plot analyses showed different patterns for each subspecies in the last 100 000 years, which is compatible with a divergence time between 35 000 and 107 000 years ago between P. a. axillaris and P. a. parodii, as estimated with the IMa program. Coalescent simulation tests using Approximate Bayesian Computation do not support previous suggestions of extensive gene flow between P. a. axillaris and P. a. parodii in their contact zone. © 2013 John Wiley & Sons Ltd.

A rare case of breast carcinoma co-existing with axillary mantle cell lymphoma

Directory of Open Access Journals (Sweden)

Scally John

2003-12-01

Full Text Available Abstract Background Mantle cell lymphoma (MCL is a rare variety of non-Hodgkin's lymphoma which originates from CD5+ B-cell population in the mantle zones of lymphoid follicles. Coexistence of such tumours in the axillary lymph nodes with invasive breast cancers without prior history of adjuvant chemotherapy or radiotherapy has not been previously reported in literature. Case report We report a rare case of breast cancer co-existing with stage I mantle cell lymphoma of the ipsilateral axillary lymph node detected fortuitously by population screening. Conclusion Though some studies have tried to prove breast carcinomas and lymphomas to share a common molecular or viral link, more research needs to be done to establish whether such a link truly exists.

The Effect of Ketamine and Dexamethasone in Combination with Lidocaine on the Onset and Duration of Axillary Block in Hand and Forearm Soft Tissue Surgery.

Science.gov (United States)

Zaman, Behrooz; Hojjati Ashrafi, Siavash; Seyed Siamdoust, Seyedalireza; Hassani, Valiollah; Mohamad Taheri, Siavash; Noorizad, Samad

2017-10-01

Using peripheral nerve block compared to general anesthesia has gained more popularity due to reduced postoperative pain, less need for post-surgery analgesic drugs, reduced incidence of nausea, shortness of PACU time, and increased patient satisfaction. The aim of this study was to compare the effect of ketamine and dexamethasone as additives to lidocaine on duration and onset of axillary block action. In this clinical trial, all patients who referred to Hazrat-e-Fatemeh hospital for forearm and hand soft tissue surgery with informed consent were randomly divided into three groups in order to examine the onset and duration of axillary block: lidocaine + ketamine, lidocaine + dexamethasone in axillary block, and lidocaine alone (control). Then, the onset and duration of sensory and motor blocks were measured and recorded every three minutes and after the surgery. Quantitative and qualitative variables were analyzed using ANOVA or Kruskal-Wallis test and Chi-square or Fisher exact test in SPSS v.22. Duration of sensory and motor block axillary was significantly higher in lidocaine + dexamethasone group than in lidocaine + ketamine group (P block axillary between the three groups (P > 0.05). According to the results of our study, we can conclude that adding dexamethasone or ketamine to lidocaine could improve duration of sensory and motor axillary block in patients undergoing forearm and hand soft tissue surgery. However, dexamethasone had the highest effect on duration of block axillary. We proved that dexamethasone or ketamine added to lidocaine had no effect on the onset of block axillary.

Component-Minimized Buck-Boost Voltage Source Inverters

DEFF Research Database (Denmark)

Gao, F.; Loh, P.C.; Blaabjerg, Frede

2007-01-01

This paper presents the design of buck-boost B4 inverters that can be derived from either Ćuk- or SEPIC-derived buck-boost B6 inverters. Unlike traditional inverters, the integration of front-end voltage boost circuitry and inverter circuitry allows it to perform buck-boost voltage inversion...... between capacitors. Modulation wise, the proposed buck-boost B4 inverters can be controlled using a carefully designed carrier-based pulse-width modulation (PWM) scheme that will always ensure balanced threephase outputs as desired, while simultaneously achieving minimal voltage stress across...

Readiness for surgery after axillary block

DEFF Research Database (Denmark)

Koscielniak-Nielsen, Z J; Stens-Pedersen, H L; Lippert, F K

1997-01-01

required less time for block performance (mean 5.5 min) than multiple injections (mean 9.5 min), P requirement for supplemental nerve blocks was greater, after single injections (33 min and 57%) than after multiple injections (15.5 min and 7......We have assessed prospectively the time to readiness for surgery following axillary block (sum of block performance and latency times) in 80 patients. The brachial plexus was identified using a nerve stimulator, and anaesthetized with 45 mL of mepivacaine 1% with adrenaline 5 micrograms mL-1......%, respectively), P effectiveness was 100% in group 1 and 98% in group 2 (NS). The frequency of adverse effects (vessel puncture or paraesthesia) was similar...

Can you boost your metabolism?

Science.gov (United States)

... this page: //medlineplus.gov/ency/patientinstructions/000893.htm Can you boost your metabolism? To use the sharing ... boosting metabolism than tactics that work. Some myths can backfire. If you think you are burning more ...

Repair of Multiple Subclavian and Axillary Artery Aneurysms in a 58-Year-Old Man with Marfan Syndrome

OpenAIRE

Dolapoglu, Ahmet; de la Cruz, Kim I.; Preventza, Ourania; Coselli, Joseph S.

2016-01-01

Dilation of the ascending aorta and aortic dissections are often seen in Marfan syndrome; however, true aneurysms of the subclavian and axillary arteries rarely seem to develop in patients who have this disease. We present the case of a 58-year-old man with Marfan syndrome who had undergone a Bentall procedure and thoracoabdominal aortic repair for an aortic dissection and who later developed multiple aneurysmal dilations of his right subclavian and axillary arteries. The aneurysms were succe...

In vitro Proliferation Ability of Axillary Buds in Musa spp | Youmbi ...

African Journals Online (AJOL)

from : Pisang Mas (AA), Grande Naine (AAA), Batard and French Clair (AAB), CRBP 39 (AAAB) and Pelipita (ABB) varieties were used as explants. The proliferation rate of Axillary and apical buds and other growth parameters were measured. Results showed that no significant differences were observed between the two ...

Learning Boost C++ libraries

CERN Document Server

Mukherjee, Arindam

2015-01-01

If you are a C++ programmer who has never used Boost libraries before, this book will get you up-to-speed with using them. Whether you are developing new C++ software or maintaining existing code written using Boost libraries, this hands-on introduction will help you decide on the right library and techniques to solve your practical programming problems.

The role of sonography in patients with breast cancer presenting as an axillary mass

International Nuclear Information System (INIS)

Park, Sun Young; Kim, Eun Kyung; Oh, Ki Keun; Lee, Kyong Sik; Park, Byeong Woo

2002-01-01

To compare sonography and mammography in terms of their diagnostic value in breast cancer cases which initially presented as an axillary mass without a palpable mass or other clinical symptoms. Seven patients with enlarged axillary lymph nodes who first presented with no evidence of palpable breast lesions and who underwent both mammography and sonography were enrolled in this study. In six of the seven, the presence of metastatic adenocarcinoma was confirmed preoperatively by axillary needle aspiration biopsy; in four, subsequent sonographically guided breast core biopsy performed after careful examination of the primary site indicated that primary breast cancer was present. In each case, the radiologic findings were evaluated by both breast sonography and mammography. Breast lesions were detected mammographically in four of seven cases (57%); in three of the four, the lesion presented as a mass, and in one as microcalcification. In three of these four detected cases, fatty or scattered fibroglandular breast parenchyma was present; in one, the parenchyma was dense. In the three cases in which lesions were not detected, mammography revealed the presence of heterogeneously dense parenchyma. Breast sonography showed that lesions were present in six of seven cases (86%); in the remaining patient, malignant microcalcification was detected at mammography. Final pathologic examination indicated that all breast lesions except one, which was a ductal carcinoma in situ, with microinvasion, were infiltrating ductal carcinomas whose size ranged from microscopic to greater than 3 cm. At the time of this study, all seven patients were alive and well, having been disease free for up to 61 months after surgery. In women with a palpable axillary mass confirmed as metastatic adenocarcinoma, breast sonography may be a valuable adjunct to mammography

Technetium-99m-tetrofosmin in diagnosis of breast cancer and axillary lymph node involvement

International Nuclear Information System (INIS)

Jaukovic, Dj.; Ajdinovic, B.Z.; Jankovic, Z. D.; Strbac, M.

2006-01-01

The aim of this study was to evaluate the accuracy of breast cancer seeking agent Tc-99m-Tetrofosmin in the detection of breast malignancy and axillary lymph node metastases. Twenty-eight female patients (mean age 52.4) with 30 breast lesions suspected of malignancy were enrolled in the study. All the patients underwent clinical investigation, Tc-99m Tetrofosmin scintimammography (SMM), mammography (MM) and biopsy/surgery for final histopathologic diagnosis. Patients were injected intravenously with 555 MBq of Tc-99m Tetrofosmin, cubitally, in the contralateral arm to the side of suspicious lesion. Seven minute static scans or at least 2.0 million counts were obtained using single head gamma camera (Orbiter 75, Siemens). Planar images were acquired in left and right prone lateral view as well as in the supine position for an anterior view of chest and axillary region. SMM scans of 30 breast lesions were compared to the definitive histopathology findings (HP) using decision matrix. In the group of 23 patients with positive SMM scans 19 had breast malignancy: 15 infiltrating ductal cancer, three patients with one infiltrating lobular, one papillary, one colloidal cancer and one patient with cystosarcoma phyllodes-malignant type. SMM detected primary breast malignancy with 95% sensitivity, 60% specificity and 83% accuracy. Axillary dissection was performed in 19/20 with malignant disease. The number of lymph nodes extracted and HP evaluated varied from 4 to 23 per patient. Metastatic involvement was confirmed by HP in 9 out of 20 patients. SMM detected axillary metastases with 55% sensitivity and 80% accuracy. Our results showed that SMM might be useful as a complementary test to improve the sensitivity and specificity of conventional imaging modalities, although SMM in the staging of breast carcinoma was less reliable. Further studies to evaluate the role of SMM in metastatic node involvement are necessary. (author)

Association between US features of primary tumor and axillary lymph node metastasis in patients with clinical T1-T2N0 breast cancer.

Science.gov (United States)

Bae, Min Sun; Shin, Sung Ui; Song, Sung Eun; Ryu, Han Suk; Han, Wonshik; Moon, Woo Kyung

2018-04-01

Background Most patients with early-stage breast cancer have clinically negative lymph nodes (LNs). However, 15-20% of patients have axillary nodal metastasis based on the sentinel LN biopsy. Purpose To assess whether ultrasound (US) features of a primary tumor are associated with axillary LN metastasis in patients with clinical T1-T2N0 breast cancer. Material and Methods This retrospective study included 138 consecutive patients (median age = 51 years; age range = 27-78 years) who underwent breast surgery with axillary LN evaluation for clinically node-negative T1-T2 breast cancer. Three radiologists blinded to the axillary surgery results independently reviewed the US images. Tumor distance from the skin and distance from the nipple were determined based on the US report. Association between US features of a breast tumor and axillary LN metastasis was assessed using a multivariate logistic regression model after controlling for clinicopathologic variables. Results Of the 138 patients, 28 (20.3%) had nodal metastasis. At univariate analysis, tumor distance from the skin ( P = 0.019), tumor size on US ( P = 0.023), calcifications ( P = 0.036), architectural distortion ( P = 0.001), and lymphovascular invasion ( P = 0.049) were associated with axillary LN metastasis. At multivariate analysis, shorter skin-to-tumor distance (odds ratio [OR] = 4.15; 95% confidence interval [CI] = 1.01-16.19; P = 0.040) and masses with associated architectural distortion (OR = 3.80; 95% CI = 1.57-9.19; P = 0.003) were independent predictors of axillary LN metastasis. Conclusion US features of breast cancer can be promising factors associated with axillary LN metastasis in patients with clinically node-negative early-stage breast cancer.

Concomitant boost radiotherapy for squamous carcinoma of the tonsillar fossa

International Nuclear Information System (INIS)

Gwozdz, John T.; Morrison, William H.; Garden, Adam S.; Weber, Randal S.; Peters, Lester J.; Ang, K. Kian

1997-01-01

Purpose: To assess the efficacy of a concomitant boost fractionation schedule of radiotherapy for treating patients with squamous carcinoma of the tonsillar fossa. Patients and Methods: Between December 1983 and November 1992, 83 patients with squamous carcinoma of the tonsil were treated with concomitant boost fractionation. The distribution of American Joint Committee on Cancer T stages was TX-4, T1-5, T2-29, T3-41, T4-4; N stages were NX-1, N0-26, N1-13, N2-31, N3-12. Patients were treated with standard large fields to 54 Gy in 6 weeks. The boost treatment consisted of a second daily 1.5 Gy fraction for 10-12 fractions, usually delivered during the final phase of treatment. The tumor dose was 69-72 Gy, given over 6 weeks. Twenty-one patients, who all had N2 or N3 regional disease, underwent neck dissections, either before (13 patients) or 6 weeks after radiotherapy (8 patients); the other patients were treated with radiotherapy alone. Results: The 5-year actuarial disease-specific survival and overall survival rates were 71 and 60%, respectively. Patients with T2 and T3 primary tumors had 5-year actuarial local control rates of 96 and 78%, respectively. Patients with T3 disease who received the final-phase boost had a 5-year actuarial local control rate of 82%. Actuarial 5-year regional disease control rates were N0, 92%; N1, 76%; N2, 89%; and N3, 89%. The 21 patients who had neck dissections all had their disease regionally controlled. Patients presenting with nodal disease or after a node excision who were treated with radiation alone had a 5-year actuarial regional disease control rate of 79%. All but five patients had confluent Grade 4 mucositis during treatment. Severe late complications attributable to radiation included mandibular necrosis, in-field osteosarcoma, and chronic dysphagia for solid foods. Conclusions: High rates of local and regional disease control were achieved with the concomitant boost fractionation schedule, with few cases of severe late

Detection of Illegitimate Emails using Boosting Algorithm

DEFF Research Database (Denmark)

Nizamani, Sarwat; Memon, Nasrullah; Wiil, Uffe Kock

2011-01-01

and spam email detection. For our desired task, we have applied a boosting technique. With the use of boosting we can achieve high accuracy of traditional classification algorithms. When using boosting one has to choose a suitable weak learner as well as the number of boosting iterations. In this paper, we......In this paper, we report on experiments to detect illegitimate emails using boosting algorithm. We call an email illegitimate if it is not useful for the receiver or for the society. We have divided the problem into two major areas of illegitimate email detection: suspicious email detection...

Malampaya to boost flow of foreign investment

International Nuclear Information System (INIS)

Skrebowski, C.

1995-01-01

The petroleum industry in the Philippines has recently enjoyed a boost with the commissioning of a new modern refinery, and the development of sophisticated off-shore technology in the Malampaya/Camago oil and gas field. The foreign investment, which has made these initiatives possible, came about because of the countries new found political stability. It also reflects the rapid economic growth which has occurred and the accompanying increase in energy demand. (UK)

Extranodal extension of axillary metastasis of invasive breast carcinoma as a possible predictor for the total number of positive lymph nodes

NARCIS (Netherlands)

Palamba, H. W.; Rombouts, M. C.; Ruers, T. J.; Klinkenbijl, J. H.; Wobbes, T.

2001-01-01

By the implementation of the sentinel node procedure in the treatment of breast carcinoma routine axillary lymph node, dissection can be abandoned in patients with a tumour-negative sentinel node. When the sentinel node is positive there are two options; an axillary dissection or radiotherapy of the

A clinical assessment tool for ultrasound-guided axillary brachial plexus block.

LENUS (Irish Health Repository)

Sultan, S F

2012-05-01

Competency in anesthesia traditionally has been determined subjectively in practice. Optimal training in procedural skills requires valid and reliable forms of assessment. The objective was to examine a procedure-specific clinical assessment tool for ultrasound-guided axillary brachial plexus block for inter-rater reliability and construct validity in a clinical setting.

Comparison of ultrasound and ultrasound plus nerve stimulator guidance axillary plexus block

International Nuclear Information System (INIS)

Demirelli, G.; Baskan, S.; Karabeyoglu, I.; Aytac, I.; Omek, D.H.; Erdogmus, A.; Baydar, M.

2017-01-01

To evaluate the characteristics of axillary plexus blockade applied using ultrasound only and using ultrasound together with nerve stimulator in patients undergoing planned forearm, wrist or hand surgery. Methods: This randomised, prospective, double-blinded, single-centre study was conducted at Ankara Numune Training and Research Hospital, Ankara, Turkey, from November 2014 to August 2015, and comprised patients undergoing forearm, wrist or hand surgery. Participants were separated into 2 groups. In Group 1, the nerve roots required for the surgical site were located one by one and local anaesthetic was applied separately to each nerve for the block. In Group 2, the vascular nerve bundle was located under ultrasound guidance and a total block was achieved by administering all the local anaesthetic within the nerve sheath. In the operating room, standard monitorisation was applied. Following preparation of the skin, the axillary region nerve roots and branches and vascular structures were observed by examination with a high-frequency ultrasound probe. In both groups, a 22-gauge, 5cm block needle was entered to the axillary region with visualisation of the whole needle on ultrasound and 20ml local anaesthetic of 0.5% bupivacaine was injected. SPSS 19 was used for data analysis. Results: Of the 60 participants, there were 30(50%) in each group. The mean age was 39.1+-15 years in the group 1 which was the ultrasound nerve stimulation group, and 41.5+-14.3 years in group 2. The duration of the procedure was longer in group I than in group 2 (p<0.05). Patient satisfaction values during the procedure were higher in group 2(p<0.05). In the ulnar sensory examination, the values of the patients in group 1 were higher at 10, 15, 20 and 25 minutes (p<0.05). In the median, radial and ulnar motor examination, the values of the patients in group 1were higher at 15 and 20 minutes (p<0.05). Conclusion: Brachial plexus blockade via axillary approach guided by ultrasound offered

Detection of axillary lymph node metastases in breast carcinoma by technetium-99m sestamibi breast scintigraphy, ultrasound and conventional mammography

International Nuclear Information System (INIS)

Lam, W.W.M.; Yang, W.T.; Chan, Y.L.; Stewart, I.E.T.; Metreweli, C.; King, W.

1996-01-01

Axillary lymph node status is important in the staging of breast carcinoma. To evaluate the accuracy of technetium-99m sestamibi breast scintigraphy in detecting metastatic axillary lymph nodes as compared with other accepted imaging modalities, we performed 99m Tc-sestamibi breast scintigraphy, conventional mammography and ultrasound in 36 patients with primary untreated breast cardinoma. With histopathology as the gold standard, 99m Tc-sestamibi breast scintigraphy was found to yield true-positive results in 7 of 11 cases (64%) of axillary lymph nodes metastases and true-negative results in 18 of 20 cases (90%); it has an accuracy of 81%, a positive predictive value of 77.8% and a negative predicive value of 81.8%. (orig.)

The value of completion axillary treatment in sentinel node positive breast cancer patients undergoing a mastectomy: a Dutch randomized controlled multicentre trial (BOOG 2013-07)

International Nuclear Information System (INIS)

Roozendaal, L. M. van; Wilt, J. HW de; Dalen, T. van; Hage, J. A. van der; Strobbe, L. JA; Boersma, L. J.; Linn, S. C.; Lobbes, M. BI; Poortmans, P. MP; Tjan-Heijnen, V. CG; Van de Vijver, K. KBT; Vries, J. de; Westenberg, A. H.; Kessels, A. GH; Smidt, M. L.

2015-01-01

Trials failed to demonstrate additional value of completion axillary lymph node dissection in case of limited sentinel lymph node metastases in breast cancer patients undergoing breast conserving therapy. It has been suggested that the low regional recurrence rates in these trials might partially be ascribed to accidental irradiation of part of the axilla by whole breast radiation therapy, which precludes extrapolation of results to mastectomy patients. The aim of the randomized controlled BOOG 2013–07 trial is therefore to investigate whether completion axillary treatment can be safely omitted in sentinel lymph node positive breast cancer patients treated with mastectomy. This study is designed as a non-inferiority randomized controlled multicentre trial. Women aged 18 years or older diagnosed with unilateral invasive clinically T1-2 N0 breast cancer who are treated with mastectomy, and who have a maximum of three axillary sentinel lymph nodes containing micro- and/or macrometastases, will be randomized for completion axillary treatment versus no completion axillary treatment. Completion axillary treatment can consist of completion axillary lymph node dissection or axillary radiation therapy. Primary endpoint is regional recurrence rate at 5 years. Based on a 5-year regional recurrence free survival rate of 98 % among controls and 96 % for study subjects, the sample size amounts 439 per arm (including 10 % lost to follow-up), to be able to reject the null hypothesis that the rate for study and control subjects is inferior by at least 5 % with a probability of 0.8. Results will be reported after 5 and 10 years of follow-up. We hypothesize that completion axillary treatment can be safely omitted in sentinel node positive breast cancer patients undergoing mastectomy. If confirmed, this study will significantly decrease the number of breast cancer patients receiving extensive treatment of the axilla, thereby diminishing the risk of morbidity and improving quality of

Negative pressure wound therapy, staged excision and definitive closure with split-thickness skin graft for axillary hidradenitis suppurativa: a retrospective study.

Science.gov (United States)

Pearce, F B; Richardson, K A

2017-01-02

Bilateral axillary hidradenitis is a chronic, suppurative, and scarring disease that is most effectively treated by complete excision of all hair-bearing tissues. We assessed our staged procedure for excision and placement of a split-thickness skin graft for bilateral axillary hidradenitis in terms of costs, outcomes, and timing of excision. An IRB approved retrospective case analysis was performed on patients that underwent bilateral axillary hidradenitis skin excision with eventual placement of split-thickness skin grafting using the current LSUHSC/University Health hidradenitis surgical treatment protocol. Using ICD-9 codes (705.83) and CPT codes (11041, 11042, 11451, 11600, 11601, 11602, 11603, 11604) we reviewed cases performed at our institution from 1 January 2008 to 24 Febuary 2014 and we selected patients based on bilateral axillary involvement (alone) and >1 year history of active disease. Patients were excluded if resection of tissue encompassed regions outside of the immediately adjacent axillary. A total of seven patients matching criteria for bilateral axillary hidradenitis were selected for analysis. Clinical course, cost and surgical techniques were assessed. Of the seven patients, six required admission throughout their treatment due to lack of funding making use of negative pressure wound therapy at home not possible. These patients stayed an average of 10 days with a mean hospital charge of $35,178 and a mean hospital provider charge of $10,019. No recurrence was demonstrated. All patients attained full range of motion, post grafting. No patient required a further operation due to graft failure. Split-thickness skin grafting without use of bilayer dermal regenerative templates yielded definitive results with acceptable cosmesis and functionality, without the added cost of treatments such as a bilayer dermal regenerative template.

Evaluation of Breast Sentinel Lymph Node Coverage by Standard Radiation Therapy Fields

International Nuclear Information System (INIS)

Rabinovitch, Rachel; Ballonoff, Ari; Newman, Francis M.S.; Finlayson, Christina

2008-01-01

Background: Biopsy of the breast sentinel lymph node (SLN) is now a standard staging procedure for early-stage invasive breast cancer. The anatomic location of the breast SLN and its relationship to standard radiation fields has not been described. Methods and Materials: A retrospective review of radiotherapy treatment planning data sets was performed in patients with breast cancer who had undergone SLN biopsy, and those with a surgical clip at the SLN biopsy site were identified. The location of the clip was evaluated relative to vertebral body level on an anterior-posterior digitally reconstructed radiograph, treated whole-breast tangential radiation fields, and standard axillary fields in 106 data sets meeting these criteria. Results: The breast SLN varied in vertebral body level position, ranging from T2 to T7 but most commonly opposite T4. The SLN clip was located below the base of the clavicle in 90%, and hence would be excluded from standard axillary radiotherapy fields where the inferior border is placed at this level. The clip was within the irradiated whole-breast tangent fields in 78%, beneath the superior-posterior corner multileaf collimators in 12%, and outside the tangent field borders in 10%. Conclusions: Standard axillary fields do not encompass the lymph nodes at highest risk of containing tumor in breast cancer patients. Elimination of the superior-posterior corner MLCs from the tangent field design would result in inclusion of the breast SLN in 90% of patients treated with standard whole-breast irradiation

Boosted tops at ATLAS

CERN Document Server

Villaplana, M; The ATLAS collaboration

2011-01-01

A sample of candidate events for highly boosted top quarks is selected following the standard ATLAS selection for semi-leptonic ttbar events plus a requirement that the invariant mass of the reconstructed ttbar pair is greater than 700 GeV. Event displays are presented for the most promising candidates, as well as quantitative results for observables designed to isolate a boosted top quark signal.

Intramedullary fixation of proximal humerus fractures: do locking bolts endanger the axillary nerve or the ascending branch of the anterior circumflex artery? A cadaveric study

Directory of Open Access Journals (Sweden)

Sermon An

2008-12-01

Full Text Available Abstract Background Proximal humerus fractures are one of the most common fractures. Intramedullary locked nailing is becoming a popular alternative treatment, especially for easier fracture patterns. Although axillary nerve injury has been reported, no study has compared the safety of the proximal locking options relative to the axillary nerve and the ascending branch of the anterior circumflex artery. Method Six different commercially available proximal humeral nails were implanted in 30 shoulders of 18 cadavers. After fluoroscopically guided implantation the shoulders were carefully dissected and the distance between the locking screws, the axillary nerve and the ascending branch of the anterior circumflex artery was measured. Results The course of the axillary nerve varies. A mean distance of 55.8 mm (SD = 5.3 between the lateral edge of the acromions and the axillary nerve at the middle of the humerus in a neutrally rotated position was observed. The minimum distance was 43.4 mm, the maximum 63.9 mm. Bent nails with oblique head interlocking bolts appeared to be the most dangerous in relation to the axillary nerve. The two designs featuring such a bend and oblique bolt showed a mean distance of the locking screw to the axillary nerve of 1 mm and 2.7 mm respectively Sirus (Zimmer® and (Stryker® T2 PHN (Proximal Humeral Nail. Regarding the ascending branch of the anterior circumflex artery, there was no difference between the nails which have an anteroposterior locking option. Conclusion It is of great importance for surgeons treating proximal humerus fractures to understand the relative risk of any procedure they perform. Since the designs of different nailing systems risk damaging the axillary nerve and ascending branch, blunt dissection, the use of protection sleeves during drilling and screw insertion, and individual risk evaluation prior to the use of a proximal humeral nail are advocated.

Ototoxicity evaluation in medulloblastoma patients treated with involved field boost using intensity-modulated radiation therapy (IMRT): a retrospective review

International Nuclear Information System (INIS)

Vieira, Wilson Albieri; Nadalin, Wladimir; Odone Filho, Vicente; Petrilli, Antonio Sergio; Weltman, Eduardo; Chen, Michael Jenwei; Silva, Nasjla Saba da; Cappellano, Andrea Maria; Pereira, Liliane Desgualdo; Gonçalves, Maria Ines Rabelo; Ferrigno, Robson; Hanriot, Rodrigo Morais

2014-01-01

Ototoxicity is a known side effect of combined radiation therapy and cisplatin chemotherapy for the treatment of medulloblastoma. The delivery of an involved field boost by intensity modulated radiation therapy (IMRT) may reduce the dose to the inner ear when compared with conventional radiotherapy. The dose of cisplatin may also affect the risk of ototoxicity. A retrospective study was performed to evaluate the impact of involved field boost using IMRT and cisplatin dose on the rate of ototoxicity. Data from 41 medulloblastoma patients treated with IMRT were collected. Overall and disease-free survival rates were calculated by Kaplan-Meier method Hearing function was graded according to toxicity criteria of Pediatric Oncology Group (POG). Doses to inner ear and total cisplatin dose were correlated with hearing function by univariate and multivariate data analysis. After a mean follow-up of 44 months (range: 14 to 72 months), 37 patients remained alive, with two recurrences, both in spine with CSF involvement, resulting in a disease free-survival and overall survival of 85.2% and 90.2%, respectively. Seven patients (17%) experienced POG Grade 3 or 4 toxicity. Cisplatin dose was a significant factor for hearing loss in univariate analysis (p < 0.03). In multivariate analysis, median dose to inner ear was significantly associated with hearing loss (p < 0.01). POG grade 3 and 4 toxicity were uncommon with median doses to the inner ear bellow 42 Gy (p < 0.05) and total cisplatin dose of less than 375 mg/m 2 (p < 0.01). IMRT leads to a low rate of severe ototoxicity. Median radiation dose to auditory apparatus should be kept below 42 Gy. Cisplatin doses should not exceed 375 mg/m 2

Hyperfractionated Radiotherapy with Concomitant Boost Technique for Unresectable Non-Small Cell Carcinoma of the Lung

International Nuclear Information System (INIS)

Chun, Ha Chung; Lee, Myung Za

1991-01-01

Twenty five patients with unresectable non-small cell carcinoma of the lung have been treated with hyperfractionated radiotherapy with concomitant boost technique since September, 1989. Those patients with history of previous surgery or chemotherapy, pleural effusion or significant weight loss (greater than 10% of body weight) were excluded from the study. Initially, 27 Gy were delivered in 15 fractions in 3 weeks to the large field. Thereafter, large field received 1.8 Gy and cone down boost field received 1.4Gy with twice a day fractinations up to 49.4Gy. After 49.4Gy, only boost field was treated twice a day with 1.8 and 1.4 Gy. Total tumor doses were 62.2Gy for 12 patients and 65.4Gy for remaining 13 patients. Follow up period was ranged from 6 to 24 month. Actuarial survival rates at 6, 12, and 18 month were 88%, 62%, and 38%, respectively. Corresponding disease free survival rates were 88%, 41%, and 21%, respectively. Actuarial cumulative local failure rates at 9,12 and 15 month were 36%, 42%, and 59%, respectively. No significant increase of acute or late complications including radiation pneumonitis was noted with maximum follow up of 24 month. Although the longer follow up is needed, it is worthwhile to try the prospective randomized study to evaluate the efficacy of hyperfractionated radiotherapy with concomitant boost technique for unresectable non-small cell lung cancers in view of excellent tolerance of this treatment. In the future, further increase of total radiation dose might be necessary to improve local control for non-small cell lung cancer

A unique branching pattern of the axillary artery: a case report.

Science.gov (United States)

Bagoji, Ishwar B; Hadimani, Gavishiddappa A; Bannur, Balappa M; Patil, B G; Bharatha, Ambadasu

2013-12-01

During routine dissection classes for under graduate students, we found a unique and unusual case regarding the anomalous branching in the third part of the axillary artery was terminated into subscapular arterial trunk, superficial brachial artery and deep brachial artery. The subscapular arterial trunk was origin of several important arteries as the circumflex scapular, thoracodorsal, posterior circumflex humeral, thoraco-acromial and lateral thoracic arteries. The deep brachial artery in the arm gave anterior circumflex humeral artery at the surgical neck of humerus, which terminated in the cubital fossa by dividing into radial and ulnar arteries. The superficial brachial artery gave two profunda brachii arteries, both of which passed through spiral groove, along with radial nerve and three muscular branches, to brachialis muscle. This variation is very rare. As per our knowledge, we did not find any literature which explained variations which were similar to this. The normal and abnormal anatomy of the axillary region has practical importance among vascular radiologists and surgeons and it should be known for making an accurate diagnostic interpretation.

CLINICOPATHOLOGICAL FACTORS ASSOCIATED WITH POSITIVE PREOPERATIVE AXILLARY ULTRASOUND SCANNING IN BREAST CANCER PATIENTS

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Lona Jalini

2016-01-01

Full Text Available Background: Axillary lymph node status is the most important breast cancer prognostic factor. Preoperative axillary ultrasound examination (PAUS is used to triage patients for sentinel lymph node biopsy (SLNB or axillary lymph node dissection (ALND. We assessed the detection rate of lymph node metastases by PAUS in a screening unit and evaluated associations between clinicopathological factors and PAUS positivity. Patients and Methods: This was a single-centre retrospective analysis of data extracted from a hospital breast cancer database and clinical records. Clinical, radiological, and pathological and prognostic indices were compared between PAUS-positive and PAUS-negative patients subsequently found to have lymph node metastases on histopathological analysis. Results: Two hundred and two patients were eligible for analysis. 50.5% of lymph node-positive patients were correctly identified as PAUS positive. Patients with PAUS-positive lymph nodes had less favorable disease characteristics, namely clinically palpable lymph nodes, higher Nottingham prognostic (NPI index, high lymph node burden according to the European Society of Medical Oncology (ESMO group classification, and larger, grade 3 tumors with lymphovascular invasion and extranodal spread. Moreover, PAUS-positive patients had more macrometastases and lymph node involvement than PAUS-negative patients. Conclusion: PAUS-positive patients and PAUS-negative (SLNB-positive patients have different clinicopathological characteristics. The presence of LVI, extranodal spread, grade 3 histology, or large tumors with poor prognostic indices in PAUS-negative patients should be regarded with caution and perhaps prompt second-look ultrasound examination.

Ultrasound Guidance Versus Peripheral Neurostimulation for Brachial Plexus Block Anesthesia with Axillary Approach and Multiple Injection Technique

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Lazar Alexandra

2017-09-01

Full Text Available Introduction: There are several approaches for brachial plexus anesthesia: supraclavicular, infraclavicular, interscalenic and axillary. Out of these, the axillary approach is considered to be the safest because of the low risk of lesioning the adjacent structures, low risk of phrenic nerve blockade or of producing an iatrogenic pneumothorax. The block can be performed by one single injection at the site, by two injections or by several injection, among each nerve of the plexus. Ultrasound was introduced in regional anesthesia since 1978, being used initially as an auxiliary method to peripheral neurostimulator.

Ultrasound-guided approach for axillary brachial plexus, femoral nerve, and sciatic nerve blocks in dogs.

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Campoy, Luis; Bezuidenhout, Abraham J; Gleed, Robin D; Martin-Flores, Manuel; Raw, Robert M; Santare, Carrie L; Jay, Ariane R; Wang, Annie L

2010-03-01

To describe an ultrasound-guided technique and the anatomical basis for three clinically useful nerve blocks in dogs. Prospective experimental trial. Four hound-cross dogs aged 2 +/- 0 years (mean +/- SD) weighing 30 +/- 5 kg and four Beagles aged 2 +/- 0 years and weighing 8.5 +/- 0.5 kg. Axillary brachial plexus, femoral, and sciatic combined ultrasound/electrolocation-guided nerve blocks were performed sequentially and bilaterally using a lidocaine solution mixed with methylene blue. Sciatic nerve blocks were not performed in the hounds. After the blocks, the dogs were euthanatized and each relevant site dissected. Axillary brachial plexus block Landmark blood vessels and the roots of the brachial plexus were identified by ultrasound in all eight dogs. Anatomical examination confirmed the relationship between the four ventral nerve roots (C6, C7, C8, and T1) and the axillary vessels. Three roots (C7, C8, and T1) were adequately stained bilaterally in all dogs. Femoral nerve block Landmark blood vessels (femoral artery and femoral vein), the femoral and saphenous nerves and the medial portion of the rectus femoris muscle were identified by ultrasound in all dogs. Anatomical examination confirmed the relationship between the femoral vessels, femoral nerve, and the rectus femoris muscle. The femoral nerves were adequately stained bilaterally in all dogs. Sciatic nerve block. Ultrasound landmarks (semimembranosus muscle, the fascia of the biceps femoris muscle and the sciatic nerve) could be identified in all of the dogs. In the four Beagles, anatomical examination confirmed the relationship between the biceps femoris muscle, the semimembranosus muscle, and the sciatic nerve. In the Beagles, all but one of the sciatic nerves were stained adequately. Ultrasound-guided needle insertion is an accurate method for depositing local anesthetic for axillary brachial plexus, femoral, and sciatic nerve blocks.

Axillary node metastasis from differentiated thyroid carcinoma with hürthle and signet ring cell differentiation. A case of disseminated thyroid cancer with peculiar histologic findings

International Nuclear Information System (INIS)

Chiofalo, Maria Grazia; Losito, Nunzia Simona; Fulciniti, Franco; Setola, Sergio Venanzio; Tommaselli, Antonio; Marone, Ugo; Di Cecilia, Maria Luisa; Pezzullo, Luciano

2012-01-01

Differentiated thyroid cancer is usually associated with an excellent prognosis and indolent course. Distant metastases are rare events at the onset of thyroid cancer. Among these presentations, metastasis to the axillary lymph nodes is even more unusual: only few cases were previously reported in the literature; there has been no report of axillary lymph node metastasis from follicular thyroid carcinoma. Axillary lymph node metastasis generally arises in the context of disseminated disease and carries an ominous prognosis. Here we present a case of axillary lymph node metastasis in the context of disseminated differentiated thyroid cancer. The patient underwent near total thyroidectomy and neck and axillary lymph node dissection. A histopathological diagnosis of poorly differentiated follicular carcinoma with 'signet ring cells' and Hürthle cell features was established. The patient received radioactive iodine therapy and TSH suppression therapy. Subsequently his serum thyroglobulin level decreased to 44.000 ng/ml from over 100.000 ng/ml. Currently there are only few reported cases of axillary node metastases from thyroid cancer, and to our knowledge, this is the first report on axillary lymph node metastasis from follicular thyroid carcinoma. 'Signet ring cell' is a morphologic feature shared by both benign and, more rarely, malignant follicular thyroid neoplasm, and it generally correlates with an arrest in folliculogenesis. Our case is one of the rare 'signet ring cells' carcinomas so far described

Tangential vs. defined radiotherapy in early breast cancer treatment without axillary lymph node dissection. A comparative study

Energy Technology Data Exchange (ETDEWEB)

Nitsche, Mirko [Zentrum fuer Strahlentherapie und Radioonkologie, Bremen (Germany); Universitaet Kiel, Klinik fuer Strahlentherapie, Karl-Lennert-Krebscentrum, Kiel (Germany); Temme, Nils; Foerster, Manuela; Reible, Michael [Zentrum fuer Strahlentherapie und Radioonkologie, Bremen (Germany); Hermann, Robert Michael [Zentrum fuer Strahlentherapie und Radioonkologie, Bremen (Germany); Medizinische Hochschule Hannover, Abteilung Strahlentherapie und Spezielle Onkologie, Hannover (Germany)

2014-08-15

Recent studies have demonstrated low regional recurrence rates in early-stage breast cancer omitting axillary lymph node dissection (ALND) in patients who have positive nodes in sentinel lymph node dissection (SLND). This finding has triggered an active discussion about the effect of radiotherapy within this approach. The purpose of this study was to analyze the dose distribution in the axilla in standard tangential radiotherapy (SRT) for breast cancer and the effects on normal tissue exposure when anatomic level I-III axillary lymph node areas are included in the tangential radiotherapy field configuration. We prospectively analyzed the dosimetric treatment plans from 51 consecutive women with early-stage breast cancer undergoing radiotherapy. We compared and analyzed the SRT and the defined radiotherapy (DRT) methods for each patient. The clinical target volume (CTV) of SRT included the breast tissue without specific contouring of lymph node areas, whereas the CTV of DRT included the level I-III lymph node areas. We evaluated the dose given in SRT covering the axillary lymph node areas of level I-III as contoured in DRT. The mean V{sub D95} {sub %} of the entire level I-III lymph node area in SRT was 50.28 % (range, 37.31-63.24 %), V{sub D45} {sub Gy} was 70.1 % (54.8-85.4 %), and V{sub D40} {sub Gy} was 83.5 % (72.3-94.8 %). A significant difference was observed between lung dose and heart toxicity in SRT vs. DRT. The V{sub 20} {sub Gy} and V{sub 30} {sub Gy} of the right and the left lung in DRT were significantly higher in DRT than in SRT (p < 0.001). The mean heart dose in SRT was significantly lower (3.93 vs. 4.72 Gy, p = 0.005). We demonstrated a relevant dose exposure of the axilla in SRT that should substantially reduce local recurrences. Furthermore, we demonstrated a significant increase in lung and heart exposure when including the axillary lymph nodes regions in the tangential radiotherapy field set-up. (orig.) [German] Aktuelle Studien zeigen

BoostEMM : Transparent boosting using exceptional model mining

NARCIS (Netherlands)

van der Zon, S.B.; Zeev Ben Mordehay, O.; Vrijdag, T.S.; van Ipenburg, W.; Veldsink, J.; Duivesteijn, W.; Pechenizkiy, M.; Bordino, I.; Caldarelli, G.; Fumarola, F.; Gullo, F.; Squartini, T.

2017-01-01

Boosting is an iterative ensemble-learning paradigm. Every iteration, a weak predictor learns a classification task, taking into account performance achieved in previous iterations. This is done by assigning weights to individual records of the dataset, which are increased if the record is

Buck-Boost Current-Source Inverters With Diode-Inductor Network

DEFF Research Database (Denmark)

Gao, Feng; Liang, Chao; Loh, Poh Chiang

2009-01-01

This paper presents a number of novel currentsource inverters (CSIs) with enhanced current buck-boost capability. By adding a unique diode-inductor network between the inverter circuitry and current-boost elements, the proposed buck-boost CSIs demonstrate a doubling of current-boost capability......, as compared with other recently reported buck-boost CSIs. For controlling the proposed CSIs, two modulation schemes are designed for achieving either optimized harmonic performance or minimized commutation count without influencing the inverter current buck-boost gain. These theoretical findings were...

The Use of Ultrasound to Improve Axillary Vein Access and Minimize Complications during Pacemaker Implantation.

Science.gov (United States)

Esmaiel, Abdullah; Hassan, Jeremy; Blenkhorn, Fay; Mardigyan, Vartan

2016-05-01

The Agency for Healthcare Research and Quality in the United States recommends the use of ultrasound (US) for central venous access to improve patient outcomes. However, in a recent publication, US is still underutilized for axillary vein access during pacemaker implantation. We sought to describe a technique for US-guided axillary vein access during pacemaker implantation and to report complication rates and success rate. Retrospective data collection included success rate and complications on all pacemaker implants by one operator since implementing the systematic use of US at our institution, from November 2012 to January 2015. For the last 59 cases, data were collected prospectively to include time of venous access and number of attempts. A total of 403 consecutive patients were included in the analysis. Two leads were implanted in 255 cases and one lead was implanted in 148 cases. The rate of successful US-guided access was 99.25%. There were no access-related complications. The average number of venipuncture attempts was 1.18 per patient. The average time to obtain venous access was 2.24 minutes including the time to apply the sterile US sleeve. The described technique has the potential to improve the success rate of axillary vein access and minimize complications during pacemaker implantation. ©2016 Wiley Periodicals, Inc.

Prognostic significance of pathological response of primary tumor and metastatic axillary lymph nodes after neoadjuvant chemotherapy for locally advanced breast carcinoma.

Science.gov (United States)

Machiavelli, M R; Romero, A O; Pérez, J E; Lacava, J A; Domínguez, M E; Rodríguez, R; Barbieri, M R; Romero Acuña, L A; Romero Acuña, J M; Langhi, M J; Amato, S; Ortiz, E H; Vallejo, C T; Leone, B A

1998-01-01

The prognostic significance of pathological response of primary tumor and metastatic axillary lymph nodes after neoadjuvant chemotherapy was assessed in patients with noninflammatory locally advanced breast carcinoma. Between January 1989 and April 1995, 148 consecutive patients with locally advanced breast carcinoma participated in the study. Of these, 140 fully evaluable patients (67, stage IIIA; 73, stage IIIB) were treated with three courses of 5-fluorouracil, doxorubicin, and cyclophosphamide (FAC), followed by modified radical mastectomy when technically feasible or definitive radiation therapy. The median age was 53 years (range, 26 to 75 years); 55% of patients were postmenopausal. Objective response was recorded in 99 of 140 patients (71%; 95% confidence interval, 63% to 79%). Complete response occurred in 11 patients (8%), and partial response occurred in 88 patients (63%). No change was recorded in 37 patients (26%), and progressive disease occurred in 4 patients (3%). One hundred and thirty-six patients underwent the planned surgery. Maximal pathological response of the primary tumor (in situ carcinoma or minimal microscopic residual tumor) was observed in 24 (18%); 112 patients (82%) presented minimal pathological response of the primary tumor (gross residual tumor). The number of metastatic axillary nodes after neoadjuvant chemotherapy was as follows: N0, 39 patients (29%); N1-N3, 35 patients (26%); > N3, 62 patients (45%). Considering the initial TNM status, 75% of the patients had decreases in tumor compartment after neoadjuvant chemotherapy. Also, 31% and 23% of patients with clinical N1 and N2, respectively, showed uninvolved axillary lymph nodes. A significant correlation was noted between pathological response of primary tumor and the number of metastatic axillary lymph nodes. Median disease-free survival was 34 months, whereas median overall survival was 66 months. Pathological responses of both primary tumor and metastatic axillary lymph nodes

Successful ablation of a right atrium-axillary ventricular accessory pathway associated with Wolff-Parkinson-White syndrome.

Science.gov (United States)

Yuan, Yuan; Long, Deyong; Dong, Jianzeng; Tao, Ling; Ma, Changsheng

2017-12-01

We report a case of a patient with right axillary ventricular. Similar congenital anomaly of the right atrium was reported as "right appendage diverticulum or right atrial diverticulum." However, this independent chamber has its own annulus, synchronizes with the right ventricular, and generates large ventricular potential. Under the guidance of the CARTO mapping system (Biosense Webster, Diamond Bar, CA, USA), a right atrioventricular accessory pathway associated with type B Wolff-Parkinson-White syndrome was ablated successfully. This pathway was close to the annulus of the axillary ventricular. The patient remained free of arrhythmia at 1-year follow-up. © 2017 Wiley Periodicals, Inc.

AlignerBoost: A Generalized Software Toolkit for Boosting Next-Gen Sequencing Mapping Accuracy Using a Bayesian-Based Mapping Quality Framework.

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Qi Zheng

2016-10-01

Full Text Available Accurate mapping of next-generation sequencing (NGS reads to reference genomes is crucial for almost all NGS applications and downstream analyses. Various repetitive elements in human and other higher eukaryotic genomes contribute in large part to ambiguously (non-uniquely mapped reads. Most available NGS aligners attempt to address this by either removing all non-uniquely mapping reads, or reporting one random or "best" hit based on simple heuristics. Accurate estimation of the mapping quality of NGS reads is therefore critical albeit completely lacking at present. Here we developed a generalized software toolkit "AlignerBoost", which utilizes a Bayesian-based framework to accurately estimate mapping quality of ambiguously mapped NGS reads. We tested AlignerBoost with both simulated and real DNA-seq and RNA-seq datasets at various thresholds. In most cases, but especially for reads falling within repetitive regions, AlignerBoost dramatically increases the mapping precision of modern NGS aligners without significantly compromising the sensitivity even without mapping quality filters. When using higher mapping quality cutoffs, AlignerBoost achieves a much lower false mapping rate while exhibiting comparable or higher sensitivity compared to the aligner default modes, therefore significantly boosting the detection power of NGS aligners even using extreme thresholds. AlignerBoost is also SNP-aware, and higher quality alignments can be achieved if provided with known SNPs. AlignerBoost's algorithm is computationally efficient, and can process one million alignments within 30 seconds on a typical desktop computer. AlignerBoost is implemented as a uniform Java application and is freely available at https://github.com/Grice-Lab/AlignerBoost.

AlignerBoost: A Generalized Software Toolkit for Boosting Next-Gen Sequencing Mapping Accuracy Using a Bayesian-Based Mapping Quality Framework.

Science.gov (United States)

Zheng, Qi; Grice, Elizabeth A

2016-10-01

Accurate mapping of next-generation sequencing (NGS) reads to reference genomes is crucial for almost all NGS applications and downstream analyses. Various repetitive elements in human and other higher eukaryotic genomes contribute in large part to ambiguously (non-uniquely) mapped reads. Most available NGS aligners attempt to address this by either removing all non-uniquely mapping reads, or reporting one random or "best" hit based on simple heuristics. Accurate estimation of the mapping quality of NGS reads is therefore critical albeit completely lacking at present. Here we developed a generalized software toolkit "AlignerBoost", which utilizes a Bayesian-based framework to accurately estimate mapping quality of ambiguously mapped NGS reads. We tested AlignerBoost with both simulated and real DNA-seq and RNA-seq datasets at various thresholds. In most cases, but especially for reads falling within repetitive regions, AlignerBoost dramatically increases the mapping precision of modern NGS aligners without significantly compromising the sensitivity even without mapping quality filters. When using higher mapping quality cutoffs, AlignerBoost achieves a much lower false mapping rate while exhibiting comparable or higher sensitivity compared to the aligner default modes, therefore significantly boosting the detection power of NGS aligners even using extreme thresholds. AlignerBoost is also SNP-aware, and higher quality alignments can be achieved if provided with known SNPs. AlignerBoost's algorithm is computationally efficient, and can process one million alignments within 30 seconds on a typical desktop computer. AlignerBoost is implemented as a uniform Java application and is freely available at https://github.com/Grice-Lab/AlignerBoost.

Boosted Higgs shapes

International Nuclear Information System (INIS)

Schlaffer, Matthias; Spannowsky, Michael; Wymant, Chris

2014-05-01

The inclusive Higgs production rate through gluon fusion has been measured to be in agreement with the Standard Model (SM). We show that even if the inclusive Higgs production rate is very SM-like, a precise determination of the boosted Higgs transverse momentum shape offers the opportunity to see effects of natural new physics. These measurements are generically motivated by effective field theory arguments and specifically in extensions of the SM with a natural weak scale, like composite Higgs models and natural supersymmetry. We show in detail how a measurement at high transverse momentum of H→2l+p T via H→ττ and H→WW * could be performed and demonstrate that it offers a compelling alternative to the t anti tH channel. We discuss the sensitivity to new physics in the most challenging scenario of an exactly SM-like inclusive Higgs cross-section.

Axillary Temperature, as Recorded by the iThermonitor WT701, Well Represents Core Temperature in Adults Having Noncardiac Surgery.

Science.gov (United States)

Pei, Lijian; Huang, Yuguang; Mao, Guangmei; Sessler, Daniel I

2018-03-01

Core temperature can be accurately measured from the esophagus or nasopharynx during general anesthesia, but neither site is suitable for neuraxial anesthesia. We therefore determined the precision and accuracy of a novel wireless axillary thermometer, the iThermonitor, to determine its suitability for use during neuraxial anesthesia and in other patients who are not intubated. We enrolled 80 adults having upper abdominal surgery with endotracheal intubation. Intraoperative core temperature was measured in distal esophagus and was estimated at the axilla with a wireless iThermonitor WT701 (Raiing Medical, Boston MA) at 5-minute intervals. Pairs of axillary and reference distal esophageal temperatures were compared and summarized using linear regression and repeated-measured Bland-Altman methods. We a priori determined that the iThermonitor would have clinically acceptable accuracy if most estimates were within ±0.5°C of the esophageal reference, and suitable precision if the limits of agreement were within ±0.5°C. There were 3339 sets of paired temperatures. Axillary and esophageal temperatures were similar, with a mean difference (esophageal minus axillary) of only 0.14°C ± 0.26°C (standard deviation). The Bland-Altman 95% limits of agreement were reasonably narrow, with the estimated upper limit at 0.66°C and the lower limit at -0.38°C, thus ±0.52°C, indicating good agreement across the range of mean temperatures from 34.9°C to 38.1°C. The absolute difference was within 0.5°C in 91% of the measurements (95% confidence interval, 88%-93%). Axillary temperature, as recorded by the iThermonitor WT701, well represents core temperature in adults having noncardiac surgery and thus appears suitable for clinical use.

Extending statistical boosting. An overview of recent methodological developments.

Science.gov (United States)

Mayr, A; Binder, H; Gefeller, O; Schmid, M

2014-01-01

Boosting algorithms to simultaneously estimate and select predictor effects in statistical models have gained substantial interest during the last decade. This review highlights recent methodological developments regarding boosting algorithms for statistical modelling especially focusing on topics relevant for biomedical research. We suggest a unified framework for gradient boosting and likelihood-based boosting (statistical boosting) which have been addressed separately in the literature up to now. The methodological developments on statistical boosting during the last ten years can be grouped into three different lines of research: i) efforts to ensure variable selection leading to sparser models, ii) developments regarding different types of predictor effects and how to choose them, iii) approaches to extend the statistical boosting framework to new regression settings. Statistical boosting algorithms have been adapted to carry out unbiased variable selection and automated model choice during the fitting process and can nowadays be applied in almost any regression setting in combination with a large amount of different types of predictor effects.

Concurrent Rotator Cuff Tear and Axillary Nerve Palsy Associated with Anterior Dislocation of the Shoulder and Large Glenoid Rim Fracture: A “Terrible Tetrad”

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Fumiaki Takase

2014-01-01

Full Text Available We present a case of concurrent rotator cuff tear and axillary nerve palsy resulting from anterior dislocation of the shoulder and a large glenoid rim fracture—a “terrible tetrad.” A 61-year-old woman fell on her right shoulder. Radiographs showed anterior dislocation of the shoulder with a glenoid rim fracture, and an MRI two months after injury revealed a rotator cuff tear. Upon referral to our hospital, physical and electrophysiological examinations revealed axillary nerve palsy. The axillary nerve palsy was incomplete and recovering, and displacement of the glenoid rim fracture was minimal and already united; therefore, we surgically repaired only the rotator cuff tear three months after injury. The patient recovered satisfactorily following the operation. In patients whose axillary nerve palsy is recovering, surgeons should consider operating on rotator cuff tears in an attempt to prevent rotator cuff degeneration.

Impact of axillary ultrasound and core needle biopsy on the utility of intraoperative frozen section analysis and treatment decision making in women with invasive breast cancer.

Science.gov (United States)

Caretta-Weyer, Holly; Sisney, Gale A; Beckman, Catherine; Burnside, Elizabeth S; Salkowsi, Lonie R; Strigel, Roberta M; Wilke, Lee G; Neuman, Heather B

2012-09-01

Our objective was to evaluate the impact of preoperative axillary ultrasound and core needle biopsy (CNB) on breast cancer treatment decision making. A secondary aim was to evaluate the impact on the utility of intraoperative sentinel lymph node (SLN) frozen section. A review of 84 patients with clinically negative axilla who underwent axillary ultrasound was performed. Sensitivity, specificity, and positive/negative predictive value for axillary ultrasound with CNB was calculated. Thirty-one (37%) had suspicious nodes. Of 27 amenable to CNB, 12 (14%) were malignant, changing treatment plans. The sensitivity of ultrasound and CNB was 54% and specificity 100%; the positive and negative predictive values were 100% and 80%, respectively. In 41 patients with normal ultrasounds who underwent SLN frozen section, 10 (24%) were positive. Preoperative axillary ultrasound impacts treatment decision making in 14%. With a sensitivity of 54%, it is a useful adjunct to, but not replacement for, SLN biopsy. Frozen section remains of utility even after a negative axillary ultrasound. Copyright © 2012 Elsevier Inc. All rights reserved.

Automatic detection of axillary lymphadenopathy on CT scans of untreated chronic lymphocytic leukemia patients

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Liu, Jiamin; Hua, Jeremy; Chellappa, Vivek; Petrick, Nicholas; Sahiner, Berkman; Farooqui, Mohammed; Marti, Gerald; Wiestner, Adrian; Summers, Ronald M.

2012-03-01

Patients with chronic lymphocytic leukemia (CLL) have an increased frequency of axillary lymphadenopathy. Pretreatment CT scans can be used to upstage patients at the time of presentation and post-treatment CT scans can reduce the number of complete responses. In the current clinical workflow, the detection and diagnosis of lymph nodes is usually performed manually by examining all slices of CT images, which can be time consuming and highly dependent on the observer's experience. A system for automatic lymph node detection and measurement is desired. We propose a computer aided detection (CAD) system for axillary lymph nodes on CT scans in CLL patients. The lung is first automatically segmented and the patient's body in lung region is extracted to set the search region for lymph nodes. Multi-scale Hessian based blob detection is then applied to detect potential lymph nodes within the search region. Next, the detected potential candidates are segmented by fast level set method. Finally, features are calculated from the segmented candidates and support vector machine (SVM) classification is utilized for false positive reduction. Two blobness features, Frangi's and Li's, are tested and their free-response receiver operating characteristic (FROC) curves are generated to assess system performance. We applied our detection system to 12 patients with 168 axillary lymph nodes measuring greater than 10 mm. All lymph nodes are manually labeled as ground truth. The system achieved sensitivities of 81% and 85% at 2 false positives per patient for Frangi's and Li's blobness, respectively.

Intraductal papilloma in an axillary lymph node of a patient with human immunodeficiency virus: a case report and review of the literature.

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Cottom, Hannah; Rengabashyam, Bhavani; Turton, Philip E; Shaaban, Abeer M

2014-05-23

Inclusions of ectopic breast tissue in axillary lymph nodes are reported very infrequently and typically are only identified microscopically as an incidental finding. Furthermore the development of a benign proliferative lesion in the form of an intraductal papilloma from intranodal ectopic breast tissue is an extremely rare phenomenon with only three previous cases reported. This report describes an unusual and rare case of an intraductal papilloma arising in an axillary lymph node of a patient known to have the human immunodeficiency virus. A 40-year-old Black African woman underwent excision of an enlarged palpable axillary lymph node. In the preceding 7 years she had received at least six separate surgical excisions to her ipsilateral breast for papillomatosis. The last surgical intervention was performed 1 year prior to presentation with an enlarged axillary lymph node. Histological examination of her axillary lymph node revealed a papillomatous proliferative epithelial lesion within an apparent encompassing duct, resembling a mammary intraductal papilloma. In the surrounding lymphoid tissue small groups of duct-like structures were additionally noted. Immunostaining with a panel of myoepithelial markers in conjunction with oestrogen receptor produced a mixed heterogeneous staining pattern in both the papillomatous lesion and the peripheral duct-like structures. This confirmed the diagnosis of a benign intraductal papilloma within an axillary lymph node, considered to have arisen from ectopic breast tissue. This case demonstrates that intranodal ectopic breast tissue has the potential to undergo benign proliferative change albeit extremely rarely. Therefore this possibility must be considered to ensure the correct diagnosis is made. In addition, to the best of our knowledge, this is the first case report which has described recurrent intraductal papillomas and the subsequent development of an intraductal papilloma within an ipsilateral axillary lymph node, in

Frequency and associated factors of axillary web syndrome in women who had undergone breast cancer surgery: a transversal and retrospective study.

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Fukushima, Kassandra Ferreira Pessoa; Carmo, Luana Aroucha; Borinelli, Adriana Carvalho; Ferreira, Caroline Wanderley Souto

2015-01-01

Breast cancer is the most common malignancy among women. Surgical treatment is an essential part of therapy, which still includes chemotherapy, radiotherapy and hormone therapy. The increase in early cancer detection and less aggressive treatment has made longer survival rates possible for women with this neoplasia. Morbidities after treatment have subsequently aroused particular interest in the scientific community in order to minimize their effects and provide increased quality-of-life for these patients. The present study aimed at investigating one of these morbidities: axillary web syndrome, which occurs after axillary surgical management. From December 2011 to September 2012, according to the inclusion and exclusion criteria, 97 patients, who had been surgically treated for breast cancer, were enrolled, interviewed, and submitted to a specific physical exam. An investigation of the axillary cords, characteristic of this syndrome, was performed in all patients. The axillary web syndrome was diagnosed in 28.86% of the women. Higher risk of triggering the syndrome has been associated with younger age (21.7%), longer time between first treatment and data collection (29.3%), greater number of resected lymph nodes (149.7%) and surgical management medical teams (113.2%). One can conclude that axillary web syndrome was associated with younger age, greater time elapsed since surgery, surgical management of medical staff and number of resected lymph nodes. Further studies are needed to review prior-to-surgery and post-operative follow-up, to properly assess the effects of surgery in the axilla on homeostatic balance, not only in the ipsilateral upper limb, but also assess their compensatory consequences throughout the body.

Sclerotic fibroma (storiform collagenoma)-like stroma in a fibroadenoma of axillary accessory breast tissue.

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Val-Bernal, José Fernando; González-Vela, María Carmen; De Grado, Mauricio; Garijo, María Francisca

2012-08-01

Accessory breast tissue is a subcutaneous remnant persisting after normal embryological development of the breast. It occurs most frequently in the axilla. Fibroadenomas in axillary breast tissue are rare. We report the case of a 29-year-old female patient who presented a fibroadenoma arising in the accessory breast tissue of the right axillary fossa. The neoplasm showed foci of sclerotic fibroma-like stroma. The patient had no signs of Cowden's syndrome. To the best of our knowledge, a lesion of this kind has not been previously reported. This stromal change suggests an uncommon involutional phase of the fibroadenoma with production of sclerotic and hypocellular collagen. The lesion should be differentiated from extraneural perineuroma, from the changes in fibroadenomas in Cowden's syndrome, from sclerosing lobular hyperplasia (fibroadenomatoid mastopathy) and from pseudoangiomatous stromal hyperplasia. Copyright © 2012 John Wiley & Sons A/S.

International multicenter tool to predict the risk of four or more tumor-positive axillary lymph nodes in breast cancer patients with sentinel node macrometastases

DEFF Research Database (Denmark)

Meretoja, Tuomo J; Audisio, R A; Heikkilä, P S

2013-01-01

Recently, many centers have omitted routine axillary lymph node dissection (ALND) after metastatic sentinel node biopsy in breast cancer due to a growing body of literature. However, existing guidelines of adjuvant treatment planning are strongly based on axillary nodal stage. In this study, we aim...

Axillary local anesthetic spread after the thoracic interfacial ultrasound block – a cadaveric and radiological evaluation

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Patricia Alfaro de la Torre

2017-11-01

Full Text Available Background: Oral opioid analgesics have been used for management of peri- and postoperative analgesia in patients undergoing axillary dissection. The axillary region is a difficult zone to block and does not have a specific regional anesthesia technique published that offers its adequate blockade. Methods: After institutional review board approval, anatomic and radiological studies were conducted to determine the deposition and spread of methylene blue and local anesthetic injected respectively into the axilla via the thoracic inter-fascial plane. Magnetic Resonance Imaging studies were then conducted in 15 of 34 patients scheduled for unilateral breast surgery that entailed any of the following: axillary clearance, sentinel node biopsy, axillary node biopsy, or supernumerary breasts, to ascertain the deposition and time course of spread of solution within the thoracic interfascial plane in vivo. Results: Radiological and cadaveric studies showed that the injection of local anesthetic and methylene blue via the thoracic inter-fascial plane, using ultrasound guide technique, results in reliable deposition into the axilla. In patients, the injection of the local anesthetic produced a reliable axillary sensory block. This finding was supported by Magnetic Resonance Imaging studies that showed hyper-intense signals in the axillary region. Conclusions: These findings define the anatomic characteristics of the thoracic interfascial plane nerve block in the axillary region, and underline the clinical potential of this novel nerve block. Resumo: Justificativa: Os analgésicos orais à base de opioides têm sido usados para o manejo da analgesia nos períodos peri e pós-operatório de pacientes submetidos à linfadenectomia axilar. A região axilar é uma zona difícil de bloquear e não há registro de uma técnica de anestesia regional específica que ofereça o seu bloqueio adequado. Métodos: Após a aprovação do Conselho de Ética institucional

Real-time three-dimensional ultrasound-assisted axillary plexus block defines soft tissue planes.

Science.gov (United States)

Clendenen, Steven R; Riutort, Kevin; Ladlie, Beth L; Robards, Christopher; Franco, Carlo D; Greengrass, Roy A

2009-04-01

Two-dimensional (2D) ultrasound is commonly used for regional block of the axillary brachial plexus. In this technical case report, we described a real-time three-dimensional (3D) ultrasound-guided axillary block. The difference between 2D and 3D ultrasound is similar to the difference between plain radiograph and computer tomography. Unlike 2D ultrasound that captures a planar image, 3D ultrasound technology acquires a 3D volume of information that enables multiple planes of view by manipulating the image without movement of the ultrasound probe. Observation of the brachial plexus in cross-section demonstrated distinct linear hyperechoic tissue structures (loose connective tissue) that initially inhibited the flow of the local anesthesia. After completion of the injection, we were able to visualize the influence of arterial pulsation on the spread of the local anesthesia. Possible advantages of this novel technology over current 2D methods are wider image volume and the capability to manipulate the planes of the image without moving the probe.

Gastric Metastasis of Ectopic Breast Cancer Mimicking Axillary Metastasis of Primary Gastric Cancer

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Selami Ilgaz Kayılıoğlu

2014-01-01

Full Text Available Ectopic breast tissue has the ability to undergo all the pathological changes of the normal breast, including breast cancer. Gastrointestinal metastasis of breast cancer is rarely observed and it is very difficult to differentiate gastric metastases from primary gastric cancer. We present a case of 52-year-old female, who suffered from abdominal pain. Physical examination showed a palpable mass in the left anterior axilla and computerized tomography revealed gastric wall thickening with linitis plastica. When gastroscopic biopsy showed no signs of malignancy, excisional biopsy was performed in the left axilla. Histological examination revealed invasive lobular carcinoma of the breast, consistent with ectopic breast cancer. Further gastroscopic submucosal biopsies and immunohistochemical studies revealed gastric metastases of invasive lobular carcinoma. Axillary ectopic breast tissue carcinomas can mimic axillary lymphadenopathies. Additionally, gastric metastasis of breast cancer is an uncommon but possible condition. To the best of our knowledge, this is the first report of ectopic breast cancer with gastric metastasis.

OKVAR-Boost: a novel boosting algorithm to infer nonlinear dynamics and interactions in gene regulatory networks.

Science.gov (United States)

Lim, Néhémy; Senbabaoglu, Yasin; Michailidis, George; d'Alché-Buc, Florence

2013-06-01

Reverse engineering of gene regulatory networks remains a central challenge in computational systems biology, despite recent advances facilitated by benchmark in silico challenges that have aided in calibrating their performance. A number of approaches using either perturbation (knock-out) or wild-type time-series data have appeared in the literature addressing this problem, with the latter using linear temporal models. Nonlinear dynamical models are particularly appropriate for this inference task, given the generation mechanism of the time-series data. In this study, we introduce a novel nonlinear autoregressive model based on operator-valued kernels that simultaneously learns the model parameters, as well as the network structure. A flexible boosting algorithm (OKVAR-Boost) that shares features from L2-boosting and randomization-based algorithms is developed to perform the tasks of parameter learning and network inference for the proposed model. Specifically, at each boosting iteration, a regularized Operator-valued Kernel-based Vector AutoRegressive model (OKVAR) is trained on a random subnetwork. The final model consists of an ensemble of such models. The empirical estimation of the ensemble model's Jacobian matrix provides an estimation of the network structure. The performance of the proposed algorithm is first evaluated on a number of benchmark datasets from the DREAM3 challenge and then on real datasets related to the In vivo Reverse-Engineering and Modeling Assessment (IRMA) and T-cell networks. The high-quality results obtained strongly indicate that it outperforms existing approaches. The OKVAR-Boost Matlab code is available as the archive: http://amis-group.fr/sourcecode-okvar-boost/OKVARBoost-v1.0.zip. Supplementary data are available at Bioinformatics online.

Arm morbidity following sentinel lymph node biopsy or axillary lymph node dissection: a study from the Danish Breast Cancer Cooperative Group

DEFF Research Database (Denmark)

Husted, Madsen A.; Haugaard, K.; Soerensen, J.

2008-01-01

BACKGROUND: Sentinel lymph node biopsy was implemented in the treatment of early breast cancer with the aim of reducing shoulder and arm morbidity. Relatively few prospective studies have been published where the morbidity was assessed by clinical examination. Very few studies have examined...... lymph node biopsy with node negative patients having a lymph node dissection of levels I and II of the axilla, we found significant increase in arm volume among the patients who had an axillary dissection. Only minor, but significant, differences in shoulder mobility were observed comparing the two...... groups of node negative patients. Highly significant difference was found comparing sensibility. Comparing the morbidity in node positive patients who had a one-step axillary dissection with patients having a two-step procedure (sentinel lymph node biopsy followed by delayed axillary dissection) revealed...

Rupture of an expander prosthesis mimics axillary cancer recurrence.

LENUS (Irish Health Repository)

Ismael, T

2005-10-01

Regional silicone gel migration from a ruptured breast implant has been reported at different locations including the upper extremity, chest wall muscles, axilla and back. We report a patient who presented with an axillary mass that mimicked a regional recurrence 5 years after breast cancer reconstruction with a latissimus dorsi musculocutaneous flap and silicon gel expander-prosthesis. Surgical exploration revealed that the mass contained silicone gel around the port of the breast expander that had ruptured. The mass was confluent with an intracapsular silicone leak through a tract along the tube of the expander port.

Boosting Learning Algorithm for Stock Price Forecasting

Science.gov (United States)

Wang, Chengzhang; Bai, Xiaoming

2018-03-01

To tackle complexity and uncertainty of stock market behavior, more studies have introduced machine learning algorithms to forecast stock price. ANN (artificial neural network) is one of the most successful and promising applications. We propose a boosting-ANN model in this paper to predict the stock close price. On the basis of boosting theory, multiple weak predicting machines, i.e. ANNs, are assembled to build a stronger predictor, i.e. boosting-ANN model. New error criteria of the weak studying machine and rules of weights updating are adopted in this study. We select technical factors from financial markets as forecasting input variables. Final results demonstrate the boosting-ANN model works better than other ones for stock price forecasting.

The efficacy of physiotherapy upon shoulder function following axillary dissection in breast cancer, a randomized controlled study

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Oostendorp Rob AB

2007-08-01

Full Text Available Abstract Background Many patients suffer from severe shoulder complaints after breast cancer surgery and axillary lymph node dissection. Physiotherapy has been clinically observed to improve treatment of these patients. However, it is not a standard treatment regime. The purpose of this study is to investigate the efficacy of physiotherapy treatment of shoulder function, pain and quality of life in patients who have undergone breast cancer surgery and axillary lymph node dissection. Methods Thirty patients following breast cancer surgery and axillary lymph node dissection were included in a randomised controlled study. Assessments were made at baseline and after three and six months. The treatment group received standardised physiotherapy treatment of advice and exercises for the arm and shoulder for three months; the control group received a leaflet containing advice and exercises. If necessary soft tissue massage to the surgical scar was applied. Primary outcome variables were amount of pain in the shoulder/arm recorded on the Visual Analogue Scale, and shoulder mobility (flexion, abduction measured using a digital inclinometer under standardized conditions. Secondary outcome measures were shoulder disabilities during daily activities, edema, grip strength of both hands and quality of life. The researcher was blinded to treatment allocation. Results All thirty patients completed the trial. After three and six months the treatment group showed a significant improvement in shoulder mobility and had significantly less pain than the control group. Quality of life improved significantly, however, handgrip strength and arm volume did not alter significantly. Conclusion Physiotherapy reduces pain and improves shoulder function and quality of life following axillary dissection after breast cancer. Trial registration ISRCTN31186536

Multidetector-row computed tomography for the preoperative evaluation of axillary nodal status in patients with breast cancer

International Nuclear Information System (INIS)

Ogasawara, Yutaka; Doihara, Hiroyoshi; Shiraiwa, Misaki; Ishihara, Setsuko

2008-01-01

We evaluated the effectiveness of multidetector-row computed tomography (MD-CT) for detecting axillary lymph nodal status (ALNS) in patients with breast cancer. We reviewed 42 patients with breast cancer. A metastatic lymph node on MD-CT was defined as oval or round, with more than 5 mm on the short axis. We evaluated ALNS preoperatively by both palpation and MD-CT findings and performed sentinel lymph node biopsy (SLNB) and complete axillary lymph node dissection (ALND). For establishing the ALNS, MD-CT showed a sensitivity of 76.9%, a specificity of 96.6%, and an accuracy of 90.5%. On the basis of the MD-CT findings, misdiagnosis was made in 4 of the 42 patients, only one of which was false positive. On the other hand, one patient with a histologically negative sentinel lymph node (SLN) result had metastasis only in a non-SLN. Preoperative MD-CT showed a positive node in this patient. Multidetector-row computed tomography assists in identifying women who require ALND without SLNB, with sufficient positive predictive value. False-negative detection by SLNB could be avoided with careful interpretation of the axillary lymph nodes shown by MD-CT. (author)

Localization studies of metastatic axillary lymph node by radioimmunoimmaging with monoclonal antibody C50 in breast cancer

International Nuclear Information System (INIS)

Feng Jue; Gao Yougong

1993-01-01

Eleven patients with breast cancer and 2 normal controls (26 axillary lymph-nodes) were studied by the radio immunoimaging with 131 I labelled anti-CEA monoclonal antibody C 50 . Among them, the imaging was positive in 8 patients and negative in 3 patients. 7 of the 8 positive patients were proven by the pathological examination of postoperative lymph nodes. Other one had proved with the presence of CEA-antigen and antigen-antibody immuno complexes in the lymphoid sinus by immuno histochemistry. Cancer cell was not found by pathology in the axillary lymph node of 3 negative imaging patients. 2 normal controls was also negative

Preoperative axillary lymph node staging by ultrasound-guided cytology using a four-level sonographic score

International Nuclear Information System (INIS)

De Coninck, Caroline; Noël, Jean-Christophe; Boutemy, Rachel; Simon, Philippe

2016-01-01

The staging of axillary lymph nodes is critical to the management and prognosis of breast cancer, the most frequent cancer in females. Neoadjuvant therapy and lymph node dissection are recommended when malignant cells invade the lymph nodes. Therefore the pre-operative examination of these lymph nodes is crucial to treatment. In this study, we examined the effectiveness of cytology through ultrasound-guided fine needle aspiration (USG-FNA) and ultrasound (US) imaging using an established classification system in correctly identifying lymph node status compared to the final histological results after surgery. Cytology by USG-FNA and US classification were found to be promising methods of axillary lymph node staging. US and CB offer minimally invasive techniques to pre-operatively examine these lymph nodes in patients with primary breast cancer

Para-axillary subcutaneous endoscopic approach in torticollis: tips and tricks in the surgical technique.

Science.gov (United States)

Tokar, Baran; Karacay, Safak; Arda, Surhan; Alici, Umut

2015-04-01

An obvious scar on the neck may appear following the open surgery for congenital muscular torticollis (CMT). The cosmetic result may displease the patient and the family. In this study, we describe a minimally invasive technique, para-axillary subcutaneous endoscopic approach (PASEA) in CMT. A total of 11 children (seven girls and four boys with the age range between 1 and 15 years) were operated for torticollis by PASEA. All patients had facial asymmetry and head and neck postural abnormality. Following an incision at the ipsilateral para-axillary region, a subcutaneous cavernous working space is formed toward sternocleidomastoid (SCM) muscle. The muscle and fascia are cut by cautery under endoscopic vision. The patients had postoperative 2nd-week and 3rd-month visits. The incision scar, inspection, and palpation findings of the region, head posture, and shoulder position of the affected side were considered in evaluation of the cosmetic outcome. Preoperative and postoperative range of motion of the head and neck were compared for functional outcome. We preferred single incision surgery in our last two patients; the rest had double para-axillary incision for port insertion. Incomplete transection of the muscle was not observed. There was no serious complication. Postoperatively, head posture and shoulder elevation were corrected significantly. Range of motion of the head was improved. Postoperatively, all the patients had rotation capacity with more than 30 degrees. The range of postoperative flexion and extension movements was between 45 and 60 degrees. The open surgery techniques of CMT causes visible lifelong incision scar on the neck. PASEA leaves a cosmetically hidden scar in the axillary region. A single incision surgery is also possible. A well-formed cavernous working space is needed. External manual palpation, delicate dissection, and cutting of SCM muscle with cautery are the important components of the procedure. Surgeons having experience in pediatric

A novel circuit topology of modified switched boost hybrid resonant inverter fitted induction heating equipment

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Bhattacharya Ananyo

2016-12-01

Full Text Available A novel circuit topology of modified switched boost high frequency hybrid resonant inverter fitted induction heating equipment is presented in this paper for efficient induction heating. Recently, induction heating technique is becoming very popular for both domestic and industrial purposes because of its high energy efficiency and controllability. Generally in induction heating, a high frequency alternating magnetic field is required to induce the eddy currents in the work piece. High frequency resonant inverters are incorporated in induction heating equipment which produce a high frequency alternating magnetic field surrounding the coil. Previously this high frequency alternating magnetic field was produced by voltage source inverters. But VSIs have several demerits. So, in this paper, a new scheme of modified switched boost high frequency hybrid resonant inverter fitted induction heating equipment has been depicted which enhances the energy efficiency and controllability and the same is validated by PSIM.

Proactive error analysis of ultrasound-guided axillary brachial plexus block performance.

LENUS (Irish Health Repository)

O'Sullivan, Owen

2012-07-13

Detailed description of the tasks anesthetists undertake during the performance of a complex procedure, such as ultrasound-guided peripheral nerve blockade, allows elements that are vulnerable to human error to be identified. We have applied 3 task analysis tools to one such procedure, namely, ultrasound-guided axillary brachial plexus blockade, with the intention that the results may form a basis to enhance training and performance of the procedure.

A Unique Branching Pattern of the Axillary Artery: A Case Report

OpenAIRE

Bagoji, Ishwar B.; Hadimani, Gavishiddappa A.; Bannur, Balappa M.; Patil, B.G.; Bharatha, Ambadasu

2013-01-01

During routine dissection classes for under graduate students, we found a unique and unusual case regarding the anomalous branching in the third part of the axillary artery was terminated into subscapular arterial trunk, superficial brachial artery and deep brachial artery. The subscapular arterial trunk was origin of several important arteries as the circumflex scapular, thoracodorsal, posterior circumflex humeral, thoraco-acromial and lateral thoracic arteries. The deep brachial artery in t...

Topical niacinamide 4% and desonide 0.05% for treatment of axillary hyperpigmentation: a randomized, double-blind, placebo-controlled study

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Castanedo-Cazares JP

2013-01-01

Full Text Available Juan Pablo Castanedo-Cazares,1 Gabryela Lárraga-Piñones,1 Adriana Ehnis-Pérez,1 Cornelia Fuentes-Ahumada,1 Cuauhtemoc Oros-Ovalle,2 Bruce R Smoller,3 Bertha Torres-Álvarez11Department of Dermatology, 2Department of Pathology, Hospital Central Dr Ignacio Morones Prieto, Universidad Autónoma de San Luis Potosí, México; 3Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AK, USABackground: Axillary hyperpigmentation is a frequent cause of cosmetic consultations in dark-skinned women from tropical areas, including Latin America. Currently, there is no widely accepted treatment for the disorder, but it is usually treated with bleaching agents because it is considered a variant of inflammatory hyperpigmentation. The purpose of this study was to assess the efficacy of niacinamide 4% and desonide 0.05% emulsions compared with placebo in the treatment of axillary hyperpigmentation.Methods: Twenty-four women aged 19–27 years with hyperpigmented axillae (phototype III–V were randomly assigned to receive the study treatments in the axillary region. Improvement was assessed at baseline, then clinically and by colorimetry 9 weeks later. Quantitative evaluation including melanin, inflammatory infiltrates, NKI/Beteb, CD1a, CD68, and collagen type IV content was performed by histochemistry and immunohistochemistry, assisted by computerized morphometric analysis.Results: Both niacinamide and desonide induced significant colorimetric improvement compared with placebo; however, desonide showed a better depigmenting effect than niacinamide. A good to excellent response was achieved in 24% of cases for niacinamide, 30% for desonide, and 6% for placebo. We observed a marked disruption of the basal membrane in axillary hyperpigmentation and an inflammatory infiltrate that improved after treatment. Decreased pigmentation in the desonide-treated axillae was associated with recovery of disruption at the basal membrane

Movement of the cervix in after-loading brachytherapy: implications for designing external-beam radiotherapy boost fields.

Science.gov (United States)

Hombaiah, U; Blake, P; Bidmead, M

2006-05-01

Women with invasive carcinoma of the cervix treated by chemo-radiotherapy and brachytherapy may also receive a pelvic sidewall boost using a midline shield (MLS). The purpose of this study was to assess the usefulness of implanted gold grains in detecting the movement of the cervix caused by the insertion of low-dose-rate brachytherapy applicators, and its implications in designing the MLS. The medical records of 42 women with various stages of cervical carcinoma, who were treated by radical chemo-radiotherapy, were reviewed. All of these women underwent examination under anaesthesia (EUA) and a gold-grain insertion to demarcate the vaginal tumour extent, in the antero-posterior and lateral planes, before starting external-beam radiotherapy. The isocentric orthogonal films (simulator films) of external radiotherapy and brachytherapy were compared to assess the change in position of the gold grains and the consequences for the design of the MLS for parametrial and pelvic sidewall boosts. A significant shift in the position of the gold grains was noted in both the x (lateral) and the y (cranial/caudal) axes. The median shift of the midline, right and left lateral gold grains was 4.5, 5 and 7 mm in the x axis, whereas it was 10, 8 and 9.5 mm in the y axis, respectively. The median shift in the x and y axes was 5.5 and 9 mm, ranging from 1 to 40 mm and 1 to 45 mm, respectively. The gold grains were shifted cranially in 34 (80%) and laterally in 29 (69%) women. Thirty-two women (76.2%) received parametrial boost radiotherapy, of which 25 (59.5%) women had a customised, pear-shaped shield, and the remaining seven (16.7%) had a straight-sided, rectangular MLS. Four women (9.5%) relapsed locally, and three of them had been treated using a customised shield. In two of these four women, there was an absolute under-dosage of the central pelvis at the tip of the intra-uterine tube by 50% of the parametrial boost dose (5.4 Gy/3 fractions/3 days). Insertion of the gold grains

Role of axillary lymph node ultra-sound and large core biopsy in the preoperative assessment of patients selected for sentinel node biopsy

International Nuclear Information System (INIS)

Nori, Jacopo; Boeri, Cecilia; Vanzi, Ermanno; Nori Bufalini, Filippo; Masi, Andrea; Bazzocchi, Massimo; Londero, Viviana; Mangialavori, Giuseppe; Distante, Vito; Simoncini, Roberta

2005-01-01

Purpose: To aim of this study was to evaluate the diagnostic accuracy of axillary lymph node sonography, if necessary in collaboration with US-guided large core biopsy, in the preoperative evaluation of breast cancer patients scheduled for quadrantectomy and sentinel lymph node excision. Materials and methods: From July 2001 to December 2002, we evaluated 117 breast cancer patients with ultrasound and, where indicated, FNAB. Breast lesions has diameters between 4 and 26 mm (mean diameter 11 mm). Fifteen (13%) of the 117 patients were excluded from the series as they did not found fulfil the criteria for preliminary sonography of the axilla: in 9 patients fewer than 4 nodes were detected and in 6 patients the breast lesions were intraoperatively found to be benign. Eleven patients (10.7%) with sonographically suspicious axillary nodes were sampled by US-guided core biopsy using a 14 or 16 Gauge Tru-Cut needle. Results: The ultrasound study aims to evaluate the dimensions and morphology of the breast lesion as well as detect and assess at least 4 axillary nodes. These were evaluated for hilar and cortical thickening and radio between the sinus diameter and the total longitudinal diameter. Lymph nodes with hilar diameters equal to or greater than 50% of the longitudinal diameter were considered normal. Of the 102 patients evaluated, 77 (75.7%) had normal axillary nodes according to the US criteria adopted. Negativity was confirmed by histology in 56 cases (72.7%, true negative); 21 (27.3%, false negative) were found to be positive, in contrast with the sonographic appearance. The false negative cases were due to lymph node micrometastasis which probably did not cause morphologic alterations perceptible at ultrasound. The remaining 25 patients (24.5%) had axillary lymph nodes classified as suspicious. In 13 cases of (52%, true positive) there was agreement with histology, whereas in 12 cases (48%, false positive) the US suspicion was not confirmed at surgery. The most

Characterization of Trichome-Expressed BAHD Acyltransferases in Petunia axillaris Reveals Distinct Acylsugar Assembly Mechanisms within the Solanaceae.

Science.gov (United States)

Nadakuduti, Satya Swathi; Uebler, Joseph B; Liu, Xiaoxiao; Jones, A Daniel; Barry, Cornelius S

2017-09-01

Acylsugars are synthesized in the glandular trichomes of the Solanaceae family and are implicated in protection against abiotic and biotic stress. Acylsugars are composed of either sucrose or glucose esterified with varying numbers of acyl chains of differing length. In tomato ( Solanum lycopersicum ), acylsugar assembly requires four acylsugar acyltransferases (ASATs) of the BAHD superfamily. Tomato ASATs catalyze the sequential esterification of acyl-coenzyme A thioesters to the R4, R3, R3', and R2 positions of sucrose, yielding a tetra-acylsucrose. Petunia spp. synthesize acylsugars that are structurally distinct from those of tomato. To explore the mechanisms underlying this chemical diversity, a Petunia axillaris transcriptome was mined for trichome preferentially expressed BAHDs. A combination of phylogenetic analyses, gene silencing, and biochemical analyses coupled with structural elucidation of metabolites revealed that acylsugar assembly is not conserved between tomato and petunia. In P. axillaris , tetra-acylsucrose assembly occurs through the action of four ASATs, which catalyze sequential addition of acyl groups to the R2, R4, R3, and R6 positions. Notably, in P. axillaris , PaxASAT1 and PaxASAT4 catalyze the acylation of the R2 and R6 positions of sucrose, respectively, and no clear orthologs exist in tomato. Similarly, petunia acylsugars lack an acyl group at the R3' position, and congruently, an ortholog of SlASAT3, which catalyzes acylation at the R3' position in tomato, is absent in P. axillaris Furthermore, where putative orthologous relationships of ASATs are predicted between tomato and petunia, these are not supported by biochemical assays. Overall, these data demonstrate the considerable evolutionary plasticity of acylsugar biosynthesis. © 2017 American Society of Plant Biologists. All Rights Reserved.

Axillary staging for breast cancer during pregnancy

DEFF Research Database (Denmark)

Han, S N; Amant, F; Cardonick, E H

2018-01-01

BACKGROUND: Safety of sentinel lymph node (SLN) biopsy for breast cancer during pregnancy is insufficiently explored. We investigated efficacy and local recurrence rate in a large series of pregnant patients. PATIENTS AND METHODS: Women diagnosed with breast cancer who underwent SLN biopsy during...... pregnancy were identified from the International Network on Cancer, Infertility and Pregnancy, the German Breast Group, and the Cancer and Pregnancy Registry. Chart review was performed to record technique and outcome of SLN biopsy, locoregional and distant recurrence, and survival. RESULTS: We identified...... were alive and free of disease. Eleven patients experienced a locoregional relapse, including 1 isolated ipsilateral axillary recurrence (0.7%). Eleven (7.6%) patients developed distant metastases, of whom 9 (6.2%) died of breast cancer. No neonatal adverse events related to SLN procedure during...

Detection of axillary lymph node involvement of breast cancer by Tc-99m MIBI scintimammography

International Nuclear Information System (INIS)

Pusuwan, P.; Chakrappe-sirisuk, S.; Amornpichetkul, K.; Padhy, A.K.; Dondi, M.; Watanabe, N.

2006-01-01

Breast cancer is the most common malignancy among women, leading to hundreds of thousands of deaths annually around the world. Lymph node status is the most important prognostic indicator in newly diagnosed breast cancer. The presence of axillary lymph node metastases has major prognostic implications in breast cancer patients, and it is an important criterion in determining the need for adjuvant chemotherapy. There is not an accurate anatomical test for detecting axillary lymph node metastasis and clinical examination has inappropriate diagnostic values. Routine lymph node dissection is the only accepted method for therapeutic decisions but it is invasive and produces significant morbidity such as lymphedema and infections. On the other hand, an important proportion of breast cancer patients are nodenegative. Ultrasonography has also been reported to be helpful, especially in conjunction with fine needle aspiration biopsy

Population based study on sentinel node biopsy before or after neoadjuvant chemotherapy in clinically node negative breast cancer patients : Identification rate and influence on axillary treatment

NARCIS (Netherlands)

van der Heiden-van der Loo, M.; de Munck, L.; Sonke, G. S.; van Dalen, T.; van Diest, P. J.; van den Bongard, H. J. G. D.; Peeters, P. H. M.; Rutgers, E. J. T.

The timing of the sentinel lymph node biopsy (SNB) is controversial in clinically node negative patients receiving neoadjuvant chemotherapy (NAC). We studied variation in the timing of axillary staging in breast cancer patients who received NAC and the subsequent axillary treatment in The

Repair of Multiple Subclavian and Axillary Artery Aneurysms in a 58-Year-Old Man with Marfan Syndrome.

Science.gov (United States)

Dolapoglu, Ahmet; de la Cruz, Kim I; Preventza, Ourania; Coselli, Joseph S

2016-10-01

Dilation of the ascending aorta and aortic dissections are often seen in Marfan syndrome; however, true aneurysms of the subclavian and axillary arteries rarely seem to develop in patients who have this disease. We present the case of a 58-year-old man with Marfan syndrome who had undergone a Bentall procedure and thoracoabdominal aortic repair for an aortic dissection and who later developed multiple aneurysmal dilations of his right subclavian and axillary arteries. The aneurysms were successfully repaired by means of a surgical bypass technique in which a Dacron graft was placed between the carotid and brachial arteries. We also discuss our strategy for determining the optimal surgical approach in these patients.

Supine MRI for regional breast radiotherapy: imaging axillary lymph nodes before and after sentinel-node biopsy

Science.gov (United States)

van Heijst, Tristan C. F.; Eschbach-Zandbergen, Debora; Hoekstra, Nienke; van Asselen, Bram; Lagendijk, Jan J. W.; Verkooijen, Helena M.; Pijnappel, Ruud M.; de Waard, Stephanie N.; Witkamp, Arjen J.; van Dalen, Thijs; Desirée van den Bongard, H. J. G.; Philippens, Marielle E. P.

2017-08-01

Regional radiotherapy (RT) is increasingly used in breast cancer treatment. Conventionally, computed tomography (CT) is performed for RT planning. Lymph node (LN) target levels are delineated according to anatomical boundaries. Magnetic resonance imaging (MRI) could enable individual LN delineation. The purpose was to evaluate the applicability of MRI for LN detection in supine treatment position, before and after sentinel-node biopsy (SNB). Twenty-three female breast cancer patients (cTis-3N0M0) underwent 1.5 T MRI, before and after SNB, in addition to CT. Endurance for MRI was monitored. Axillary levels were delineated. LNs were identified and delineated on MRI from before and after SNB, and on CT, and compared by Wilcoxon signed-rank tests. LN locations and LN-based volumes were related to axillary delineations and associated volumes. Although postoperative effects were visible, LN numbers on postoperative MRI (median 26 LNs) were highly reproducible compared to preoperative MRI when adding excised sentinel nodes, and higher than on CT (median 11, p  <  0.001). LN-based volumes were considerably smaller than respective axillary levels. Supine MRI of LNs is feasible and reproducible before and after SNB. This may lead to more accurate RT target definition compared to CT, with potentially lower toxicity. With the MRI techniques described here, initiation of novel MRI-guided RT strategies aiming at individual LNs could be possible.

Validation of sentinel lymph node biopsy in breast cancer women N1-N2 with complete axillary response after neoadjuvant chemotherapy. Multicentre study in Tarragona.

Science.gov (United States)

Carrera, D; de la Flor, M; Galera, J; Amillano, K; Gomez, M; Izquierdo, V; Aguilar, E; López, S; Martínez, M; Martínez, S; Serra, J M; Pérez, M; Martin, L

2016-01-01

The aim of our study was to evaluate sentinel lymph node biopsy as a diagnostic test for assessing the presence of residual metastatic axillary lymph nodes after neoadjuvant chemotherapy, replacing the need for a lymphadenectomy in negative selective lymph node biopsy patients. A multicentre, diagnostic validation study was conducted in the province of Tarragona, on women with T1-T3, N1-N2 breast cancer, who presented with a complete axillary response after neoadjuvant chemotherapy. Study procedures consisted of performing an selective lymph node biopsy followed by lymphadenectomy. A total of 53 women were included in the study. Surgical detection rate was 90.5% (no sentinel node found in 5 patients). Histopathological analysis of the lymphadenectomy showed complete disease regression of axillary nodes in 35.4% (17/48) of the patients, and residual axillary node involvement in 64.6% (31/48) of them. In lymphadenectomy positive patients, 28 had a positive selective lymph node biopsy (true positive), while 3 had a negative selective lymph node biopsy (false negative). Of the 28 true selective lymph node biopsy positives, the sentinel node was the only positive node in 10 cases. All lymphadenectomy negative cases were selective lymph node biopsy negative. These data yield a sensitivity of 93.5%, a false negative rate of 9.7%, and a global test efficiency of 93.7%. Selective lymph node biopsy after chemotherapy in patients with a complete axillary response provides valid and reliable information regarding axillary status after neoadjuvant treatment, and might prevent lymphadenectomy in cases with negative selective lymph node biopsy. Copyright © 2016 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

The value of level III clearance in patients with axillary and sentinel node positive breast cancer.

LENUS (Irish Health Repository)

Dillon, Mary F

2012-02-01

BACKGROUND: The value of level III axillary clearance is contentious, with great variance worldwide in the extent and levels of clearance performed. OBJECTIVE: To determine rates of level III positivity in patients undergoing level I-III axillary clearance, and identify which patients are at highest risk of involved level III nodes. METHODS: From a database of 2850 patients derived from symptomatic and population-based screening service, 1179 patients who underwent level I-III clearance between the years 1999-2007 were identified. The pathology, surgical details, and prior sentinel nodes biopsies of patients were recorded. RESULTS: Eleven hundred seventy nine patients had level I-III axillary clearance. Of the patients, 63% (n = 747) were node positive. Of patients with node positive disease, 23% (n = 168) were level II positive and 19% (n = 141) were level III positive. Two hundred fifty patients had positive sentinel node biopsies prior to axillary clearance. Of these, 12% (n = 30) and 9% (n = 22) were level II and level III positive, respectively. On multivariate analysis, factors predictive of level III involvement in patients with node positive disease were tumor size (P < 0.001, OR = 1.36; 95% CI: 1.2-1.5), invasive lobular disease (P < 0.001, OR = 3.6; 95% CI: 1.9-6.95), extranodal extension (P < 0.001, OR = 0.27; 95% CI: 0.18-0.4), and lymphovascular invasion (P = 0.04, OR = 0.58; 95% CI: 0.35-1). Lobular invasive disease (P = 0.049, OR = 4.1; 95% CI: 1-16.8), extranodal spread (P = 0.003, OR = 0.18; 95% CI: 0.06-0.57), and having more than one positive sentinel node (P = 0.009, OR = 4.9; 95% CI: 1.5-16.1) were predictive of level III involvement in patients with sentinel node positive disease. CONCLUSION: Level III clearance has a selective but definite role to play in patients who have node positive breast carcinoma. Pathological characteristics of the primary tumor are of particular use in identifying those who are at various risk of level III nodal

Axillary brachial plexus block duration with mepivacaine in patients with chronic renal failure. Case-control study.

Science.gov (United States)

Mojica, V; Nieuwveld, D; Herrera, A E; Mestres, G; López, A M; Sala-Blanch, X

2017-04-01

Regional anaesthesia is commonly preferred for arteriovenous fistula (AVF) creation. Previous studies suggest a shorter block duration in patients with chronic renal failure, maybe because of the changes in regional blood flow. The aim of our study was to evaluate the duration of the axillary block with 1.5% mepivacaine in patients with chronic renal failure scheduled for AVF compared with healthy controls. Patients scheduled for AVF creation for the first time (GIRC) were included. They were compared with patients without renal failure (GC), with similar anthropometric characteristics. Ultrasound-guided axillary blocks with 20mL of 1.5% mepivacaine were performed on all patients. We evaluated onset time, humeral artery diameter and blood flow before and after the block, as well as the block duration. Twenty-three patients (GIRC: 12 and GC: 11) were included. No differences between groups were observed in block duration (GIRC: 227±43min vs GC: 229±27min; P=.781), or in onset time (GIRC: 13±5min vs GC: 12.2±3min; P=.477). The humeral blood flow before and after block was significantly lower in the GIRC (pre-block: GIRC: 52±21ml/min GC: 100±62ml/min; P=.034 and p ost block: GIRC: 130±57ml/min and GC: 274±182ml/min; P=.010). There was no significant correlation between the duration of the block and the preblock humeral blood flow (Spearman Rho: 0.106; P=.657) or the postblock humeral blood flow (Spearman Rho: 0.267; P=.254). The duration of the axillary block with 1.5% mepivacaine in patients with chronic renal failure was similar to that of the control patients. The duration of axillary brachial plexus block seems not to be related to changes in regional blood flow. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Predictors of axillary lymph node metastases in women with early breast cancer in Singapore.

Science.gov (United States)

Tan, L G L; Tan, Y Y; Heng, D; Chan, M Y

2005-12-01

The presence of axillary lymph node metastases is an important prognostic factor in breast cancer. Sentinel lymph node biopsy (SLNB) is an emerging method for the staging of the axilla. It is hoped that with SLNB, the morbidity from axillary lymph node dissection (ALND) can be avoided without compromising the staging and management of early breast cancer. However, only patients found to be SLNB negative benefit from this procedure, as those with positive SLNB may still require ALND. Our objective is to study the various clinico-pathological factors to find predictive factors for axillary lymph node involvement in early breast cancer. It is hoped that with these factors, we will be better able to identify groups of patients most likely to benefit from SLNB. A retrospective study of 380 early breast cancer cases (stage T1 and T2, N0, N1, M0) in women treated in the Department of General Surgery, Tan Tock Seng Hospital, between January 1999 and August 2002, was conducted. Incidence of nodal metastases was correlated with clinico-pathological factors, and analysed by univariate and multivariate analyses. Approximately 35 percent of the 380 cases of early breast cancer had nodal metastases. Multivariate analyses revealed four independent predictors of node positivity: tumour size (p-value equals 0.0001), presence of lymphovascular invasion (p-value is less than 0.0001), tumours with histology other than invasive ductal or lobular carcinoma (p-value equals 0.04), and presence of progesterone receptors (p-value equals 0.05). We have found independent preoperative predictive factors in our local population for the presence of nodal metastases. This information can aid patient selection for SLNB and improve patient counselling.

Face Alignment Using Boosting and Evolutionary Search

NARCIS (Netherlands)

Zhang, Hua; Liu, Duanduan; Poel, Mannes; Nijholt, Antinus; Zha, H.; Taniguchi, R.-I.; Maybank, S.

2010-01-01

In this paper, we present a face alignment approach using granular features, boosting, and an evolutionary search algorithm. Active Appearance Models (AAM) integrate a shape-texture-combined morphable face model into an efficient fitting strategy, then Boosting Appearance Models (BAM) consider the

Inelastic Boosted Dark Matter at direct detection experiments

Science.gov (United States)

Giudice, Gian F.; Kim, Doojin; Park, Jong-Chul; Shin, Seodong

2018-05-01

We explore a novel class of multi-particle dark sectors, called Inelastic Boosted Dark Matter (iBDM). These models are constructed by combining properties of particles that scatter off matter by making transitions to heavier states (Inelastic Dark Matter) with properties of particles that are produced with a large Lorentz boost in annihilation processes in the galactic halo (Boosted Dark Matter). This combination leads to new signals that can be observed at ordinary direct detection experiments, but require unconventional searches for energetic recoil electrons in coincidence with displaced multi-track events. Related experimental strategies can also be used to probe MeV-range boosted dark matter via their interactions with electrons inside the target material.

High-Dose-Rate Brachytherapy Boost Effect on Local Tumor Control in Young Women With Breast Cancer

International Nuclear Information System (INIS)

Guinot, Jose-Luis; Baixauli-Perez, Cristobal; Soler, Pablo; Tortajada, Maria Isabel; Moreno, Araceli; Santos, Miguel Angel; Mut, Alejandro; Gozalbo, Francisco; Arribas, Leoncio

2015-01-01

Purpose: To evaluate the local control rate and complications of a single fraction of high-dose-rate brachytherapy (HDR BT) boost in women aged 45 yeas and younger after breast-conserving therapy. Methods and Materials: Between 1999 and 2007, 167 patients between the ages of 26 and 45 years old (72 were 40 years old or younger), with stages T1 to T2 invasive breast cancer with disease-free margin status of at least 5 mm after breast-conserving surgery received 46 to 50 Gy whole-breast irradiation plus a 7-Gy HDR-BT boost (“fast boost”). An axillary dissection was performed in 72.5% of the patients and sentinel lymph node biopsy in 27.5%. A supraclavicular area was irradiated in 19% of the patients. Chemotherapy was used in 86% of the patients and hormone treatment in 77%. Clinical nodes were present in 18% and pathological nodes in 29%. The pathological stage was pT0: 5%, pTis: 3%, pT1: 69% and pT2: 23%. Intraductal component was present in 40% and 28% were G3. Results: At a median follow-up of 92 months, 9 patients relapsed on the margin of the implant, and 1 patient in another quadrant, resulting in a 10-year local relapse rate of 4.3% and a breast relapse rate of 4.9%, with breast preservation in 93.4%; no case of mastectomy due to poor cosmesis arose. Actuarial 5- and 10-year disease-free, cause-specific, and overall survival rates were 87.9% and 85.8%, and 92.1% and 88.4%, and 92.1% and 87.3%, respectively. In a univariate analysis, triple-negative cases and negative hormone receptors did worse, but in a multivariate analysis, only the last factor was significant for local and breast control. Asymptomatic fibrosis G2 was recorded in 3 cases, and there were no other late complications. Cosmetic results were good to excellent in 97% of cases. Conclusions: A single dose of 7 Gy using the fast-boost technique is well tolerated, with a low rate of late complications and improved local tumor control in women aged 45 and younger, compared to published data

High-Dose-Rate Brachytherapy Boost Effect on Local Tumor Control in Young Women With Breast Cancer

Energy Technology Data Exchange (ETDEWEB)

Guinot, Jose-Luis, E-mail: jguinot@fivo.org [Department of Radiation Oncology, Fundacion Instituto Valenciano de Oncologia, Valencia (Spain); Baixauli-Perez, Cristobal [Health Services Research Unit, Center for Public Health Research, Valencia (Spain); Soler, Pablo; Tortajada, Maria Isabel; Moreno, Araceli; Santos, Miguel Angel; Mut, Alejandro [Department of Radiation Oncology, Fundacion Instituto Valenciano de Oncologia, Valencia (Spain); Gozalbo, Francisco [Department of Pathology, Fundacion Instituto Valenciano de Oncologia, Valencia (Spain); Arribas, Leoncio [Department of Radiation Oncology, Fundacion Instituto Valenciano de Oncologia, Valencia (Spain)

2015-01-01

Purpose: To evaluate the local control rate and complications of a single fraction of high-dose-rate brachytherapy (HDR BT) boost in women aged 45 yeas and younger after breast-conserving therapy. Methods and Materials: Between 1999 and 2007, 167 patients between the ages of 26 and 45 years old (72 were 40 years old or younger), with stages T1 to T2 invasive breast cancer with disease-free margin status of at least 5 mm after breast-conserving surgery received 46 to 50 Gy whole-breast irradiation plus a 7-Gy HDR-BT boost (“fast boost”). An axillary dissection was performed in 72.5% of the patients and sentinel lymph node biopsy in 27.5%. A supraclavicular area was irradiated in 19% of the patients. Chemotherapy was used in 86% of the patients and hormone treatment in 77%. Clinical nodes were present in 18% and pathological nodes in 29%. The pathological stage was pT0: 5%, pTis: 3%, pT1: 69% and pT2: 23%. Intraductal component was present in 40% and 28% were G3. Results: At a median follow-up of 92 months, 9 patients relapsed on the margin of the implant, and 1 patient in another quadrant, resulting in a 10-year local relapse rate of 4.3% and a breast relapse rate of 4.9%, with breast preservation in 93.4%; no case of mastectomy due to poor cosmesis arose. Actuarial 5- and 10-year disease-free, cause-specific, and overall survival rates were 87.9% and 85.8%, and 92.1% and 88.4%, and 92.1% and 87.3%, respectively. In a univariate analysis, triple-negative cases and negative hormone receptors did worse, but in a multivariate analysis, only the last factor was significant for local and breast control. Asymptomatic fibrosis G2 was recorded in 3 cases, and there were no other late complications. Cosmetic results were good to excellent in 97% of cases. Conclusions: A single dose of 7 Gy using the fast-boost technique is well tolerated, with a low rate of late complications and improved local tumor control in women aged 45 and younger, compared to published data

Fast neutron boost for the treatment of grade IV astrocytomas

International Nuclear Information System (INIS)

Breteau, N.; Destembert, B.; Favre, A.; Pheline, C.; Schlienger, M.

1989-01-01

A previous study, on grade IV astrocytomas, compared a combination of photons and fast neutron boost to photons only, both treatments being delivered following a concentrated irradiation schedule. A slight improvement in survival was observed after neutron boost for non operated patients, but not for operated patients. Since death was always related to local recurrence and since no complication occurred after neutron boost, the neutron dose was increased from 6 to 7 Gy in January 1985. No improvement in survival was observed for patients treated with neutron boost after complete resection. After subtotal resection, the group that was treated with the higher neutron boost (7 Gy) showed a significant benefit in survival at twelve months. When patients had only a biopsy before irradiation, there was a benefit in survival after neutron boost, but no additional benefit was gained when the size of the neutron boost was increased from 6 to 7 Gy. (orig.) [de

In elective arch surgery with circulatory arrest, does the arterial cannulation site really matter? A propensity score analysis of right axillary and innominate artery cannulation.

Science.gov (United States)

Preventza, Ourania; Price, Matt D; Spiliotopoulos, Konstantinos; Amarasekara, Hiruni S; Cornwell, Lorraine D; Omer, Shuab; de la Cruz, Kim I; Zhang, Qianzi; Green, Susan Y; LeMaire, Scott A; Rosengart, Todd K; Coselli, Joseph S

2018-05-01

The preferred arterial cannulation site for elective proximal aortic procedures requiring circulatory arrest varies, and different sites have been tried. We evaluated the relationships between arterial cannulation site and adverse outcomes, including stroke, in patients undergoing elective aortic arch surgery. We reviewed the records of 938 patients who underwent elective hemiarch or total arch surgery with circulatory arrest between 2006 and 2016. Five cannulation sites were used: the right axillary (n = 515; 54.9%), innominate (n = 376; 40.1%), and right common carotid arteries (n = 15; 1.6%), each with a side graft; the ascending aorta (n = 19; 2.0%); and the femoral artery (n = 13; 1.4%). Multivariable logistic regression analysis was used to model the effects of cannulation site on adverse outcomes for the entire cohort and for a subcohort of 891 patients who underwent innominate or axillary artery cannulation. Propensity-matching yielded 564 patients (282 pairs) from the right axillary and innominate artery groups. For the entire cohort, mortality, stroke, and composite adverse outcome (operative death or persistent stroke or renal failure at hospital discharge) rates were 7.0%, 4.1%, and 9.8%. In the multivariable analysis of the axillary/innominate subcohort, cannulation site did not independently predict operative mortality, persistent stroke, or composite adverse event. These results were confirmed with the propensity-matched analysis, where both axillary and innominate artery cannulation provided equivalent composite adverse event rates, operative death rates, and overall stroke rates. During elective arch surgery, right axillary artery cannulation and innominate artery cannulation (both via a side graft) produce excellent results and can be used interchangeably. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Utility of 18F-fluoro-deoxyglucose emission tomography/computed tomography fusion imaging (18F-FDG PET/CT) in combination with ultrasonography for axillary staging in primary breast cancer

International Nuclear Information System (INIS)

Ueda, Shigeto; Ishida, Jiro; Abe, Yoshiyuki; Mochizuki, Hidetaka; Tsuda, Hitoshi; Asakawa, Hideki; Omata, Jiro; Fukatsu, Kazuhiko; Kondo, Nobuo; Kondo, Tadaharu; Hama, Yukihiro; Tamura, Katsumi

2008-01-01

Accurate evaluation of axillary lymph node (ALN) involvement is mandatory before treatment of primary breast cancer. The aim of this study is to compare preoperative diagnostic accuracy between positron emission tomography/computed tomography with 18 F-fluorodeoxyglucose ( 18 F-FDG PET/CT) and axillary ultrasonography (AUS) for detecting ALN metastasis in patients having operable breast cancer, and to assess the clinical management of axillary 18 F-FDG PET/CT for therapeutic indication of sentinel node biopsy (SNB) and preoperative systemic chemotherapy (PSC). One hundred eighty-three patients with primary operable breast cancer were recruited. All patients underwent 18 F-FDG PET/CT and AUS followed by SNB and/or ALN dissection (ALND). Using 18 F-FDG PET/CT, we studied both a visual assessment of 18 F-FDG uptake and standardized uptake value (SUV) for axillary staging. In a visual assessment of 18 F-FDG PET/CT, the diagnostic accuracy of ALN metastasis was 83% with 58% in sensitivity and 95% in specificity, and when cut-off point of SUV was set at 1.8, sensitivity, specificity, and accuracy were 36, 100, and 79%, respectively. On the other hand, the diagnostic accuracy of AUS was 85% with 54% in sensitivity and 99% in specificity. By the combination of 18 F-FDG PET/CT and AUS to the axilla, the sensitivity, specificity, and accuracy were 64, 94, and 85%, respectively. If either 18 F-FDG PET uptake or AUS was positive in allixa, the probability of axillary metastasis was high; 50% (6 of 12) in 18 F-FDG PET uptake only, 80% (4 of 5) in AUS positive only, and 100% (28 of 28) in dual positive. By the combination of AUS and 18 F-FDG PET/CT, candidates of SNB were more appropriately selected. The axillary 18 F-FDG uptake was correlated with the maximum size and nuclear grade of metastatic foci (p = 0.006 and p = 0.03). The diagnostic accuracy of 18 F-FDG PET/CT was shown to be nearly equal to ultrasound, and considering their limited sensitivities, the high radiation

Bilateral axillary skin fold flaps used for dorsal thoracic skin wound closure in a dog : clinical communication

Directory of Open Access Journals (Sweden)

B. G. Nevill

2010-05-01

Full Text Available A 10-year-old greyhound-cross dog was presented with a large, chronic skin wound extending over the interscapular region. The substantial skin defect was closed by making use of bilateral axillary skin fold flaps. It was possible to elevate the 2 skin flaps sufficiently to allow them to meet at the dorsal midline and thus facilitate complete closure of a large and awkwardly positioned wound. Small dorsal areas of the skin flaps underwent necrosis, but the resulting defects were closed without difficulty in a subsequent procedure. To the author's knowledge, this is the 1st clinical report of the use of bilateral axillary skin fold flaps in this fashion and describes an additional use of a versatile skin flap procedure.

Orthodontics Align Crooked Teeth and Boost Self-Esteem

Science.gov (United States)

... desktop! more... Orthodontics Align Crooked Teeth and Boost Self- esteem Article Chapters Orthodontics Align Crooked Teeth and Boost Self- esteem print full article print this chapter email this ...

Boost.Unicode : a Unicode library for C++

OpenAIRE

Wien, Erik; Gigstad, Lars Erik

2005-01-01

The project has resulted in a Unicode string library for C++ that abstracts away the complexity of working with Unicode text. The idea behind the project originated from the Boost community's developer mailings lists, and is developed with inclusion into the Boost library collection in mind.

Sentinel Lymph Node Biopsy in Breast Cancer: Predictors of Axillary and Non-Sentinel Lymph Node Involvement

Directory of Open Access Journals (Sweden)

Hakan Postacı

2013-12-01

Full Text Available Background: Sentinel lymph node biopsy is a standard method for the evaluation of axillary status in patients with T1-2N0M0 breast cancers. Aims: To determine the prognostic significance of primary tumour-related clinico-histopathological factors on axillary and non-sentinel lymph node involvement of patients who underwent sentinel lymph node biopsy. Study design: Retrospective clinical study. Methods: In the present study, 157 sentinel lymph node biopsies were performed in 151 consecutive patients with early stage breast cancer between June 2008 and December 2011. Results: Successful lymphatic mapping was obtained in 157 of 158 procedures (99.4%. The incidence of larger tumour size (2.543±1.21 vs. 1.974±1.04, lymphatic vessel invasion (70.6% vs. 29.4%, blood vessel invasion (84.2% vs. 15.8%, and invasive lobular carcinoma subtype (72.7% vs. 27.3% were statistically significantly higher in patients with positive SLNs. Logistic stepwise regression analysis disclosed tumour size (odds ratio: 1.51, p=0.0021 and lymphatic vessel invasion (odds ratio: 4.68, p=0.001 as significant primary tumour-related prognostic determinants of SLN metastasis. Conclusion: A close relationship was identified between tumour size and lymphatic vessel invasion of the primary tumour and axillary lymph node involvement. However, the positive predictive value of these two independent variables is low and there is no compelling evidence to recommend their use in routine clinical practice.

Dose analysis of boost irradiation of parapharyngeal space in nasopharyngeal carcinoma

International Nuclear Information System (INIS)

Wu, V.W.C.

2000-01-01

Parapharyngeal space (PPS) is one of the common spreads of nasopharyngeal carcinoma (NPC). Since early eighties boost treatment has been routinely given to patients with PPS involvement. The use of oblique facio-cervical field in this treatment posed difficulty in assessing the dose distribution before the 3-D computer systems are available. This study evaluated the variations of dose distribution by different boost techniques on fifteen patients with PPS involvement using 3-D computer planning system. Comparisons were made between different radiation types, photon energies and modes of collimation respectively. Results showed that the dose distributions in the boost treatment were acceptable, as they did not bring the total doses of the normal structures exceeding their tolerance. There was little difference between 6 and 10 MV photons, but significant differences were found between photon and electron beams. Photon beams were better than the electron beams in giving lower doses to the spinal cord and the TM joint with more homogeneous dose to the target volume, whereas electron beams gave better sparing of the lens and temporal lobe. For the photon beams, half-blocked beam was superior to symmetrical beam in reducing the brain stem dose, but there was no advantage to the rest of normal structures. Copyright (1999) Australian Institute of Radiography

Radiation Dose to the Esophagus From Breast Cancer Radiation Therapy, 1943-1996: An International Population-Based Study of 414 Patients

International Nuclear Information System (INIS)

Lamart, Stephanie; Stovall, Marilyn; Simon, Steven L.; Smith, Susan A.; Weathers, Rita E.; Howell, Rebecca M.; Curtis, Rochelle E.; Aleman, Berthe M.P.; Travis, Lois; Kwon, Deukwoo; Morton, Lindsay M.

2013-01-01

Purpose: To provide dosimetric data for an epidemiologic study on the risk of second primary esophageal cancer among breast cancer survivors, by reconstructing the radiation dose incidentally delivered to the esophagus of 414 women treated with radiation therapy for breast cancer during 1943-1996 in North America and Europe. Methods and Materials: We abstracted the radiation therapy treatment parameters from each patient’s radiation therapy record. Treatment fields included direct chest wall (37% of patients), medial and lateral tangentials (45%), supraclavicular (SCV, 64%), internal mammary (IM, 44%), SCV and IM together (16%), axillary (52%), and breast/chest wall boosts (7%). The beam types used were 60 Co (45% of fields), orthovoltage (33%), megavoltage photons (11%), and electrons (10%). The population median prescribed dose to the target volume ranged from 21 Gy to 40 Gy. We reconstructed the doses over the length of the esophagus using abstracted patient data, water phantom measurements, and a computational model of the human body. Results: Fields that treated the SCV and/or IM lymph nodes were used for 85% of the patients and delivered the highest doses within 3 regions of the esophagus: cervical (population median 38 Gy), upper thoracic (32 Gy), and middle thoracic (25 Gy). Other fields (direct chest wall, tangential, and axillary) contributed substantially lower doses (approximately 2 Gy). The cervical to middle thoracic esophagus received the highest dose because of its close proximity to the SCV and IM fields and less overlying tissue in that part of the chest. The location of the SCV field border relative to the midline was one of the most important determinants of the dose to the esophagus. Conclusions: Breast cancer patients in this study received relatively high incidental radiation therapy doses to the esophagus when the SCV and/or IM lymph nodes were treated, whereas direct chest wall, tangentials, and axillary fields contributed lower doses

Radiation dose to the esophagus from breast cancer radiation therapy, 1943-1996: an international population-based study of 414 patients.

Science.gov (United States)

Lamart, Stephanie; Stovall, Marilyn; Simon, Steven L; Smith, Susan A; Weathers, Rita E; Howell, Rebecca M; Curtis, Rochelle E; Aleman, Berthe M P; Travis, Lois; Kwon, Deukwoo; Morton, Lindsay M

2013-07-15

To provide dosimetric data for an epidemiologic study on the risk of second primary esophageal cancer among breast cancer survivors, by reconstructing the radiation dose incidentally delivered to the esophagus of 414 women treated with radiation therapy for breast cancer during 1943-1996 in North America and Europe. We abstracted the radiation therapy treatment parameters from each patient's radiation therapy record. Treatment fields included direct chest wall (37% of patients), medial and lateral tangentials (45%), supraclavicular (SCV, 64%), internal mammary (IM, 44%), SCV and IM together (16%), axillary (52%), and breast/chest wall boosts (7%). The beam types used were (60)Co (45% of fields), orthovoltage (33%), megavoltage photons (11%), and electrons (10%). The population median prescribed dose to the target volume ranged from 21 Gy to 40 Gy. We reconstructed the doses over the length of the esophagus using abstracted patient data, water phantom measurements, and a computational model of the human body. Fields that treated the SCV and/or IM lymph nodes were used for 85% of the patients and delivered the highest doses within 3 regions of the esophagus: cervical (population median 38 Gy), upper thoracic (32 Gy), and middle thoracic (25 Gy). Other fields (direct chest wall, tangential, and axillary) contributed substantially lower doses (approximately 2 Gy). The cervical to middle thoracic esophagus received the highest dose because of its close proximity to the SCV and IM fields and less overlying tissue in that part of the chest. The location of the SCV field border relative to the midline was one of the most important determinants of the dose to the esophagus. Breast cancer patients in this study received relatively high incidental radiation therapy doses to the esophagus when the SCV and/or IM lymph nodes were treated, whereas direct chest wall, tangentials, and axillary fields contributed lower doses. Published by Elsevier Inc.

Radiation Dose to the Esophagus From Breast Cancer Radiation Therapy, 1943-1996: An International Population-Based Study of 414 Patients

Energy Technology Data Exchange (ETDEWEB)

Lamart, Stephanie, E-mail: stephanie.lamart@nih.gov [Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States); Stovall, Marilyn [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Simon, Steven L. [Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States); Smith, Susan A.; Weathers, Rita E.; Howell, Rebecca M. [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Curtis, Rochelle E. [Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States); Aleman, Berthe M.P. [Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam (Netherlands); Travis, Lois [Rubin Center for Cancer Survivorship and Department of Radiation Oncology, University of Rochester Medical Center, Rochester, New York (United States); Kwon, Deukwoo [Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida (United States); Morton, Lindsay M. [Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States)

2013-07-15

Purpose: To provide dosimetric data for an epidemiologic study on the risk of second primary esophageal cancer among breast cancer survivors, by reconstructing the radiation dose incidentally delivered to the esophagus of 414 women treated with radiation therapy for breast cancer during 1943-1996 in North America and Europe. Methods and Materials: We abstracted the radiation therapy treatment parameters from each patient’s radiation therapy record. Treatment fields included direct chest wall (37% of patients), medial and lateral tangentials (45%), supraclavicular (SCV, 64%), internal mammary (IM, 44%), SCV and IM together (16%), axillary (52%), and breast/chest wall boosts (7%). The beam types used were {sup 60}Co (45% of fields), orthovoltage (33%), megavoltage photons (11%), and electrons (10%). The population median prescribed dose to the target volume ranged from 21 Gy to 40 Gy. We reconstructed the doses over the length of the esophagus using abstracted patient data, water phantom measurements, and a computational model of the human body. Results: Fields that treated the SCV and/or IM lymph nodes were used for 85% of the patients and delivered the highest doses within 3 regions of the esophagus: cervical (population median 38 Gy), upper thoracic (32 Gy), and middle thoracic (25 Gy). Other fields (direct chest wall, tangential, and axillary) contributed substantially lower doses (approximately 2 Gy). The cervical to middle thoracic esophagus received the highest dose because of its close proximity to the SCV and IM fields and less overlying tissue in that part of the chest. The location of the SCV field border relative to the midline was one of the most important determinants of the dose to the esophagus. Conclusions: Breast cancer patients in this study received relatively high incidental radiation therapy doses to the esophagus when the SCV and/or IM lymph nodes were treated, whereas direct chest wall, tangentials, and axillary fields contributed lower

Characterization of Trichome-Expressed BAHD Acyltransferases in Petunia axillaris Reveals Distinct Acylsugar Assembly Mechanisms within the Solanaceae1[OPEN

Science.gov (United States)

Uebler, Joseph B.; Liu, Xiaoxiao

2017-01-01

Acylsugars are synthesized in the glandular trichomes of the Solanaceae family and are implicated in protection against abiotic and biotic stress. Acylsugars are composed of either sucrose or glucose esterified with varying numbers of acyl chains of differing length. In tomato (Solanum lycopersicum), acylsugar assembly requires four acylsugar acyltransferases (ASATs) of the BAHD superfamily. Tomato ASATs catalyze the sequential esterification of acyl-coenzyme A thioesters to the R4, R3, R3ʹ, and R2 positions of sucrose, yielding a tetra-acylsucrose. Petunia spp. synthesize acylsugars that are structurally distinct from those of tomato. To explore the mechanisms underlying this chemical diversity, a Petunia axillaris transcriptome was mined for trichome preferentially expressed BAHDs. A combination of phylogenetic analyses, gene silencing, and biochemical analyses coupled with structural elucidation of metabolites revealed that acylsugar assembly is not conserved between tomato and petunia. In P. axillaris, tetra-acylsucrose assembly occurs through the action of four ASATs, which catalyze sequential addition of acyl groups to the R2, R4, R3, and R6 positions. Notably, in P. axillaris, PaxASAT1 and PaxASAT4 catalyze the acylation of the R2 and R6 positions of sucrose, respectively, and no clear orthologs exist in tomato. Similarly, petunia acylsugars lack an acyl group at the R3ʹ position, and congruently, an ortholog of SlASAT3, which catalyzes acylation at the R3ʹ position in tomato, is absent in P. axillaris. Furthermore, where putative orthologous relationships of ASATs are predicted between tomato and petunia, these are not supported by biochemical assays. Overall, these data demonstrate the considerable evolutionary plasticity of acylsugar biosynthesis. PMID:28701351

Inelastic Boosted Dark Matter at direct detection experiments

OpenAIRE

Giudice, Gian F.; Kim, Doojin; Park, Jong-Chul; Shin, Seodong

2018-01-01

We explore a novel class of multi-particle dark sectors, called Inelastic Boosted Dark Matter (iBDM). These models are constructed by combining properties of particles that scatter off matter by making transitions to heavier states (Inelastic Dark Matter) with properties of particles that are produced with a large Lorentz boost in annihilation processes in the galactic halo (Boosted Dark Matter). This combination leads to new signals that can be observed at ordinary direct detection experimen...

Boosted top: experimental tools overview

CERN Document Server

Usai, Emanuele

2015-01-01

An overview of tools and methods for the reconstruction of high-boost top quark decays at the LHC is given in this report. The focus is on hadronic decays, in particular an overview of the current status of top quark taggers in physics analyses is presented. The most widely used jet substructure techniques, normally used in combination with top quark taggers, are reviewed. Special techniques to treat pileup in large cone jets are described, along with a comparison of the performance of several boosted top quark reconstruction techniques.

A PIPO Boost Converter with Low Ripple and Medium Current Application

Science.gov (United States)

Bandri, S.; Sofian, A.; Ismail, F.

2018-04-01

This paper presents a Parallel Input Parallel Output (PIPO) boost converter is proposed to gain power ability of converter, and reduce current inductors. The proposed technique will distribute current for n-parallel inductor and switching component. Four parallel boost converters implement on input voltage 20.5Vdc to generate output voltage 28.8Vdc. The PIPO boost converter applied phase shift pulse width modulation which will compare with conventional PIPO boost converters by using a similar pulse for every switching component. The current ripple reduction shows an advantage PIPO boost converter then conventional boost converter. Varies loads and duty cycle will be simulated and analyzed to verify the performance of PIPO boost converter. Finally, the unbalance of current inductor is able to be verified on four area of duty cycle in less than 0.6.

Concomitant boost radiotherapy for muscle invasive bladder cancer

Energy Technology Data Exchange (ETDEWEB)

Pos, Floris J; Tienhoven, Geertjan van; Hulshof, Maarten C.C.M.; Koedooder, Kees; Gonzalez Gonzalez, Dionisio

2003-07-01

Purpose: To evaluate the feasibility and efficacy of a concomitant partial bladder boost schedule in radiotherapy for invasive bladder cancer, coupling a limited boost volume with shortening of the overall treatment time. Methods and materials: Between 1994 and 1999, 50 patients with a T2-T4 N0M0 transitional cell carcinoma of the bladder received radiotherapy delivered in a short overall treatment time with a concomitant boost technique. With this technique a dose of 40 Gy in 2-Gy fractions was administered to the small pelvis with a concomitant boost limited to the bladder tumor area plus margin of 15 Gy in fractions of 0.75 Gy. The total tumor dose was 55 Gy in 20 fractions in 4 weeks. Toxicity was scored according to EORTC/RTOG toxicity criteria. Results: The feasibility of the treatment was good. Severe acute toxicity {>=}G3 was observed in seven patients (14%). Severe late toxicity {>=}G3 was observed in six patients (13%). Thirty-seven patients (74%) showed a complete and five (10 %) a partial remission after treatment. The actuarial 3-year freedom of local progression was 55%. Conclusion: In external radiotherapy for muscle invasive bladder cancer a concomitant boost technique coupling a partial bladder boost with shortening of the overall treatment time provides a high probability of local control with acceptable toxicity.

Concomitant boost radiotherapy for muscle invasive bladder cancer

International Nuclear Information System (INIS)

Pos, Floris J.; Tienhoven, Geertjan van; Hulshof, Maarten C.C.M.; Koedooder, Kees; Gonzalez Gonzalez, Dionisio

2003-01-01

Purpose: To evaluate the feasibility and efficacy of a concomitant partial bladder boost schedule in radiotherapy for invasive bladder cancer, coupling a limited boost volume with shortening of the overall treatment time. Methods and materials: Between 1994 and 1999, 50 patients with a T2-T4 N0M0 transitional cell carcinoma of the bladder received radiotherapy delivered in a short overall treatment time with a concomitant boost technique. With this technique a dose of 40 Gy in 2-Gy fractions was administered to the small pelvis with a concomitant boost limited to the bladder tumor area plus margin of 15 Gy in fractions of 0.75 Gy. The total tumor dose was 55 Gy in 20 fractions in 4 weeks. Toxicity was scored according to EORTC/RTOG toxicity criteria. Results: The feasibility of the treatment was good. Severe acute toxicity ≥G3 was observed in seven patients (14%). Severe late toxicity ≥G3 was observed in six patients (13%). Thirty-seven patients (74%) showed a complete and five (10 %) a partial remission after treatment. The actuarial 3-year freedom of local progression was 55%. Conclusion: In external radiotherapy for muscle invasive bladder cancer a concomitant boost technique coupling a partial bladder boost with shortening of the overall treatment time provides a high probability of local control with acceptable toxicity

Introducing state-trajectory control for the synchronous interleaved boost converter

DEFF Research Database (Denmark)

Peña-Alzola, Rafael; Ksiazek, Peter; Ordonez, Martin

2015-01-01

Synchronous interleaved boost converters (SIBCs) result in lower ripple currents and bidirectional power flow. The boost topology has a non-minimum phase characteristic, producing instability problems when a large bandwidth is required. Linear controllers inherently limit the boost controller...

[Efficacy and safety of ultrasound-guided or neurostimulator-guided bilateral axillary brachial plexus block].

Science.gov (United States)

Xu, C S; Zhao, X L; Zhou, H B; Qu, Z J; Yang, Q G; Wang, H J; Wang, G

2017-10-17

Objective: To explore the efficacy and safety of bilateral axillary brachial plexus block under the guidance of ultrasound or neurostimulator. Methods: From February 2012 to April 2014, 120 patients undergoing bilateral hand/forearm surgery in Beijing Jishuitan Hospital were enrolled and anaesthetized with bilateral axillary brachial plexus block. All patients were divided into two groups randomly using random number table: the ultrasound-guided group (group U, n =60) and the neurostimulator-guidedgroup (group N, n =60). The block was performed with 0.5% ropivacaine. Patients' age, sex and operation duration were recorded. Moreover, success rate, performance time, onset of sensor and motor block, performance pain, patient satisfaction degree and the incidence of related complications were also documented. Venous samples were collected at selected time points and the total and the plasma concentrations of ropivacaine were analyzed with HPLC. Results: The performance time, the onset of sensor block and the onset of motor block of group U were (8.2±1.5), (14.2± 2.2)and (24.0±3.5)min respectively, which were markedly shorter than those in group N( (14.6±3.9), (19.9±3.8), (28.8±4.2)min, respectively), and the differences were statistically significant( t =11.74, 10.09, 6.73, respectively, all P 0.05). No analgesic was superadded and no other anesthesia methods were applied. No complications were detected perioperatively. Conclusions: The bilateral axillary brachial plexus block under the guidance of ultrasound or neurostimulator are both effective and safe for bilateral hand/forearm surgery. However, the ultrasound-guided block may be more clinically beneficial because of its shorter performance time, rapid onset and higher patient satisfaction degree.

Normal tissue complication probability: Does simultaneous integrated boost intensity-modulated radiotherapy score over other techniques in treatment of prostate adenocarcinoma

Directory of Open Access Journals (Sweden)

Jothy Basu K

2009-01-01

Full Text Available Aim: The main objective of this study was to analyze the radiobiological effect of different treatment strategies on high-risk prostate adenocarcinoma. Materials and Methods: Ten cases of high-risk prostate adenocarcinoma were selected for this dosimetric study. Four different treatment strategies used for treating prostate cancer were compared. Conventional four-field box technique covering prostate and nodal volumes followed by three-field conformal boost (3D + 3DCRT, four-field box technique followed by intensity-modulated radiotherapy (IMRT boost (3D + IMRT, IMRT followed by IMRT boost (IMRT + IMRT, and simultaneous integrated boost IMRT (SIBIMRT were compared in terms of tumor control probability (TCP and normal tissue complication probability (NTCP. The dose prescription except for SIBIMRT was 45 Gy in 25 fractions for the prostate and nodal volumes in the initial phase and 27 Gy in 15 fractions for the prostate in the boost phase. For SIBIMRT, equivalent doses were calculated using biologically equivalent dose assuming the α/β ratio of 1.5 Gy with a dose prescription of 60.75 Gy for the gross tumor volume (GTV and 45 Gy for the clinical target volume in 25 fractions. IMRT plans were made with 15-MV equispaced seven coplanar fields. NTCP was calculated using the Lyman-Kutcher-Burman (LKB model. Results: An NTCP of 10.7 ± 0.99%, 8.36 ± 0.66%, 6.72 ± 0.85%, and 1.45 ± 0.11% for the bladder and 14.9 ± 0.99%, 14.04 ± 0.66%, 11.38 ± 0.85%, 5.12 ± 0.11% for the rectum was seen with 3D + 3DCRT, 3D + IMRT, IMRT + IMRT, and SIBIMRT respectively. Conclusions: SIBIMRT had the least NTCP over all other strategies with a reduced treatment time (3 weeks less. It should be the technique of choice for dose escalation in prostate carcinoma.

4 Types of Foods that Boost Your Memory

Science.gov (United States)

... 4 Types of Foods to Help Boost Your Memory By Marisa Moore, MBA, RDN, LD Published November ... in brain health. The best menu for boosting memory and brain function encourages good blood flow to ...

[Axillary ectopic breast tissue fibroadenoma: report of three cases and review of the literature].

Science.gov (United States)

Ortiz-Mendoza, Carlos Manuel

2012-02-01

Ninety-five percent of women have mammary tissue at the axilla. However, the fibroadenoma seldom occur in this area and there are only isolated case reports of this tumor. This paper presents a series of three cases of this rare entity. Three women came to our hospital by axillary lumps. The patients had a median age of 36 +/- 9-years-old with an average time of evolution of 34 +/- 53 months. One patient had the history of a breast phyllodes tumor previously excised, and two were nulliparous. In two cases, neither ultrasound nor mammogram gave useful information for its diagnosis. Mammary glands of all cases were normal. The tumors were firm and movable, similar to a lymphadenopathy, and one was evident. The mean tumor size was 28 +/- 18 mm; all were oval and with white appearance. Histological diagnosis for all cases was fibroadenoma. Our findings match with literature reports. The axillary fibroadenomas may occur in women aged 30 to 50-years-old, mimicking a lymphadenopathy. Finally, the ultrasound and the mammography are not useful tools for its diagnosis.

ZVS Operating Region of Multiresonant DC/DC Boost Conveter

Directory of Open Access Journals (Sweden)

Elzbieta Szychta

2007-01-01

Full Text Available Electromagnetic phenomena that occur during stable operation in resonant circuits of multiresonant ZVS boost converter are described, which can be applied in many fields of the needs of DC voltage electricity. The operating region of the converter is defined which assures the circuit’s operation in which semiconductor elements are switched at zero voltage (ZVS. Conditions delimiting the ZVS operating region are provided. Analysis of the circuit’s operation is based on results of simulation testing by means of Simplorer software.

Very boosted Higgs in gluon fusion

CERN Document Server

Grojean, Christophe; Schlaffer, Matthias; Weiler, Andreas

2014-01-01

The Higgs production and decay rates offer a new way to probe new physics beyond the Standard Model. While dynamics aiming at alleviating the hierarchy problem generically predict deviations in the Higgs rates, the current experimental analyses cannot resolve the long- and short-distance contributions to the gluon fusion process and thus cannot access directly the coupling between the Higgs and the top quark. We investigate the production of a boosted Higgs in association with a high-transverse momentum jet as an alternative to the $t\\bar{t}h$ channel to pin down this crucial coupling. Presented first in the context of an effective field theory, our analysis is then applied to models of partial compositeness at the TeV scale and of natural supersymmetry.

Very boosted Higgs in gluon fusion

Energy Technology Data Exchange (ETDEWEB)

Grojean, C. [Univ. Autonoma de Barcelona, Bellaterra (Spain). ICREA at IFAE; Salvioni, E. [California Univ., Davis, CA (United States). Dept. of Physics; European Organization for Nuclear Research (CERN), Geneva (Switzerland); Padova Univ. (Italy). Dipt. di Fisica e Astronomica; INFN, Sezione di Padova (Italy); Schlaffer, M. [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Weiler, A. [European Organization for Nuclear Research (CERN), Geneva (Switzerland); Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany)

2013-12-15

The Higgs production and decay rates offer a new way to probe new physics beyond the Standard Model. While dynamics aiming at alleviating the hierarchy problem generically predict deviations in the Higgs rates, the current experimental analyses cannot resolve the long- and short-distance contributions to the gluon fusion process and thus cannot access directly the coupling between the Higgs and the top quark. We investigate the production of a boosted Higgs in association with a high-transverse momentum jet as an alternative to the t anti th channel to pin down this crucial coupling. Presented rst in the context of an effective field theory, our analysis is then applied to models of partial compositeness at the TeV scale and of natural supersymmetry.

Diode-Assisted Buck-Boost Current Source Inverters

DEFF Research Database (Denmark)

Gao, F.; Cai, Liang; Loh, P.C.

2007-01-01

This paper presents a couple of novel current source inverters (CSIs) with the enhanced current buckboost capability. With the unique diode-inductor network added between current source inverter circuitry and current boost elements, the proposed buck-boost current source inverters demonstrate...... uninfluenced. Lastly, all theoretical findings were verified experimentally using constructed laboratory prototypes....

Persistent pain, sensory disturbances and functional impairment after immediate or delayed axillary lymph node dissection

DEFF Research Database (Denmark)

Geving Andersen, Kenneth; Jensen, Maj-Britt Raaby; Tvedskov, Tove Filtenborg

2013-01-01

BACKGROUND: Patients treated with 2-step axillary lymph node dissection (ALND) may be at increased risk of nerve damage due to more challenging surgery than an ALND immediately after a sentinel lymph node biopsy (SLNB), and thus more at risk for persistent pain after breast cancer treatment (PPBCT...

Utility of 18F-fluoro-deoxyglucose emission tomography/computed tomography fusion imaging (18F-FDG PET/CT in combination with ultrasonography for axillary staging in primary breast cancer

Directory of Open Access Journals (Sweden)

Tamura Katsumi

2008-06-01

Full Text Available Abstract Background Accurate evaluation of axillary lymph node (ALN involvement is mandatory before treatment of primary breast cancer. The aim of this study is to compare preoperative diagnostic accuracy between positron emission tomography/computed tomography with 18F-fluorodeoxyglucose (18F-FDG PET/CT and axillary ultrasonography (AUS for detecting ALN metastasis in patients having operable breast cancer, and to assess the clinical management of axillary 18F-FDG PET/CT for therapeutic indication of sentinel node biopsy (SNB and preoperative systemic chemotherapy (PSC. Methods One hundred eighty-three patients with primary operable breast cancer were recruited. All patients underwent 18F-FDG PET/CT and AUS followed by SNB and/or ALN dissection (ALND. Using 18F-FDG PET/CT, we studied both a visual assessment of 18F-FDG uptake and standardized uptake value (SUV for axillary staging. Results In a visual assessment of 18F-FDG PET/CT, the diagnostic accuracy of ALN metastasis was 83% with 58% in sensitivity and 95% in specificity, and when cut-off point of SUV was set at 1.8, sensitivity, specificity, and accuracy were 36, 100, and 79%, respectively. On the other hand, the diagnostic accuracy of AUS was 85% with 54% in sensitivity and 99% in specificity. By the combination of 18F-FDG PET/CT and AUS to the axilla, the sensitivity, specificity, and accuracy were 64, 94, and 85%, respectively. If either 18F-FDG PET uptake or AUS was positive in allixa, the probability of axillary metastasis was high; 50% (6 of 12 in 18F-FDG PET uptake only, 80% (4 of 5 in AUS positive only, and 100% (28 of 28 in dual positive. By the combination of AUS and 18F-FDG PET/CT, candidates of SNB were more appropriately selected. The axillary 18F-FDG uptake was correlated with the maximum size and nuclear grade of metastatic foci (p = 0.006 and p = 0.03. Conclusion The diagnostic accuracy of 18F-FDG PET/CT was shown to be nearly equal to ultrasound, and considering their

In vitro mass propagation of Salvia canariensis by axillary shoots

Directory of Open Access Journals (Sweden)

Sebastiana Mederos Molina

2014-01-01

Full Text Available During the establishment of shoots of Salvia canariensis L., five environmental factor treatments were applied. For each axillary node two shoots grew well when explants were incubated at continued ligth for 15 days followed by 16 hrs photoperiod by 30 days. Shoots multiplication was improved on a modified Murashige and Skoog (MS (1962 medium - MS + 825 mg/l NH4NO3 - supplemented with 10-7 M BA and 10-7 M NAA. The shoots produced well developed root systems within three weeks after transfer to the same culture medium supplemented with 5x 10-7 M NAA.

Primary Paralleled Isolated Boost Converter with Extended Operating Voltage Range

DEFF Research Database (Denmark)

Hernandez Botella, Juan Carlos; Sen, Gökhan; Mira Albert, Maria del Carmen

2012-01-01

Applications requiring wide input and output voltage range cannot often be satisfied by using buck or boost derived topologies. Primary paralleled isolated boost converter (PPIBC) [1]-[2] is a high efficiency boost derived topology. This paper proposes a new operation mode for extending the input...

Subsea innovative boosting technologies on deep water scenarios -- Impacts and demands

International Nuclear Information System (INIS)

Caetano, E.F.; Mendonca, J.E.; Pagot, P.R.; Cotrim, M.L.; Camargo, R.M.T.; Assayag, M.I.

1995-01-01

This paper presents the importance of deep water scenario for Brazil, the PETROBRAS Deep and Ultra-Deep Water R and D Program (PROCAP-2000) and the candidate fields for the deployment of subsea innovative boosting technologies (ESPS -- electrical submersible pump in subsea wells, SSS -- subsea separation systems and SBMS -- subsea multiphase flow pumping system) as well as the problems associated with the flow assurance in such conditions. The impact of those innovative systems, their technological stage and remaining demands to make them available for deployment in offshore subsea areas, mainly in giant deepwater fields, are discussed and predicted

Symmetry boost of the fidelity of Shor factoring

Science.gov (United States)

Nam, Y. S.; Blümel, R.

2018-05-01

In Shor's algorithm quantum subroutines occur with the structure F U F-1 , where F is a unitary transform and U is performing a quantum computation. Examples are quantum adders and subunits of quantum modulo adders. In this paper we show, both analytically and numerically, that if, in analogy to spin echoes, F and F-1 can be implemented symmetrically when executing Shor's algorithm on actual, imperfect quantum hardware, such that F and F-1 have the same hardware errors, a symmetry boost in the fidelity of the combined F U F-1 quantum operation results when compared to the case in which the errors in F and F-1 are independently random. Running the complete gate-by-gate implemented Shor algorithm, we show that the symmetry-induced fidelity boost can be as large as a factor 4. While most of our analytical and numerical results concern the case of over- and under-rotation of controlled rotation gates, in the numerically accessible case of Shor's algorithm with a small number of qubits, we show explicitly that the symmetry boost is robust with respect to more general types of errors. While, expectedly, additional error types reduce the symmetry boost, we show explicitly, by implementing general off-diagonal SU (N ) errors (N =2 ,4 ,8 ), that the boost factor scales like a Lorentzian in δ /σ , where σ and δ are the error strengths of the diagonal over- and underrotation errors and the off-diagonal SU (N ) errors, respectively. The Lorentzian shape also shows that, while the boost factor may become small with increasing δ , it declines slowly (essentially like a power law) and is never completely erased. We also investigate the effect of diagonal nonunitary errors, which, in analogy to unitary errors, reduce but never erase the symmetry boost. Going beyond the case of small quantum processors, we present analytical scaling results that show that the symmetry boost persists in the practically interesting case of a large number of qubits. We illustrate this result

An Update on Statistical Boosting in Biomedicine.

Science.gov (United States)

Mayr, Andreas; Hofner, Benjamin; Waldmann, Elisabeth; Hepp, Tobias; Meyer, Sebastian; Gefeller, Olaf

2017-01-01

Statistical boosting algorithms have triggered a lot of research during the last decade. They combine a powerful machine learning approach with classical statistical modelling, offering various practical advantages like automated variable selection and implicit regularization of effect estimates. They are extremely flexible, as the underlying base-learners (regression functions defining the type of effect for the explanatory variables) can be combined with any kind of loss function (target function to be optimized, defining the type of regression setting). In this review article, we highlight the most recent methodological developments on statistical boosting regarding variable selection, functional regression, and advanced time-to-event modelling. Additionally, we provide a short overview on relevant applications of statistical boosting in biomedicine.

A moat around castle walls. The role of axillary and facial hair in lymph node protection from mutagenic factors.

Science.gov (United States)

Komarova, Svetlana V

2006-01-01

Axillary hair is a highly conserved phenotypical feature in humans, and as such deserves at least consideration of its functional significance. Protection from environmental factors is one of the main functions attributed to hair in furred vertebrates, but is believed to be inapplicable to humans. I considered the hypothesis that the phenotypic preservation of axillary hair is due to its unrecognized role in the organism protection. Two immediate questions arise--what exactly is being protected and what it is protected from. A large group of axillary lymph nodes represents a major difference between underarms and the adjacent areas of the trunk. The consideration of potential factors from which hair can offer protection identifies sunlight as the most likely candidate. Intense sweat production underarms may represent an independent defense mechanism, specifically protecting lymph nodes from overheating. Moreover, the pattern of facial hair growth in males strikingly overlaps with the distribution of superficial lymph nodes, suggesting potential role for facial hair in protection of lymph nodes, and possibly thymus and thyroid. The idea of lymph node protection from environmental mutagenic factors, such as UV radiation and heat, appears particularly important in light of wide association of lymph nodes with cancers. The position of contemporary fashion towards body hair is aggressively negative, including the social pressure for removal of axillary and bikini line hair for women, facial hair for men in many professional occupations, and even body hair for men. If this hypothesis is proven to be true, the implications will be significant for immunology (by providing new insights in lymph node physiology), health sciences (depilation is painful and therefore easily modifiable habit if proven to increase disease risk), as well as art, social fashion and economy.

Diagnostic performance of fluorodeoxyglucose-positron emission tomography/computed tomography of breast cancer in detecting axillary lymph node metastasis. Comparison with ultrasonography and contrast-enhanced CT

International Nuclear Information System (INIS)

Monzawa, Shuichi; Adachi, Shuji; Suzuki, Kayo; Hirokaga, Koichi; Takao, Shintaro; Sakuma, Toshiko; Hanioka, Keisuke

2009-01-01

The purpose of this retrospective study was to evaluate the diagnostic performance of positron emission tomography/computed tomography (PET/CT) with fluorine-18-labeled 2-fluoro-2-deoxy-D-glucose (FDG) in comparison with that of ultrasonography and contrast-enhanced computed tomography (CT) in detecting axillary lymph node metastasis in patients with breast cancer. Fifty patients with invasive breast cancer were recruited. They had received no neoadjuvant chemotherapy and underwent PET/CT, ultrasonography and contrast-enhanced CT before mastectomy. The clinical stage was I in 34 patients, II in 15 patients, and III in one patient. The images of these modalities were interpreted in usual practice before surgery and the diagnostic reports were reviewed for analysis. Sensitivity, specificity, positive predictive value, and negative predictive value of each modality were obtained taking histopathological results of axillary lymph node dissection or sentinel lymph node biopsy as the reference standard. Axillary lymph node metastasis was confirmed in 15 of 50 patients by histopathological studies. PET/CT identified lymph node metastasis in three of these 15 patients. The overall sensitivity and specificity, positive predictive value, and negative predictive value of PET/CT in the diagnosis of axillary lymph node metastasis were 20, 97, 75, and 74%, and those of ultrasonography were 33, 94, 71, and 77% and those of contrast-enhanced CT were 27, 97, 80, and 76%, respectively. PET/CT showed poor sensitivity and high specificity in the detection of axillary lymph node metastasis of breast cancer. Diagnostic performance of PET/CT was not superior to that of ultrasonography and contrast-enhanced CT. (author)

Mapping axillary microbiota responsible for body odours using a culture-independent approach.

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Troccaz, Myriam; Gaïa, Nadia; Beccucci, Sabine; Schrenzel, Jacques; Cayeux, Isabelle; Starkenmann, Christian; Lazarevic, Vladimir

2015-01-01

Human axillary odour is commonly attributed to the bacterial degradation of precursors in sweat secretions. To assess the role of bacterial communities in the formation of body odours, we used a culture-independent approach to study axillary skin microbiota and correlated these data with olfactory analysis. Twenty-four Caucasian male and female volunteers and four assessors showed that the underarms of non-antiperspirant (non-AP) users have significantly higher global sweat odour intensities and harboured on average about 50 times more bacteria than those of AP users. Global sweat odour and odour descriptors sulfury-cat urine and acid-spicy generally increased from the morning to the afternoon sessions. Among non-AP users, male underarm odours were judged higher in intensity with higher fatty and acid-spicy odours and higher bacterial loads. Although the content of odour precursors in underarm secretions varied widely among individuals, males had a higher acid: sulfur precursor ratio than females did. No direct correlations were found between measured precursor concentration and sweat odours. High-throughput sequencing targeting the 16S rRNA genes of underarm bacteria collected from 11 non-AP users (six females and five males) confirmed the strong dominance of the phyla Firmicutes and Actinobacteria, with 96% of sequences assigned to the genera Staphylococcus, Corynebacterium and Propionibacterium. The proportion of several bacterial taxa showed significant variation between males and females. The genera Anaerococcus and Peptoniphilus and the operational taxonomic units (OTUs) from Staphylococcus haemolyticus and the genus Corynebacterium were more represented in males than in females. The genera Corynebacterium and Propionibacterium were correlated and anti-correlated, respectively, with body odours. Within the genus Staphylococcus, different OTUs were either positively or negatively correlated with axillary odour. The relative abundance of five OTUs (three

Ultrasound-guided diffuse optical tomography (DOT) of invasive breast carcinoma: Does tumour total haemoglobin concentration contribute to the prediction of axillary lymph node status?

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Zhu, Qingli, E-mail: qinglizhu@gmail.com [Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1, Dongcheng District, Beijing 100730 (China); Xiao, Mengsu, E-mail: xiaomengsu_2000@sina.com [Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1, Dongcheng District, Beijing 100730 (China); You, Shanshan, E-mail: shanshan_0531@sina.com [Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1, Dongcheng District, Beijing 100730 (China); Zhang, Jing, E-mail: zhang.jing1029@163.com [Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1, Dongcheng District, Beijing 100730 (China); Jiang, Yuxin, E-mail: yuxinjiangxh@yahoo.com.cn [Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1, Dongcheng District, Beijing 100730 (China); Lai, Xingjian, E-mail: lxjpumch@yahoo.com.cn [Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1, Dongcheng District, Beijing 100730 (China); Dai, Qing, E-mail: qingdai_2000@yahoo.com [Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1, Dongcheng District, Beijing 100730 (China)

2012-11-15

Objectives: To prospectively study the ultrasound-guided near-infrared diffuse optical tomography (DOT) findings of the total haemoglobin concentration (THC) detected in invasive breast carcinomas and its contribution to the prediction of axillary lymph node (LN) status. Methods: A total of 195 invasive breast carcinomas were prospectively studied with DOT before surgery. Lumpectomy or mastectomy with full axillary nodal dissection was performed. Tumour size and THC level were correlated with LN status by a logistic regression analysis. Results: One hundred twenty-four patients (63.59%) was LN(-) and 71 (36.41%) was LN(+). The average THC was significantly higher in the LN(+) group than in the LN(-) group (252.94 {+-} 69.19 {mu}mol/L versus 203.86 {+-} 83.13 {mu}mol/L, P = 0.01). A multivariate analysis showed an independent relationship between the probability of axillary metastasis, elevated THC level (P = 0.01), and tumour size (P = 0.001). The odds ratio with THC {>=} 140 {mu}mol/L was 13.651 (1.781-104.560), whereas that of tumour size with a 1 cm increment was only 1.777 (1.283-2.246). Conclusions: The THC level and the tumour size are independent and preoperative predictors of axillary nodal status; these variables may improve the diagnosis of patients with lymph node metastasis.

Axillary lymph node dissection for breast cancer utilizing Harmonic Focus®

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Moldrem Amy

2011-08-01

Full Text Available Abstract Background For patients with axillary lymph node metastases from breast cancer, performance of a complete axillary lymph node dissection (ALND is the standard approach. Due to the rich lymphatic network in the axilla, it is necessary to carefully dissect and identify all lymphatic channels. Traditionally, these lymphatics are sealed with titanium clips or individually sutured. Recently, the Harmonic Focus®, a hand-held ultrasonic dissector, allows lymphatics to be sealed without the utilization of clips or ties. We hypothesize that ALND performed with the Harmonic Focus® will decrease operative time and reduce post-operative complications. Methods Retrospective review identified all patients who underwent ALND at a teaching hospital between January of 2005 and December of 2009. Patient demographics, presenting pathology, treatment course, operative time, days to drain removal, and surgical complications were recorded. Comparisons were made to a selected control group of patients who underwent similar surgical procedures along with an ALND performed utilizing hemostatic clips and electrocautery. A total of 41 patients were included in this study. Results Operative time was not improved with the use of ultrasonic dissection, however, there was a decrease in the total number of days that closed suction drainage was required, although this was not statistically significant. Complication rates were similar between the two groups. Conclusion In this case-matched retrospective review, there were fewer required days of closed suction drainage when ALND was performed with ultrasonic dissection versus clips and electrocautery.

Internationalization of Boost Juice to Malaysia

OpenAIRE

Jane L. Menzies; Stuart C. Orr

2014-01-01

This case describes the process that the Australian juice retail chain, Boost Juice, has used to internationalize to Malaysia. The main objective of this case is to demonstrate good practice in regard to internationalization. The case provides the background of the juice bar industry in Malaysia and determines that it is an attractive market for new start-up juice bars. An analysis of Boost Juice's capability determined that the company utilized the skills of its staff, product innovations, b...

Comparative analysis of multi-slice spiral CT and positron emission tomography-CT in evaluation of axillary lymph nodes in breast cancer patients

International Nuclear Information System (INIS)

Sun Xianchang; Zhang Ruyi; Liu Qingwei; Zhao Suhong; Zu Degui; Li Xin

2008-01-01

Objective: To evaluate and compare spiral CT and positron emission tomography-CT (PET-CT) in characterization of of axillary lymph nodes in breast cancer patients. Methods: Forty patients with pathologically proven breast cancer underwent contrast-enhanced spiral CT of the breast and axilla, 13 of them also underwent PET-CT examination. One hundred and fifty-eight axillary lymph nodes were found in the 40 patients through contrast enhanced spiral CT, while 57 lymph nodes were found in the 13 patients through PET-CT. Three radiologists rated the lymph nodes found in CT images on a five-point scale. If the score was equal to or greater than 3, it was defined as positive (metastatic), otherwise negative. Visual observation and semiquantitative analysis were used to classify lymph nodes in PET-CT images. The results of spiral CT observation and PET-CT observation of lymph nodes were compared with pathological results. The relative value of CT and PET-CT was analyzed. Exact probability statistics were employed. Results: One hundred and fifty eight lymph nodes of 40 patients were detected by spiral CT, 91 of them were diagnosed as positive and 67 as negative Among the lymph nodes found in spiral CT, 99 were positive and 59 were negative pathologicall. A total of 57 lymph nodes were found by PET-CT. Thirty-nine of them were defined as positive and 18 as negative. Among the lymph nodes found in PET-CT, 39 were positive and 18 were negative pathologically. The sensitivity, specificity, accuracy, positive and negative predictive values in CT prediction in axillary lymph nodes metastases were 88.89%, 94.91%, 91.14%, 96.70%, and 83.58%, respectively. The sensitivity, specificity, accuracy, positive and negative predictive values in PET-CT prediction in axillary lymph nodes metastases were 97.44%, 94.44%, 96.49%, 97.44%, and 94.44%, respectively. PET-CT had no significant difference with spiral CT in sensitivity, accuracy, positive and negative predictive values for detection

Low-Volume Brachial Plexus Block Providing Surgical Anesthesia for Distal Arm Surgery Comparing Supraclavicular, Infraclavicular, and Axillary Approach: A Randomized Observer Blind Trial

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Mojgan Vazin

2016-01-01

Full Text Available Background. Distal arm surgery is widely performed under regional anesthesia with brachial plexus block. The preponderance of evidence for the efficacy relies upon injection of local anesthetic in excess of 30 mL. We aimed to compare three different ultrasound-guided brachial plexus block techniques restricting the total volume to 20 mL. Methods. 120 patients were prospectively randomized to ultrasound-guided brachial plexus block with 20 mL ropivacaine 0.75% at either the supraclavicular, infraclavicular, or axillary level. Multiinjection technique was performed with all three approaches. Primary outcome measure was performance time. Results. Performance time and procedural pain were similar between groups. Needle passes and injection numbers were significantly reduced in the infraclavicular group (P<0.01. Nerve visibility was significantly reduced in the axillary group (P=0.01. Success-rate was significantly increased in the supraclavicular versus the axillary group (P<0.025. Total anesthesia-related time was significantly reduced in the supraclavicular compared to the infraclavicular group (P<0.01. Block duration was significantly increased in the infraclavicular group (P<0.05. No early adverse effects occurred. Conclusion. Supraclavicular and infraclavicular blocks exhibited favorable characteristics compared to the axillary block. Supraclavicular brachial plexus block with the multiinjection intracluster technique exhibited significantly reduced total anesthesia-related time and higher success rate without any early adverse events.

Axillary artery injury after an anterior shoulder fracture dislocation and “periosteal sleeve avulsion of the rotator cuff” (SARC. Case report and review of the literature

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Ash Chehata

2017-04-01

Full Text Available We present the rare complication of an axillary artery injury associated with an anterior dislocation of the humerus and what we believe to be the first reported periosteal sleeve avulsion of the entire rotator cuff (SARC. We review the literature and discuss the cause of this unusual injury pattern. Keywords: Axillary artery, Shoulder fracture dislocation, Periosteal sleeve avulsion, SARC

Role of fluorine-18-labeled 2-fluoro-2-deoxy-D-glucose positron emission tomography-computed tomography in the evaluation of axillary lymph node involvement in operable breast cancer in comparison with sentinel lymph node biopsy

International Nuclear Information System (INIS)

Challa, Vasu Reddy; Srivastava, Anurag; Dhar, Anita; Parshad, Rajinder; Bal, Chandrasekhar; Gona, Rama Mohan Reddy; Kumar, Rakesh; Sharma, Punit; Gupta, Siddhartha Datta

2013-01-01

Role of (18(F)fluorine-18-labeled 2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography-computed tomography (PET-CT) in the evaluation of axillary lymph node involvement in T1T2N0 breast cancer and compare results with sentinel lymph node biopsy (SLNB). SLN was identified in 32 of 37 patients with an identification rate of 86.48% (32/37). With combined technique SLN identification rate was 100% (6/6) while with blue dye alone; it was 83.8% (26/31). Among 37 patients, 16 had axillary metastases of which 12 had macrometastases and four had micrometastases detected by immunohistochemistry (IHC). Of 12 patients with axillary macrometastases, skip metastases were present in two patients in whom SLN was negative and in two patients SLN was not identified, but axillary dissection showed metastases. PET-CT had shown sensitivity, specificity, negative predictive value and positive predictive value of 56%, 90%, 73%, and 81.8%, respectively. IHC of SLN detected four patients with micrometastases upstaging the disease by 11% (4/37). Because FDG PET-CT has a high specificity in the evaluation of axillary lymph node involvement in T1T2N0 breast cancer patients according to the results of this study if FDG PET-CT is positive in axillary lymph nodes, axillary lymph node dissection may be considered instead of SLNB

Giving top quark effective operators a boost

CERN Document Server

Englert, Christoph

2016-01-01

We investigate the prospects to systematically improve generic effective field theory-based searches for new physics in the top sector during LHC run 2 as well as the high luminosity phase. In particular, we assess the benefits of high momentum transfer final states on top EFT-fit as a function of systematic uncertainties in comparison with sensitivity expected from fully-resolved analyses focusing on $t\\bar t$ production. We find that constraints are typically driven by fully-resolved selections, while boosted top quarks can serve to break degeneracies in the global fit. This demystifies and clarifies the importance of high momentum transfer final states for global fits to new interactions in the top sector from direct measurements.

An Update on Statistical Boosting in Biomedicine

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Andreas Mayr

2017-01-01

Full Text Available Statistical boosting algorithms have triggered a lot of research during the last decade. They combine a powerful machine learning approach with classical statistical modelling, offering various practical advantages like automated variable selection and implicit regularization of effect estimates. They are extremely flexible, as the underlying base-learners (regression functions defining the type of effect for the explanatory variables can be combined with any kind of loss function (target function to be optimized, defining the type of regression setting. In this review article, we highlight the most recent methodological developments on statistical boosting regarding variable selection, functional regression, and advanced time-to-event modelling. Additionally, we provide a short overview on relevant applications of statistical boosting in biomedicine.

Boosted jets

International Nuclear Information System (INIS)

Juknevich, J.

2014-01-01

We present a study of the substructure of jets high transverse momentum at hadron colliders. A template method is introduced to distinguish heavy jets by comparing their energy distributions to the distributions of a set of templates which describe the kinematical information from signal or background. As an application, a search for a boosted Higgs boson decaying into bottom quarks in association with a leptonically decaying W boson is presented as well. (author)

Improved Stereo Matching With Boosting Method

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Shiny B

2015-06-01

Full Text Available Abstract This paper presents an approach based on classification for improving the accuracy of stereo matching methods. We propose this method for occlusion handling. This work employs classification of pixels for finding the erroneous disparity values. Due to the wide applications of disparity map in 3D television medical imaging etc the accuracy of disparity map has high significance. An initial disparity map is obtained using local or global stereo matching methods from the input stereo image pair. The various features for classification are computed from the input stereo image pair and the obtained disparity map. Then the computed feature vector is used for classification of pixels by using GentleBoost as the classification method. The erroneous disparity values in the disparity map found by classification are corrected through a completion stage or filling stage. A performance evaluation of stereo matching using AdaBoostM1 RUSBoost Neural networks and GentleBoost is performed.

Topological Design and Modulation Strategy for Buck-Boost Three-Level Inverters

DEFF Research Database (Denmark)

Gao, Feng; Loh, Poh Chiang; Teodorescu, Remus

2009-01-01

To date, designed topologies for dc-ac inversion with both voltage buck and boost capabilities are mainly focused on two-level circuitries with extensions to three-level possibilities left nearly unexplored. Contributing to this area of research, this paper presents the design of a number of viable...... can perform distinct five-level line voltage and three-level phase voltage switching by simply controlling the active switches located in the designed voltage boost section of the circuits. As a cost saving option, one active switch can further be removed from the voltage boost section of the circuits...... buck-boost threelevel inverters that can also support bidirectional power conversion. The proposed front-end circuitry is developed from the C´ ukderived buck-boost two-level inverter, and by using the "alternative phase opposition disposition" modulation scheme, the buck-boost three-level inverters...

Dexmedetomidine as an adjuvant to 0.5% ropivacaine in ultrasound-guided axillary brachial plexus block.

Science.gov (United States)

Koraki, E; Stachtari, C; Kapsokalyvas, I; Stergiouda, Z; Katsanevaki, A; Trikoupi, A

2018-06-01

The aim of this study was to elucidate the effect of dexmedetomidine added to ropivacaine on the onset and duration of sensory and motor block and duration of analgesia of ultrasound-guided axillary brachial plexus block. Thirty-seven ASA physical status I-II patients with elective forearm and hand surgery under ultrasound-guided axillary brachial plexus block were randomly divided into 2 groups. Patients in ropivacaine-dexmedetomidine group (group RD, n = 19) received 15 mL of 0.5% ropivacaine with 100 μg (1 mL) dexmedetomidine, and patients in ropivacaine group (group R, n = 18) received 15 mL of 0.5% ropivacaine with 1 mL of normal saline. Onset time and duration of sensory and motor block and duration of analgesia were assessed. Duration of sensory block (U-value = 35, P block (P = .001) and duration of analgesia (P block in group RD was significantly faster than in group R (U-value = 65.5, P = .001). Onset time of motor block showed no significant difference between the 2 groups (U-value = 116.5, P = .096). Adverse reactions were reported only in group RD (bradycardia in 2 and hypotension in 3 patients). Our study indicated that dexmedetomidine 100 μg as adjuvant on ultrasound-guided axillary plexus block significantly prolonged the duration of sensory block and analgesia, as well as accelerated the time to onset of sensory block. These results should be weighed against the increased risks of motor block prolongation, transient bradycardia and hypotension and allow for attentive optimism, only if prolonged clinical trials provide a definitive answer. © 2017 John Wiley & Sons Ltd.

Boosted beta regression.

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Matthias Schmid

Full Text Available Regression analysis with a bounded outcome is a common problem in applied statistics. Typical examples include regression models for percentage outcomes and the analysis of ratings that are measured on a bounded scale. In this paper, we consider beta regression, which is a generalization of logit models to situations where the response is continuous on the interval (0,1. Consequently, beta regression is a convenient tool for analyzing percentage responses. The classical approach to fit a beta regression model is to use maximum likelihood estimation with subsequent AIC-based variable selection. As an alternative to this established - yet unstable - approach, we propose a new estimation technique called boosted beta regression. With boosted beta regression estimation and variable selection can be carried out simultaneously in a highly efficient way. Additionally, both the mean and the variance of a percentage response can be modeled using flexible nonlinear covariate effects. As a consequence, the new method accounts for common problems such as overdispersion and non-binomial variance structures.

The efficacy of physiotherapy upon shoulder function following axillary dissection in breast cancer, a randomized controlled study.

NARCIS (Netherlands)

Beurskens, C.H.G.; Uden, C. van; Strobbe, L.J.; Oostendorp, R.A.B.; Wobbes, Th.

2007-01-01

BACKGROUND: Many patients suffer from severe shoulder complaints after breast cancer surgery and axillary lymph node dissection. Physiotherapy has been clinically observed to improve treatment of these patients. However, it is not a standard treatment regime. The purpose of this study is to

Abscisic acid signaling is controlled by a BRANCHED1/HD-ZIP i cascade in Arabidopsis axillary buds

NARCIS (Netherlands)

Gonzalez-Grandio, Eduardo; Pajoro, Alice; Franco-Zorrilla, Jose M.; Tarancon, Carlos; Immink, Richard G.H.; Cubas, Pilar

2017-01-01

Shoot-branching patterns determine key aspects of plant life and are important targets for crop breeding. However, we are still largely ignorant of the genetic networks controlling locally themost important decision during branch development: whether the axillary bud, or branch primordium, grows out

Nerve Stimulator Guided Axillary Block in Painless Reduction of Distal Radius Fractures; a Randomized Clinical Trial

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Hossein Alimohammadi

2013-12-01

Full Text Available Introduction: Given the high prevalence of upper extremity fractures and increasing need to perform painless reduction in the emergency departments, the use of analgesic methods with fewer complications and more satisfaction appears to be essential. The aim of this study is comparison the nerve stimulator guided axillary block (NSAB with intravenous sedation in induction of analgesia for painless reduction of distal radius fractures. Methods: In the present randomized clinical trial, 60 patients (18-70 years of age suffered from distal radius fractures, were divided into two equal groups. One group received axillary nerve block by nerve stimulator guidance and the other procedural sedation and analgesia (PSA using midazolam/fentanyl. Onset of analgesia, duration of analgesic effect, total procedure time and pain scores were recorded using visual analogue scale (VAS and the outcomes were compared. Chi-squared and student t test were performed to evaluate differences between two groups. Results: Sixty patients were randomly divided into two groups (83.3% male. The mean age of patients was 31 ±0.7 years. While the onset of analgesia was significantly longer in the NSAB group, the mean total time of procedure was shorter than PSA (p<0.001. The NSAB group needed a shorter post-operative observation time (P<0.001. Both groups experienced equal pain relief before, during and after procedure (p>0.05. Conclusion: It seems that shorter post-operative monitoring time and consequently lesser total time of procedure, make nerve stimulator guided axillary block as an appropriate alternative for procedural sedation and analgesia in painless reduction of distal radius fractures in emergency department. 

CyberKnife Boost for Patients with Cervical Cancer Unable to Undergo Brachytherapy

International Nuclear Information System (INIS)

Haas, Jonathan Andrew; Witten, Matthew R.; Clancey, Owen; Episcopia, Karen; Accordino, Diane; Chalas, Eva

2012-01-01

Standard radiation therapy for patients undergoing primary chemosensitized radiation for carcinomas of the cervix usually consists of external beam radiation followed by an intracavitary brachytherapy boost. On occasion, the brachytherapy boost cannot be performed due to unfavorable anatomy or because of coexisting medical conditions. We examined the safety and efficacy of using CyberKnife stereotactic body radiotherapy (SBRT) as a boost to the cervix after external beam radiation in those patients unable to have brachytherapy to give a more effective dose to the cervix than with conventional external beam radiation alone. Six consecutive patients with anatomic or medical conditions precluding a tandem and ovoid boost were treated with combined external beam radiation and CyberKnife boost to the cervix. Five patients received 45 Gy to the pelvis with serial intensity-modulated radiation therapy boost to the uterus and cervix to a dose of 61.2 Gy. These five patients received an SBRT boost to the cervix to a dose of 20 Gy in five fractions of 4 Gy each. One patient was treated to the pelvis to a dose of 45 Gy with an external beam boost to the uterus and cervix to a dose of 50.4 Gy. This patient received an SBRT boost to the cervix to a dose of 19.5 Gy in three fractions of 6.5 Gy. Five percent volumes of the bladder and rectum were kept to ≤75 Gy in all patients (i.e., V75 Gy ≤ 5%). All of the patients remain locally controlled with no evidence of disease following treatment. Grade 1 diarrhea occurred in 4/6 patients during the conventional external beam radiation. There has been no grade 3 or 4 rectal or bladder toxicity. There were no toxicities observed following SBRT boost. At a median follow-up of 14 months, CyberKnife radiosurgical boost is well tolerated and efficacious in providing a boost to patients with cervix cancer who are unable to undergo brachytherapy boost. Further follow-up is required to see if these results remain durable.

Axillary basal cell carcinoma in patients with Goltz-Gorlin syndrome: report of basal cell carcinoma in both axilla of a woman with basal cell nevus syndrome and literature review.

Science.gov (United States)

Cohen, Philip R

2014-08-17

Basal cell carcinoma of the axilla, an area that is not usually exposed to the sun, is rare. Individuals with basal cell nevus syndrome, a disorder associated with a mutation in the patch 1 (PTCH1) gene, develop numerous basal cell carcinomas. To describe a woman with basal cell nevus syndrome who developed a pigmented basal cell carcinoma in each of her axilla and to review the features of axillary basal cell carcinoma patients with Goltz-Gorlin syndrome. Pubmed was used to search the following terms: axillary basal cell carcinoma and basal cell nevus syndrome. The papers and their citations were evaluated. Basal cell nevus syndrome patients with basal cell carcinoma of the axilla were observed in two women; this represents 2.5% (2 of 79) of the patients with axillary basal cell carcinoma. Both women had pigmented tumors that were histologically nonaggressive. The cancers did not recur after curettage or excision. Basal cell carcinoma of the axilla has only been described in 79 individuals; two of the patients were women with pigmented tumors who had basal cell nevus syndrome. Similar to other patients with axillary basal cell carcinoma, the tumors were histologically nonaggressive and did not recur following treatment. Whether PTCH1 gene mutation predisposes basal cell nevus patients to develop axillary basal cell carcinomas remains to be determined.

Micropropagation of Helleborus through axillary budding.

Science.gov (United States)

Beruto, Margherita; Viglione, Serena; Bisignano, Alessandro

2013-01-01

Helleborus genus, belonging to the Ranunculaceae family, has 20 species of herbaceous perennial flowering plants. The commercial exploitation of this plant is dependent on the selection and propagation of appropriate lines. High propagation rate could be accomplished by using a suitable tissue culture method enabling the rapid introduction of valuable selections in the market. However, in vitro cultivation of Helleborus is still very difficult. Thereby the development of reliable in vitro propagation procedures is crucial for future production systems. Axillary buds cultured on agar-solidified Murashige and Skoog medium supplemented with 1 mg/L benzyladenine, 0.1 mg/L β-naphthoxyacetic acid, and 2 mg/L isopentenyl adenine develop shoots after 16 weeks of culture under 16 h light regime, 50-60 μmol/s/m(2), and 19 ± 1°C. The multiplication rate ranges from 1.4 to 2.1. However, the genotype and the number of subcultures affect the efficiency of the micropropagation process. The rooting of shoots is about 80% in solidified MS medium containing 1 mg/L 1-naphthaleneacetic acid and 3 mg/L indole-3-butyric acid. The described protocol provides information which can contribute to the commercial production of Helleborus plants.

Sequentially delivered boost plans are superior to simultaneously delivered plans in head and neck cancer when the boost volume is located further away from the parotid glands

International Nuclear Information System (INIS)

Lamers-Kuijper, Emmy; Heemsbergen, Wilma; Mourik, Anke van; Rasch, Coen

2011-01-01

Purpose: To find parameters that predict which head and neck patients benefit from a sequentially delivered boost treatment plan compared to a simultaneously delivered plan, with the aim to spare the salivary glands. Methods and materials: We evaluated 50 recently treated head and neck cancer patients. Apart from the clinical plan with a sequentially (SEQ) given boost using an Intensity Modulated Radiotherapy Technique (IMRT), a simultaneous integrated boost (SIB) technique plan was constructed with the same beam set-up. The mean dose to the parotid glands was calculated and compared. The elective nodal areas were bilateral in all cases, with a boost on either one side or both sides of the neck. Results: When the parotid gland volume and the Planning Target Volume (PTV) for the boost overlap there is on average a lower dose to the parotid gland with a SIB technique (-1.2 Gy), which is, however, not significant (p = 0.08). For all parotid glands with no boost PTV overlap, there is a benefit from a SEQ technique compared to a SIB technique for the gland evaluated (on average a 2.5 Gy lower dose to the parotid gland, p < 0.001). When the distance between gland and PTV is 0-1 cm, this difference is on average 0.8 Gy, for 1-2 cm distance 2.9 Gy and for glands with a distance greater than 2 cm, 3.3 Gy. When the lymph nodes on the evaluated side are also included in the boost PTV, however, this relationship between the distance and the gain of a SEQ seems less clear. Conclusions: A sequentially delivered boost technique results in a better treatment plan for most cases, compared to a simultaneous integrated boost IMRT technique, if the boost PTV is more than 1 cm away from at least one parotid gland.

Potential Bud Bank Responses to Apical Meristem Damage and Environmental Variables: Matching or Complementing Axillary Meristems?

Czech Academy of Sciences Publication Activity Database

Klimešová, Jitka; Malíková, Lenka; Rosenthal, J.; Šmilauer, P.

2014-01-01

Roč. 9, č. 2 (2014), e88093 E-ISSN 1932-6203 R&D Projects: GA ČR GPP504/12/P540; GA ČR GA526/09/0963 Institutional support: RVO:67985939 Keywords : bud bank * axillary meristem * disturbance Subject RIV: EH - Ecology, Behaviour Impact factor: 3.234, year: 2014

Male occult breast cancer with axillary lymph node metastasis as the first manifestation: A case report and literature review.

Science.gov (United States)

Xu, Ruixin; Li, Jianbin; Zhang, Yingjie; Jing, Hongbiao; Zhu, Youzhe

2017-12-01

Occult breast cancer (OBC) is extremely rare in males with neither symptoms in the breast nor abnormalities upon imaging examination. This current case report presents a young male patient who was diagnosed with male OBC first manifesting as axillary lymph node metastasis. The physical and imaging examination showed no primary lesions in either breasts or in other organs. The pathological results revealed infiltrating ductal carcinoma in the axillary lymph nodes. Immunohistochemical (IHC) staining was negative for estrogen receptor (ER), progesterone receptor (PR), cytokeratin (CK)20 and thyroid transcription factor-1 (TTF-1), positive for CK7, gross cystic disease fluid protein-15 (GCDFP-15), epithelial membrane antigen (EMA) and carcinoembryonic antigen (CEA), and suspicious positive for human epidermal receptor-2 (Her-2). On basis of IHC markers, particularly such as CK7, CK20 and GCDFP-15, and eliminating other malignancies, male OBC was identified in spite of negativity for hormone receptors. The patient underwent left axillary lymph node dissection (ALND) but not mastectomy. After the surgery, the patient subsequently underwent chemotherapy and radiotherapy. The patient is currently being followed up without any signs of recurrence. Carefully imaging examination and pathological analysis were particularly essential in the diagnosis of male OBC. The guidelines for managing male OBC default to those of female OBC and male breast cancer. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Revealing impaired pathways in the an11 mutant by high-throughput characterization of Petunia axillaris and Petunia inflata transcriptomes.

Science.gov (United States)

Zenoni, Sara; D'Agostino, Nunzio; Tornielli, Giovanni B; Quattrocchio, Francesca; Chiusano, Maria L; Koes, Ronald; Zethof, Jan; Guzzo, Flavia; Delledonne, Massimo; Frusciante, Luigi; Gerats, Tom; Pezzotti, Mario

2011-10-01

Petunia is an excellent model system, especially for genetic, physiological and molecular studies. Thus far, however, genome-wide expression analysis has been applied rarely because of the lack of sequence information. We applied next-generation sequencing to generate, through de novo read assembly, a large catalogue of transcripts for Petunia axillaris and Petunia inflata. On the basis of both transcriptomes, comprehensive microarray chips for gene expression analysis were established and used for the analysis of global- and organ-specific gene expression in Petunia axillaris and Petunia inflata and to explore the molecular basis of the seed coat defects in a Petunia hybrida mutant, anthocyanin 11 (an11), lacking a WD40-repeat (WDR) transcription regulator. Among the transcripts differentially expressed in an11 seeds compared with wild type, many expected targets of AN11 were found but also several interesting new candidates that might play a role in morphogenesis of the seed coat. Our results validate the combination of next-generation sequencing with microarray analyses strategies to identify the transcriptome of two petunia species without previous knowledge of their genome, and to develop comprehensive chips as useful tools for the analysis of gene expression in P. axillaris, P. inflata and P. hybrida. © 2011 The Authors. The Plant Journal © 2011 Blackwell Publishing Ltd.

Clustering Using Boosted Constrained k-Means Algorithm

Directory of Open Access Journals (Sweden)

Masayuki Okabe

2018-03-01

Full Text Available This article proposes a constrained clustering algorithm with competitive performance and less computation time to the state-of-the-art methods, which consists of a constrained k-means algorithm enhanced by the boosting principle. Constrained k-means clustering using constraints as background knowledge, although easy to implement and quick, has insufficient performance compared with metric learning-based methods. Since it simply adds a function into the data assignment process of the k-means algorithm to check for constraint violations, it often exploits only a small number of constraints. Metric learning-based methods, which exploit constraints to create a new metric for data similarity, have shown promising results although the methods proposed so far are often slow depending on the amount of data or number of feature dimensions. We present a method that exploits the advantages of the constrained k-means and metric learning approaches. It incorporates a mechanism for accepting constraint priorities and a metric learning framework based on the boosting principle into a constrained k-means algorithm. In the framework, a metric is learned in the form of a kernel matrix that integrates weak cluster hypotheses produced by the constrained k-means algorithm, which works as a weak learner under the boosting principle. Experimental results for 12 data sets from 3 data sources demonstrated that our method has performance competitive to those of state-of-the-art constrained clustering methods for most data sets and that it takes much less computation time. Experimental evaluation demonstrated the effectiveness of controlling the constraint priorities by using the boosting principle and that our constrained k-means algorithm functions correctly as a weak learner of boosting.

Boosted black holes on Kaluza-Klein bubbles

International Nuclear Information System (INIS)

Iguchi, Hideo; Mishima, Takashi; Tomizawa, Shinya

2007-01-01

We construct an exact stationary solution of black-hole-bubble sequence in the five-dimensional Kaluza-Klein theory by using solitonic solution-generating techniques. The solution describes two stationary black holes with topology S 3 on a Kaluza-Klein bubble and has a linear momentum component in the compactified direction. We call the solution boosted black holes on Kaluza-Klein bubble because it has the linear momentum. The Arnowitt-Deser-Misner mass and the linear momentum depend on the two boosted velocity parameters of black holes. In the effective four-dimensional theory, the solution has an electric charge which is proportional to the linear momentum. The solution includes the static solution found by Elvang and Horowitz. The small and the big black holes limits are investigated. The relation between the solution and the single boosted black string are considered

Centrifugal compressor design for electrically assisted boost

International Nuclear Information System (INIS)

Yang, M Y; Martinez-Botas, R F; Zhuge, W L; Qureshi, U; Richards, B

2013-01-01

Electrically assisted boost is a prominent method to solve the issues of transient lag in turbocharger and remains an optimized operation condition for a compressor due to decoupling from turbine. Usually a centrifugal compressor for gasoline engine boosting is operated at high rotational speed which is beyond the ability of an electric motor in market. In this paper a centrifugal compressor with rotational speed as 120k RPM and pressure ratio as 2.0 is specially developed for electrically assisted boost. A centrifugal compressor including the impeller, vaneless diffuser and the volute is designed by meanline method followed by 3D detailed design. Then CFD method is employed to predict as well as analyse the performance of the design compressor. The results show that the pressure ratio and efficiency at design point is 2.07 and 78% specifically

Chemical composition of axillary odorants reflects social and individual attributes in rhesus macaques.

Science.gov (United States)

Weiß, Brigitte M; Kücklich, Marlen; Thomsen, Ruth; Henkel, Stefanie; Jänig, Susann; Kulik, Lars; Birkemeyer, Claudia; Widdig, Anja

2018-01-01

Scents play an important role in the life of most terrestrial mammals and may transmit valuable information about conspecifics. Olfaction was long considered of low importance in Old World monkeys due to their relative reduction of olfactory structures and low incidence of scent-marking behavior but has been increasingly recognized for mediating social relationships in recent years. Yet, studies investigating the composition of their chemical cues remain scarce. In the present study, we analyzed the potential information content of chemicals present on the skin of rhesus macaques ( Macaca mulatta ). We collected axillary secretions from 60 animals of the semifree-ranging population on Cayo Santiago (Puerto Rico, USA) with precleaned cotton swabs from which the secretions were subsequently extracted and analyzed by gas chromatography-mass spectrometry. Rhesus macaque axillary odorants varied in their overall similarity and composition. This variation was attributable to differences in sex, group membership, and kinship and further appeared to reflect age and rank in parts of our sample. The compounds most strongly associated with this variation primarily comprised larger molecular weight aldehydes and steroids. Such compounds are considered to be perceivable by the primate olfactory system through close-range interactions or through breakdown into smaller molecules by bacterial fermentation. Overall, our results provide additional evidence that odors of Old World monkeys reflect a wealth of potential information about their carrier, which provides the basis for chemical communication via body odors; however, its use by conspecifics needs to be confirmed in bioassays. One prerequisite for olfactory communication is the presence of systematic variation in animal odors that is related to attributes such as age, sex, or kinship. The composition of odors has been examined in numerous mammals but, with the exception of humans, remains poorly understood in Old World

Solar-Based Boost Differential Single Phase Inverter | Eya | Nigerian ...

African Journals Online (AJOL)

Solar-Based Boost Differential Single Phase Inverter. ... Solar-based boost differential inverter is reduced down to 22.37% in closed loop system with the aid of Proportional –integral-Differential (PID) ... The dc power source is photovoltaic cell.

Substructure boosts to dark matter annihilation from Sommerfeld enhancement

International Nuclear Information System (INIS)

Bovy, Jo

2009-01-01

The recently introduced Sommerfeld enhancement of the dark matter annihilation cross section has important implications for the detection of dark matter annihilation in subhalos in the Galactic halo. In addition to the boost to the dark matter annihilation cross section from the high densities of these subhalos with respect to the main halo, an additional boost caused by the Sommerfeld enhancement results from the fact that they are kinematically colder than the Galactic halo. If we further believe the generic prediction of the cold dark matter paradigm that in each subhalo there is an abundance of substructure which is approximately self-similar to that of the Galactic halo, then I show that additional boosts coming from the density enhancements of these small substructures and their small velocity dispersions enhance the dark matter annihilation cross section even further. I find that very large boost factors (10 5 to 10 9 ) are obtained in a large class of models. The implications of these boost factors for the detection of dark matter annihilation from dwarf spheroidal galaxies in the Galactic halo are such that, generically, they outshine the background gamma-ray flux and are detectable by the Fermi Gamma-ray Space Telescope.

TOPOLOGICAL REVIEW AND ANALYSIS OF DC-DC BOOST CONVERTERS

Directory of Open Access Journals (Sweden)

V. INDRA GANDHI

2017-06-01

Full Text Available DC voltage boost up is essential in numerous applications; especially considering Photovoltaic (PV based renewable power generation system. The conventional DC-DC boost converter is the most admired configuration for this scheme, even if the converter efficiency is restricted at duty cycle near to maximum value. In order to find solution to the problem and improve its conversion capability, many converter configurations have been implemented so far. With this circumstance, this research work proposes to give overview of a few most imperative research works related to DC-DC boost converters. Some configurations are covered and classified basically based on the application. The major benefits and disadvantages related to the available techniques are also briefly conveyed. At last, a proper evaluation is recognized among the important types of DC-DC boost converters in terms of efficiency, number of components, and stability.

Boosted Multivariate Trees for Longitudinal Data

Science.gov (United States)

Pande, Amol; Li, Liang; Rajeswaran, Jeevanantham; Ehrlinger, John; Kogalur, Udaya B.; Blackstone, Eugene H.; Ishwaran, Hemant

2017-01-01

Machine learning methods provide a powerful approach for analyzing longitudinal data in which repeated measurements are observed for a subject over time. We boost multivariate trees to fit a novel flexible semi-nonparametric marginal model for longitudinal data. In this model, features are assumed to be nonparametric, while feature-time interactions are modeled semi-nonparametrically utilizing P-splines with estimated smoothing parameter. In order to avoid overfitting, we describe a relatively simple in sample cross-validation method which can be used to estimate the optimal boosting iteration and which has the surprising added benefit of stabilizing certain parameter estimates. Our new multivariate tree boosting method is shown to be highly flexible, robust to covariance misspecification and unbalanced designs, and resistant to overfitting in high dimensions. Feature selection can be used to identify important features and feature-time interactions. An application to longitudinal data of forced 1-second lung expiratory volume (FEV1) for lung transplant patients identifies an important feature-time interaction and illustrates the ease with which our method can find complex relationships in longitudinal data. PMID:29249866

Top reconstruction and boosted top experimental overview

CERN Document Server

Skinnari, Louise

2015-01-01

An overview of techniques used to reconstruct resolved and boosted top quarks is presented. Techniques for resolved top quark reconstruction include kinematic likelihood fitters and pseudo- top reconstruction. Many tools and methods are available for the reconstruction of boosted top quarks, such as jet grooming techniques, jet substructure variables, and dedicated top taggers. Different techniques as used by ATLAS and CMS analyses are described and the performance of different variables and top taggers are shown.

Brachytherapy Boost Utilization and Survival in Unfavorable-risk Prostate Cancer.

Science.gov (United States)

Johnson, Skyler B; Lester-Coll, Nataniel H; Kelly, Jacqueline R; Kann, Benjamin H; Yu, James B; Nath, Sameer K

2017-11-01

There are limited comparative survival data for prostate cancer (PCa) patients managed with a low-dose rate brachytherapy (LDR-B) boost and dose-escalated external-beam radiotherapy (DE-EBRT) alone. To compare overall survival (OS) for men with unfavorable PCa between LDR-B and DE-EBRT groups. Using the National Cancer Data Base, we identified men with unfavorable PCa treated between 2004 and 2012 with androgen suppression (AS) and either EBRT followed by LDR-B or DE-EBRT (75.6-86.4Gy). Treatment selection was evaluated using logistic regression and annual percentage proportions. OS was analyzed using the Kaplan-Meier method, log-rank test, Cox proportional hazards, and propensity score matching. We identified 25038 men between 2004 and 2012, during which LDR-B boost utilization decreased from 29% to 14%. LDR-B was associated with better OS on univariate (7-yr OS: 82% vs 73%; pLDR-B boost (HR 0.74, 95% CI 0.66-0.89). The OS benefit of LDR-B boost persisted when limited to men aged LDR-B boost utilization declined and was associated with better OS compared to DE-EBRT alone. LDR-B boost is probably the ideal treatment option for men with unfavorable PCa, pending long-term results of randomized trials. We compared radiotherapy utilization and survival for prostate cancer (PCa) patients using a national database. We found that low-dose rate brachytherapy (LDR-B) boost, a method being used less frequently, was associated with better overall survival when compared to dose-escalated external-beam radiotherapy alone for men with unfavorable PCa. Randomized trials are needed to confirm that LDR-B boost is the ideal treatment. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

arXiv Inelastic Boosted Dark Matter at Direct Detection Experiments

CERN Document Server

Giudice, Gian F.; Park, Jong-Chul; Shin, Seodong

2018-05-10

We explore a novel class of multi-particle dark sectors, called Inelastic Boosted Dark Matter (iBDM). These models are constructed by combining properties of particles that scatter off matter by making transitions to heavier states (Inelastic Dark Matter) with properties of particles that are produced with a large Lorentz boost in annihilation processes in the galactic halo (Boosted Dark Matter). This combination leads to new signals that can be observed at ordinary direct detection experiments, but require unconventional searches for energetic recoil electrons in coincidence with displaced multi-track events. Related experimental strategies can also be used to probe MeV-range boosted dark matter via their interactions with electrons inside the target material.

adabag: An R Package for Classification with Boosting and Bagging

Directory of Open Access Journals (Sweden)

Esteban Alfaro

2013-09-01

Full Text Available Boosting and bagging are two widely used ensemble methods for classification. Their common goal is to improve the accuracy of a classifier combining single classifiers which are slightly better than random guessing. Among the family of boosting algorithms, AdaBoost (adaptive boosting is the best known, although it is suitable only for dichotomous tasks. AdaBoost.M1 and SAMME (stagewise additive modeling using a multi-class exponential loss function are two easy and natural extensions to the general case of two or more classes. In this paper, the adabag R package is introduced. This version implements AdaBoost.M1, SAMME and bagging algorithms with classification trees as base classifiers. Once the ensembles have been trained, they can be used to predict the class of new samples. The accuracy of these classifiers can be estimated in a separated data set or through cross validation. Moreover, the evolution of the error as the ensemble grows can be analysed and the ensemble can be pruned. In addition, the margin in the class prediction and the probability of each class for the observations can be calculated. Finally, several classic examples in classification literature are shown to illustrate the use of this package.

Rare Case of Male Breast Cancer and Axillary Lymphoma in the Same Patient: An Unique Case Report

Directory of Open Access Journals (Sweden)

Emiliano Sordi

2011-01-01

Full Text Available Breast cancer in men is uncommon, and even more rare is the simultaneous presentation of two different malignancies. A 39-year-old man was diagnosed with both breast cancer and axillary lymphoma. Familiar history revealed that his mother died because of breast cancer. The patient underwent fine needle aspiration leading to the diagnosis of malignant lesion. Modified radical mastectomy was performed. Histology revealed an infiltrating ductal carcinoma 2.8 cm wide, grade 2, with vascular and lymphatic invasion. Surprisingly, one of the second level nodes was confirmed as a high-grade large B cell non-Hodgkin's lymphoma. No family inheritance or gene mutations (BRCA 1 and 2 were found. The patient underwent local radiotherapy, followed by 6 chemotherapy courses (RCHOP and treatment with tamoxifen 20 mg/daily. To our knowledge, this is the first case reported in literature of male breast cancer and axillary lymphoma simultaneously confirmed in the same patient.

Pre-operative and intra-operative detection of axillary lymph node metastases in 108 patients with invasive lobular breast cancer undergoing mastectomy.

Science.gov (United States)

Novak, Jerica; Besic, Nikola; Dzodic, Radan; Gazic, Barbara; Vogrin, Andrej

2018-02-05

Despite the recent changes in the treatment of the axilla in selected breast cancer patient, positive sentinel lymph node (SLN) in patients undergoing mastectomy still necessitates axillary lymph node dissection (ALND). In invasive lobular carcinoma (ILC), pre-operative detection of the lymph node metastasis may be demanding due to its unique morphology. The aim of this study was to examine the benefit of preoperative axillary ultrasound (AUS), ultrasound-guided fine-needle aspiration biopsy (US-FNAB), and intra-operative imprint cytology (IIC), in order to avoid two-stage axillary surgery in patients with ILC undergoing mastectomy. The object of this study were 102 patients (median age 52, range 34-73 years) with clinically non-suspicious axilla in whom 108 mastectomies were performed after a pre-operative AUS investigation. Whenever a metastasis was detected in a sentinel lymph node, ALND was done. Reports of the pre-operative AUS investigation, US-FNAB, and IIC were compared with definitive histopathological reports of surgical specimens. In 46 cases lymph node metastases were diagnosed. AUS suspicious lymph nodes were found in 29/108 cases and histopathology confirmed metastases in 22/30 cases. US-FNAB was performed in 29 cases with AUS suspicious lymph nodes. Cytology proved metastases in 11/29 cases. Histopathology confirmed metastases in 10/11 cases with only isolated tumor cells found in one case. IIC investigation was performed in 63 cases and in 10/27 cases metastases were confirmed by histopathology. Pre-operative AUS, US-FNAB, and/or IIC investigation enabled ALND during a single surgical procedure in 20/46 patients with metastases in lymph nodes. Pre-operative AUS, US-FNAB, and/or IIC are/is beneficial in patients with ILC planned for mastectomy in order to decrease the number of two stage axillary procedures.

Tumour bed boost radiotherapy for women after breast-conserving surgery.

Science.gov (United States)

Kindts, Isabelle; Laenen, Annouschka; Depuydt, Tom; Weltens, Caroline

2017-11-06

Breast-conserving therapy, involving breast-conserving surgery followed by whole-breast irradiation and optionally a boost to the tumour bed, is a standard therapeutic option for women with early-stage breast cancer. A boost to the tumour bed means that an extra dose of radiation is applied that covers the initial tumour site. The rationale for a boost of radiotherapy to the tumour bed is that (i) local recurrence occurs mostly at the site of the primary tumour because remaining microscopic tumour cells are most likely situated there; and (ii) radiation can eliminate these causative microscopic tumour cells. The boost continues to be used in women at high risk of local recurrence, but is less widely accepted for women at lower risk. Reasons for questioning the boost are twofold. Firstly, the boost brings higher treatment costs. Secondly, the potential adverse events are not negligible. In this Cochrane Review, we investigated the effect of the tumour bed boost on local control and side effects. To assess the effects of tumour bed boost radiotherapy after breast-conserving surgery and whole-breast irradiation for the treatment of breast cancer. We searched the Cochrane Breast Cancer Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (January 1966 to 1 March 2017), Embase (1980 to 1 March 2017), the World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov on 1 March 2017. We also searched the European Society of Radiotherapy and Oncology Annual Meeting, the St Gallen Oncology Conferences, and the American Society for Radiation Oncology Annual Meeting for abstracts. Randomised controlled trials comparing the addition and the omission of breast cancer tumour bed boost radiotherapy. Two review authors (IK and CW) performed data extraction and assessed risk of bias using Cochrane's 'Risk of bias' tool, resolving any disagreements through discussion. We entered data into Review Manager 5 for

The Synergy Between PAV and AdaBoost

OpenAIRE

WILBUR, W. JOHN; YEGANOVA, LANA; KIM, WON

2005-01-01

Schapire and Singer’s improved version of AdaBoost for handling weak hypotheses with confidence rated predictions represents an important advance in the theory and practice of boosting. Its success results from a more efficient use of information in weak hypotheses during updating. Instead of simple binary voting a weak hypothesis is allowed to vote for or against a classification with a variable strength or confidence. The Pool Adjacent Violators (PAV) algorithm is a method for converting a ...

14 CFR 27.695 - Power boost and power-operated control system.

Science.gov (United States)

2010-01-01

... Systems § 27.695 Power boost and power-operated control system. (a) If a power boost or power-operated... failure of all engines. (b) Each alternate system may be a duplicate power portion or a manually operated... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Power boost and power-operated control...

14 CFR 29.695 - Power boost and power-operated control system.

Science.gov (United States)

2010-01-01

... Systems § 29.695 Power boost and power-operated control system. (a) If a power boost or power-operated... failure of all engines. (b) Each alternate system may be a duplicate power portion or a manually operated... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Power boost and power-operated control...

Non-Inverting Buck-Boost Converter for Fuel Cell Applications

DEFF Research Database (Denmark)

Schaltz, Erik; Rasmussen, Peter Omand; Khaligh, Alireza

2008-01-01

Fuel cell DC/DC converters often have to be able to both step-up and step-down the input voltage, and provide a high efficiency in the whole range of output power. Conventional negative output buck-boost and non-inverting buck-boost converters provide both step-up and step-down characteristics....... In this paper the non-inverting buck-boost with either diodes or synchronous rectifiers is investigated for fuel cell applications. Most of previous research does not consider  the parasitic in the evaluation of the converters. In this study, detailed analytical expressions of the efficiencies for the system...

Prognostic significance of axillary dissection in breast cancer patients with micrometastases or isolated tumor cells in sentinel nodes

DEFF Research Database (Denmark)

Tvedskov, Tove Filtenborg; Jensen, Maj-Britt; Ejlertsen, Bent

2015-01-01

We estimated the impact of axillary lymph node dissection (ALND) on the risk of axillary recurrence (AR) and overall survival (OS) in breast cancer patients with micrometastases or isolated tumor cells (ITC) in sentinel nodes. We used the Danish Breast Cancer Cooperative Group (DBCG) database...... to identify patients with micrometastases or ITC in sentinel nodes following surgery for primary breast cancer between 2002 and 2008. A Cox proportional hazard regression model was developed to assess the hazard ratios (HR) for AR and OS between patients with and without ALND. We identified 2074 patients...... and 2.21 (95 % CI 0.54-8.95, P = 0.27), in patients with ITC after a median follow-up of 6 years and 3 months. There was no significant difference in overall survival between patients with and without ALND, when adjusting for age, co-morbidity, tumor size, histology type, malignancy grade...

DESAIN DAN IMPLEMENTSI SOFT SWITCHING BOOST KONVERTER DENGAN SIMPLE AUXILLARY RESONANT SWITCH (SARC

Directory of Open Access Journals (Sweden)

Dimas Bagus Saputra

2017-01-01

Full Text Available Boost konverter merupakan penaik tegangan DC ke tegangan DC yang mempunyai tegangan output yang lebih tinggi dibanding inputnya. Penggunaan boost konverter diera modern semakin meningkat dan dibuat dengan dimensi yang lebih kecil, berat yang lebih ringan dan efisiensi yang lebih tinggi dibanding dengan boost konverter generasi terdahulu. Tetapi rugi-rugi periodik saat on/off meningkat. Untuk meraih kriteria tersebut, teknik hard switching boost konverter berevolusi menjadi teknik soft switching dengan menambah rangkaian simple auxiliary resonant circuit (SARC. Karena penambahan rangkaian SARC tersebut konverter bekerja pada kondisi zero-voltage switching switch (ZVS dan zero current switch (ZCS, sehingga saklar semikonduktor tidak bekerja secara hard switching lagi. Pada penelitian ini akan di desain dan diimplementaskan soft switching boost konverter dengan SARC. Kelebihan dari soft switching boost konverter dengan SARC adalah mempunyai efisiensi yang lebih tinggi dibanding dengan boost konverter konventional. Dari hasil implementasi menunjukkan konverter yang diajukan telah meraih zero voltage switch (ZVS. Sehingga boost konverter zero voltage switch (ZVS bisa diaplikasikan pada sistem power suplay yang membutuhkan efisiensi energi yang tinggi terutama pada daya yang tinggi.

Y-Source Boost DC/DC Converter for Distributed Generation

DEFF Research Database (Denmark)

Siwakoti, Yam P.; Loh, Poh Chiang; Blaabjerg, Frede

2015-01-01

This paper introduces a versatile Y-source boost dc/dc converter intended for distributed power generation, where high gain is often demanded. The proposed converter uses a Y-source impedance network realized with a tightly coupled three-winding inductor for high voltage boosting that is presently...

Changes In Men’s Salivary Testosterone And Cortisol Levels, And In Sexual Desire After Smelling Female Axillary And Vulvar Scents

Directory of Open Access Journals (Sweden)

Ricardo eMondragón-Ceballos

2013-10-01

Full Text Available Several studies have shown that a woman’s vaginal or axillary odors convey information on her attractivity. Yet, whether such scents induce psychoneuroendocrinological changes in perceivers is still controversial. We studied if smelling axillary and vulvar odors collected in the periovulatory and late luteal phases of young women modify salivary testosterone and cortisol levels, as well as sexual desire in men. Forty-five women and 115 men, all of them college students and unacquainted with each other, participated in the study. Female odors were collected on pads affixed to the axilla and on panty protectors both worn the entire night before experiments. Men provided five saliva samples, a basal one before the smelling procedure, and four more 15, 30, 60 and 75 min after exposure to odors. Immediately after smelling the odor source, men answered a questionnaire rating hedonic qualities of scents, and after providing the last saliva sample they answered questionnaire on sexual desire. We found that periovulatory axillary and vulvar odors increased testosterone and cortisol levels, with vulvar scents producing a more prolonged effect. Luteal axilla odors decreased testosterone and cortisol levels, while luteal vulva odors increased cortisol. Periovulatory axilla and vulva scents accounted for a general increase of interest in sex. These odors were also rated as more pleasant and familiar, while luteal vulvar odors were perceived as intense and unpleasant.

Nudging and Boosting: Steering or Empowering Good Decisions.

Science.gov (United States)

Hertwig, Ralph; Grüne-Yanoff, Till

2017-11-01

In recent years, policy makers worldwide have begun to acknowledge the potential value of insights from psychology and behavioral economics into how people make decisions. These insights can inform the design of nonregulatory and nonmonetary policy interventions-as well as more traditional fiscal and coercive measures. To date, much of the discussion of behaviorally informed approaches has emphasized "nudges," that is, interventions designed to steer people in a particular direction while preserving their freedom of choice. Yet behavioral science also provides support for a distinct kind of nonfiscal and noncoercive intervention, namely, "boosts." The objective of boosts is to foster people's competence to make their own choices-that is, to exercise their own agency. Building on this distinction, we further elaborate on how boosts are conceptually distinct from nudges: The two kinds of interventions differ with respect to (a) their immediate intervention targets, (b) their roots in different research programs, (c) the causal pathways through which they affect behavior, (d) their assumptions about human cognitive architecture, (e) the reversibility of their effects, (f) their programmatic ambitions, and (g) their normative implications. We discuss each of these dimensions, provide an initial taxonomy of boosts, and address some possible misconceptions.

High field MRI of axillary lymph nodes and breast cancer

NARCIS (Netherlands)

Korteweg, M.A.

2011-01-01

In this thesis nodal characteristics have been assessed with high field Magnetic Resonance Imaging (MRI) using a clinical scanner in order to discriminate non-metastatic from metastatic nodes of breast cancer patients. The final goal is to non-invasively determine nodal and tumor stage of breast

An improved gravity compensation method for high-precision free-INS based on MEC–BP–AdaBoost

International Nuclear Information System (INIS)

Zhou, Xiao; Yang, Gongliu; Wang, Jing; Li, Jing

2016-01-01

In recent years, with the rapid improvement of inertial sensors (accelerometers and gyroscopes), gravity compensation has become more important for improving navigation accuracy in inertial navigation systems (INS), especially for high-precision INS. This paper proposes a mind evolutionary computation (MEC) back propagation (BP) AdaBoost algorithm neural-network-based gravity compensation method that estimates the gravity disturbance on the track based on measured gravity data. A MEC–BP–AdaBoost network-based gravity compensation algorithm used in the training process to establish the prediction model takes the carrier position (longitude and latitude) provided by INS as the input data and the gravity disturbance as the output data, and then compensates the obtained gravity disturbance into the INS’s error equations to restrain the position error propagation. The MEC–BP–AdaBoost algorithm can not only effectively avoid BP neural networks being trapped in local extrema, but also perfectly solve the nonlinearity between the input and output data that cannot be solved by traditional interpolation methods, such as least-square collocation (LSC) interpolation. The accuracy and feasibility of the proposed interpolation method are verified through numerical tests. A comparison of several other compensation methods applied in field experiments, including LSC interpolation and traditional BP interpolation, highlights the superior performance of the proposed method. The field experiment results show that the maximum value of the position error can reduce by 28% with the proposed gravity compensation method. (paper)

Linfonodo sentinela intramamário comprometido e axila livre: esvaziamento axilar ou conduta conservadora? Intramammary lymph node sentinel metastasis without metastasis in axilla: axillary lymph node dissection or conservative surgery?

Directory of Open Access Journals (Sweden)

René Aloisio da Costa Vieira

2012-01-01

Full Text Available A pesquisa do linfonodo sentinela constitui tratamento padrão para pacientes portadoras de câncer de mama e axila clinicamente negativa. A presença do linfonodo sentinela (LS extra-axilar e intramamário (IM ocorre em até 2,6% dos casos, e na presença do LS IM metastático, a positividade axilar pode alcançar até 81%. Na associação do LS IM metastático ao LS axilar não metastático, não há conduta padronizada, visto um limitado número de casos descritos. Adicionamos dois casos à literatura, observando, em um deles, a presença de doença metastática axilar na linfadenectomia complementar. A utilização de nomograma demonstrou que o risco de doença metastática axilar era inferior a 10%, e a adição destes casos à literatura mostrou que, nesta situação, a taxa de doença metastática axilar é de 6,25%. Discutimos os prós e contras da linfadenectomia axilar complementar nesta situação.The sentinel lymph node biopsy is a standard treatment for patients with breast cancer and clinically negative axilla lymph node. The presence of an extra-axillary and intra-axillary (IM sentinel lymph node (SLN occurs in up to 2.6% of cases. In the presence of a metastatic IM SLN, axillary positivity may occur in up to 81% of cases. Due to the limited number of cases reported, there is no standard treatment for the association of metastatic SLN IM and non-metastatic axillary SLN . We add here two cases to the literature, one of them with metastatic disease in the axilla. The use of a nomogram demonstrated that the risk of axillary metastasis was less than 10% and the addition of these cases to the literature showed that in this situation the rate of axillary metastasis is 6.25%. We discuss the pros and cons of further axillary dissection in this situation.

Deodorant effects of a sage extract stick: Antibacterial activity and sensory evaluation of axillary deodorancy.

Science.gov (United States)

Shahtalebi, Mohammad Ali; Ghanadian, Mustafa; Farzan, Ali; Shiri, Niloufar; Shokri, Dariush; Fatemi, Syed Ali

2013-10-01

Deodorant products prevent the growth and activity of the degrading apocrine gland bacteria living in the armpit. Common antibacterial agents in the market like triclosan and aluminum salts, in spite of their suitable antibacterial effects, increase the risk of Alzheimer's disease, breast and prostate cancers or induce contact dermatitis. Therefore, plant extracts possessing antibacterial effects are of interest. The aim of the present study was to verify the in vitro antimicrobial effects of different sage extracts against two major bacteria responsible for axillary odor, and to evaluate the deodorant effect of a silicon-based stick containing sage extracts in different densities in humans. Different fractions of methanolic extract of Salvia officinalis (sage) were evaluated on a culture of armpit skin surface of volunteers through agar microdilution antimicrobial assay. Then, randomized, double-blind placebo-controlled clinical trial with the best antibacterial fraction was conducted on 45 female healthy volunteers. Participants were treated with a single dose in four groups, each containing 15 individuals: Group 1 (200 μg/mL), 2 (400 μg/mL), 3 (600 μg/mL) of dichloromethane sage extract, and placebo (without extract). A standard sensory evaluation method for the evaluation of deodorant efficacy was used before, and two hours, four hours, and eight hours after single application of a deodorant or placebo (ASTM method E 1207-87 Standard Practice for the Sensory Evaluation of Axillary Deodorancy). The data were analyzed with two factors relating to densities and time. In 45 participants with a mean [± standard deviation (SD)] age of 61.5±11.8 years, statistically significant within-group differences were observed before and two, four, and eight hours after deodorant treatment for groups 1, 2, and 3. Groups 1, 2, and 3 had a significantly smaller odor score than placebo after two, four, and eight hours (P sage extract sticks (P sage extract of 200, 400, or 600

[Ultrasound-assisted approach to blocking the intercostal nerves in the mid-axillary line for non-reconstructive breast and axilla surgery].

Science.gov (United States)

Diéguez García, P; Fajardo Pérez, M; López Álvarez, S; Alfaro de la Torre, P; Pensado Castiñeiras, A P

2013-01-01

Several nerve blocks have recently been used for pain treatment in breast surgery. The main objective of our study was to determine the efficacy and safety of ultrasound-assisted blocking of the anterior and lateral cutaneous branches of the intercostal nerves in the mid-axillary line for non-reconstructive breast and axilla surgery. A prospective observational study was conducted on 30 patients scheduled for non-reconstructive breast and axilla surgery. An intercostal branches block was performed in the mid-axillary line with 0,5% levobupivacaine (3ml in each intercostal space). Clinical efficacy was assessed by standard intraoperative hemodynamic response to surgical stimulus and the need for opioids, and in the postoperative period, by assessing pain intensity as a verbal numerical scale and the need for rescue treatment. We also evaluated the quality of sleep the first night after surgery, any adverse events that occurred, and the satisfaction of patients and surgeons with the anesthetic technique. The intercostal branches block in the mid-axillary line was effective in most cases, with only 2 patients requiring intraoperative opioids, and in one case analgesic rescue was necessary in the postoperative period. The duration of postoperative analgesia was 19±4h. There were no notable adverse events or complications. The satisfaction with the chosen technique was assessed as "very good" in all patients, and by 97% of the surgeons. Intercostal branches block in the mid-axillary line provides adequate intraoperative and postoperative analgesia for non-reconstructive breast and axilla surgery. It is a simple, reproducible technique in most patients of this study, with an easy to understand ultrasound anatomy, in which adequate analgesia could be provided through a single puncture, and may be an alternative to neuroaxial blocks. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights

Three-Dimensional Conformal Simultaneously Integrated Boost Technique for Breast-Conserving Radiotherapy

International Nuclear Information System (INIS)

Laan, Hans Paul van der; Dolsma, Wil V.; Maduro, John H.; Korevaar, Erik W.; Hollander, Miranda; Langendijk, Johannes A.

2007-01-01

Purpose: To compare the target coverage and normal tissue dose with the simultaneously integrated boost (SIB) and the sequential boost technique in breast cancer, and to evaluate the incidence of acute skin toxicity in patients treated with the SIB technique. Methods and Materials: Thirty patients with early-stage left-sided breast cancer underwent breast-conserving radiotherapy using the SIB technique. The breast and boost planning target volumes (PTVs) were treated simultaneously (i.e., for each fraction, the breast and boost PTVs received 1.81 Gy and 2.3 Gy, respectively). Three-dimensional conformal beams with wedges were shaped and weighted using forward planning. Dose-volume histograms of the PTVs and organs at risk with the SIB technique, 28 x (1.81 + 0.49 Gy), were compared with those for the sequential boost technique, 25 x 2 Gy + 8 x 2 Gy. Acute skin toxicity was evaluated for 90 patients treated with the SIB technique according to Common Terminology Criteria for Adverse Events, version 3.0. Results: PTV coverage was adequate with both techniques. With SIB, more efficiently shaped boost beams resulted in smaller irradiated volumes. The mean volume receiving ≥107% of the breast dose was reduced by 20%, the mean volume outside the boost PTV receiving ≥95% of the boost dose was reduced by 54%, and the mean heart and lung dose were reduced by 10%. Of the evaluated patients, 32.2% had Grade 2 or worse toxicity. Conclusion: The SIB technique is proposed for standard use in breast-conserving radiotherapy because of its dose-limiting capabilities, easy implementation, reduced number of treatment fractions, and relatively low incidence of acute skin toxicity

Measuring performance in health care: case-mix adjustment by boosted decision trees.

Science.gov (United States)

Neumann, Anke; Holstein, Josiane; Le Gall, Jean-Roger; Lepage, Eric

2004-10-01

The purpose of this paper is to investigate the suitability of boosted decision trees for the case-mix adjustment involved in comparing the performance of various health care entities. First, we present logistic regression, decision trees, and boosted decision trees in a unified framework. Second, we study in detail their application for two common performance indicators, the mortality rate in intensive care and the rate of potentially avoidable hospital readmissions. For both examples the technique of boosting decision trees outperformed standard prognostic models, in particular linear logistic regression models, with regard to predictive power. On the other hand, boosting decision trees was computationally demanding and the resulting models were rather complex and needed additional tools for interpretation. Boosting decision trees represents a powerful tool for case-mix adjustment in health care performance measurement. Depending on the specific priorities set in each context, the gain in predictive power might compensate for the inconvenience in the use of boosted decision trees.

A comparative study on accuracy of liquid crystal forehead, digital electronic axillary, infrared tympanic with glass-mercury rectal thermometer in infants and young children.

Science.gov (United States)

Kongpanichkul, A; Bunjongpak, S

2000-09-01

This study was carried out to assess the accuracy of three devices namely, liquid crystal forehead, digital electronic axillary and infrared tympanic thermometer, using a glass-mercury rectal thermometer as the control. The subjects were two hundred children aged 0-48 months. The mean rectal temperature was 38.0 +/- 0.91 degrees C; forehead, 37.83 +/- 0.94 degrees C; tympanic, 37.77 +/- 0.95 degrees C, and axillary, 37.71 +/- 0.86 degrees C. Compared to the rectal temperature, all values were significantly lower (p < 0.05). Forehead, tympanic and axillary temperature differed from rectal temperature by at least 0.5 degrees C in 33.33 per cent, 23.5 per cent and 31.5 per cent of subjects, and at least 1 degrees C in 22 per cent, 1 per cent and 6 per cent of subjects respectively. Accuracy in detection of fever was 79 per cent for forehead, 85.5 per cent for tympanic and 84 per cent for axillary thermometry. Sensitivity of the three devices was 67-83 per cent in detection of fever and 64-77 per cent in detection of high fever. Tympanic thermometry had the best performance while forehead thermometry had the poorest. After using revised diagnostic threshold temperature by ROC curves, sensitivity of each device improved but accuracy was nearly the same. It is concluded that the three devices are not suitable as a substitute for a glass-mercury rectal thermometer in assessment of fever in infants and young children.

Base-of-tongue carcinoma: treatment results using concomitant boost radiotherapy

International Nuclear Information System (INIS)

Mak, Albert C.; Morrison, William H.; Garden, Adam S.; Ang, Kian K.; Goepfert, Helmuth; Peters, Lester J.

1995-01-01

Purpose: To evaluate the efficacy of accelerated fractionated radiotherapy using the concomitant boost schedule for patients with squamous cell carcinoma of the base of tongue. Methods and Materials: Between September 1984 and July 1992, 54 patients with squamous carcinoma of the base of tongue were treated at The University of Texas M. D. Anderson Cancer Center using the concomitant boost schedule. The distribution of T and N stages was T1-4, T2-27, T3-22, and T4-1; N0-9, N1-11, N2-24, N3-7, and NX-3. American Joint Committee on Cancer (AJCC) stage groupings were II-6, III-14, and IV-34. Before radiation, nodal excision and neck dissection were done in 5 and 10 patients, respectively; 5 patients had neck dissections after radiotherapy. Standard on and off spinal cord fields were irradiated with 1.8 Gy fractions to 54 Gy given over 6 weeks. The boost was given concomitantly during the large field treatment as a second daily (1.5 Gy) fraction, with an interfraction interval of 4-6 h. The median dose to the primary tumor was 72 Gy (range, 66-74 Gy). The median treatment duration was 42 days (range, 39-48 days). Only three patients had treatment interrupted for more than one scheduled treatment day. Results: The 5-year actuarial overall survival and disease-specific survival rates were 59 and 65%, respectively, with a median follow-up of 41 months. The 5-year actuarial locoregional control rate was 76%. The actuarial local control rates achieved with radiotherapy at 5 years for T1, T2, and T3 primary tumors were 100%, 96%, and 67%, respectively; including surgical salvage, the local control rate of T3 primary tumors was 70%. Six patients had regional failures, which in three patients occurred in conjunction with primary tumor recurrence. Twenty-six patients with regional adenopathy were treated with radiation alone to full dose and had a complete clinical response in the neck; no planned neck dissections were performed in these patients. Only 2 of these 26 patients

Concomitant GRID boost for Gamma Knife radiosurgery

International Nuclear Information System (INIS)

Ma Lijun; Kwok, Young; Chin, Lawrence S.; Simard, J. Marc; Regine, William F.

2005-01-01

We developed an integrated GRID boost technique for Gamma Knife radiosurgery. The technique generates an array of high dose spots within the target volume via a grid of 4-mm shots. These high dose areas were placed over a conventional Gamma Knife plan where a peripheral dose covers the full target volume. The beam weights of the 4-mm shots were optimized iteratively to maximize the integral dose inside the target volume. To investigate the target volume coverage and the dose to the adjacent normal brain tissue for the technique, we compared the GRID boosted treatment plans with conventional Gamma Knife treatment plans using physical and biological indices such as dose-volume histogram (DVH), DVH-derived indices, equivalent uniform dose (EUD), tumor control probabilities (TCP), and normal tissue complication probabilities (NTCP). We found significant increase in the target volume indices such as mean dose (5%-34%; average 14%), TCP (4%-45%; average 21%), and EUD (2%-22%; average 11%) for the GRID boost technique. No significant change in the peripheral dose coverage for the target volume was found per RTOG protocol. In addition, the EUD and the NTCP for the normal brain adjacent to the target (i.e., the near region) were decreased for the GRID boost technique. In conclusion, we demonstrated a new technique for Gamma Knife radiosurgery that can escalate the dose to the target while sparing the adjacent normal brain tissue

Boosting aquaculture production systems in Osun state: Role of ...

African Journals Online (AJOL)

This scenario leaves a high percentage of the population who depend on fish and fish products food insecure, and thus, the need to boost aquaculture production to argument the supply from the wild. The study therefore looks into the possibility of boosting the production systems through the use of micro-credit and ...

A Longitudinal Comparison of Arm Morbidity in Stage I-II Breast Cancer Patients Treated with Sentinel Lymph Node Biopsy, Sentinel Lymph Node Biopsy Followed by Completion Lymph Node Dissection, or Axillary Lymph Node Dissection

NARCIS (Netherlands)

Kootstra, Jan J.; Hoekstra-Weebers, Josette E. H. M.; Rietman, Johan S.; de Vries, Jakob; Baas, Peter C.; Geertzen, Jan H. B.; Hoekstra, Harald J.

Background. Long-term shoulder and arm function following sentinel lymph node biopsy (SLNB) may surpass that following complete axillary lymph node dissection (CLND) or axillary lymph node dissection (ALND). We objectively examined the morbidity and compared outcomes after SLNB, SLNB + CLND, and

A longitudinal comparison of arm morbidity in stage I-II breast cancer patients treated with sentinel lymph node biopsy, sentinel lymph node biopsy followed by completion lymph node dissection, or axillary lymph node dissection

NARCIS (Netherlands)

Kootstra, Jan J.; Hoekstra-Weebers, Josette E.; Rietman, Johan Swanik; de Vries, Jakob; Baas, Peter C.; Geertzen, Jan H.B.; Hoekstra, Harald J.

2010-01-01

Background: Long-term shoulder and arm function following sentinel lymph node biopsy (SLNB) may surpass that following complete axillary lymph node dissection (CLND) or axillary lymph node dissection (ALND). We objectively examined the morbidity and compared outcomes after SLNB, SLNB + CLND, and

Radiotherapy Breast Boost With Reduced Whole-Breast Dose Is Associated With Improved Cosmesis: The Results of a Comprehensive Assessment From the St. George and Wollongong Randomized Breast Boost Trial

International Nuclear Information System (INIS)

Hau, Eric; Browne, Lois H.; Khanna, Sam; Cail, Stacy; Cert, Grad; Chin, Yaw; Clark, Catherine; Inder, Stephanie; Szwajcer, Alison; Graham, Peter H.

2012-01-01

Purpose: To evaluate comprehensively the effect of a radiotherapy boost on breast cosmetic outcomes after 5 years in patients treated with breast-conserving surgery. Methods: The St. George and Wollongong trial (NCT00138814) randomized 688 patients with histologically proven Tis-2, N 0–1, M0 carcinoma to the control arm of 50 Gy in 25 fractions (342 patients) and the boost arm of 45 Gy in 25 fractions to the whole breast followed by a 16 Gy in 8 fraction electron boost (346 patients). Five-year cosmetic outcomes were assessed by a panel subjectively in 385 patients and objectively using pBRA (relative breast retraction assessment). A subset of patients also had absolute BRA measurements. Clinician assessment and patient self-assessment of overall cosmetic and specific items as well as computer BCCT.core analysis were also performed. Results: The boost arm had improved cosmetic overall outcomes as scored by the panel and BCCT.core software with 79% (p = 0.016) and 81% (p = 0.004) excellent/good cosmesis respectively compared with 68% in no-boost arm. The boost arm also had lower pBRA and BRA values with a mean difference of 0.60 and 1.82 mm, respectively, but was not statistically significant. There was a very high proportion of overall excellent/good cosmetic outcome in 95% and 93% in the boost and no–boost arms using patient self-assessment. However, no difference in overall and specific items scored by clinician assessment and patient self-assessment was found. Conclusion: The results show the negative cosmetic effect of a 16-Gy boost is offset by a lower whole-breast dose of 45 Gy.

Boosted top production in ATLAS and CMS

CERN Document Server

AUTHOR|(INSPIRE)INSPIRE-00237277; The ATLAS collaboration

2017-01-01

An overview of the boosted top production analyses using data collected by the ATLAS and CMS experiments at $\\sqrt{s}=$' 8 TeV and 13 TeV of proton-proton collisions at the LHC is presented. These analyses use techniques for the reconstruction of boosted objects to measure the production of top quarks at high transverse momenta. The measurements are optimized for the different final states and for different ranges of the transverse momenta of the particles involved, improving on measurements with traditional objects reconstruction based on the combination of resolved objects.

The boosts in the noncommutative special relativity

International Nuclear Information System (INIS)

Lagraa, M.

2001-01-01

From the quantum analogue of the Iwasawa decomposition of SL(2, C) group and the correspondence between quantum SL(2, C) and Lorentz groups we deduce the different properties of the Hopf algebra representing the boost of particles in noncommutative special relativity. The representation of the boost in the Hilbert space states is investigated and the addition rules of the velocities are established from the coaction. The q-deformed Clebsch-Gordon coefficients describing the transformed states of the evolution of particles in noncommutative special relativity are introduced and their explicit calculation are given. (author)

Heterologous prime-boost immunization of Newcastle disease virus vectored vaccines protected broiler chickens against highly pathogenic avian influenza and Newcastle disease viruses.

Science.gov (United States)

Kim, Shin-Hee; Samal, Siba K

2017-07-24

Avian Influenza virus (AIV) is an important pathogen for both human and animal health. There is a great need to develop a safe and effective vaccine for AI infections in the field. Live-attenuated Newcastle disease virus (NDV) vectored AI vaccines have shown to be effective, but preexisting antibodies to the vaccine vector can affect the protective efficacy of the vaccine in the field. To improve the efficacy of AI vaccine, we generated a novel vectored vaccine by using a chimeric NDV vector that is serologically distant from NDV. In this study, the protective efficacy of our vaccines was evaluated by using H5N1 highly pathogenic avian influenza virus (HPAIV) strain A/Vietnam/1203/2004, a prototype strain for vaccine development. The vaccine viruses were three chimeric NDVs expressing the hemagglutinin (HA) protein in combination with the neuraminidase (NA) protein, matrix 1 protein, or nonstructural 1 protein. Comparison of their protective efficacy between a single and prime-boost immunizations indicated that prime immunization of 1-day-old SPF chicks with our vaccine viruses followed by boosting with the conventional NDV vector strain LaSota expressing the HA protein provided complete protection of chickens against mortality, clinical signs and virus shedding. Further verification of our heterologous prime-boost immunization using commercial broiler chickens suggested that a sequential immunization of chickens with chimeric NDV vector expressing the HA and NA proteins following the boost with NDV vector expressing the HA protein can be a promising strategy for the field vaccination against HPAIVs and against highly virulent NDVs. Copyright © 2017 Elsevier Ltd. All rights reserved.

Desain dan Implementsi Soft Switching Boost Konverter dengan Simple Auxillary Resonant Switch (Sarc)

OpenAIRE

Saputra, Dimas Bagus; Suryoatmojo, Heri; Musthofa, Arif

2016-01-01

Boost konverter merupakan penaik tegangan DC ke tegangan DC yang mempunyai tegangan output yang lebih tinggi dibanding inputnya. Penggunaan boost konverter diera modern semakin meningkat dan dibuat dengan dimensi yang lebih kecil, berat yang lebih ringan dan efisiensi yang lebih tinggi dibanding dengan boost konverter generasi terdahulu. Tetapi rugi-rugi periodik saat on/off meningkat. Untuk meraih kriteria tersebut, teknik hard switching boost konverter berevolusi menjadi teknik soft switchi...

Modeling and Simulation of Buck-Boost Converter with Voltage Feedback Control

Directory of Open Access Journals (Sweden)

Zhou Xuelian

2015-01-01

Full Text Available In order to design the control system, it is necessary to have an exact model of buck-boost converter. This paper put forward the transfer function model of buck-boost converter by the state-space average method. The open-loop transfer function model of uncompensated system is deduced according to the mathematic model of the buck-boost converter, the controller is designed according to frequency domain. The phase and magnitude margin of the open-loop system of the buck-boost converter with compensator have both been increased. After compensating, this control system has the advantages of small overshoot and short settling time. It can also improve control system’s real time property and anti-interference ability.

Cytological and Pathological Correlation of FNAC in Assessing Breast Lumps and Axillary Lymph Node Swellings in a Public Sector Hospital in India

Directory of Open Access Journals (Sweden)

Vasu Reddy Challa

2013-01-01

Full Text Available Background. Breast lumps have varied pathology, and there are different techniques to prove the diagnosis. The aim of the present study is to analyze the role of fine needle aspiration cytology (FNAC of the breast lesions at our center. Methods. We had retrospectively analysed 854 patients who underwent FNAC for primary breast lumps and 190 patients who underwent FNAC for an axillary lymph node in the year 2010. Results. Of 854 patients, histological correlation was available in 723 patients. The analysis was done for 812 patients as medical records were not available for 42 patients. FNAC was false negative in seven cases; 2 cases of phyllodes were reported as fibroadenoma, and 5 cases of carcinoma were diagnosed as atypical hyperplasia. The sensitivity, specificity, and false negative value of FNAC in diagnosing breast lumps were 99% (715/723, 100%, and 1%, respectively. Of 190 patients for whom FNAC was performed for axilla, 170 had proven to have axillary lymph node metastases, and the rest had reactive hyperplasia or inflammatory cells. Conclusions. FNAC is rapid, accurate, outpatient based, and less complicated procedure and helps in diagnosis of breast cancer, benign diseases, and axillary involvement in experienced hands with less chance of false results.

Impact on regional recurrence and survival of axillary surgery in women with node-negative primary breast cancer

DEFF Research Database (Denmark)

Axelsson, C K; Düring, M; Christiansen, P M

2009-01-01

-negative primary breast cancer treated solely by surgery. Median follow-up was 9 years. RESULTS: The number of lymph nodes removed correlated with a reduction in the rate of subsequent axillary recurrence (from 2.1 to 0.4 per cent; P = 0.037), local recurrence (from 7.4 to 3.8 per cent; P

Active pre-filters for dc/dc Boost regulators

Directory of Open Access Journals (Sweden)

Carlos Andrés Ramos-Paja

2014-05-01

Full Text Available This paper proposes an active pre-filter to mitigate the current harmonics generated by classical dc/dc Boost regulators, which generate current ripples proportional to the duty cycle. Therefore, high output voltage conditions, i.e., high voltage conversion ratios, produce high current harmonics that must be filtered to avoid damage or source losses. Traditionally, these current components are filtered using electrolytic capacitors, which introduce reliability problems because of their high failure rate. The solution introduced in this paper instead uses a dc/dc converter based on the parallel connection of the Boost canonical cells to filter the current ripples generated by the Boost regulator, improving the system reliability. This solution provides the additional benefits of improving the overall efficiency and the voltage conversion ratio. Finally, the solution is validated with simulations and experimental results.

Comparison of three concomitant boost techniques for early-stage breast cancer

International Nuclear Information System (INIS)

Horton, Janet K.; Halle, Jan S.; Chang, Sha X.; Sartor, Carolyn I.

2006-01-01

Purpose: Whole breast radiotherapy (RT) followed by a tumor bed boost typically spans 5-6 weeks of treatment. Interest is growing in RT regimens, such as concomitant boost, that decrease overall treatment time, lessening the time/cost burden to patients and facilities. Methods and Materials: Computed tomography (CT) scans from 20 cases were selected for this retrospective, dosimetric study to compare three different techniques of concomitant boost delivery: (1) standard tangents plus an electron boost (2) intensity-modulated RT (IMRT) tangents using custom compensators plus an electron boost, and (3) IMRT tangents plus a conformal photon boost. The equivalent uniform dose model was used to compare the plans. Results: The average breast equivalent uniform dose value for the three techniques (standard, IMRT plus electrons, and IMRT plus photons) was 48.6, 47.9, and 48.3, respectively. The plans using IMRT more closely approximated the prescribed dose of 46 Gy to the whole breast. The breast volume receiving >110% of the dose was less with the IMRT tangents than with standard RT (p 0.037), but no significant difference in the maximal dose or other evaluated parameters was noted. Conclusion: Although the IMRT techniques delivered the prescribed dose with better dose uniformity, the small improvement seen did not support a goal of improved resource use

Short versus long-term postoperative drainage of the axilla after axillary lymph node dissection. A prospective randomized study

NARCIS (Netherlands)

Baas-Vrancken Peeters, Marie-Jeanne T. F. D.; Kluit, Ariane B.; Merkus, Jos W. S.; Breslau, Paul J.

2005-01-01

Background. Axillary lymph node dissection (ALND) is a standard procedure in the treatment of breast cancer. Current practice following ALND involves several days of drainage of the axilla to reduce the formation of seroma. The aim of this study is to investigate the feasibility of 24 h drainage.

Ultrasonographic measurement of the axillary recess thickness in an asymptomatic shoulder

Directory of Open Access Journals (Sweden)

Gi-Young Park

2017-04-01

Full Text Available Purpose The purpose of this study was to measure the axillary recess (AR thickness in an asymptomatic shoulder by using ultrasonography (US and to analyze the factors affecting it. Methods We recruited 141 patients (52 males; 89 females; age, 57.7±9.9 years with unilateral shoulder pain and performed US on the unaffected shoulder. Two physiatrists measured the AR thickness of the unaffected shoulder independently. All patients were examined in an upright sitting position with 90° shoulder abduction. The ultrasonographic transducer was placed longitudinally on the mid-axillary line and along the long axis of the humeral shaft. The factors affecting the AR thickness values were analyzed, and intra-class correlation coefficients were used for assessing the reproducibility of each measurement. Results The intrarater reliability values for the two physiatrists were 0.98 and 0.96, respectively. The inter-rater reliability of the mean AR thickness measurements was 0.91. The mean AR thickness in all subjects, males, and females was 2.8±0.6 mm, 3.1±0.6 mm, and 2.6±0.5 mm (P<0.01, respectively. No difference between the left and the right sides (males, P=0.086; females, P=0.535 or between the dominant and the non-dominant sides (males, P=0.173; female, P=0.244 was found. The AR thickness correlated positively with the height (r=0.313, P<0.01 and the weight (r=0.319, P<0.01. However, it did not correlate with the body mass index (r=0.152, P=0.077 or the age (r=-0.056, P=0.515. Conclusion US measurements of the AR thickness in asymptomatic shoulders demonstrated excellent intrarater and inter-rater reliabilities. The AR thickness showed anatomical variation with sex, height, and weight.

Ultrasonographic measurement of the axillary recess thickness in an asymptomatic shoulder

Energy Technology Data Exchange (ETDEWEB)

Park, Gi Young; Lee, Jin Hoon; Kwon, Dae Gil [Dept. of Rehabilitation Medicine, Catholic University of Daegu School of Medicine, Daegu (Korea, Republic of)

2017-04-15

The purpose of this study was to measure the axillary recess (AR) thickness in an asymptomatic shoulder by using ultrasonography (US) and to analyze the factors affecting it. We recruited 141 patients (52 males; 89 females; age, 57.7±9.9 years) with unilateral shoulder pain and performed US on the unaffected shoulder. Two physiatrists measured the AR thickness of the unaffected shoulder independently. All patients were examined in an upright sitting position with 90° shoulder abduction. The ultrasonographic transducer was placed longitudinally on the mid-axillary line and along the long axis of the humeral shaft. The factors affecting the AR thickness values were analyzed, and intra-class correlation coefficients were used for assessing the reproducibility of each measurement. The intrarater reliability values for the two physiatrists were 0.98 and 0.96, respectively. The inter-rater reliability of the mean AR thickness measurements was 0.91. The mean AR thickness in all subjects, males, and females was 2.8±0.6 mm, 3.1±0.6 mm, and 2.6±0.5 mm (P<0.01), respectively. No difference between the left and the right sides (males, P=0.086; females, P=0.535) or between the dominant and the non-dominant sides (males, P=0.173; female, P=0.244) was found. The AR thickness correlated positively with the height (r=0.313, P<0.01) and the weight (r=0.319, P<0.01). However, it did not correlate with the body mass index (r=0.152, P=0.077) or the age (r=-0.056, P=0.515). US measurements of the AR thickness in asymptomatic shoulders demonstrated excellent intrarater and inter-rater reliabilities. The AR thickness showed anatomical variation with sex, height, and weight.

Strain elastography of abnormal axillary nodes in breast cancer patients does not improve diagnostic accuracy compared with conventional ultrasound alone.

Science.gov (United States)

Park, Young Mi; Fornage, Bruno D; Benveniste, Ana Paula; Fox, Patricia S; Bassett, Roland L; Yang, Wei Tse

2014-12-01

The purpose of this study was to determine the diagnostic value of strain elastography (SE) alone and in combination with gray-scale ultrasound in the diagnosis of benign versus metastatic disease for abnormal axillary lymph nodes in breast cancer patients. Patients with breast cancer and axillary lymph nodes suspicious for metastatic disease on conventional ultrasound who underwent SE of the suspicious node before ultrasound-guided fine-needle aspiration biopsy (FNAB) were included in this study. On conventional ultrasound, the long- and short-axis diameters, long-axis-to-short-axis ratio, cortical echogenicity, thickness, and evenness were documented. The nodal vascularity was assessed on power Doppler imaging. Elastograms were evaluated for the percentage of black (hard) areas in the lymph node, and the SE-ultrasound size ratio was calculated. Two readers assessed the images independently and then in consensus in cases of disagreement. ROC AUCs were calculated for conventional ultrasound, SE, and both methods combined. Interreader reliability was assessed using kappa statistics. A total of 101 patients with 104 nodes were examined; 35 nodes were benign, and 69 had metastases. SE alone showed a significantly lower AUC (62%) than did conventional ultrasound (92%) (pultrasound and the AUC of the combination of conventional ultrasound and SE (93%) (p=0.16). Interreader reliability was moderate for all variables (κ≥0.60) except the SE-ultrasound size ratio (κ=0.35). Added SE does not improve the diagnostic ability of conventional ultrasound when evaluating abnormal axillary lymph nodes.

Using quantitative image analysis to classify axillary lymph nodes on breast MRI: A new application for the Z 0011 Era

Energy Technology Data Exchange (ETDEWEB)

Schacht, David V., E-mail: dschacht@radiology.bsd.uchicago.edu; Drukker, Karen, E-mail: kdrukker@uchicago.edu; Pak, Iris, E-mail: irisgpak@gmail.com; Abe, Hiroyuki, E-mail: habe@radiology.bsd.uchicago.edu; Giger, Maryellen L., E-mail: m-giger@uchicago.edu

2015-03-15

Highlights: •Quantitative image analysis showed promise in evaluating axillary lymph nodes. •13 of 28 features performed better than guessing at metastatic status. •When all features were used in together, a considerably higher AUC was obtained. -- Abstract: Purpose: To assess the performance of computer extracted feature analysis of dynamic contrast enhanced (DCE) magnetic resonance images (MRI) of axillary lymph nodes. To determine which quantitative features best predict nodal metastasis. Methods: This institutional board-approved HIPAA compliant study, in which informed patient consent was waived, collected enhanced T1 images of the axilla from patients with breast cancer. Lesion segmentation and feature analysis were performed on 192 nodes using a laboratory-developed quantitative image analysis (QIA) workstation. The importance of 28 features were assessed. Classification used the features as input to a neural net classifier in a leave-one-case-out cross-validation and evaluated with receiver operating characteristic (ROC) analysis. Results: The area under the ROC curve (AUC) values for features in the task of distinguishing between positive and negative nodes ranged from just over 0.50 to 0.70. Five features yielded AUCs greater than 0.65: two morphological and three textural features. In cross-validation, the neural net classifier obtained an AUC of 0.88 (SE 0.03) for the task of distinguishing between positive and negative nodes. Conclusion: QIA of DCE MRI demonstrated promising performance in discriminating between positive and negative axillary nodes.

Minimal Subdermal Shaving by Means of Sclerotherapy Using Absolute Ethanol: A New Method for the Treatment of Axillary Osmidrosis

Directory of Open Access Journals (Sweden)

Hyung-Sup Shim

2013-07-01

Full Text Available BackgroundAxillary osmidrosis is characterized by unpleasant odors originating from the axillary apocrine glands, resulting in psychosocial stress. The main treatment modality is apocrine gland removal. Until now, of the various surgical techniques have sometimes caused serious complications. We describe herein the favorable outcomes of a new method for ablating apocrine glands by minimal subdermal shaving using sclerotherapy with absolute ethanol.MethodsA total of 12 patients underwent the procedure. The severity of osmidrosis was evaluated before surgery. Conventional subdermal shaving was performed on one side (control group and ablation by means of minimal subdermal shaving and absolute ethanol on the other side (study group. Postoperative outcomes were compared between the study and control groups.ResultsThe length of time to removal of the drain was 1 day shorter in the study group than in the control group. There were no serious complications, such as hematoma or seroma, in either group, but flap margin necrosis and flap desquamation occurred in the control group, and were successfully managed with conservative treatment. Six months after surgery, we and our patients were satisfied with the outcomes.ConclusionsSclerotherapy using absolute ethanol combined with minimal subdermal shaving may be useful for the treatment of axillary osmidrosis. It can reduce the incidence of seroma and hematoma and allow the skin flap to adhere to its recipient site. It can degrade and ablate the remaining apocrine glands and eliminate causative organisms. Furthermore, since this technique is relatively simple, it takes less time than the conventional method.

Minimal Subdermal Shaving by Means of Sclerotherapy Using Absolute Ethanol: A New Method for the Treatment of Axillary Osmidrosis

Directory of Open Access Journals (Sweden)

Hyung­Sup Shim

2013-07-01

Full Text Available Background Axillary osmidrosis is characterized by unpleasant odors originating from the axillary apocrine glands, resulting in psychosocial stress. The main treatment modality is apocrine gland removal. Until now, of the various surgical techniques have sometimes caused serious complications. We describe herein the favorable outcomes of a new method for ablating apocrine glands by minimal subdermal shaving using sclerotherapy with absolute ethanol.Methods A total of 12 patients underwent the procedure. The severity of osmidrosis was evaluated before surgery. Conventional subdermal shaving was performed on one side (control group and ablation by means of minimal subdermal shaving and absolute ethanol on the other side (study group. Postoperative outcomes were compared between the study and control groups.Results The length of time to removal of the drain was 1 day shorter in the study group than in the control group. There were no serious complications, such as hematoma or seroma, in either group, but flap margin necrosis and flap desquamation occurred in the control group, and were successfully managed with conservative treatment. Six months after surgery, we and our patients were satisfied with the outcomes.Conclusions Sclerotherapy using absolute ethanol combined with minimal subdermal shaving may be useful for the treatment of axillary osmidrosis. It can reduce the incidence of seroma and hematoma and allow the skin flap to adhere to its recipient site. It can degrade and ablate the remaining apocrine glands and eliminate causative organisms. Furthermore, since this technique is relatively simple, it takes less time than the conventional method.

THE PROGNOSIS SIGNIFICANCE OF CATHEPSIN-D EXPRESSION IN THE DIFFERENT LOCATIONS IN AXILLARY NODES NEGATIVE CARCINOMA

Institute of Scientific and Technical Information of China (English)

无

2001-01-01

Objective: The aim of this study was to investigate Cathepsin-D (Cath-D) expression in different location and its relationship with prognosis in the axillary lymph nodes negative (ANN) breast cancer patients. Methods: Cath-D expression in 192 cases of breast carcinoma were examined by immunohistochemistry. Depending on different parts of expression, three evaluating methods were used, compared and analysed. Results: The positive rate of Cath-D expression in ANN breast cancer with poor prognosis group and axillary nodes positive (ANP) group were significantly higher than that in ANN breast cancer with good prognosis group (x2=23.20, P0.05). Cath-D expression in stromal cells had no statistical difference among the three groups (x2=1.56, P>0.05). When the Cath-D expression in cancer and stromal cells were counted into the positive rate, it was near the same (u1=0.47, u2=1.41, P>0.05). Conclusion: These results suggest that Cath-D expression is one of the powerful prognostic markers in ANN breast cancer. It's a reliable, practical, and convenient method to observe and evaluate Cath-D expression in cancer cells.

Usefulness of dynamic MR mammography for diagnosis of axillary lymph node status in breast cancer patient

International Nuclear Information System (INIS)

Enya, Mayumi; Goto, Hiroo; Nandate, Yuka; Kiryu, Takuji; Kanematsu, Masayuki; Hoshi, Hiroaki

2000-01-01

A retrospective study was performed to evaluate whether dynamic MR imaging is useful for the diagnosis of axillary lymph node metastases from breast cancer. Thirty-five patients with breast cancer were scanned and 147 lymph nodes were detected and compared with pathological nodal status. The parameters were the long axis dimension, the short axis dimension, the long-to-short axis (L/S) ratio, the shape, the contrast enhancement ratio (CER), the CER of lymph node-to-primary tumor (L/P) ratio. All parameters had significant differences between metastatic and normal nodes and there was a positive correlation between the CER of primary breast tumors and metastatic nodes. Multivariate analysis identified three parameters: the shape, the CER (1st phase), the L/P ratio (1st phase). ROC analysis revealed the shape and CER are superior in diagnostic performance to L/P ratio. If the shape and CER (1st phase) 60% and above are employed as criteria, the sensitivity, the specificity, the accuracy and the positive and negative predictive value were 86.0%, 78.4%, 81.0%, 67.2% and 91.6%, respectively. This method gives us useful information about the evaluation of axillary lymph node status preoperatively. (author)

Fractionated stereotactic radiotherapy as a boost treatment for tumors in the head and neck region

International Nuclear Information System (INIS)

Uno, Takashi; Isobe, Kouichi; Ueno, Naoyuki; Ito, Hisao; Fukuda, Ataru; Sudo, Satoshi; Shirotori, Hiroaki; Kitahara, Isao; Fukushima, Takanori

2010-01-01

The objective of this retrospective study was to report initial results of CyberKnife stereotactic radiotherapy (SRT) boost for tumors in the head and neck area. Between March 2008 and August 2009, 10 patients were treated with SRT boost using CyberKnife system due mainly to unfavorable condition such as tumors in close proximity to serial organs or former radiotherapy fields. Treatment sites were the external auditory canal in two, the nasopharynx in one, the oropharynx in three, the nasal cavity in one, the maxillary sinus in two, and the oligometastatic cervical lymph node in one. All patients underwent preceding conventional radiotherapy of 40 to 60 Gy. Dose and fractionation scheme of the Cyberknife SRT boost was individualized, and prescribed dose ranged from 9 Gy to 16 Gy in 3 to 4 fractions. Among four patients for whom dose to the optic pathway was concerned, the maximum dose was only about 3 Gy for three patients whereas 9.6 Gy in the remaining one patient. The maximum dose for the mandible in one of three patients with oropharyngeal cancer was 19.7 Gy, whereas majority of the bone can be spared by using non-isocentric conformal beams. For a patient with nasopharyngeal cancer, the highest dose in the brain stem was 15 Gy. However, majority of the brain stem received less than 40% of the maximum dose. Although a small volume high dose area within the normal structure could be observed in several patients, results of the present study showed potential benefits of the CyberKnife SRT boost. (author)

Solid state light source driver establishing buck or boost operation

Science.gov (United States)

Palmer, Fred

2017-08-29

A solid state light source driver circuit that operates in either a buck convertor or a boost convertor configuration is provided. The driver circuit includes a controller, a boost switch circuit and a buck switch circuit, each coupled to the controller, and a feedback circuit, coupled to the light source. The feedback circuit provides feedback to the controller, representing a DC output of the driver circuit. The controller controls the boost switch circuit and the buck switch circuit in response to the feedback signal, to regulate current to the light source. The controller places the driver circuit in its boost converter configuration when the DC output is less than a rectified AC voltage coupled to the driver circuit at an input node. The controller places the driver circuit in its buck converter configuration when the DC output is greater than the rectified AC voltage at the input node.

ER, HER2, and TOP2A expression in primary tumor, synchronous axillary nodes, and asynchronous metastases in breast cancer

DEFF Research Database (Denmark)

Jensen, Jeanette Dupont; Knoop, Ann; Ewertz, Marianne

2011-01-01

with the primary tumors with respect to ER, HER2, and TOP2A. In the prospective tissue-collection study, 81 patients had biopsy from a suspected relapse. Additional archived paired material was included, leaving a total of 119 patients with paired primary tumor, synchronous axillary nodes (available in 52 patients......At recurrence of breast cancer, the therapeutic target is the metastases. However, it is current practice to base the choice of systemic treatment on the biomarker profile of the primary tumor. In the present study, confirmatory biopsies were obtained from suspected metastatic lesions and compared......) and asyncronous metastases available for analysis. ER, HER2, and TOP2A expression of primary tumors, axillary nodes and metastases were re-analysed and determined centrally by immunohistochemistry, chromogenic in situ hybridization, and fluorescence in situ hybridization. Of the 81 patients with a biopsy from...

Biomonitorization of cadmium, chromium, manganese, nickel and lead in whole blood, urine, axillary hair and saliva in an occupationally exposed population

Energy Technology Data Exchange (ETDEWEB)

Gil Fernando, E-mail: fgil@ugr.es [Department of Legal Medicine and Toxicology, University of Granada, School of Medicine (Spain); Hernandez, Antonio F. [Department of Legal Medicine and Toxicology, University of Granada, School of Medicine (Spain); Marquez, Claudia [Internal Resident in Occupational Medicine, School of Occupational Medicine of University of Granada (Spain); Femia, Pedro [Department of Statistics, University of Granada, School of Medicine (Spain); Olmedo, Pablo; Lopez-Guarnido, Olga; Pla, Antonio [Department of Legal Medicine and Toxicology, University of Granada, School of Medicine (Spain)

2011-02-15

Heavy metal contamination from occupational origin is a cause for concern because of its potential accumulation in the environment and in living organisms leading to long term toxic effects. This study was aimed to assess Cd, Cr, Mn, Ni and Pb levels in whole blood, urine, axillary hair and saliva from 178 individuals with occupational exposure to heavy metals. Levels of metal compounds were determined by atomic absorption spectrometry. We collected information on occupation, lifestyle habits and food intake by questionnaire. Multiple linear regression analyses for metal ion concentration in whole blood, urine, axillary hair and saliva were adjusted for age, gender, smoking and alcohol consumption, lifetime workplace exposure, residence area and food habits. Overall, blood and urine median concentrations found for the five metals analyzed do not exceed biological exposure indexes, so that they are very similar to a non-occupationally exposed population. Toxicokinetic differences may account for the lack of correlations found for metal levels in hair and saliva with those in blood or urine. For those heavy metals showing higher median levels in blood with respect to hair (Cd, Mn and Pb) indicating lesser hair incorporation from blood, the lifetime working experience was inversely correlated with their hair levels. The longer the lifetime working experience in industrial environments, the higher the Mn and Ni concentration in saliva. Axillary hair and saliva may be used as additional and/or alternative samples to blood or urine for biomonitoring hair Mn, and saliva Ni in subjects with occupational exposure. - Research Highlights: {yields} Metal levels in workers were similar to an occupationally non-exposed population. {yields} Metal levels in blood and urine were below recommended reference values. {yields} A lack of correlation was observed between metal levels in blood and saliva. {yields} Toxicokinetic differences may account for the lack of correlations observed

Axillary sentinel node identification in breast cancer patients: degree of radioactivity present at biopsy is critical

DEFF Research Database (Denmark)

Nielsen, Kristina R; Oturai, Peter S; Friis, Esbern

2011-01-01

The radioactivity present in the patient (Act(rem) ) at sentinel node (SN) biopsy will depend on injected activity amount as well as on the time interval from tracer injection to biopsy, which both show great variations in the literature. The purpose of this study was to analyse the influence...... of varying Act(rem) levels on the outcome of axillary SN biopsy in patients with breast cancer (BC)....

Natural working fluids for solar-boosted heat pumps

Energy Technology Data Exchange (ETDEWEB)

Chaichana, C.; Lu Aye [University of Melbourne, Victoria (Australia). International Technologies Centre, Department of Civil and Environmental Engineering; Charters, W.W.S. [University of Melbourne, Victoria (Australia). Department of Mechanical and Manufacturing Engineering

2003-09-01

The option of using natural working fluids as a substitute of R-22 for solar-boosted heat pumps depends not only upon thermal performance and hazardous rating but also on potential impacts on the environment. This paper presents the comparative assessment of natural working fluids with R-22 in terms of their characteristics and thermophysical properties, and thermal performance. Some justification is given for using natural working fluids in a solar boosted heat pump water heater. The results show that R-744 is not suitable for solar-boosted heat pumps because of its low critical temperature and high operational pressures. On the other hand, R-717 seems to be a more appropriate substitute in terms of operational parameters and overall performance. However, major changes in the heat pumps are required. R-290 and R-1270 are identified as candidates for direct drop-in substitutes for R-22. (author)

Side effects, complications and outcome of thoracoscopic sympathectomy for palmar and axillary hyperhidrosis in 406 patients.

Science.gov (United States)

Rodríguez, Pedro M; Freixinet, Jorge L; Hussein, Mohamed; Valencia, Jose M; Gil, Rita M; Herrero, Jorge; Caballero-Hidalgo, Araceli

2008-09-01

Thoracic sympathectomy (TS) is the treatment of choice for severe primary hyperhidrosis. However, complications, side effects and satisfaction have not been well defined. To analyze the complications, side effects, satisfaction degree and quality of life of patients after TS for primary upper limb hyperhidrosis. One-year follow-up after 406 consecutive TS for primary upper limb hyperhidrosis. Bilateral TS was completed in all patients. Complications arose in 23 cases (5.6%), with pneumothorax being the most frequent. The success rate after discharge, 6 and 12 months was respectively, 100%, 98.1% and 96.5% for palmo-axillary hyperhidrosis; 100%, 99.3% and 97.8% for isolated palmar hyperhidrosis and 100%, 85.7% and 71.4% for isolated axillary hyperhidrosis. No persistence of hyperhidrosis was observed. Global recurrence was 3.7% (28.5% axillary hyperhidrosis group). Compensatory sweating (CS) appeared in 55% and was not related to the extension of the TS. Being female was a predisposing factor of CS (p<0.004). Excessive dryness appeared at 9% and was associated with extensive TS (P<0.001). Plantar hyperhidrosis improved at 33.6%, worsened at 10% and remained stable during the follow-up. Satisfaction degree decreased with the passage of time and was associated with recurrence. Quality of life was excellent at discharge, 6 and 12 month in 100%, 100% and 97%, respectively. Pneumothorax is the most frequent complication of TS. CS is the main and undesirable side effect, appears with the passage of time, and is not related to the extension of TS. Being female is the only predictor factor of suffering CS. Plantar hyperhidrosis improves initially, although tends to reappear. Excessive dryness appears in extensive TS and does not improve over time. Postoperative satisfaction degree is high but decreases over time owing to the appearance of recurrence. Effectiveness and the absence of CS determine an excellent quality of life. Six percent of the patients regret the surgery

The gradient boosting algorithm and random boosting for genome-assisted evaluation in large data sets.

Science.gov (United States)

González-Recio, O; Jiménez-Montero, J A; Alenda, R

2013-01-01

In the next few years, with the advent of high-density single nucleotide polymorphism (SNP) arrays and genome sequencing, genomic evaluation methods will need to deal with a large number of genetic variants and an increasing sample size. The boosting algorithm is a machine-learning technique that may alleviate the drawbacks of dealing with such large data sets. This algorithm combines different predictors in a sequential manner with some shrinkage on them; each predictor is applied consecutively to the residuals from the committee formed by the previous ones to form a final prediction based on a subset of covariates. Here, a detailed description is provided and examples using a toy data set are included. A modification of the algorithm called "random boosting" was proposed to increase predictive ability and decrease computation time of genome-assisted evaluation in large data sets. Random boosting uses a random selection of markers to add a subsequent weak learner to the predictive model. These modifications were applied to a real data set composed of 1,797 bulls genotyped for 39,714 SNP. Deregressed proofs of 4 yield traits and 1 type trait from January 2009 routine evaluations were used as dependent variables. A 2-fold cross-validation scenario was implemented. Sires born before 2005 were used as a training sample (1,576 and 1,562 for production and type traits, respectively), whereas younger sires were used as a testing sample to evaluate predictive ability of the algorithm on yet-to-be-observed phenotypes. Comparison with the original algorithm was provided. The predictive ability of the algorithm was measured as Pearson correlations between observed and predicted responses. Further, estimated bias was computed as the average difference between observed and predicted phenotypes. The results showed that the modification of the original boosting algorithm could be run in 1% of the time used with the original algorithm and with negligible differences in accuracy

Intensity modulated radiotherapy with simultaneous integrated boost vs. conventional radiotherapy with sequential boost for breast cancer - A preliminary result.

Science.gov (United States)

Lee, Hsin-Hua; Hou, Ming-Feng; Chuang, Hung-Yi; Huang, Ming-Yii; Tsuei, Le-Ping; Chen, Fang-Ming; Ou-Yang, Fu; Huang, Chih-Jen

2015-10-01

This study was aimed to assess the acute dermatological adverse effect from two distinct RT techniques for breast cancer patients. We compared intensity-modulated radiotherapy with simultaneous integrated boost (IMRT-SIB) and conventional radiotherapy followed by sequential boost (CRT-SB). The study population was composed of 126 consecutive female breast cancer patients treated with breast conserving surgery. Sixty-six patients received IMRT-SIB to 2 dose levels simultaneously. They received 50.4 Gy at 1.8 Gy per fraction to the whole breast and 60.2 Gy at 2.15 Gy per fraction to the tumor bed by integral boost. Sixty patients in the CRT-SB group received 50 Gy in 25 fractions to the whole breast followed by a boost irradiation to tumor bed in 5-7 fractions to a total dose of 60-64 Gy. Acute skin toxicities were documented in agreement with the Common Terminology Criteria for Adverse Events version 3 (CTCAE v.3.0). Ninety-eight patients had grade 1 radiation dermatitis while 14 patients had grade 2. Among those with grade 2, there were 3 patients in IMRT-SIB group (4.5%) while 11 in CRT-SB group (18.3%). (P = 0.048) There was no patient with higher than grade 2 toxicity. Three year local control was 99.2%, 3-year disease free survival was 97.5% and 3-year overall survival was 99.2%. A significant reduction in the severity of acute radiation dermatitis from IMRT-SIB comparing with CRT-SB is demonstrated. Copyright © 2015 Elsevier Ltd. All rights reserved.

Boosted dark matter signals uplifted with self-interaction

OpenAIRE

Kong, Kyoungchul; Mohlabeng, Gopolang; Park, Jong-Chul

2018-01-01

We explore detection prospects of a non-standard dark sector in the context of boosted dark matter. We focus on a scenario with two dark matter particles of a large mass difference, where the heavier candidate is secluded and interacts with the standard model particles only at loops, escaping existing direct and indirect detection bounds. Yet its pair annihilation in the galactic center or in the Sun may produce boosted stable particles, which could be detected as visible Cherenkov light in l...

Searches with Boosted Objects at ATLAS and CMS

CERN Document Server

Behr, K; The ATLAS collaboration

2014-01-01

This talk presents an overview of searches for new physics in boosted final states conducted by the ATLAS and CMS experiments during Run-I of the LHC. An emphasis is put on techniques for the reconstruction and identification of both hadronic and leptonic decays of objects with large transverse momenta: Various substructure and grooming techniques as well as modified lepton isolation criteria are reviewed and their use in the most common algorithms for boosted top and boson tagging is discussed.

Characterization of MORE AXILLARY GROWTH genes in Populus.

Directory of Open Access Journals (Sweden)

Olaf Czarnecki

Full Text Available Strigolactones are a new class of plant hormones that play a key role in regulating shoot branching. Studies of branching mutants in Arabidopsis, pea, rice and petunia have identified several key genes involved in strigolactone biosynthesis or signaling pathway. In the model plant Arabidopsis, MORE AXILLARY GROWTH1 (MAX1, MAX2, MAX3 and MAX4 are four founding members of strigolactone pathway genes. However, little is known about the strigolactone pathway genes in the woody perennial plants.Here we report the identification of MAX homologues in the woody model plant Populus trichocarpa. We identified the sequence homologues for each MAX protein in P. trichocarpa. Gene expression analysis revealed that Populus MAX paralogous genes are differentially expressed across various tissues and organs. Furthermore, we showed that Populus MAX genes could complement or partially complement the shoot branching phenotypes of the corresponding Arabidopsis max mutants.This study provides genetic evidence that strigolactone pathway genes are likely conserved in the woody perennial plants and lays a foundation for further characterization of strigolactone pathway and its functions in the woody perennial plants.

Boosted Jet Tagging with Jet-Images and Deep Neural Networks

International Nuclear Information System (INIS)

Kagan, Michael; Oliveira, Luke de; Mackey, Lester; Nachman, Benjamin; Schwartzman, Ariel

2016-01-01

Building on the jet-image based representation of high energy jets, we develop computer vision based techniques for jet tagging through the use of deep neural networks. Jet-images enabled the connection between jet substructure and tagging with the fields of computer vision and image processing. We show how applying such techniques using deep neural networks can improve the performance to identify highly boosted W bosons with respect to state-of-the-art substructure methods. In addition, we explore new ways to extract and visualize the discriminating features of different classes of jets, adding a new capability to understand the physics within jets and to design more powerful jet tagging methods

Impact of the Radiation Boost on Outcomes After Breast-Conserving Surgery and Radiation

International Nuclear Information System (INIS)

Murphy, Colin; Anderson, Penny R.; Li Tianyu; Bleicher, Richard J.; Sigurdson, Elin R.; Goldstein, Lori J.; Swaby, Ramona; Denlinger, Crystal; Dushkin, Holly; Nicolaou, Nicos; Freedman, Gary M.

2011-01-01

Purpose: We examined the impact of radiation tumor bed boost parameters in early-stage breast cancer on local control and cosmetic outcomes. Methods and Materials: A total of 3,186 women underwent postlumpectomy whole-breast radiation with a tumor bed boost for Tis to T2 breast cancer from 1970 to 2008. Boost parameters analyzed included size, energy, dose, and technique. Endpoints were local control, cosmesis, and fibrosis. The Kaplan-Meier method was used to estimate actuarial incidence, and a Cox proportional hazard model was used to determine independent predictors of outcomes on multivariate analysis (MVA). The median follow-up was 78 months (range, 1-305 months). Results: The crude cosmetic results were excellent in 54%, good in 41%, and fair/poor in 5% of patients. The 10-year estimate of an excellent cosmesis was 66%. On MVA, independent predictors for excellent cosmesis were use of electron boost, lower electron energy, adjuvant systemic therapy, and whole-breast IMRT. Fibrosis was reported in 8.4% of patients. The actuarial incidence of fibrosis was 11% at 5 years and 17% at 10 years. On MVA, independent predictors of fibrosis were larger cup size and higher boost energy. The 10-year actuarial local failure was 6.3%. There was no significant difference in local control by boost method, cut-out size, dose, or energy. Conclusions: Likelihood of excellent cosmesis or fibrosis are associated with boost technique, electron energy, and cup size. However, because of high local control and rare incidence of fair/poor cosmesis with a boost, the anatomy of the patient and tumor cavity should ultimately determine the necessary boost parameters.

Boosting instance prototypes to detect local dermoscopic features.

Science.gov (United States)

Situ, Ning; Yuan, Xiaojing; Zouridakis, George

2010-01-01

Local dermoscopic features are useful in many dermoscopic criteria for skin cancer detection. We address the problem of detecting local dermoscopic features from epiluminescence (ELM) microscopy skin lesion images. We formulate the recognition of local dermoscopic features as a multi-instance learning (MIL) problem. We employ the method of diverse density (DD) and evidence confidence (EC) function to convert MIL to a single-instance learning (SIL) problem. We apply Adaboost to improve the classification performance with support vector machines (SVMs) as the base classifier. We also propose to boost the selection of instance prototypes through changing the data weights in the DD function. We validate the methods on detecting ten local dermoscopic features from a dataset with 360 images. We compare the performance of the MIL approach, its boosting version, and a baseline method without using MIL. Our results show that boosting can provide performance improvement compared to the other two methods.

StentBoost Visualization for the Evaluation of Coronary Stent Expansion During Percutaneous Coronary Interventions

OpenAIRE

Cura, Fernando; Albertal, Mariano; Candiello, Alfonsina; Nau, Gerardo; Bonvini, Victor; Tricherri, Hernan; Padilla, Lucio T.; Belardi, Jorge A.

2013-01-01

Introduction Inadequate stent implantation is associated with stent thrombosis and restenosis. StentBoost can enhance stent visualization and evaluate stent expansion. Currently, there are limited comparison studies between StentBoost and intravascular ultrasound (IVUS). We aimed to test the correlation and agreement between IVUS and StentBoost measurements. Methods From December 2010 to December 2011, 38 patients (54 stents) were analyzed using IVUS and StentBoost. Minimal stent diameter and...

Intensity-Modulated Radiotherapy With Use of Cone-Down Boost for Pediatric Head-and-Neck Rhabdomyosarcoma

International Nuclear Information System (INIS)

McDonald, Mark W.; Esiashvili, Natia; George, Bradley A.; Katzenstein, Howard M.; Olson, Thomas A.; Rapkin, Louis B.; Marcus, Robert B.

2008-01-01

Purpose: To report our initial experience using intensity-modulated radiotherapy (IMRT) with a cone-down boost for pediatric head-and-neck rhabdomyosarcoma (RMS). Methods and Materials: A review of institutional treatment records identified children treated with IMRT for head-and-neck RMS between January 2000 and February 2007. All patients had undergone chemotherapy according to cooperative group RMS protocols. The initial planning target volume (PTV) covered the prechemotherapy tumor extent with variable margins, generally 1-2 cm. The boost PTV covered the postchemotherapy tumor volume, usually with a margin of 0.5-1 cm. Results: A total of 20 patients were treated with IMRT for head-and-neck RMS. Of these 20 patients, 4 had Group II, 15 Group III, and 1 Group IV disease. The site was parameningeal in 12, nonparameningeal in 6, and orbit primary in 2. Of the 20 patients, 14 were treated with a cone-down boost after a median dose of 36 Gy (range, 30-45.6). The mean initial PTV was 213.5 cm 3 , and the mean boost PTV was 76.9 cm 3 . Patients received a median total dose of 50.4 Gy. The median follow-up time was 29 months. The 3-year Kaplan-Meier local control rate was 100%, although 1 patient developed an in-field recurrence 50 months after IMRT. The 3-year event-free survival rate, overall survival rate, and risk of central nervous system failure was 74%, 76%, and 7%, respectively. Conclusions: Our preliminary follow-up of pediatric head-and-neck RMS patients treated with IMRT revealed excellent local control. The initial targeting of the prechemotherapy tumor volume with 1-2-cm margin to 30.6 or 36 Gy followed by a cone-down boost to the postchemotherapy tumor volume with a 0.5-1-cm margin allowed for significant sparing of normal tissues and provided good local control

Multiclass Boosting with Adaptive Group-Based kNN and Its Application in Text Categorization

Directory of Open Access Journals (Sweden)

Lei La

2012-01-01

Full Text Available AdaBoost is an excellent committee-based tool for classification. However, its effectiveness and efficiency in multiclass categorization face the challenges from methods based on support vector machine (SVM, neural networks (NN, naïve Bayes, and k-nearest neighbor (kNN. This paper uses a novel multi-class AdaBoost algorithm to avoid reducing the multi-class classification problem to multiple two-class classification problems. This novel method is more effective. In addition, it keeps the accuracy advantage of existing AdaBoost. An adaptive group-based kNN method is proposed in this paper to build more accurate weak classifiers and in this way control the number of basis classifiers in an acceptable range. To further enhance the performance, weak classifiers are combined into a strong classifier through a double iterative weighted way and construct an adaptive group-based kNN boosting algorithm (AGkNN-AdaBoost. We implement AGkNN-AdaBoost in a Chinese text categorization system. Experimental results showed that the classification algorithm proposed in this paper has better performance both in precision and recall than many other text categorization methods including traditional AdaBoost. In addition, the processing speed is significantly enhanced than original AdaBoost and many other classic categorization algorithms.

Is there a requirement for axillary lymph node dissection following identification of micro-metastasis or isolated tumour cells at sentinel node biopsy for breast cancer?

LENUS (Irish Health Repository)

Joyce, D P

2012-02-29

INTRODUCTION: Recent decades have seen a significant shift towards conservative management of the axilla. Increasingly, immunohistochemical analysis of sentinel nodes leads to the detection of small tumour deposits, the significance of which remains uncertain. The aims of this study are to examine patients whose sentinel lymph nodes are positive for macro-metastasis, micro-metastasis or isolated tumour cells (ITCs) and to determine the rate of further nodal disease after axillary lymph node dissection (ALND). METHODS: A retrospective analysis of all patients undergoing a sentinel lymph node biopsy (SLNB) between January 2007 and December 2010 in a tertiary referral breast unit was performed. Patients who underwent an axillary lymph node dissection for macro-metastasis, micro-metastasis or ITCs were identified. Demographics, histological data and the rate of further axillary disease were examined. RESULTS: In total, 664 breast cancer patients attended the symptomatic breast unit during the study period, 360 of whom underwent a SLNB. Seventy patients had a SLNB positive for macro-metastasis. All of these patients underwent ALND. A positive SLNB with either micro-metastasis or ITCs was identified in 58 patients. Only 41 of the 58 patients went on to have an ALND, due primarily to variations in surgeons\\' preferences. Nineteen patients with micro-metastasis underwent an ALND. Four patients had further axillary disease (21%). Twenty-two patients had ITCs identified, of whom only one had further disease (4.5%). No statistically significant difference was found between the two groups in terms of tumour size, grade, lymphovascular invasion or oestrogen receptor status. CONCLUSION: ALND should be considered in patients with micro-metastasis at SLNB. It should rarely be employed in the setting of SLNB positive for ITCs.

A Reconfigurable Buck, Boost, and Buck-Boost Converter: Unified Model and Robust Controller

Directory of Open Access Journals (Sweden)

Martín Antonio Rodríguez Licea

2018-01-01

Full Text Available The need for reconfigurable, high power density, and low-cost configurations of DC-DC power electronic converters (PEC in areas such as the transport electrification and the use of renewable energy has spread out the requirement to incorporate in a single circuit several topologies, which generally result in an increment of complexity about the modeling, control, and stability analyses. In this paper, a reconfigurable topology is presented which can be applied in alterative/changing power conversion scenarios and consists of a reconfigurable Buck, Boost, and Buck-Boost DC-DC converter (RBBC. A unified averaged model of the RBBC is obtained, a robust controller is designed through a polytopic representation, and a Lyapunov based switched stability analysis of the closed-loop system is presented. The reported RBBC provides a wide range of voltage operation, theoretically from -∞ to ∞ volts with a single power source. Robust stability, even under arbitrarily fast (bounded parameter variations and reconfiguration changes, is reported including numerical and experimental results. The main advantages of the converter and the robust controller proposed are simple design, robustness against abrupt changes in the parameters, and low cost.

Evaluating the Effects of Aluminum-Containing and Non-Aluminum Containing Deodorants on Axillary Skin Toxicity During Radiation Therapy for Breast Cancer: A 3-Armed Randomized Controlled Trial

Energy Technology Data Exchange (ETDEWEB)

Lewis, Lucy, E-mail: Lucy.lewis@curtin.edu.au [Centre for Nursing Research, Sir Charles Gairdner Hospital, Nedlands, Western Australia (Australia); School of Nursing and Midwifery Curtin University, Perth (Australia); Carson, Sharron [Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia (Australia); Bydder, Sean [Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia (Australia); School of Surgery, The University of Western Australia, Crawley, Western Australia (Australia); Athifa, Mariyam [School of Nursing and Midwifery Curtin University, Perth (Australia); Williams, Anne M. [School of Nursing and Midwifery Curtin University, Perth (Australia); School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia (Australia); Bremner, Alexandra [School of Population Health, The University of Western Australia, Crawley, Western Australia (Australia)

2014-11-15

Purpose: Deodorant use during radiation therapy for breast cancer has been controversial as there are concerns deodorant use may exacerbate axillary skin toxicity. The present study prospectively determined the use of both aluminum-containing and non aluminum containing deodorants on axillary skin toxicity during conventionally fractionated postoperative radiation therapy for breast cancer. Methods and Materials: This 3-arm randomized controlled study was conducted at a single center, tertiary cancer hospital between March 2011 and April 2013. Participants were randomized to 1 of 2 experimental groups (aluminum-containing deodorant and soap or non–aluminum containing deodorant and soap) or a control group (soap). A total of 333 participants were randomized. Generalized estimating equations were used to estimate and compare the odds of experiencing high levels of sweating and skin toxicity in each of the deodorant groups to the odds in the control group. The study evaluated a range of endpoints including objective measurements of axilla sweating, skin toxicity, pain, itch and burning. Quality of life was assessed with a validated questionnaire. Results: Radiation characteristics were similar across all groups. Patients in the deodorant groups did not report significantly different ratings for axillary pain, itch, or burning compared with the control group. Patients in the aluminum-containing deodorant group experienced significantly less sweating than the control; the odds of their sweating being barely tolerable and frequently or always interfering with their daily activities was decreased by 85% (odds ratio, 0.15; 95% confidence interval, 0.03-0.91). Conclusions: We found no evidence that the use of either aluminum-containing or non–aluminum containing deodorant adversely effects axillary skin reaction during conventionally fractionated radiation therapy for breast cancer. Our analysis also suggests patients in the aluminum-containing deodorant arm had

Evaluating the Effects of Aluminum-Containing and Non-Aluminum Containing Deodorants on Axillary Skin Toxicity During Radiation Therapy for Breast Cancer: A 3-Armed Randomized Controlled Trial

International Nuclear Information System (INIS)

Lewis, Lucy; Carson, Sharron; Bydder, Sean; Athifa, Mariyam; Williams, Anne M.; Bremner, Alexandra

2014-01-01

Purpose: Deodorant use during radiation therapy for breast cancer has been controversial as there are concerns deodorant use may exacerbate axillary skin toxicity. The present study prospectively determined the use of both aluminum-containing and non aluminum containing deodorants on axillary skin toxicity during conventionally fractionated postoperative radiation therapy for breast cancer. Methods and Materials: This 3-arm randomized controlled study was conducted at a single center, tertiary cancer hospital between March 2011 and April 2013. Participants were randomized to 1 of 2 experimental groups (aluminum-containing deodorant and soap or non–aluminum containing deodorant and soap) or a control group (soap). A total of 333 participants were randomized. Generalized estimating equations were used to estimate and compare the odds of experiencing high levels of sweating and skin toxicity in each of the deodorant groups to the odds in the control group. The study evaluated a range of endpoints including objective measurements of axilla sweating, skin toxicity, pain, itch and burning. Quality of life was assessed with a validated questionnaire. Results: Radiation characteristics were similar across all groups. Patients in the deodorant groups did not report significantly different ratings for axillary pain, itch, or burning compared with the control group. Patients in the aluminum-containing deodorant group experienced significantly less sweating than the control; the odds of their sweating being barely tolerable and frequently or always interfering with their daily activities was decreased by 85% (odds ratio, 0.15; 95% confidence interval, 0.03-0.91). Conclusions: We found no evidence that the use of either aluminum-containing or non–aluminum containing deodorant adversely effects axillary skin reaction during conventionally fractionated radiation therapy for breast cancer. Our analysis also suggests patients in the aluminum-containing deodorant arm had

Does the Addition of Tramadol and Ketamine to Ropivacaine Prolong the Axillary Brachial Plexus Block?

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Ahmet Can Senel

2014-01-01

Full Text Available Background and Objectives. A prospective, randomized, controlled, double-blind clinical trial to assess the effect of tramadol and ketamine, 50 mg, added to ropivacaine in brachial plexus anesthesia. Methods. Thirty-six ASA physical statuses I and II patients, between 18 and 60 years of age, scheduled for forearm and hand surgery under axillary brachial plexus block, were allocated to 3 groups. Group R received 0.375% ropivacaine in 40 mL, group RT received 0.375% ropivacaine in 40 mL with 50 mg tramadol, and group RK received 0.375% ropivacaine in 40 mL with 50 mg ketamine for axillary brachial plexus block. The onset times and the duration of sensory and motor blocks, duration of analgesia, hemodynamic parameters, and adverse events (nausea, vomiting, and feeling uncomfortable were recorded. Results. The onset time of sensorial block was the fastest in ropivacaine + tramadol group. Duration of sensorial and motor block was the shortest in the ropivacaine + tramadol group. Duration of analgesia was significantly longer in ropivacaine + tramadol group. Conclusion. We conclude that when added to brachial plexus analgesia at a dose of 50 mg, tramadol extends the onset and duration time of the block and improves the quality of postoperative analgesia without any side effects.

Axillary silicone lymphadenopathy presenting with a lump and altered sensation in the breast: a case report

Directory of Open Access Journals (Sweden)

Adams Simon T

2009-03-01

Full Text Available Abstract Introduction Silicone lymphadenopathy is a rare but recognised complication of procedures involving the use of silicone. It has a poorly understood mechanism but is thought to occur following the transportation of silicone particles from silicone-containing prostheses to lymph nodes by macrophages. Case presentation We report of a case involving a 35-year-old woman who presented to the breast clinic with a breast lump and altered sensation below her left nipple 5 years after bilateral cosmetic breast augmentations. A small lump was detected inferior to the nipple but clinical examination and initial ultrasound investigation showed both implants to be intact. However, mammography and magnetic resonance imaging of both breasts revealed both intracapsular and extracapsular rupture of the left breast prosthesis. The patient went on to develop a flu-like illness and tender lumps in the left axilla and right mastoid regions. An excision biopsy of the left axillary lesion and replacement of the ruptured implant was performed. Subsequent histological analysis showed that the axillary lump was a lymph node containing large amounts of silicone. Conclusion The exclusion of malignancy remains the priority when dealing with lumps in the breast or axilla. Silicone lymphadenopathy should however be considered as a differential diagnosis in patients in whom silicone prostheses are present.

Axillary lymph node core biopsy for breast cancer metastases — How many needle passes are enough?

International Nuclear Information System (INIS)

Macaskill, E.J.; Purdie, C.A.; Jordan, L.B.; Mclean, D.; Whelehan, P.; Brown, D.C.; Evans, A.

2012-01-01

Aim: To determine the diagnostic yield of each of three core passes when sampling abnormal lymph nodes in patients presenting with breast cancer. Materials and methods: All patients suspected of having breast cancer had axillary ultrasound as part of initial assessment. Radiologically abnormal nodes (cortical thickness >2.3 mm or round shape) were biopsied with three passes of a 22 mm throw 14 G core biopsy needle and sent for histopathology in separate numbered pots. Data were collected prospectively, and analysis performed on the data of 55 consecutive patients who had positive nodes on at least one core biopsy needle pass. Results: Of 55 patients with a positive node on core biopsy, tumour was noted in all three cores taken in 39 (70.9%). Lymph node metastasis was detected in 45 (81.8%) first core biopsies. With the first two cores taken, positive results were detected in 53 of 55 cases (96.4%). In both cases where tumour was only found on a third core biopsy pass, no lymph node tissue was present in the first two biopsy passes. Conclusion: Two well-directed 14 G core biopsy samples from an abnormal axillary node are adequate for diagnosis of breast cancer metastasis.

FDG uptake in axillary lymph nodes after vaccination against pandemic (H1N1)

International Nuclear Information System (INIS)

Panagiotidis, Emmanouil; Exarhos, Demetrios; Housianakou, Irene; Bournazos, Apostolos; Datseris, Ioannis

2010-01-01

To alert the imaging community to potential false positive findings related to current immunization programmes against H1N1 influenza virus. We reviewed 10 patients referred for positron emission tomography/computed tomography (PET/CT) who had undergone recent vaccination. All studies showed 18 F-fluorodeoxyglucose (FDG) uptake in the draining axillary lymph nodes close to the vaccination site, while low-dose CT revealed lymph nodes ranged between 0.5 cm and 1.2 cm at the same site. This potential pitfall in PET/CT should be borne in mind during current vaccination programmes. (orig.)

SU-F-T-208: An Efficient Planning Approach to Posterior Fossa Tumor Bed Boosts Using Proton Pencil Beam Scanning in Fixed-Beam Room

International Nuclear Information System (INIS)

Ju, N; Chen, C; Gans, S; Hug, E; Cahlon, O; Chon, B; Tsai, H; Sine, K; Mah, D; Wolden, S; Yeh, B

2016-01-01

Purpose: A fixed-beam room could be underutilized in a multi-room proton center. We investigated the use of proton pencil beam scanning (PBS) on a fixed-beam as an alternative for posterior fossa tumor bed (PF-TB) boost treatments which were usually treating on a gantry with uniform scanning. Methods: Five patients were treated with craniospinal irradiation (CSI, 23.4 or 36.0 Gy(RBE)) followed by a PF-TB boost to 54 Gy(RBE) with proton beams. Three PF-TB boost plans were generated for each patient: (1) a uniform scanning (US) gantry plan with 4–7 posterior fields shaped with apertures and compensators (2) a PBS plan using bi-lateral and vertex fields with a 3-mm planning organ-at-risk volume (PRV) expansion around the brainstem and (3) PBS fields using same beam arrangement but replacing the PRV with robust optimization considering a 3-mm setup uncertainty. Results: A concave 54-Gy(RBE) isodose line surrounding the brainstem could be achieved using all three techniques. The mean V95% of the PTV was 99.7% (range: 97.6% to 100%) while the V100% of the PTV ranged from 56.3% to 93.1% depending on the involvement of the brainstem with the PTV. The mean doses received by 0.05 cm"3 of the brainstem were effectively identical: 54.0 Gy(RBE), 53.4 Gy(RBE) and 53.3 Gy(RBE) for US, PBS optimized with PRV, and PBS optimized with robustness plans respectively. The cochlea mean dose increased by 23% of the prescribed boost dose in average from the bi-lateral fields used in the PBS plan. Planning time for the PBS plan with PRV was 5–10 times less than the US plan and the robustly optimized PBS plan. Conclusion: We have demonstrated that a fixed-beam with PBS can deliver a dose distribution comparable to a gantry plan using uniform scanning. Planning time can be reduced substantially using a PRV around the brainstem instead of robust optimization.

SU-F-T-208: An Efficient Planning Approach to Posterior Fossa Tumor Bed Boosts Using Proton Pencil Beam Scanning in Fixed-Beam Room

Energy Technology Data Exchange (ETDEWEB)

Ju, N; Chen, C; Gans, S; Hug, E; Cahlon, O; Chon, B; Tsai, H; Sine, K; Mah, D [Procure Treatment Center, Somerset, New Jersey (United States); Wolden, S [Memorial Sloan Kettering Cancer Center, New York, NY (United States); Yeh, B [Mount Sinai Hospital, New York, NY (United States)

2016-06-15

Purpose: A fixed-beam room could be underutilized in a multi-room proton center. We investigated the use of proton pencil beam scanning (PBS) on a fixed-beam as an alternative for posterior fossa tumor bed (PF-TB) boost treatments which were usually treating on a gantry with uniform scanning. Methods: Five patients were treated with craniospinal irradiation (CSI, 23.4 or 36.0 Gy(RBE)) followed by a PF-TB boost to 54 Gy(RBE) with proton beams. Three PF-TB boost plans were generated for each patient: (1) a uniform scanning (US) gantry plan with 4–7 posterior fields shaped with apertures and compensators (2) a PBS plan using bi-lateral and vertex fields with a 3-mm planning organ-at-risk volume (PRV) expansion around the brainstem and (3) PBS fields using same beam arrangement but replacing the PRV with robust optimization considering a 3-mm setup uncertainty. Results: A concave 54-Gy(RBE) isodose line surrounding the brainstem could be achieved using all three techniques. The mean V95% of the PTV was 99.7% (range: 97.6% to 100%) while the V100% of the PTV ranged from 56.3% to 93.1% depending on the involvement of the brainstem with the PTV. The mean doses received by 0.05 cm{sup 3} of the brainstem were effectively identical: 54.0 Gy(RBE), 53.4 Gy(RBE) and 53.3 Gy(RBE) for US, PBS optimized with PRV, and PBS optimized with robustness plans respectively. The cochlea mean dose increased by 23% of the prescribed boost dose in average from the bi-lateral fields used in the PBS plan. Planning time for the PBS plan with PRV was 5–10 times less than the US plan and the robustly optimized PBS plan. Conclusion: We have demonstrated that a fixed-beam with PBS can deliver a dose distribution comparable to a gantry plan using uniform scanning. Planning time can be reduced substantially using a PRV around the brainstem instead of robust optimization.

Is it beneficial to selectively boost high-risk tumor subvolumes? A comparison of selectively boosting high-risk tumor subvolumes versus homogeneous dose escalation of the entire tumor based on equivalent EUD plans

International Nuclear Information System (INIS)

Kim, Yusung; To me, Wolfgang A.

2008-01-01

Purpose. To quantify and compare expected local tumor control and expected normal tissue toxicities between selective boosting IMRT and homogeneous dose escalation IMRT for the case of prostate cancer. Methods. Four different selective boosting scenarios and three different high-risk tumor subvolume geometries were designed to compare selective boosting and homogeneous dose escalation IMRT plans delivering the same equivalent uniform dose (EUD) to the entire PTV. For each scenario, differences in tumor control probability between both boosting strategies were calculated for the high-risk tumor subvolume and remaining low-risk PTV, and were visualized using voxel based iso-TCP maps. Differences in expected rectal and bladder complications were quantified using radiobiological indices (generalized EUD (gEUD) and normal tissue complication probability (NTCP)) as well as %-volumes. Results. For all investigated scenarios and high-risk tumor subvolume geometries, selective boosting IMRT improves expected TCP compared to homogeneous dose escalation IMRT, especially when lack of control of the high-risk tumor subvolume could be the cause for tumor recurrence. Employing, selective boosting IMRT significant increases in expected TCP can be achieved for the high-risk tumor subvolumes. The three conventional selective boosting IMRT strategies, employing physical dose objectives, did not show significant improvement in rectal and bladder sparing as compared to their counterpart homogeneous dose escalation plans. However, risk-adaptive optimization, utilizing radiobiological objective functions, resulted in reduction in NTCP for the rectum when compared to its corresponding homogeneous dose escalation plan. Conclusions. Selective boosting is a more effective method than homogeneous dose escalation for achieving optimal treatment outcomes. Furthermore, risk-adaptive optimization increases the therapeutic ratio as compared to conventional selective boosting IMRT

Two-inductor boost and buck converters

Science.gov (United States)

White, J. L.; Muldoon, W. J.

The derivation, analysis and design of a coupled inductor boost converter is presented. Aspects of the qualitative ac behavior of coupled inductor converters are discussed. Considerations for the design of the magnetics for such converters are addressed.

Experimental Treatment for Duchenne Muscular Dystrophy Gets Boost from Existing Medication

Science.gov (United States)

... Boost from Existing Medication Spotlight on Research Experimental Treatment for Duchenne Muscular Dystrophy Gets Boost from Existing Medication By Colleen Labbe, M.S. | March 1, 2013 A mouse hanging on a wire during a test of muscle strength. Mice with a mutant dystrophin gene, which ...

The relationship between morbidity after axillary surgery and long-term quality of life in breast cancer patients: the role of anxiety

NARCIS (Netherlands)

Aerts, P. D. M.; de Vries, J.; van der Steeg, A. F. W.; Roukema, J. A.

2011-01-01

Although arm/shoulder morbidity after sentinel lymph node biopsy (SLNB) and/or axillary lymph node dissection (ALND) has been studied before, information is lacking concerning self-imposed restrictions in activities and long-term consequences of both surgical procedures in relationship to quality of

Single Phase Transformer-less Buck-Boost Inverter with Zero Leakage Current for PV Systems

DEFF Research Database (Denmark)

Mostaan, Ali; Abdelhakim, Ahmed; N. Soltani, Mohsen

2017-01-01

In this paper, a novel single-stage single-phase transformer-less buck-boost inverter is proposed, in which a reduced number of passive components is used. The proposed inverter combines the conventional buck, boost, and buck-boost converters in one converter in order to obtain a sinusoidal output...

Balanced G-band Gm-boosted frequency doublers in transferred substrate InP HBT technology

DEFF Research Database (Denmark)

Johansen, Tom Keinicke; Thualfiqar, Al-Sawaf; Weimann, Nils

2016-01-01

In this paper, balanced G-band Gm-boosted frequency doublers in transferred substrate (TS) InP HBT technology are reported for the first time. The Gm-boosted frequency doublers consist of a phase compensated Marchand balun, Gm-boosted doubler stage, and an optional cascode gain stage at the outpu...

Results of brachytherapy boost in high risk breast cancer patients

International Nuclear Information System (INIS)

Battermann, J.J.

1996-01-01

Introduction: in breast conserving therapy the role of brachytherapy as a boost after whole breast irradiation is not clear. The series from the Netherlands Cancer Institute show a very high local control rate, but the question could be raised whether all these patients need a brachy boost. Therefore, it was decided at our institute, to deliver a brachy boost only to high risk patients, viz. patients with incomplete resection margins and/or extensive in situ cancer (ECI). Materials and methods: in the period 1988 through 1993 a total of 148 patients with 151 breast tumours received a boost on the tumour bed using brachytherapy. Age varied from 25 till 74 years, with a mean age of 52.3 years. Incomplete resection margins were found in 60 patients, ECI in 31 and both in 49 patients. In the majority of patients, the ECI component was not completely removed. T-stage was unknown in 9 patients. T1 in 83, T2 in 49 and T3 in 10. Nodal status was N0 in 119 and N1 in 33 patients. Infiltrating duct carcinoma was the most common histology. No infiltrating growth was found in 6 patients, but one patient presented a positive node. The interval period between day of operation and day of brachytherapy implantation was between 3 and 4 months in 62%. The mean interval between completion of beam irradiation and day of implantation was 18 days, while 12 patients received their brachytherapy previous to the beam irradiation. External irradiation was with two tangential fields and a total dose of 50 Gy in 25 fractions over 6 weeks (9 fractions in two weeks). The number of needles in two planes. Most patients were implanted under local anaesthesia. Dose rate in 97 patients was 51 - 60 cGy/h. Results: follow-up for patients alive varied from 2 years till 7 years with a mean follow-up period of 4 years. One hundred and twenty five patients are alive, including 6 patients with manifest metastases. Local recurrence was encountered in 8 patients (interval 14 - 60 months, mean 30 months), with

A coincidental variation of the axillary artery: the brachioradial artery and the aberrant posterior humeral circumflex artery passing under the tendon of the latissimus dorsi muscle

Directory of Open Access Journals (Sweden)

Marek Konarik

2014-09-01

Full Text Available A case of anomalous terminal branching of the axillary artery was encountered and described in a left upper limb of a male cadaver. A series of 214 upper limbs of Caucasian race was dissected. A variant artery, stemming from the very end of the axillary artery followed a superficial course distally. It passed the cubital fossa, ran on the lateral side of the forearm as usual radial artery, crossed ventrally to the palm and terminated in the deep palmar arch. This vessel is a case of the brachioradial artery (incorrectly termed as the “radial artery with high origin”. Moreover, it was associated with another variation, concerning the aberrant posterior humeral circumflex artery passing under the tendon of the latissimus dorsi muscle. The anatomical knowledge of the axillary region is essential for radiodiagnostic, surgical and traumatologic procedures. The superficially located artery brings an elevated danger of heavy bleeding in all unexpected situations, its variant branching can cause problems in radial catheterization procedures and the anomalously coursing other arterial variant poses an elevated danger in surgical procedures concerning the surgical neck of humerus.

Generalized Switched-Inductor Based Buck-Boost Z-H Converter

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E. Babaei

2017-12-01

Full Text Available In this paper, a generalized buck-boost Z-H converter based on switched inductors is proposed. This structure consists of a set of series connected switched-inductor cells. The voltage conversion ratio of the proposed structure is adjusted by changing the number of cells and the duty cycle. Like the conventional Z-H converter, the shoot-through switching state and the diode before LC network are eliminated. The proposed converter can provide high voltage gain in low duty cycles. Considering different values for duty cycle, the proposed structure works in two operating zones. In the first operating zone, it works as a buck-boost converter and in the second operating zone, it works as a boost converter. In this paper, a complete analysis of the proposed converter is presented. In order to confirm the accuracy of mathematic calculations, the simulations results by using PSCAD/EMTDC software are given.

Reduced risk of axillary lymphatic spread in triple-negative breast cancer

DEFF Research Database (Denmark)

Holm-Rasmussen, Emil Villiam; Jensen, Maj-Britt; Balslev, Eva

2015-01-01

We examined the association between the hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status of women with primary breast cancer and the risk of axillary lymph node (ALN) involvement at the time of diagnosis. Information on 20,009 women diagnosed with primary breast...... cancer between 2008 and 2012 was retrieved from the Danish Breast Cancer Cooperative Group database. The associations between clinical and pathological variables and ALN involvement at the time of diagnosis were evaluated in univariate and multivariate regression analyses, as well as the significance......-negative breast cancer (TNBC) patients showed a significantly reduced risk of ALN involvement at the time of diagnosis compared to patients with HR-positive/HER2-negative tumors (OR 0.55; 95 % CI 0.49-0.62; P

Brachytherapy boost for breast cancer: what do we know? where do we go?

International Nuclear Information System (INIS)

Hannoun-Levi, J.M.; Marsiglia, H.

2004-01-01

Since many years, Brachytherapy (BT) appears to play an important role in the treatment of many solid tumors. For breast cancer, BT is usually used as boost after postoperative external beam radiation therapy. In certain circumstances. BT can be used as sole radiation technique focalized on the tumor bed or more rarely, as second conservative treatment in case of local recurrence for woman refusing salvage mastectomy. Boost BT is most often applied via an interstitial technique while the dose rate can vary from low to high close rate through pulse dose rate. All of those boost techniques were published and some of them compared the results obtained with BT and external beam electron therapy. The analysis of the published phase II and III trials was not able to show significant differences between the two boost techniques in term of local control as well as late skin side effects. However, we noted that the patients who received BT boost presented a higher risk of local recurrence compare to those treated with electron therapy, due to age, margin status or presence of extensive intraductal component. Only a phase III trial randomizing BT boost vs electron therapy boost could show a possible improvement of local control rate in the BT arm; however, this trial should enroll patients with a real high risk of local recurrence in order to take benefit from the dosimetric advantages of BT. (author)

Estimation of age-specific rates of reactivation and immune boosting of the varicella zoster virus

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Isabella Marinelli

2017-06-01

Full Text Available Studies into the impact of vaccination against the varicella zoster virus (VZV have increasingly focused on herpes zoster (HZ, which is believed to be increasing in vaccinated populations with decreasing infection pressure. This idea can be traced back to Hope-Simpson's hypothesis, in which a person's immune status determines the likelihood that he/she will develop HZ. Immunity decreases over time, and can be boosted by contact with a person experiencing varicella (exogenous boosting or by a reactivation attempt of the virus (endogenous boosting. Here we use transmission models to estimate age-specific rates of reactivation and immune boosting, exogenous as well as endogenous, using zoster incidence data from the Netherlands (2002–2011, n = 7026. The boosting and reactivation rates are estimated with splines, enabling these quantities to be optimally informed by the data. The analyses show that models with high levels of exogenous boosting and estimated or zero endogenous boosting, constant rate of loss of immunity, and reactivation rate increasing with age (to more than 5% per year in the elderly give the best fit to the data. Estimates of the rates of immune boosting and reactivation are strongly correlated. This has important implications as these parameters determine the fraction of the population with waned immunity. We conclude that independent evidence on rates of immune boosting and reactivation in persons with waned immunity are needed to robustly predict the impact of varicella vaccination on the incidence of HZ.

Breast conserving treatment for breast cancer: dosimetric comparison of sequential versus simultaneous integrated photon boost.

Science.gov (United States)

Van Parijs, Hilde; Reynders, Truus; Heuninckx, Karina; Verellen, Dirk; Storme, Guy; De Ridder, Mark

2014-01-01

Breast conserving surgery followed by whole breast irradiation is widely accepted as standard of care for early breast cancer. Addition of a boost dose to the initial tumor area further reduces local recurrences. We investigated the dosimetric benefits of a simultaneously integrated boost (SIB) compared to a sequential boost to hypofractionate the boost volume, while maintaining normofractionation on the breast. For 10 patients 4 treatment plans were deployed, 1 with a sequential photon boost, and 3 with different SIB techniques: on a conventional linear accelerator, helical TomoTherapy, and static TomoDirect. Dosimetric comparison was performed. PTV-coverage was good in all techniques. Conformity was better with all SIB techniques compared to sequential boost (P = 0.0001). There was less dose spilling to the ipsilateral breast outside the PTVboost (P = 0.04). The dose to the organs at risk (OAR) was not influenced by SIB compared to sequential boost. Helical TomoTherapy showed a higher mean dose to the contralateral breast, but less than 5 Gy for each patient. SIB showed less dose spilling within the breast and equal dose to OAR compared to sequential boost. Both helical TomoTherapy and the conventional technique delivered acceptable dosimetry. SIB seems a safe alternative and can be implemented in clinical routine.

IORT with electrons as boost strategy during breast conserving therapy in limited stage breast cancer: results of an ISIORT pooled analysis

International Nuclear Information System (INIS)

Sedlmayer, F.; Fastner, G.; Merz, F.; Deutschmann, H.; Reitsamer, R.; Menzel, C.; Ciabattoni, A.; Petrucci, A.; Hager, E.; Willich, N.; Orecchia, R.; Valentini, V.

2007-01-01

There is common consensus that postoperative whole-breast irradiation with doses around 50 Gy remains the gold standard for local treatment after breast conserving surgery (BCS). A substantial benefit of an additional boost with 16 Gy to the tumor bed was recently confirmed by a re-analysis of the EORTC trial data: local recurrence rates were reduced by 50% in all age groups. The idea of a Linac-based IORT with electrons (IOERT) during breast conserving surgery is the delivery of a single boost dose to the tumor bed with utmost precision, due to direct visualization. However, the published data about boost-IOERT for breast cancer are scarce and rarely updated with only few centers participating. Therefore, we initiated a collaborative analysis within the European Group of the International Society of Intraoperative Radiotherapy (ISIORT). A pooled analysis has been performed by 6 institutions of the ISIORT-Europe using comparable methods, sequencing and dosage in intra- and postoperative radiotherapy during BCT. Between 10/98 and 05/05, 1131 patients were treated. Patients' characteristics, histologic workup and tumor staging are summarized in Table 1. Sixty percent of all patients (671 pat.) presented with at least one risk factor for local recurrence in terms of tumor size > 2 cm, high grading, young age < 45 years and/or positive axillary nodes. Breast tumor resection was primarily performed by circular incision. Surgical margins were assessed by frozen section after tumorectomy. Prior to IOERT, the tissue surrounding the excision cavity was temporarily approximated by sutures to bring it in reach of the electron beam. In most cases, intraoperative sonography was performed for depth measurement allowing dose prescription, alternatively mobile CT or direct ruler measurement was used. During IOERT, median single fractional doses of 9,7 Gy (range 5-17) were applied to the 90% reference isodose, using round perspex tubes with 5-8 cm diameter and electron energies of

Targeted intraoperative radiotherapy tumour bed boost during breast-conserving surgery after neoadjuvant chemotherapy

Energy Technology Data Exchange (ETDEWEB)

Kolberg, Hans-Christian; Akpolat-Basci, Leyla; Stephanou, Miltiades [Marienhospital Bottrop gGmbH, Department of Gynecology and Obstetrics, Bottrop (Germany); Loevey, Gyoergy [BORAD, Bottrop (Germany); Fasching, Peter A. [University of Erlangen, Erlangen (Germany); Untch, Michael [Helios Klinikum Berlin-Buch, Berlin (Germany); Liedtke, Cornelia [University Hospital Schleswig-Holstein/Campus Luebeck, Luebeck (Germany); Bulsara, Max [University of Notre Dame, Fremantle (Australia); University College, London (United Kingdom); Vaidya, Jayant S. [University College, London (United Kingdom)

2017-01-15

The use of targeted intraoperative radiotherapy (TARGIT-IORT) as a tumour bed boost during breast-conserving surgery (BCS) for breast cancer has been reported since 1998. We present its use in patients undergoing breast conservation following neoadjuvant therapy (NACT). In this retrospective study involving 116 patients after NACT we compared outcomes of 61 patients who received a tumour bed boost with IORT during lumpectomy versus 55 patients treated in the previous 13 months with external (EBRT) boost. All patients received whole breast radiotherapy. Local recurrence-free survival (LRFS), disease-free survival (DFS), distant disease-free survival (DDFS), breast cancer mortality (BCM), non-breast cancer mortality (NBCM) and overall mortality (OS) were compared. Median follow up was 49 months. The differences in LRFS, DFS and BCM were not statistically significant. The 5-year Kaplan-Meier estimate of OS was significantly better by 15% with IORT: IORT 2 events (96.7%, 95%CI 87.5-99.2), EBRT 9 events (81.7%, 95%CI 67.6-90.1), hazard ratio (HR) 0.19 (0.04-0.87), log rank p = 0.016, mainly due to a reduction of 10.1% in NBCM: IORT 100%, EBRT 89.9% (77.3-95.7), HR (not calculable), log rank p = 0.015. The DDFS was as follows: IORT 3 events (95.1%, 85.5-98.4), EBRT 12 events (69.0%, 49.1-82.4), HR 0.23 (0.06-0.80), log rank p = 0.012. IORT during lumpectomy after neoadjuvant chemotherapy as a tumour bed boost appears to give results that are not worse than external beam radiotherapy boost. These data give further support to the inclusion of such patients in the TARGIT-B (boost) randomised trial that is testing whether IORT boost is superior to EBRT boost. (orig.) [German] Die intraoperative Radiotherapie (TARGIT-IORT) als vorgezogener Boost im Rahmen der brusterhaltenden Therapie (BET) ist seit 1998 Gegenstand der wissenschaftlichen Diskussion. Wir praesentieren Daten zum Einsatz der IORT bei der BET nach neoadjuvanter Therapie (NACT). In diese retrospektive Analyse

A Novel Single Switch Transformerless Quadratic DC/DC Buck-Boost Converter

DEFF Research Database (Denmark)

Mostaan, Ali; A. Gorji, Saman; N. Soltani, Mohsen

2017-01-01

A novel quadratic buck-boost DC/DC converter is presented in this study. The proposed converter utilizes only one active switch and can step-up/down the input voltage, while the existing single switch quadratic buck/boost converters can only work in step-up or step-down mode. First, the proposed ...

Estimation of reliability of a interleaving PFC boost converter

Directory of Open Access Journals (Sweden)

Gulam Amer Sandepudi

2010-01-01

Full Text Available Reliability plays an important role in power supplies. For other electronic equipment, a certain failure mode, at least for a part of the total system, can often be employed without serious (critical effects. However, for power supply no such condition can be accepted, since very high demands on its reliability must be achieved. At higher power levels, the continuous conduction mode (CCM boost converter is preferred topology for implementation a front end with PFC. As a result, significant efforts have been made to improve the performance of high boost converter. This paper is one of the efforts for improving the performance of the converter from the reliability point of view. In this paper, interleaving boost power factor correction converter is simulated with single switch in continuous conduction mode (CCM, discontinuous conduction mode (DCM and critical conduction mode (CRM under different output power ratings. Results of the converter are explored from reliability point of view.

Pulse width modulated buck-boost five-level current source inverters

DEFF Research Database (Denmark)

Blaabjerg, Frede; Gao, F.; Loh, P.C.

2008-01-01

, resulting in the natural balance of input current. For maintaining the normalized volt-sec average unchanged, the alternative phase opposition disposition (APOD) modulation scheme with typical gating signal mapping technique from voltage source inverter (VSI) to CSI can be assumed to control the five......This paper presents new five-level current source inverters (CSIs) with voltage/current buck-boost capability. Being different from the existing multilevel CSI, the proposed CSIs were first designed to regulate the flowing path of dc input current by controlling two additional active switches......-level buck-boost CSIs. Next by observing the hidden current charging path during inductive charging interval under APOD modulation, it is noted that the buck-boost five-level CSI can then be further modified with lesser active component without degrading output performance. To verify the theoretical findings...

Use of the Lorentz-Boosted Frame Transformation to Simulate Free-Electron Laser Amplifier Physics

International Nuclear Information System (INIS)

Fawley, W.M.; Vay, J.-L.

2008-01-01

Recently it has been pointed out that numerical simulation of some systems containing charged particles with highly relativistic directed motion can by speeded up by orders of magnitude by choice of the proper Lorentz boosted frame. A particularly good example is that of short wavelength free-electron lasers (FELs) in which a high energy (E0 (ge) 250 MeV) electron beam interacts with a static magnetic undulator. In the optimal boost frame with Lorentz factor gamma F, the red-shifted FEL radiation and blue shifted undulator have identical wavelengths and the number of required time-steps (presuming the Courant condition applies) decreases by a factor of g2 F for fully electromagnetic simulation. We have adapted the WARP code to apply this method to several FEL problems including coherent spontaneous emission (CSE) from pre-bunched e-beams, and strong exponential gain in a single pass amplifier configuration. We discuss our results and compare with those from the 'standard' FEL simulation approach which adopts the eikonal approximation for propagation of the radiation field

Staging of women with breast cancer after introduction of sentinel node guided axillary dissection

DEFF Research Database (Denmark)

Tvedskov, Tove Filtenborg

2012-01-01

Today, sentinel lymph node dissection (SLND) has replaced axillary lymph node dissection (ALND) as standard procedure for staging of the axilla in the treatment of breast cancer. SLND can accurately stage the axilla by removing on average only two lymph nodes. Only in case of metastatic spread...... was not significantly different in the two periods, whereas the proportion of patients with micrometastases increased significantly from 5.1% to 9.0%. However, the proportion of patients offered adjuvant systemic treatment due to positive nodal status as the only high-risk criterion did only increase from 7.8% to 8...

Coulomb-driven energy boost of heavy ions for laser-plasma acceleration.

Science.gov (United States)

Braenzel, J; Andreev, A A; Platonov, K; Klingsporn, M; Ehrentraut, L; Sandner, W; Schnürer, M

2015-03-27

An unprecedented increase of kinetic energy of laser accelerated heavy ions is demonstrated. Ultrathin gold foils have been irradiated by an ultrashort laser pulse at a peak intensity of 8×10^{19}  W/  cm^{2}. Highly charged gold ions with kinetic energies up to >200  MeV and a bandwidth limited energy distribution have been reached by using 1.3 J laser energy on target. 1D and 2D particle in cell simulations show how a spatial dependence on the ion's ionization leads to an enhancement of the accelerating electrical field. Our theoretical model considers a spatial distribution of the ionization inside the thin target, leading to a field enhancement for the heavy ions by Coulomb explosion. It is capable of explaining the energy boost of highly charged ions, enabling a higher efficiency for the laser-driven heavy ion acceleration.

Application of a synchronous generator with a boost converter in wind turbines: an experimental overview

DEFF Research Database (Denmark)

Sharma, Ranjan; Rasmussen, Tonny Wederberg; Jensen, Bogi Bech

2012-01-01

An electrical structure of a variable-speed wind turbine based on an externally excited synchronous generator; a passive diode rectifier; and a boost converter is discussed in this study. The clear advantage of such a system is its lower-semi-conductor devices count. A brief theoretical explanation...... of such a system is included. A boost converter normally utilies an inductor (energy storage) to boost the voltage level from its input to a higher output value. This study analyses the possibility of using the generator inductance as a boost inductor. It is discussed and verified in the study that for the given...... switching frequency of the boost converter (fs=1= kHz), the generator sub-transient inductance (not the synchronous inductance) appears as an equivalent inductance seen by the boost converter. The parasitic capacitors present in the generator terminals are often neglected from design issues. It is presented...

Heterologous Prime-Boost Immunizations with a Virosomal and an Alphavirus Replicon Vaccine

NARCIS (Netherlands)

Walczak, Mateusz; de Mare, Arjan; Riezebos-Brilman, Annelies; Regts, Joke; Hoogeboom, Baukje-Nynke; Visser, Jeroen T.; Fiedler, Marc; Jansen-Duerr, Pidder; van der Zee, Ate G. J.; Nijman, Hans W.; Wilschut, Jan; Daemen, Toos

2011-01-01

Heterologous prime-boost immunization strategies in general establish higher frequencies of antigen-specific T lymphocytes than homologous prime-boost protocols or single immunizations. We developed virosomes and recombinant Semliki Forest virus (rSFV) as antigen delivery systems, each capable of

Isolation barriers between petunia axillaris and Petunia integrifolia (Solanaceae).

Science.gov (United States)

Dell'olivo, Alexandre; Hoballah, Maria Elena; Gübitz, Thomas; Kuhlemeier, Cris

2011-07-01

The isolation barriers restricting gene flow between populations or species are of crucial interest for understanding how biological species arise and how they are maintained. Few studies have examined the entire range of possible isolation barriers from geographic isolation to next generation hybrid viability. Here, we present a detailed analysis of isolation barriers between two flowering plant species of the genus Petunia (Solanaceae). Petunia integrifolia and P. axillaris feature divergent pollination syndromes but can produce fertile hybrids when crossed in the laboratory. Both Petunia species are primarily isolated in space but appear not to hybridize in sympatry. Our experiments demonstrate that pollinator isolation is very high but not strong enough to explain the absence of hybrids in nature. However, pollinator isolation in conjunction with male gametic isolation (i.e., pollen-pistil interaction) can explain the lack of natural hybridization, while postzygotic isolation barriers are low or nonexistent. Our study supports the notion that reproductive isolation in flowering plants is mainly caused by pre- rather than postzygotic isolation mechanisms. © 2011 The Author(s). Evolution© 2011 The Society for the Study of Evolution.

Early boost and slow consolidation in motor skill learning.

Science.gov (United States)

Hotermans, Christophe; Peigneux, Philippe; Maertens de Noordhout, Alain; Moonen, Gustave; Maquet, Pierre

2006-01-01

Motorskill learning is a dynamic process that continues covertly after training has ended and eventually leads to delayed increments in performance. Current theories suggest that this off-line improvement takes time and appears only after several hours. Here we show an early transient and short-lived boost in performance, emerging as early as 5-30 min after training but no longer observed 4 h later. This early boost is predictive of the performance achieved 48 h later, suggesting its functional relevance for memory processes.

Breast Conserving Treatment for Breast Cancer: Dosimetric Comparison of Sequential versus Simultaneous Integrated Photon Boost

Directory of Open Access Journals (Sweden)

Hilde Van Parijs

2014-01-01

Full Text Available Background. Breast conserving surgery followed by whole breast irradiation is widely accepted as standard of care for early breast cancer. Addition of a boost dose to the initial tumor area further reduces local recurrences. We investigated the dosimetric benefits of a simultaneously integrated boost (SIB compared to a sequential boost to hypofractionate the boost volume, while maintaining normofractionation on the breast. Methods. For 10 patients 4 treatment plans were deployed, 1 with a sequential photon boost, and 3 with different SIB techniques: on a conventional linear accelerator, helical TomoTherapy, and static TomoDirect. Dosimetric comparison was performed. Results. PTV-coverage was good in all techniques. Conformity was better with all SIB techniques compared to sequential boost (P = 0.0001. There was less dose spilling to the ipsilateral breast outside the PTVboost (P = 0.04. The dose to the organs at risk (OAR was not influenced by SIB compared to sequential boost. Helical TomoTherapy showed a higher mean dose to the contralateral breast, but less than 5 Gy for each patient. Conclusions. SIB showed less dose spilling within the breast and equal dose to OAR compared to sequential boost. Both helical TomoTherapy and the conventional technique delivered acceptable dosimetry. SIB seems a safe alternative and can be implemented in clinical routine.

Boosted dark matter signals uplifted with self-interaction

Energy Technology Data Exchange (ETDEWEB)

Kong, Kyoungchul, E-mail: kckong@ku.edu [Department of Physics and Astronomy, University of Kansas, Lawrence, KS 66045 (United States); Mohlabeng, Gopolang, E-mail: mohlabeng319@gmail.com [Department of Physics and Astronomy, University of Kansas, Lawrence, KS 66045 (United States); Park, Jong-Chul, E-mail: log1079@gmail.com [Department of Physics and Astronomy, University of Kansas, Lawrence, KS 66045 (United States); Department of Physics, Sungkyunkwan University, Suwon 440-746 (Korea, Republic of)

2015-04-09

We explore detection prospects of a non-standard dark sector in the context of boosted dark matter. We focus on a scenario with two dark matter particles of a large mass difference, where the heavier candidate is secluded and interacts with the standard model particles only at loops, escaping existing direct and indirect detection bounds. Yet its pair annihilation in the galactic center or in the Sun may produce boosted stable particles, which could be detected as visible Cherenkov light in large volume neutrino detectors. In such models with multiple candidates, self-interaction of dark matter particles is naturally utilized in the assisted freeze-out mechanism and is corroborated by various cosmological studies such as N-body simulations of structure formation, observations of dwarf galaxies, and the small scale problem. We show that self-interaction of the secluded (heavier) dark matter greatly enhances the capture rate in the Sun and results in promising signals at current and future experiments. We perform a detailed analysis of the boosted dark matter events for Super-Kamiokande, Hyper-Kamiokande and PINGU, including notable effects such as evaporation due to self-interaction and energy loss in the Sun.

Influence of the timing of a concomitant boost during fractionated irradiation of rat rhabdomyosarcoma R1H

International Nuclear Information System (INIS)

Dubben, H.H.; Beck-Bornholdt, H.P.

1993-01-01

Rhabdomyosarcomas R1H of the rat (WAG/Rij) were treated using fractionation schedules including a boost. The total dose was 60 Gy. Overall treatment time was 6 weeks. Four different boost schedules were applied: A single dose boost (12.15 Gy) at the last day of treatment, a single dose boost (12.15 Gy) at the first day of treatment, a schedule including the boost in 7 fractions during the first week, and a schedule including the boost in 10 fractions during the first week of treatment. A standard schedule with 30 fractions of 2 Gy without a boost was used for comparison. Initially accelerated schedules, i.e. those with a boost at start of treatment, revealed higher effect on tumour parenchyma as monitored by local control rate and net growth delay. This could be due to a decrease of radio-sensitivity, that is, an increase of the hypoxic fraction of clonogenic tumour cells during fractionated irradiation. (orig.)

Prognostic Impact of Adjuvant Radiotherapy in Breast Cancer Patients with One to Three Positive Axillary Lymph Nodes

OpenAIRE

Mansour Ansari; Behnam Kadkhodaei; Mehdi Shariat; Abdolrasoul Talei; Majid Akrami; Vahid Zangouri; Niloofar Ahmadloo; Mohammad Mohammadianpanah; Sayed Hasan Hamedi; Hamid Nasrolahi; Shapour Omidvari; Ahmad Mosalaei

2018-01-01

Background: Radiotherapy, as an adjuvant treatment, plays a well-known role in prevention of locoregional recurrence in breast cancer patients. This study aims to investigate the impact of radiotherapy in patients with N1 disease. Methods: In this retrospective study, we reviewed the characteristics and treatment outcomes of 316 patients with a biopsy proven diagnosis of breast carcinoma and 1-3 positive axillary lymph nodes. The patients received treatment between 1995 and 201...

Quadratic Boost A-Source Impedance Network

DEFF Research Database (Denmark)

Siwakoti, Yam Prasad; Blaabjerg, Frede; Chub, Andrii

2016-01-01

A novel quadratic boost A-source impedance network is proposed to realize converters that demand very high voltage gain. To satisfy the requirement, the network uses an autotransformer where the obtained gain is quadratically dependent on the duty ratio and is unmatched by any existing impedance...

In vitro clonal propagation of bael (Aegle marmelos Corr.) CV. CISH-B1 through enhanced axillary branching.

Science.gov (United States)

Pati, Rajesh; Chandra, Ramesh; Chauhan, Ugam Kumari; Mishra, Maneesh; Srivastava, Navin

2008-10-01

Rapid clonal micropropagation protocol of Aegle marmelos (L.) Corr. cv. CISH-B1 was achieved by nodal stem segment of mature bearing tree. Three centimeter long shoots having one axillary bud excised from 10-15th nodal region of shoots during September gave quick in vitro bud burst (5.33 days) when cultured on MS medium supplemented with BAP, 8.84 μM + IAA 5.7 μM. The maximum number of proliferated shoots (9.0/explant) were obtained on same medium supplemented with BAP 8.84 μM + IAA 5.7 μM. The micro shoots were rooted (100 %) on + IAA 5.7 μM. In vitro rooted plants were acclimatized on autoclaved coconut husk containing plant salt mixture and under shade net house (50 % shade 70-80 % RH). The plants were established in the field after acclimatization. The micropropagated plants were tested for its genetic fidelity using 13 RAPD, 3 ISSR and 2 DAMD primers. Profile obtained by all the three Single Primer Amplification Reaction (SPAR) technique from mother tree and micropropagated plants revealed genetic integrity of micropropagated plants with that of mother tree.

Emergency splenectomy for trauma in the setting of splenomegaly, axillary lymphadenopathy, and incidental B-cell chronic lymphocytic leukemia: A case report

Directory of Open Access Journals (Sweden)

Rodolfo J. Oviedo, MD, FACS

2017-01-01

Conclusion: An emergency splenectomy is an appropriate operative intervention for a grade V splenic laceration with hemoperitoneum, splenomegaly, and axillary lymphadenopathy regardless of the potential for a neoplastic process such as B-cell CLL. Post-splenectomy vaccinations and oncologic follow-up for systemic chemotherapy should be facilitated after recovery.

Diode-Assisted Buck-Boost Voltage-Source Inverters

DEFF Research Database (Denmark)

Gao, Feng; Loh, Poh Chiang; Teodorescu, Remus

2009-01-01

, a number of diode-assisted inverter variants can be designed with each having its own operational principle and voltage gain expression. For controlling them, a generic modulation scheme that can be used for controlling all diode-assisted variants with minimized harmonic distortion and component stress......This paper proposes a number of diode-assisted buck-boost voltage-source inverters with a unique X-shaped diode-capacitor network inserted between the inverter circuitry and dc source for producing a voltage gain that is comparatively higher than those of other buck-boost conversion techniques....... Using the diode-assisted network, the proposed inverters can naturally configure themselves to perform capacitive charging in parallel and discharging in series to give a higher voltage multiplication factor without compromising waveform quality. In addition, by adopting different front-end circuitries...

Effect of pole zero location on system dynamics of boost converter for micro grid

Science.gov (United States)

Lavanya, A.; Vijayakumar, K.; Navamani, J. D.; Jayaseelan, N.

2018-04-01

Green clean energy like photo voltaic, wind energy, fuel cell can be brought together by microgrid.For low voltage sources like photovoltaic cell boost converter is very much essential. This paper explores the dynamic analysis of boost converter in a continuous conduction mode (CCM). The transient performance and stability analysis is carried out in this paper using time domain analysis and frequency domain analysis techniques. Boost converter is simulated using both PSIM and MATLAB software. Furthermore, state space model obtained and the transfer function is derived. The converter behaviour when a step input is applied is analyzed and stability of the converter is analyzed from bode plot frequency for open loop. Effect of the locations of poles and zeros in the transfer function of boost converter and how the performance parameters are affected is discussed in this paper. Closed loop performance with PI controller is also analyzed for boost converter.

Maximum power point tracking techniques for wind energy systems using three levels boost converter

Science.gov (United States)

Tran, Cuong Hung; Nollet, Frédéric; Essounbouli, Najib; Hamzaoui, Abdelaziz

2018-05-01

This paper presents modeling and simulation of three level Boost DC-DC converter in Wind Energy Conversion System (WECS). Three-level Boost converter has significant advantage compared to conventional Boost. A maximum power point tracking (MPPT) method for a variable speed wind turbine using permanent magnet synchronous generator (PMSG) is also presented. Simulation of three-level Boost converter topology with Perturb and Observe algorithm and Fuzzy Logic Control is implemented in MATLAB/SIMULINK. Results of this simulation show that the system with MPPT using fuzzy logic controller has better performance to the Perturb and Observe algorithm: fast response under changing conditions and small oscillation.

Pathway-Based Kernel Boosting for the Analysis of Genome-Wide Association Studies

Science.gov (United States)

Manitz, Juliane; Burger, Patricia; Amos, Christopher I.; Chang-Claude, Jenny; Wichmann, Heinz-Erich; Kneib, Thomas; Bickeböller, Heike

2017-01-01

The analysis of genome-wide association studies (GWAS) benefits from the investigation of biologically meaningful gene sets, such as gene-interaction networks (pathways). We propose an extension to a successful kernel-based pathway analysis approach by integrating kernel functions into a powerful algorithmic framework for variable selection, to enable investigation of multiple pathways simultaneously. We employ genetic similarity kernels from the logistic kernel machine test (LKMT) as base-learners in a boosting algorithm. A model to explain case-control status is created iteratively by selecting pathways that improve its prediction ability. We evaluated our method in simulation studies adopting 50 pathways for different sample sizes and genetic effect strengths. Additionally, we included an exemplary application of kernel boosting to a rheumatoid arthritis and a lung cancer dataset. Simulations indicate that kernel boosting outperforms the LKMT in certain genetic scenarios. Applications to GWAS data on rheumatoid arthritis and lung cancer resulted in sparse models which were based on pathways interpretable in a clinical sense. Kernel boosting is highly flexible in terms of considered variables and overcomes the problem of multiple testing. Additionally, it enables the prediction of clinical outcomes. Thus, kernel boosting constitutes a new, powerful tool in the analysis of GWAS data and towards the understanding of biological processes involved in disease susceptibility. PMID:28785300

Pathway-Based Kernel Boosting for the Analysis of Genome-Wide Association Studies.

Science.gov (United States)

Friedrichs, Stefanie; Manitz, Juliane; Burger, Patricia; Amos, Christopher I; Risch, Angela; Chang-Claude, Jenny; Wichmann, Heinz-Erich; Kneib, Thomas; Bickeböller, Heike; Hofner, Benjamin

2017-01-01

The analysis of genome-wide association studies (GWAS) benefits from the investigation of biologically meaningful gene sets, such as gene-interaction networks (pathways). We propose an extension to a successful kernel-based pathway analysis approach by integrating kernel functions into a powerful algorithmic framework for variable selection, to enable investigation of multiple pathways simultaneously. We employ genetic similarity kernels from the logistic kernel machine test (LKMT) as base-learners in a boosting algorithm. A model to explain case-control status is created iteratively by selecting pathways that improve its prediction ability. We evaluated our method in simulation studies adopting 50 pathways for different sample sizes and genetic effect strengths. Additionally, we included an exemplary application of kernel boosting to a rheumatoid arthritis and a lung cancer dataset. Simulations indicate that kernel boosting outperforms the LKMT in certain genetic scenarios. Applications to GWAS data on rheumatoid arthritis and lung cancer resulted in sparse models which were based on pathways interpretable in a clinical sense. Kernel boosting is highly flexible in terms of considered variables and overcomes the problem of multiple testing. Additionally, it enables the prediction of clinical outcomes. Thus, kernel boosting constitutes a new, powerful tool in the analysis of GWAS data and towards the understanding of biological processes involved in disease susceptibility.

A THREE-PHASE BOOST DC-AC CONVERTER

African Journals Online (AJOL)

dc-ac converter (inverter) based on the dc-dc boost converters. ... Sliding mode controllers are designed to perform a robust control for the ... Computer simulations and spectral analysis demon- ... the conventional three-phase buck inverter,.

Avoiding Anemia: Boost Your Red Blood Cells

Science.gov (United States)

... Issues Subscribe January 2014 Print this issue Avoiding Anemia Boost Your Red Blood Cells En español Send ... Disease When Blood Cells Bend Wise Choices Preventing Anemia To prevent or treat iron-deficiency anemia: Eat ...

A Survey on Voltage Boosting Techniques for Step-Up DC-DC Converters

DEFF Research Database (Denmark)

Forouzesh, Mojtaba; Siwakoti, Yam Prasad; Gorji, Saman Asghari

2016-01-01

boosting techniques and topologies are large, which at times may be confusing and difficult to follow/adapt for different applications. Considering these aspects and in order to make a clear sketch of the general law and framework of various voltage boosting techniques, this paper comprehensively reviews...

Linfadenectomia Axilar Conservadora no Câncer de Mama Estádio Clínico I Conservative Axillary Dissection in Stage I Breast Cancer

Directory of Open Access Journals (Sweden)

Luiz Antonio Guimarães Brondi

2000-01-01

Full Text Available Objetivo: determinar a eficácia da linfadenectomia axilar conservadora (esvaziamento dos níveis I e II no tratamento cirúrgico do câncer da mama estádio I. Métodos: foram avaliados os resultados de 142 cirurgias realizadas em pacientes portadoras de câncer mamário estádio I (T1NO entre janeiro/93 e dezembro/98. Removidos os linfonodos axilares presentes nos níveis I e II com preservação dos músculos peitorais, os mesmos foram dissecados pelo próprio autor (LAGB, sendo posteriormente examinados histopatologicamente com a realização de apenas 1 corte por linfonodo. A quadrantectomia foi realizada em 138 casos e a mastectomia modificada segundo Patey em 4 casos. Houve predomínio dos casos T1c (130 casos. Resultados: foram removidos 3.282 linfonodos (2.456 presentes no nível I e 826 no nível II com um número médio de 23,1 linfonodos por axila. Desse total, apenas 68 estavam comprometidos (2,1%. Skip metastasis estava presente em apenas um caso (0,7%. Foram observados 35 casos de falso-negativos clínicos (24,6%, estando o nível I comprometido em 34 casos (97,1% e o nível II em apenas 2 casos (5,7%. A axila estava negativa nos 107 casos restantes (75,4%. Conclusão: a dissecção axilar dos níveis I e II é suficiente para tratar a axila no estádio I do câncer de mama. Se linfonodos suspeitos são identificados durante a cirurgia, os gânglios do nível III e o grupo interpeitoral de Rotter deverão ser retirados.Purpose: to evaluate the efficacy of conservative axillary dissection (levels I and II in the surgical treatment of stage I breast cancer. Methods: the results of 142 mastectomies performed from January/93 to December/98 in patients with clinical stage I breast cancer (T1NO were evaluated. Removing the axillary lymph nodes present at levels I and II, with the preservation of the pectoralis muscles, the axillary lymph nodes were dissected by the author (LAGB, and subsequently one section of each lymph node was

Semi-supervised learning via regularized boosting working on multiple semi-supervised assumptions.

Science.gov (United States)

Chen, Ke; Wang, Shihai

2011-01-01

Semi-supervised learning concerns the problem of learning in the presence of labeled and unlabeled data. Several boosting algorithms have been extended to semi-supervised learning with various strategies. To our knowledge, however, none of them takes all three semi-supervised assumptions, i.e., smoothness, cluster, and manifold assumptions, together into account during boosting learning. In this paper, we propose a novel cost functional consisting of the margin cost on labeled data and the regularization penalty on unlabeled data based on three fundamental semi-supervised assumptions. Thus, minimizing our proposed cost functional with a greedy yet stagewise functional optimization procedure leads to a generic boosting framework for semi-supervised learning. Extensive experiments demonstrate that our algorithm yields favorite results for benchmark and real-world classification tasks in comparison to state-of-the-art semi-supervised learning algorithms, including newly developed boosting algorithms. Finally, we discuss relevant issues and relate our algorithm to the previous work.

Axillary lymph node metastases in patients with breast carcinomas: assessment with nonenhanced versus uspio-enhanced MR imaging.

Science.gov (United States)

Memarsadeghi, Mazda; Riedl, Christopher C; Kaneider, Andreas; Galid, Arik; Rudas, Margaretha; Matzek, Wolfgang; Helbich, Thomas H

2006-11-01

To prospectively assess the accuracy of nonenhanced versus ultrasmall superparamagnetic iron oxide (USPIO)-enhanced magnetic resonance (MR) imaging for depiction of axillary lymph node metastases in patients with breast carcinoma, with histopathologic findings as reference standard. The study was approved by the university ethics committee; written informed consent was obtained. Twenty-two women (mean age, 60 years; range, 40-79 years) with breast carcinomas underwent nonenhanced and USPIO-enhanced (2.6 mg of iron per kilogram of body weight intravenously administered) transverse T1-weighted and transverse and sagittal T2-weighted and T2*-weighted MR imaging in adducted and elevated arm positions. Two experienced radiologists, blinded to the histopathologic findings, analyzed images of axillary lymph nodes with regard to size, morphologic features, and USPIO uptake. A third independent radiologist served as a tiebreaker if consensus between two readers could not be reached. Visual and quantitative analyses of MR images were performed. Sensitivity, specificity, and accuracy values were calculated. To assess the effect of USPIO after administration, signal-to-noise ratio (SNR) changes were statistically analyzed with repeated-measurements analysis of variance (mixed model) for MR sequences. At nonenhanced MR imaging, of 133 lymph nodes, six were rated as true-positive, 99 as true-negative, 23 as false-positive, and five as false-negative. At USPIO-enhanced MR imaging, 11 lymph nodes were rated as true-positive, 120 as true-negative, two as false-positive, and none as false-negative. In two metastatic lymph nodes in two patients with more than one metastatic lymph node, a consensus was not reached. USPIO-enhanced MR imaging revealed a node-by-node sensitivity, specificity, and accuracy of 100%, 98%, and 98%, respectively. At USPIO-enhanced MR imaging, no metastatic lymph nodes were missed on a patient-by-patient basis. Significant interactions indicating differences

Chagas Parasite Detection in Blood Images Using AdaBoost

Directory of Open Access Journals (Sweden)

Víctor Uc-Cetina

2015-01-01

Full Text Available The Chagas disease is a potentially life-threatening illness caused by the protozoan parasite, Trypanosoma cruzi. Visual detection of such parasite through microscopic inspection is a tedious and time-consuming task. In this paper, we provide an AdaBoost learning solution to the task of Chagas parasite detection in blood images. We give details of the algorithm and our experimental setup. With this method, we get 100% and 93.25% of sensitivity and specificity, respectively. A ROC comparison with the method most commonly used for the detection of malaria parasites based on support vector machines (SVM is also provided. Our experimental work shows mainly two things: (1 Chagas parasites can be detected automatically using machine learning methods with high accuracy and (2 AdaBoost + SVM provides better overall detection performance than AdaBoost or SVMs alone. Such results are the best ones known so far for the problem of automatic detection of Chagas parasites through the use of machine learning, computer vision, and image processing methods.

Boosted decision trees as an alternative to artificial neural networks for particle identification

International Nuclear Information System (INIS)

Roe, Byron P.; Yang Haijun; Zhu Ji; Liu Yong; Stancu, Ion; McGregor, Gordon

2005-01-01

The efficacy of particle identification is compared using artificial neutral networks and boosted decision trees. The comparison is performed in the context of the MiniBooNE, an experiment at Fermilab searching for neutrino oscillations. Based on studies of Monte Carlo samples of simulated data, particle identification with boosting algorithms has better performance than that with artificial neural networks for the MiniBooNE experiment. Although the tests in this paper were for one experiment, it is expected that boosting algorithms will find wide application in physics

Boosting bonsai trees for handwritten/printed text discrimination

Science.gov (United States)

Ricquebourg, Yann; Raymond, Christian; Poirriez, Baptiste; Lemaitre, Aurélie; Coüasnon, Bertrand

2013-12-01

Boosting over decision-stumps proved its efficiency in Natural Language Processing essentially with symbolic features, and its good properties (fast, few and not critical parameters, not sensitive to over-fitting) could be of great interest in the numeric world of pixel images. In this article we investigated the use of boosting over small decision trees, in image classification processing, for the discrimination of handwritten/printed text. Then, we conducted experiments to compare it to usual SVM-based classification revealing convincing results with very close performance, but with faster predictions and behaving far less as a black-box. Those promising results tend to make use of this classifier in more complex recognition tasks like multiclass problems.

Y-source impedance-network-based isolated boost DC/DC converter

DEFF Research Database (Denmark)

Siwakoti, Yam P.; Town, Graham; Loh, Poh Chiang

2014-01-01

A dc-dc converter with very high voltage gain is proposed in this paper for any medium-power application requiring a high voltage boost with galvanic isolation. The proposed converter topology can be realized using only two switches. With this topology a very high voltage boost can be achieved even...... with a relatively low duty cycle of the switches, and the gain obtainable is presently not matched by any existing impedance network based converter operated at the same duty ratio. The proposed converter has a Y-source impedance network to boost the voltage at the intermediate dc-link side and a push......-pull transformer for square-wave AC inversion and isolation. The voltage-doubler rectifier provides a constant dc voltage at the output stage. A theoretical analysis of the converter is presented, supported by simulation and experimental results. A 250 W down-scaled prototype was implemented in the laboratory...

Performance of Boosted W Boson Identification with the ATLAS Detector

CERN Document Server

The ATLAS collaboration

2014-01-01

This note presents the performance of a variety of techniques used to identify highly- boosted hadronically-decaying $W$ bosons. The studies presented here are divided into two parts: the first is based on Monte Carlo simulation, and the second compares the simulations to 20.3$\\pm$0.6 fb$^{-1}$ of proton-–proton collisions data collected by the ATLAS detector in 2012 at $\\sqrt{s} = 8$ TeV. Various tagging approaches and different grooming algorithms are compared in simulation, using a signal of large-$R$ jets containing a highly boosted $W$ boson and a background of large-$R$ jets originating from high-momentum light quarks or gluons. These techniques could also be utilised to identify hadronic decays of boosted $Z$ and Higgs bosons. A sample enriched in $t\\bar{t}\\to (W^+b)(W^-\\bar{b}) \\to (q\\bar{q}b)(\\mu \\bar{\

[Bilateral axillary nodes. 30-year-old patient, housewife].

Science.gov (United States)

Rodak, R; Ramseier, E

2007-11-14

A 20-year old patient who had been adequately treated for lymph node tuberculosis 14 years ago presented 1 week after giving birth to a healthy daughter. She complained about painful lumps in both axillae. During pregnancy the patient suffered from hyperemesis gravidarum, lost 6 kg of weight, and had night sweats. During the last three months of her pregnancy she had a deep vein thrombosis in her right lower leg. The clinical examination showed soft axillary lumps up to 3 cm. The lab showed the following pathological findings: blood sedimentation rate 51 mm/h, CRP 44.8 mg/l, LDH 221 U/l and INR 1.3 (indicating insufficient anticoagulation with phenprocoumon). The chest x-ray showed no infiltrate or indications of a past tuberculosis. A fine needle aspiration cytology was performed on an accessible node. Gram stain, Ziehl Neelsen stain, as well as the bacteriological cultures were all negative. An ultrasound examination of the axilla showed a thickened subcutis without a mass. Cytology showed lobular epithelium, consistent wih ductal mamma epithelium without atypical cells. The diagnosis of an accessory mamma tissue in both axillae was made. During the course of the following weeks the glands decreased in size and the patient was free of symptoms.

Demonstration of brachytherapy boost dose-response relationships in glioblastoma multiforme

International Nuclear Information System (INIS)

Sneed, Penny K.; Lamborn, Kathleen R.; Larson, David A.; Prados, Michael D.; Malec, Mary K.; McDermott, Michael W.; Weaver, Keith A.; Phillips, Theodore L.; Wara, William M.; Gutin, Philip H.

1996-01-01

Purpose: To evaluate brachytherapy dose-response relationships in adults with glioblastoma undergoing temporary 125 I implant boost after external beam radiotherapy. Methods and Materials: Since June 1987, orthogonal radiographs using a fiducial marker box have been used to verify brain implant source positions and generate dose-volume histograms at the University of California, San Francisco. For adults who underwent brachytherapy boost for glioblastoma from June 1987 through December 1992, tumor volumes were reoutlined to ensure consistency and dose-volume histograms were recalculated. Univariate and multivariate analyses of various patient and treatment parameters were performed evaluating for influence of dose on freedom from local failure (FFLF) and actuarial survival. Results: Of 102 implant boosts, 5 were excluded because computer plans were unavailable. For the remaining 97 patients, analyses with adjustment for known prognostic factors (age, KPS, extent of initial surgical resection) and prognostic factors identified on univariate testing (adjuvant chemotherapy) showed that higher minimum brachytherapy tumor dose was strongly associated with improved FFLF (p = 0.001). A quadratic relationship was found between total biological effective dose and survival, with a trend toward optimal survival probability at 47 Gy minimum brachytherapy tumor dose (corresponding to about 65 Gy to 95% of the tumor volume); survival decreased with lower or higher doses. Two patients expired and one requires hospice care because of brain necrosis after brachytherapy doses > 63 Gy to 95% of the tumor volume with 60 Gy to > 18 cm 3 of normal brain. Conclusion: Although higher minimum brachytherapy tumor dose was strongly associated with better local control, a brachytherapy boost dose > 50-60 Gy may result in life-threatening necrosis. We recommend careful conformation of the prescription isodose line to the contrast enhancing tumor volume, delivery of a minimum brachytherapy

Boosted H­->bb Tagger In Run II

CERN Document Server

Sahinsoy, Merve; The ATLAS collaboration

2016-01-01

Several searches for Higgs bosons decaying to b­quark pairs benefit from the increased Run II centre­of­mass energy by exploiting the large transvers­momentum (boosted) Higgs boson regime, where the two b­jets are merged into one large­radius jet. ATLAS uses a boosted H­>bb tagger algorithm to separate the Higgs signal from the background processes (QCD, W and Z bosons, top quarks). The tagger takes as input a large­R=1.0 jet calibrating the pseudorapidity, energy and mass scale. The tagger employs b­tagging, Higgs candidate mass, and substructure information. The performance of several operating points in Higgs boson signal and QCD and ttbar all­hadronic backgrounds are presented. Systematic uncertainties are evaluated so that this tagger can be used in analyses.

Application of Boosting Regression Trees to Preliminary Cost Estimation in Building Construction Projects

Directory of Open Access Journals (Sweden)

Yoonseok Shin

2015-01-01

Full Text Available Among the recent data mining techniques available, the boosting approach has attracted a great deal of attention because of its effective learning algorithm and strong boundaries in terms of its generalization performance. However, the boosting approach has yet to be used in regression problems within the construction domain, including cost estimations, but has been actively utilized in other domains. Therefore, a boosting regression tree (BRT is applied to cost estimations at the early stage of a construction project to examine the applicability of the boosting approach to a regression problem within the construction domain. To evaluate the performance of the BRT model, its performance was compared with that of a neural network (NN model, which has been proven to have a high performance in cost estimation domains. The BRT model has shown results similar to those of NN model using 234 actual cost datasets of a building construction project. In addition, the BRT model can provide additional information such as the importance plot and structure model, which can support estimators in comprehending the decision making process. Consequently, the boosting approach has potential applicability in preliminary cost estimations in a building construction project.

Traditional grains boost nutrition in rural India

International Development Research Centre (IDRC) Digital Library (Canada)

India, particularly among vulnerable women and children. The research ... This approach will improve the quality of life for farmers, and is part of a long-term solution to rural poverty in India. ... Traditional grains boost nutrition in rural India.

Deodorant effects of a sage extract stick: Antibacterial activity and sensory evaluation of axillary deodorancy

Directory of Open Access Journals (Sweden)

Mohammad Ali Shahtalebi

2013-01-01

Full Text Available Background: Deodorant products prevent the growth and activity of the degrading apocrine gland bacteria living in the armpit. Common antibacterial agents in the market like triclosan and aluminum salts, in spite of their suitable antibacterial effects, increase the risk of Alzheimer′s disease, breast and prostate cancers or induce contact dermatitis. Therefore, plant extracts possessing antibacterial effects are of interest. The aim of the present study was to verify the in vitro antimicrobial effects of different sage extracts against two major bacteria responsible for axillary odor, and to evaluate the deodorant effect of a silicon-based stick containing sage extracts in different densities in humans. Materials and Methods: Different fractions of methanolic extract of Salvia officinalis (sage were evaluated on a culture of armpit skin surface of volunteers through agar microdilution antimicrobial assay. Then, randomized, double-blind placebo-controlled clinical trial with the best antibacterial fraction was conducted on 45 female healthy volunteers. Participants were treated with a single dose in four groups, each containing 15 individuals: Group 1 (200 μg/mL, 2 (400 μg/mL, 3 (600 μg/mL of dichloromethane sage extract, and placebo (without extract. A standard sensory evaluation method for the evaluation of deodorant efficacy was used before, and two hours, four hours, and eight hours after single application of a deodorant or placebo (ASTM method E 1207-87 Standard Practice for the Sensory Evaluation of Axillary Deodorancy. Results: The data were analyzed with two factors relating to densities and time. In 45 participants with a mean [± standard deviation (SD] age of 61.5±11.8 years, statistically significant within-group differences were observed before and two, four, and eight hours after deodorant treatment for groups 1, 2, and 3. Groups 1, 2, and 3 had a significantly smaller odor score than placebo after two, four, and eight hours

Radiotherapy Boost Following Conservative Surgery for Locally Advanced Breast Cancer

International Nuclear Information System (INIS)

Cendales, Ricardo; Ospino, Rosalba; Torres, Felipe; Cotes, Martha

2009-01-01

Nearly half of breast cancer patients in developing countries present with a locally advanced cancer. Treatment is centered on a multimodal approach based on chemotherapy, surgery and radiotherapy. The growing use of neoadjuvant chemotherapy has led to a more conservative surgical approach; nonetheless, it is not yet considered as a standard. There are no clear recommendations on the use of a radiotherapy boost in such situation. A Medline search was developed. Most articles are retrospective series. Survival free of locoregional relapse in patients treated with neoadjuvant chemotherapy, breast conserving surgery and radiotherapy is good. All articles described a boost administered to nearly all patients without regard to their prognostic factors, given that a locally advanced tumor is already considered as a poor prognostic factor. Even tough the poor level of evidence, a recommendation can be made: radiotherapy boost should be administered to all patients with locally advanced breast cancer treated with neoadjuvant chemotherapy and breast conserving surgery.

Accumulation of FDG in axillary sweat glands in hyperhidrosis: a pitfall in whole-body PET examination

International Nuclear Information System (INIS)

Jacobsson, H.; Celsing, F.; Ingvar, M.; Stone-Elander, S.; Larsson, S.A.

1998-01-01

A diabetic male with severe autonomic neuropathy and recently discovered Hodgkin's disease demonstrated bilateral uptake of [2- 18 F]-2-fluoro-2-deoxy-d-glucose (FDG) in the axillary sweat glands during profuse sweating caused by hypoglycaemia at positron emission tomography examination. It is not yet clear whether the sweating interfered with the distribution of the radiopharmaceutical. Regardless of the cause or mechanism for the uptake, the finding is clinically relevant. A bilateral symmetrical accumulation of FDG in the axillae of a tumour patient does not necessarily indicate malignant involvement of the lymph nodes. (orig.)

Wide Temperature Range DC-DC Boost Converters for Command/Control/Drive Electronics, Phase I

Data.gov (United States)

National Aeronautics and Space Administration — We shall develop wide temperature range DC-DC boost converters that can be fabricated using commercial CMOS foundries. The boost converters will increase the low...

Expression of LRP and MDR1 in locally advanced breast cancer predicts axillary node invasion at the time of rescue mastectomy after induction chemotherapy

International Nuclear Information System (INIS)

Schneider, José; Gonzalez-Roces, Severino; Pollán, Marina; Lucas, Raul; Tejerina, Armando; Martin, Miguel; Alba, Alfonso

2001-01-01

Axillary node status after induction chemotherapy for locally advanced breast cancer has been shown on multivariate analysis to be an independent predictor of relapse. However, it has been postulated that responders to induction chemotherapy with a clinically negative axilla could be spared the burden of lymphadenectomy, because most of them will not show histological nodal invasion. P-glycoprotein expression in the rescue mastectomy specimen has finally been identified as a significant predictor of patient survival. We studied the expression of the genes encoding multidrug resistance associated protein (MDR1) and lung cancer associated resistance protein (LRP) in formalin-fixed, paraffin-embedded tumor samples from 52 patients treated for locally advanced breast cancer by means of induction chemotherapy followed by rescue mastectomy. P-glycoprotein expression was assessed by means of immunohistochemistry before treatment in 23 cases, and by means of reverse-transcriptase-mediated polymerase chain reaction (RT-PCR) after treatment in 46 (6 failed). LRP expression was detected by means of immunohistochemistry, with the LRP-56 monoclonal antibody, in 31 cases before treatment. Immunohistochemistry for detecting the expression of c-erb-B2, p53, Ki67, estrogen receptor and progesterone receptor are routinely performed in our laboratory in every case, and the results obtained were included in the study. All patients had received between two and six cycles of standard 5-fluorouracil, doxorubicin and cyclophosphamide (FAC) chemotherapy, with two exceptions [one patient received four cycles of a docetaxel-adriamycin combination, and the other four cycles of standard cyclophosphamide-methotrexate-5-fluorouracil (CMF) polychemotherapy]. Response was assessed in accordance with the Response Evaluation Criteria In Solid Tumors (RECIST). By these, 2 patients achieved a complete clinical response, 37 a partial response, and the remaining 13 showed stable disease. This makes a

Niacin to Boost Your HDL "Good" Cholesterol

Science.gov (United States)

Niacin can boost 'good' cholesterol Niacin is a B vitamin that may raise your HDL ("good") cholesterol. But side effects might outweigh benefits for most ... been used to increase high-density lipoprotein (HDL) cholesterol — the "good" cholesterol that helps remove low-density ...

Directional atherectomy of a heavy calcified axillary artery stenosis inducing critical hand ischemia.

Science.gov (United States)

Anzuini, Angelo; Palloshi, Altin; Aprigliano, Gianfranco; Ielasi, Alfonso

2013-07-01

The presence of a severe calcified peripheral artery lesion is responsible for a poor response to balloon dilation, due to significant acute vessel recoil and frequent flow-limiting dissections requiring stent implantation. This possibility could be associated with very high compression and/or fracture rates particularly in cases of lesion located at the mobile joints. In this setting directional atherectomy offers the theoretical advantages of eliminating stretch injury on arterial walls and reducing the restenosis rate by direct plaque excision. In this report, we present a case of critical hand ischemia due to a heavily calcified axillary artery lesion managed by directional atherectomy and balloon angioplasty followed by immediate angiographic success and sustained clinical benefit up to 3 years of follow-up.

Closed-loop waveform control of boost inverter

DEFF Research Database (Denmark)

Zhu, Guo Rong; Xiao, Cheng Yuan; Wang, Haoran

2016-01-01

The input current of single-phase inverter typically has an AC ripple component at twice the output frequency, which causes a reduction in both the operating lifetime of its DC source and the efficiency of the system. In this paper, the closed-loop performance of a proposed waveform control method...... to eliminate such a ripple current in boost inverter is investigated. The small-signal stability and the dynamic characteristic of the inverter system for input voltage or wide range load variations under the closed-loop waveform control method are studied. It is validated that with the closedloop waveform...... control, not only was stability achieved, the reference voltage of the boost inverter capacitors can be instantaneously adjusted to match the new load, thereby achieving improved ripple mitigation for a wide load range. Furthermore, with the control and feedback mechanism, there is minimal level of ripple...

Protecting livelihoods, boosting food security in Kenya | IDRC ...

International Development Research Centre (IDRC) Digital Library (Canada)

2015-05-21

May 21, 2015 ... Protecting livelihoods, boosting food security in Kenya ... livestock fodder, with important outcomes for household food security. ... and all counties have since committed funding toward scaling up successful technologies.

Detection of lymphovascular invasion in early breast cancer by D2-40 (podoplanin): a clinically useful predictor for axillary lymph node metastases.

NARCIS (Netherlands)

Braun, M.; Flucke, U.E.; Debald, M.; Walgenbach-Bruenagel, G.; Walgenbach, K.J.; Holler, T.; Polcher, M.; Wolfgarten, M.; Sauerwald, A.; Keyver-Paik, M.; Kuhr, M.; Buttner, R.; Kuhn, W.

2008-01-01

PURPOSE: The aim of this study was to investigate the use of D2-40 for the detection of lymphovascular invasion (LVI) in node positive and negative early breast cancer. LVI is associated with axillary lymph node metastases (ALNM) and a long-term prognostic factor. A precise identification of LVI

The Near Side : Regional Lunar Gravity Field Determination

NARCIS (Netherlands)

Goossens, S.

2005-01-01

In the past ten years the Moon has come fully back into focus, resulting in missions such as Clementine and Lunar Prospector. Data from these missions resulted in a boost in lunar gravity field modelling. Until this date, the lunar gravity field has mainly been expressed in a global representation,

Boosted PWM open loop control of hydraulic proportional valves

International Nuclear Information System (INIS)

Amirante, R.; Innone, A.; Catalano, L.A.

2008-01-01

This paper presents an innovative open loop control technique for direct single stage hydraulic proportional valves whose response rate is significantly higher than that obtained by standard open loop control techniques, even comparable to more costly commercial closed loop systems. Different from standard open loop techniques, which provide the coil with a constant current proportional to the target position, the control strategy proposed in this paper employs the peak and hold (P and H) technique, widely used in Diesel engine modern supply systems, to boost the duty cycle value of the pulse width modulation (PWM) signal for a short time, namely during the spool displacement, while maintaining a lower duty cycle for holding the spool in the required opening position. The developed 'boosted PWM' technique only requires a low cost microcontroller, such as a peripheral interface controller (PIC) equipped with a metal oxide semiconductor (MOS) power driver. The PWM parameters are calibrated as a function of the spool displacement so as to maximize the response rate without introducing overshoots: the collected data are stored in the PIC. Different valve opening procedures with step response have been compared to demonstrate the merits of the proposed boosted PWM technique. No overshoots have been registered. Moreover, the proposed method is characterized by a significantly higher response rate with respect to a standard open loop control, which approximately has the same cost. Similar experimental tests show that the proposed boosted PWM technique has a response rate even higher than that provided by the more costly commercial closed loop system mounted on the valve, and it produces no overshoots

Boosted PWM open loop control of hydraulic proportional valves

Energy Technology Data Exchange (ETDEWEB)

Amirante, R.; Catalano, L.A. [Dipartimento di Ingegneria Meccanica e Gestionale, Politecnico di Bari, Via Re David 200, 70125 Bari (Italy); Innone, A. [Universita degli Studi di Foggia, via Napoli, 25 Foggia (Italy)

2008-08-15

This paper presents an innovative open loop control technique for direct single stage hydraulic proportional valves whose response rate is significantly higher than that obtained by standard open loop control techniques, even comparable to more costly commercial closed loop systems. Different from standard open loop techniques, which provide the coil with a constant current proportional to the target position, the control strategy proposed in this paper employs the peak and hold (P and H) technique, widely used in Diesel engine modern supply systems, to boost the duty cycle value of the pulse width modulation (PWM) signal for a short time, namely during the spool displacement, while maintaining a lower duty cycle for holding the spool in the required opening position. The developed 'boosted PWM' technique only requires a low cost microcontroller, such as a peripheral interface controller (PIC) equipped with a metal oxide semiconductor (MOS) power driver. The PWM parameters are calibrated as a function of the spool displacement so as to maximize the response rate without introducing overshoots: the collected data are stored in the PIC. Different valve opening procedures with step response have been compared to demonstrate the merits of the proposed boosted PWM technique. No overshoots have been registered. Moreover, the proposed method is characterized by a significantly higher response rate with respect to a standard open loop control, which approximately has the same cost. Similar experimental tests show that the proposed boosted PWM technique has a response rate even higher than that provided by the more costly commercial closed loop system mounted on the valve, and it produces no overshoots. (author)

Experimental Research in Boost Driver with EDLCs

Science.gov (United States)

Matsumoto, Hirokazu

The supply used in servo systems tends to have a high voltage in order to reduce loss and improve the response of motor drives. We propose a new boost motor driver that comprises EDLCs. The proposed driver has a simple structure, wherein the EDLCs are connected in series to the supply, and comprises a charge circuit to charge the EDLCs. The proposed driver has three advantages over conventional boost drivers. The first advantage is that the driver can easily attain the stable boost voltage. The second advantage is that the driver can reduce input power peaks. In a servo system, the input power peaks become greater than the rated power in order to accelerate the motor rapidly. This implies that the equipments that supply power to servo systems must have sufficient power capacity to satisfy the power peaks. The proposed driver can suppress the increase of the power capacity of supply facilities. The third advantage is that the driver can store almost all of the regenerative energy. Conventional drivers have a braking resistor to suppress the increase in the DC link voltage. This causes a considerable reduction in the efficiency. The proposed driver is more efficient than conventional drivers. In this study, the experimental results confirmed the effectiveness of the proposed driver and showed that the drive performance of the proposed driver is the same as that of a conventional driver. Furthermore, it was confirmed that the results of the simulation of a model of the EDLC module, whose capacitance is dependent on the frequency, correspond well with the experimental results.

Closed Loop Fuzzy Logic Controlled PV Based Cascaded Boost Five-Level Inverter System

Science.gov (United States)

Revana, Guruswamy; Kota, Venkata Reddy

2018-04-01

Recent developments in intelligent control methods and power electronics have produced PV based DC to AC converters related to AC drives. Cascaded boost converter and inverter find their way in interconnecting PV and Induction Motor. This paper deals with digital simulation and implementation of closed loop controlled five-level inverter based Photo-Voltaic (PV) system. The objective of this work is to reduce the harmonics using Multi Level Inverter based system. The DC output from the PV panel is boosted using cascaded-boost-converters. The DC output of these cascaded boost converters is applied to the bridges of the cascaded inverter. The AC output voltage is obtained by the series cascading of the output voltage of the two inverters. The investigations are done with Induction motor load. Cascaded boost-converter is proposed in the present work to produce the required DC Voltage at the input of the bridge inverter. A simple FLC is applied to CBFLIIM system. The FLC is proposed to reduce the steady state error. The simulation results are compared with the hardware results. The results of the comparison are made to show the improvement in dynamic response in terms of settling time and steady state error. Design procedure and control strategy are presented in detail.

Design and Testing of Boost Type DC/DC Converter for DC Motor Control Applications

OpenAIRE

Samman, Faizal Arya; Akil, Yusri Syam; Noor, Nirwan A.

2017-01-01

in The Proceeding of The 2nd International Symposium on Smart Material and Mechatronics 2015 This paper presents the design and testing of a boost type DC/DC converter circuit, which can be used for DC motor control applications. The Boost converter is designed using DC chopper and DC chopper cascade configurations. The experimental setup was made by connecting the boost converter circuit with four types of DC motor, i.e. self-excited DC motor shunt, series, compound and separately exci...

Interpreting the CMB aberration and Doppler measurements: boost or intrinsic dipole?

International Nuclear Information System (INIS)

Roldan, Omar; Quartin, Miguel; Notari, Alessio

2016-01-01

The aberration and Doppler coupling effects of the Cosmic Microwave Background (CMB) were recently measured by the Planck satellite. The most straightforward interpretation leads to a direct detection of our peculiar velocity β, consistent with the measurement of the well-known dipole. In this paper we discuss the assumptions behind such interpretation. We show that Doppler-like couplings appear from two effects: our peculiar velocity and a second order large-scale effect due to the dipolar part of the gravitational potential. We find that the two effects are exactly degenerate but only if we assume second-order initial conditions from single-field Inflation. Thus, detecting a discrepancy in the value of β from the dipole and the Doppler couplings implies the presence of a primordial non-Gaussianity. We also show that aberration-like signals likewise arise from two independent effects: our peculiar velocity and lensing due to a first order large-scale dipolar gravitational potential, independently on Gaussianity of the initial conditions. In general such effects are not degenerate and so a discrepancy between the measured β from the dipole and aberration could be accounted for by a dipolar gravitational potential. Only through a fine-tuning of the radial profile of the potential it is possible to have a complete degeneracy with a boost effect. Finally we discuss that we also expect other signatures due to integrated second order terms, which may be further used to disentangle this scenario from a simple boost.

Interpreting the CMB aberration and Doppler measurements: boost or intrinsic dipole?

Energy Technology Data Exchange (ETDEWEB)

Roldan, Omar; Quartin, Miguel [Instituto de Física, Universidade Federal do Rio de Janeiro, 21941-972, Rio de Janeiro, RJ (Brazil); Notari, Alessio, E-mail: oaroldan@if.ufrj.br, E-mail: notari@ffn.ub.es, E-mail: mquartin@if.ufrj.br [Departament de Física Fondamental i Institut de Ciéncies del Cosmos, Universitat de Barcelona, Martí i Franqués 1, E-08028 Barcelona (Spain)

2016-06-01

The aberration and Doppler coupling effects of the Cosmic Microwave Background (CMB) were recently measured by the Planck satellite. The most straightforward interpretation leads to a direct detection of our peculiar velocity β, consistent with the measurement of the well-known dipole. In this paper we discuss the assumptions behind such interpretation. We show that Doppler-like couplings appear from two effects: our peculiar velocity and a second order large-scale effect due to the dipolar part of the gravitational potential. We find that the two effects are exactly degenerate but only if we assume second-order initial conditions from single-field Inflation. Thus, detecting a discrepancy in the value of β from the dipole and the Doppler couplings implies the presence of a primordial non-Gaussianity. We also show that aberration-like signals likewise arise from two independent effects: our peculiar velocity and lensing due to a first order large-scale dipolar gravitational potential, independently on Gaussianity of the initial conditions. In general such effects are not degenerate and so a discrepancy between the measured β from the dipole and aberration could be accounted for by a dipolar gravitational potential. Only through a fine-tuning of the radial profile of the potential it is possible to have a complete degeneracy with a boost effect. Finally we discuss that we also expect other signatures due to integrated second order terms, which may be further used to disentangle this scenario from a simple boost.

GeoBoost: accelerating research involving the geospatial metadata of virus GenBank records.

Science.gov (United States)

Tahsin, Tasnia; Weissenbacher, Davy; O'Connor, Karen; Magge, Arjun; Scotch, Matthew; Gonzalez-Hernandez, Graciela

2018-05-01

GeoBoost is a command-line software package developed to address sparse or incomplete metadata in GenBank sequence records that relate to the location of the infected host (LOIH) of viruses. Given a set of GenBank accession numbers corresponding to virus GenBank records, GeoBoost extracts, integrates and normalizes geographic information reflecting the LOIH of the viruses using integrated information from GenBank metadata and related full-text publications. In addition, to facilitate probabilistic geospatial modeling, GeoBoost assigns probability scores for each possible LOIH. Binaries and resources required for running GeoBoost are packed into a single zipped file and freely available for download at https://tinyurl.com/geoboost. A video tutorial is included to help users quickly and easily install and run the software. The software is implemented in Java 1.8, and supported on MS Windows and Linux platforms. gragon@upenn.edu. Supplementary data are available at Bioinformatics online.

Adaptive Replanning to Account for Lumpectomy Cavity Change in Sequential Boost After Whole-Breast Irradiation

Energy Technology Data Exchange (ETDEWEB)

Chen, Xiaojian [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Qiao, Qiao [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Department of Radiotherapy, First Hospital of China Medical University, Shenyang (China); DeVries, Anthony [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Li, Wenhui [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Department of Radiotherapy, Yunnan Tumor Hospital, Kunming (China); Currey, Adam; Kelly, Tracy; Bergom, Carmen; Wilson, J. Frank [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Li, X. Allen, E-mail: ali@mcw.edu [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States)

2014-12-01

Purpose: To evaluate the efficiency of standard image-guided radiation therapy (IGRT) to account for lumpectomy cavity (LC) variation during whole-breast irradiation (WBI) and propose an adaptive strategy to improve dosimetry if IGRT fails to address the interfraction LC variations. Methods and Materials: Daily diagnostic-quality CT data acquired during IGRT in the boost stage using an in-room CT for 19 breast cancer patients treated with sequential boost after WBI in the prone position were retrospectively analyzed. Contours of the LC, treated breast, ipsilateral lung, and heart were generated by populating contours from planning CTs to boost fraction CTs using an auto-segmentation tool with manual editing. Three plans were generated on each fraction CT: (1) a repositioning plan by applying the original boost plan with the shift determined by IGRT; (2) an adaptive plan by modifying the original plan according to a fraction CT; and (3) a reoptimization plan by a full-scale optimization. Results: Significant variations were observed in LC. The change in LC volume at the first boost fraction ranged from a 70% decrease to a 50% increase of that on the planning CT. The adaptive and reoptimization plans were comparable. Compared with the repositioning plans, the adaptive plans led to an improvement in target coverage for an increased LC case (1 of 19, 7.5% increase in planning target volume evaluation volume V{sub 95%}), and breast tissue sparing for an LC decrease larger than 35% (3 of 19, 7.5% decrease in breast evaluation volume V{sub 50%}; P=.008). Conclusion: Significant changes in LC shape and volume at the time of boost that deviate from the original plan for WBI with sequential boost can be addressed by adaptive replanning at the first boost fraction.

Acute Truncal Lymphedema Secondary to Axillary Metastatic Melanoma Presenting Like Cellulitis

Directory of Open Access Journals (Sweden)

Shelley J. E. Hwang

2017-01-01

Full Text Available There are reported cases of diphencyprone used in treating cutaneous metastases of melanoma. Here, we report a patient with previous primary melanoma on his left back treated with surgical excision and lymphadenectomy, followed by radiotherapy for the recurrent tumor on the primary site. Despite radiotherapy and treatment with dabrafenib and trametinib, in-transit metastases have developed and topical diphencyprone was applied to these metastases. Six weeks later, the patient developed fever and a spreading erythematous tender indurated plaque covering the left side of the body including axillae, back, and flank, clinically suggestive of cellulitis. Systemic antibiotic therapy did not improve the condition and a biopsy showed sparse lymphocytic infiltrate. With the diagnosis of possible acute lymphedema, a CT scan was requested that showed significant axillary lymph node metastasis. The fever was considered secondary to dabrafenib and trametinib therapy. This case highlights that, in patients with lymphadenectomy, atypical forms of lymphedema on the body may appear. Truncal lymphedema is an infrequent event.

Boosted objects and jet substructure at the LHC. Report of BOOST2012, held at IFIC Valencia, 23rd-27th of July 2012

International Nuclear Information System (INIS)

Altheimer, A.; Thompson, E.N.; Arce, A.; Bjergaard, D.; Asquith, L.; Backus Mayes, J.; Hook, A.; Izaguirre, E.; Jankowiak, M.; Larkoski, A.; Nef, P.; Schwartzman, A.; Swiatlowski, M.; Wacker, J.; Kuutmann, E.B.; Berger, J.; Bryngemark, L.; Buckley, A.; Debenedetti, C.; Butterworth, J.; Campanelli, M.; Davison, A.; Cacciari, M.; Carli, T.; Roeck, A. de; Chala, M.; Chapleau, B.; Chen, C.; Chou, J.P.; Cornelissen, T.; Fleischmann, S.; Curtin, D.; Dasgupta, M.; Almeida Dias, F. de; De Cosa, A.; Doglioni, C.; Guescini, F.; Ellis, S.D.; Hornig, A.; Scholtz, J.; Fassi, F.; Hoz, S.G. de la; Kaci, M.; Oliver Garcia, E.; Rodrigo, G.; Salt, J.; Sanchez Martinez, V.; Villaplana, M.; Vos, M.; Ferrando, J.; Kar, D.; Nordstrom, K.; Freytsis, M.; Gonzalez Silva, M.L.; Han, Z.; Lopez Mateos, D.; Schwartz, M.D.; Juknevich, J.; Kasieczka, G.; Plehn, T.; Schaetzel, S.; Takeuchi, M.; Kogler, R.; Loch, P.; Marzani, S.; Spannowsky, M.; Masetti, L.; Mateu, V.; Stewart, I.; Thaler, J.; Miller, D.W.; Mishra, K.; Tran, N.V.; Penwell, J.; Pilot, J.; Rappoccio, S.; Rizzi, A.; Safonov, A.; Salam, G.P.; Schioppa, M.; Schmidt, A.; Segala, M.; Son, M.; Soyez, G.; Strom, D.; Vermilion, C.; Walsh, J.

2014-01-01

This report of the BOOST2012 workshop presents the results of four working groups that studied key aspects of jet substructure. We discuss the potential of first-principle QCD calculations to yield a precise description of the substructure of jets and study the accuracy of state-of-the-art Monte Carlo tools. Limitations of the experiments' ability to resolve substructure are evaluated, with a focus on the impact of additional (pile-up) proton proton collisions on jet substructure performance in future LHC operating scenarios. A final section summarizes the lessons learnt from jet substructure analyses in searches for new physics in the production of boosted top quarks. (orig.)

Boosted objects and jet substructure at the LHC. Report of BOOST2012, held at IFIC Valencia, 23rd-27th of July 2012

Energy Technology Data Exchange (ETDEWEB)

Altheimer, A.; Thompson, E.N. [Columbia University, Nevis Laboratory, Irvington, NY (United States); Arce, A.; Bjergaard, D. [Duke University, Durham, NC (United States); Asquith, L. [Argonne National Laboratory, Lemont, IL (United States); Backus Mayes, J.; Hook, A.; Izaguirre, E.; Jankowiak, M.; Larkoski, A.; Nef, P.; Schwartzman, A.; Swiatlowski, M.; Wacker, J. [SLAC National Accelerator Laboratory, Menlo Park, CA (United States); Kuutmann, E.B. [Deutsches Elektronen-Synchrotron, DESY, Zeuthen (Germany); Humboldt University, Berlin (Germany); Berger, J. [Cornell University, Ithaca, NY (United States); Bryngemark, L. [Lund University, Lund (Sweden); Buckley, A.; Debenedetti, C. [University of Edinburgh, Edinburgh (United Kingdom); Butterworth, J.; Campanelli, M.; Davison, A. [University College London, London (United Kingdom); Cacciari, M. [CERN, Geneva 23 (Switzerland); Carli, T.; Roeck, A. de [LPTHE, UPMC Univ. Paris 6 et CNRS UMR, Paris (France); Chala, M. [CAFPE and Univ. of Granada, Granada (Spain); Chapleau, B. [McGill University, Montreal, QC (Canada); Chen, C. [Iowa State University, Ames, IA (United States); Chou, J.P. [Rutgers University, Piscataway, NJ (United States); Cornelissen, T.; Fleischmann, S. [Bergische Universitaet Wuppertal, Wuppertal (Germany); Curtin, D. [YITP, Stony Brook University, Stony Brook, NY (United States); Dasgupta, M. [University of Manchester, Manchester (United Kingdom); Almeida Dias, F. de [UNESP-Universidade Estadual Paulista, Sao Paulo (Brazil); De Cosa, A. [INFN, Naples (Italy); University of Naples, Naples (Italy); Doglioni, C.; Guescini, F. [University of Geneva, Geneva 4 (Switzerland); Ellis, S.D.; Hornig, A.; Scholtz, J. [University of Washington, Seattle, WA (United States); Fassi, F.; Hoz, S.G. de la; Kaci, M.; Oliver Garcia, E.; Rodrigo, G.; Salt, J.; Sanchez Martinez, V.; Villaplana, M.; Vos, M. [Instituto de Fisica Corpuscular, IFIC/CSIC-UVEG, Valencia (Spain); Ferrando, J.; Kar, D.; Nordstrom, K. [University of Glasgow, Glasgow (United Kingdom); Freytsis, M. [University of California, Lawrence Berkeley National Laboratory, Berkeley, CA (United States); University of California, Berkeley, CA (United States); Gonzalez Silva, M.L. [Universidad de Buenos Aires, Buenos Aires (Argentina); Han, Z.; Lopez Mateos, D.; Schwartz, M.D. [Harvard University, Cambridge, MA (United States); Juknevich, J. [Weizmann Institute, Rehovot (Israel); Kasieczka, G.; Plehn, T.; Schaetzel, S.; Takeuchi, M. [Universitaet Heidelberg, Heidelberg (Germany); Kogler, R. [Universitaet Hamburg, Hamburg (Germany); Loch, P. [University of Arizona, Tucson, AZ (United States); Marzani, S.; Spannowsky, M. [IPPP, University of Durham, Durham (United Kingdom); Masetti, L. [Universitaet Mainz, Mainz (Germany); Mateu, V.; Stewart, I.; Thaler, J. [MIT, Cambridge, MA (United States); Miller, D.W. [University of Chicago, Chicago, IL (United States); Mishra, K.; Tran, N.V. [Fermi National Accelerator Laboratory, Batavia, IL (United States); Penwell, J. [Indiana University, Bloomington, IN (United States); Pilot, J. [University of California, Davis, CA (United States); Rappoccio, S. [Johns Hopkins University, Baltimore, MD (United States); University at Buffalo, State University of New York, Buffalo, NY (United States); Rizzi, A. [INFN, Pisa (Italy); University of Pisa, Pisa (Italy); Safonov, A. [Texas A and M University, College Station, TX (United States); Salam, G.P. [CERN, Geneva 23 (Switzerland); LPTHE, UPMC Univ. Paris 6 et CNRS UMR, Paris (France); Schioppa, M. [INFN, Rende (IT); University of Calabria, Rende (IT); Schmidt, A. [Universitaet Hamburg, Hamburg (DE); Universitaet Heidelberg, Heidelberg (DE); Segala, M. [Brown University, Richmond, RI (US); Son, M. [Yale University, New Haven, CT (US); Soyez, G. [CEA Saclay, Gif-sur-Yvette (FR); Strom, D. [University of Illinois, Chicago, IL (US); Vermilion, C. [University of California, Lawrence Berkeley National Laboratory, Berkeley, CA (US); Walsh, J. [University of California, Berkeley, CA (US)

2014-03-15

This report of the BOOST2012 workshop presents the results of four working groups that studied key aspects of jet substructure. We discuss the potential of first-principle QCD calculations to yield a precise description of the substructure of jets and study the accuracy of state-of-the-art Monte Carlo tools. Limitations of the experiments' ability to resolve substructure are evaluated, with a focus on the impact of additional (pile-up) proton proton collisions on jet substructure performance in future LHC operating scenarios. A final section summarizes the lessons learnt from jet substructure analyses in searches for new physics in the production of boosted top quarks. (orig.)

Protecting livelihoods, boosting food security in Kenya | IDRC ...

International Development Research Centre (IDRC) Digital Library (Canada)

2015-05-21

May 21, 2015 ... Protecting livelihoods, boosting food security in Kenya ... America, and the Caribbean with funds from the Government of Canada's fast-start financing. ... Water management and food security in vulnerable regions of China.

A nonaxial boost may reduce late complications of radiotherapy for prostate cancer

Energy Technology Data Exchange (ETDEWEB)

Ben-Josef, E; Mesina, C F; Choi, J; Forman, J D

1995-07-01

Purpose: The nonaxial external beam (NAEBT) prostate boost technique was designed to reduce late complications of radiotherapy for prostate cancer. It has been previously shown that with this beam arrangement, the volumes of bladder and rectum receiving high doses could be substantially reduced. This study was undertaken to find if these advantages in dose distribution would translate into clinically significant benefits. Materials and Methods: Follow-up was obtained on 106 prostate cancer patients who had been treated with 3D conformal radiotherapy. Late complications were scored using the RTOG scale. A standard four-field axial (STD) technique had been used to deliver 45 Gy to the prostate, seminal vesicles and periprostatic lymph-nodes. A subsequent 24 Gy boost had been delivered using a STD technique (58 patients) or a NAEBT technique (48 patients). In the latter, the opposing anterior and posterior pair of beams had been substituted for a right and left anterior infero-superior pair. Actuarial probabilities of developing late complications were calculated by the life-table method. The Mantel-Haenszel test was used to compare these probabilities between the two groups. Results: The groups were comparable in regard to age, race, pretreatment serum PSA, stage distribution and dose to prostate. With a median follow-up of 21 months, 18 patients have developed grade 1-2 gastrointestinal or genitourinary complications (14 in the STD group, 4 in the NAEBT group). There were no grade 3-4 complications. The actuarial 3-year complication probability was 58% and 11% in the STD and NAEBT groups, respectively. However, this difference was not statistically significant. Gastrointestinal and genitourinary complications were reduced from 12.1% to 6.2% and from 15.5% to 4.2%, respectively. Conclusion: The use of a nonaxial boost technique has resulted in fewer complications in patients treated with 3D conformal radiotherapy for localized prostate cancer. The greater reduction

Locoregional Recurrence After Sentinel Lymph Node Dissection With or Without Axillary Dissection in Patients With Sentinel Lymph Node Metastases: Long-term Follow-up From the American College of Surgeons Oncology Group (Alliance) ACOSOG Z0011 Randomized Trial.

Science.gov (United States)

Giuliano, Armando E; Ballman, Karla; McCall, Linda; Beitsch, Peter; Whitworth, Pat W; Blumencranz, Peter; Leitch, A Marilyn; Saha, Sukamal; Morrow, Monica; Hunt, Kelly K

2016-09-01

The early results of the American College of Surgeons Oncology Group (ACOSOG) Z0011 trial demonstrated no difference in locoregional recurrence for patients with positive sentinel lymph nodes (SLNs) randomized either to axillary lymph node dissection (ALND) or sentinel lymph node dissection (SLND) alone. We now report long-term locoregional recurrence results. ACOSOG Z0011 prospectively examined overall survival of patients with SLN metastases undergoing breast-conserving therapy randomized to undergo ALND after SLND or no further axillary specific treatment. Locoregional recurrence was prospectively evaluated and compared between the groups. Four hundred forty-six patients were randomized to SLND alone and 445 to SLND and ALND. Both groups were similar with respect to age, Bloom-Richardson score, Estrogen Receptor status, adjuvant systemic therapy, histology, and tumor size. Patients randomized to ALND had a median of 17 axillary nodes removed compared with a median of only 2 SLNs removed with SLND alone (P alone arm (P = 0.28). Ten-year cumulative locoregional recurrence was 6.2% with ALND and 5.3% with SLND alone (P = 0.36). Despite the potential for residual axillary disease after SLND, SLND without ALND offers excellent regional control for selected patients with early metastatic breast cancer treated with breast-conserving therapy and adjuvant systemic therapy.

The role of ultrasound and lymphoscintigraphy in the assessment of axillary lymph nodes in patients with breast cancer

Directory of Open Access Journals (Sweden)

Michał Nieciecki

2016-03-01

Full Text Available Breast cancer is the most common malignancy and the leading cause of death due to cancer in European women. Mammography screening programs aimed to increase the detection of early cancer stages were implemented in numerous European countries. Recent data show a decrease in mortality due to breast cancer in many countries, particularly among young women. At the same time, the number of sentinel node biopsy procedures and breast-conserving surgeries has increased. Intraoperative sentinel lymph node biopsy preceded by lymphoscintigraphy is used in breast cancer patients with no clinical signs of lymph node metastasis. Due to the limited sensitivity and specificity of physical examination in detecting metastatic lesions, developing an appropriate diagnostic algorithm for the preoperative assessment of axillary lymph nodes seems to be a challenge. The importance of ultrasound in patient qualification for sentinel lymph-node biopsy has been discussed in a number of works. Furthermore, different lymphoscintigraphy protocols have been compared in the literature. The usefulness of novel radiopharmaceuticals as well as the methods of image acquisition in sentinel lymph node diagnostics have also been assessed. The aim of this article is to present, basing on current guidelines, literature data as well as our own experience, the diagnostic possibilities of axillary lymph node ultrasound in patient qualification for an appropriate treatment as well as the role of lymphoscintigraphy in sentinel lymph node biopsy.

Fibroadenoma in Axillary Supernumerary Breast in a 17-Year-Old Girl: Case Report.

Science.gov (United States)

Surd, Adrian; Mironescu, Aurel; Gocan, Horatiu

2016-10-01

Supernumerary breast or polymastia is a well documented anomaly of the breast, and commonly presents along the embryonic milk line extending between the axilla and groin. However, cases of polymastia have been recorded in the face, vulva, and perineum. The clinical significance of these anomalies include their susceptibility to inflammatory and malignant changes, and their association with other congenital anomalies of the urinary and cardiovascular systems. In this article we report a case of fibroadenoma that developed in the supernumerary breast of the right axilla in a 17-year-old girl. It is uncommon to find such palpable masses in young patients. Clinical and sonographic examination of both breasts revealed no abnormalities and no lymph nodes were detected in the axillae or the neck. No associated urologic or cardiovascular abnormalities were found, and the histopathological examination of the excisional biopsy samples showed a well-defined, capsulated intracanalicular type of fibroadenoma similar to that of eutopic mammary tissue. In this report, we describe a rare case of fibroadenoma in an accessory breast in a young woman. There are a fewer than 40 reports in the world about this subject, of which differential diagnoses include: cancer in axillary supernumerary breast, hidradenitis, axillary lymphadenomegaly, lipomas, anexial cutaneous neoplasia, cysts, and phylloides tumor. The combination of clinical examination, ultrasound, and cytology leads to adequate treatment, especially surgical. The diagnosis could be confused because of findings from cytology. In this case, because of the clinical and sonographic findings and multiple differential diagnosis, only the histopathological study was used to confirm the diagnosis. Despite its high sensitivity, cytology has low specificity and could create false positive results. However, atypical lesions can be seen in fibroadenomas, especially in younger patients, pregnant patients, and in patients who use hormonal

Hybrid-mode interleaved boost converter design for fuel cell electric vehicles

International Nuclear Information System (INIS)

Wen, Huiqing; Su, Bin

2016-01-01

Highlights: • A high power interleaved boost converter is designed for a 150 kW high-power fuel cell electric vehicle application. • A hybrid-mode scheme is used: Mode I and mode II are used with each boost converter operating in continuous conduction mode and discontinuous conduction mode. • Boundary conditions for different modes are determined with respect to switching duty ratio and load conditions. • With the proposed scheme, the power density is improved by 44.2% and 34.3% in terms of the converter volume and weight. - Abstract: For Fuel Cell Electric Vehicles, DC-DC power converters are essential to provide energy storage buffers between fuel cell stacks and the traction system because fuel cells show characteristics of low-voltage high-current output and wide output voltage variation. This paper presents a hybrid-mode two-phase interleaved boost converter for fuel cell electric vehicle application in order to improve the power density, minimize the input current ripple, and enhance the system efficiency. Two operation modes are adopted in the practical design: mode I and mode II are used with each boost converter operating in continuous conduction mode and discontinuous conduction mode. The operation, design and control of the interleaved boost converter for different operating modes are discussed with their equivalent circuits. The boundary conditions are distinguished with respect to switching duty ratio and load conditions. Transitions between continuous conduction mode and discontinuous conduction mode are illustrated for the whole duty ratio range. The expressions for inductor current ripple, input current ripple and output voltage ripple are derived and verified by simulation and experimental tests. The efficiency and power density improvements are illustrated to verify the effectiveness of the proposed design scheme.

B-tagging in boosted h → b anti b decays

Energy Technology Data Exchange (ETDEWEB)

Jacobs, Ruth; Gaycken, Goetz; Hageboeck, Stephan; Kostyukhin, Vadim; Lenz, Tatjana; Schopf, Elisabeth; Toerne, Eckhard von; Wermes, Norbert [Physikalisches Institut, University of Bonn (Germany)

2015-07-01

The most likely decay channel of the standard model Higgs boson is the decay into a b- and an anti-b-quark. The properties of b-jets formed by the hadronization of b-quarks are essential input variables to all ATLAS h → b anti b analyses. In boosted topologies the performance of standard b-tagging algorithms is diminished due to the merging of close - by jets. The aim of the study presented is the optimization of a b-tagging algorithm for boosted h → b anti b decays using track jets with a smaller than standard cone radius. The study is based on simulated events containing boosted Higgs bosons from the decay of a new heavy gauge boson W{sup '} → Wh. A motivation for the use of track jets for b-tagging is the fact that the reconstructed jet axis for track jets more closely describes the b-hadron flight direction than for calorimeter jets. Using jets with a smaller cone radius allows to resolve topologies where larger radius jets are already merged.

SU-G-BRC-12: Isotoxic Dose Escalation for Advanced Lung Cancer: Comparison of Different Boosting Strategiesfor Patients with Recurrent Disease

Energy Technology Data Exchange (ETDEWEB)

Shusharina, N; Khan, F; Sharp, G; Choi, N [Massachusetts General Hospital, Boston, MA (United States)

2016-06-15

Purpose: To determine the dose level and timing of the boost in locally advanced lung cancer patients with confirmed tumor recurrence by comparing different boosting strategies by an impact of dose escalation in improvement of the therapeutic ratio. Methods: We selected eighteen patients with advanced NSCLC and confirmed recurrence. For each patient, a base IMRT plan to 60 Gy prescribed to PTV was created. Then we compared three dose escalation strategies: a uniform escalation to the original PTV, an escalation to a PET-defined target planned sequentially and concurrently. The PET-defined targets were delineated by biologically-weighed regions on a pre-treatment 18F-FDG PET. The maximal achievable dose, without violating the OAR constraints, was identified for each boosting method. The EUD for the target, spinal cord, combined lung, and esophagus was compared for each plan. Results: The average prescribed dose was 70.4±13.9 Gy for the uniform boost, 88.5±15.9 Gy for the sequential boost and 89.1±16.5 Gy for concurrent boost. The size of the boost planning volume was 12.8% (range: 1.4 – 27.9%) of the PTV. The most prescription-limiting dose constraints was the V70 of the esophagus. The EUD within the target increased by 10.6 Gy for the uniform boost, by 31.4 Gy for the sequential boost and by 38.2 for the concurrent boost. The EUD for OARs increased by the following amounts: spinal cord, 3.1 Gy for uniform boost, 2.8 Gy for sequential boost, 5.8 Gy for concurrent boost; combined lung, 1.6 Gy for uniform, 1.1 Gy for sequential, 2.8 Gy for concurrent; esophagus, 4.2 Gy for uniform, 1.3 Gy for sequential, 5.6 Gy for concurrent. Conclusion: Dose escalation to a biologically-weighed gross tumor volume defined on a pre-treatment 18F-FDG PET may provide improved therapeutic ratio without breaching predefined OAR constraints. Sequential boost provides better sparing of OARs as compared with concurrent boost.

SU-G-BRC-12: Isotoxic Dose Escalation for Advanced Lung Cancer: Comparison of Different Boosting Strategiesfor Patients with Recurrent Disease

International Nuclear Information System (INIS)

Shusharina, N; Khan, F; Sharp, G; Choi, N

2016-01-01

Purpose: To determine the dose level and timing of the boost in locally advanced lung cancer patients with confirmed tumor recurrence by comparing different boosting strategies by an impact of dose escalation in improvement of the therapeutic ratio. Methods: We selected eighteen patients with advanced NSCLC and confirmed recurrence. For each patient, a base IMRT plan to 60 Gy prescribed to PTV was created. Then we compared three dose escalation strategies: a uniform escalation to the original PTV, an escalation to a PET-defined target planned sequentially and concurrently. The PET-defined targets were delineated by biologically-weighed regions on a pre-treatment 18F-FDG PET. The maximal achievable dose, without violating the OAR constraints, was identified for each boosting method. The EUD for the target, spinal cord, combined lung, and esophagus was compared for each plan. Results: The average prescribed dose was 70.4±13.9 Gy for the uniform boost, 88.5±15.9 Gy for the sequential boost and 89.1±16.5 Gy for concurrent boost. The size of the boost planning volume was 12.8% (range: 1.4 – 27.9%) of the PTV. The most prescription-limiting dose constraints was the V70 of the esophagus. The EUD within the target increased by 10.6 Gy for the uniform boost, by 31.4 Gy for the sequential boost and by 38.2 for the concurrent boost. The EUD for OARs increased by the following amounts: spinal cord, 3.1 Gy for uniform boost, 2.8 Gy for sequential boost, 5.8 Gy for concurrent boost; combined lung, 1.6 Gy for uniform, 1.1 Gy for sequential, 2.8 Gy for concurrent; esophagus, 4.2 Gy for uniform, 1.3 Gy for sequential, 5.6 Gy for concurrent. Conclusion: Dose escalation to a biologically-weighed gross tumor volume defined on a pre-treatment 18F-FDG PET may provide improved therapeutic ratio without breaching predefined OAR constraints. Sequential boost provides better sparing of OARs as compared with concurrent boost.

Cooperatives boost opportunities for Moroccan women | IDRC ...

International Development Research Centre (IDRC) Digital Library (Canada)

2010-10-22

Oct 22, 2010 ... Cooperatives boost opportunities for Moroccan women. October 22 ... Substantial support for argan oil development continues with a €12 million grant. Half comes from the ... Research aims to identify and remove barriers faced by Africa's women entrepreneurs ... Solutions. Careers · Contact Us · Site map.

Heterologous Prime-Boost HIV-1 Vaccination Regimens in Pre-Clinical and Clinical Trials

Directory of Open Access Journals (Sweden)

Julia L. Hurwitz

2010-02-01

Full Text Available Currently, there are more than 30 million people infected with HIV-1 and thousands more are infected each day. Vaccination is the single most effective mechanism for prevention of viral disease, and after more than 25 years of research, one vaccine has shown somewhat encouraging results in an advanced clinical efficacy trial. A modified intent-to-treat analysis of trial results showed that infection was approximately 30% lower in the vaccine group compared to the placebo group. The vaccine was administered using a heterologous prime-boost regimen in which both target antigens and delivery vehicles were changed during the course of inoculations. Here we examine the complexity of heterologous prime-boost immunizations. We show that the use of different delivery vehicles in prime and boost inoculations can help to avert the inhibitory effects caused by vector-specific immune responses. We also show that the introduction of new antigens into boost inoculations can be advantageous, demonstrating that the effect of ‘original antigenic sin’ is not absolute. Pre-clinical and clinical studies are reviewed, including our own work with a three-vector vaccination regimen using recombinant DNA, virus (Sendai virus or vaccinia virus and protein. Promising preliminary results suggest that the heterologous prime-boost strategy may possibly provide a foundation for the future prevention of HIV-1 infections in humans.

Prospective trial of preoperative concomitant boost radiotherapy with continuous infusion 5-fluorouracil for locally advanced rectal cancer

International Nuclear Information System (INIS)

Janjan, Nora A.; Crane, Christopher N.; Feig, Barry W.; Cleary, Karen; Dubrow, Ronelle; Curley, Steven A.; Ellis, Lee M.; Vauthey, Jean-Nicolas; Lenzi, Renato; Lynch, Patrick; Wolff, Robert; Brown, Thomas; Pazdur, Richard; Abbruzzese, James; Hoff, Paulo M.; Allen, Pamela; Brown, Barry; Skibber, John

2000-01-01

Rationale: To evaluate the response to a concomitant boost given during standard chemoradiation for locally advanced rectal cancer. Methods and Materials: Concomitant boost radiotherapy was administered preoperatively to 45 patients with locally advanced rectal cancer in a prospective trial. Treatment consisted of 45 Gy to the pelvis with 18 mV photons at 1.8 Gy/fraction using a 3-field belly board technique with continuous infusion 5FU chemotherapy (300mg/m 2 ) 5 days per week. The boost was given during the last week of therapy with a 6-hour inter-fraction interval to the tumor plus a 2-3 cm margin. The boost dose equaled 7.5 Gy/5 fractions (1.5 Gy/fraction); a total dose of 52.5 Gy/5 weeks was given to the primary tumor. Pretreatment tumor stage, determined by endorectal ultrasound and CT scan, included 29 with T3N0 [64%], 11 T3N1, 1 T3Nx, 2 T4N0, 1 T4N3, and 1 with TxN1 disease. Mean distance from the anal verge was 5 cm (range 0-13 cm). Median age was 55 years (range 33-77 years). The population consisted of 34 males and 11 females. Median time of follow-up is 8 months (range 1-24 months). Results: Sphincter preservation (SP) has been accomplished in 33 of 42 (79%) patients resected to date. Three patients did not undergo resection because of the development of metastatic disease in the interim between the completion of chemoradiation (CTX/XRT) and preoperative evaluation. The surgical procedures included proctectomy and coloanal anastomosis (n = 16), low anterior resection (n = 13), transanal resection (n = 4). Tumor down-staging was pathologically confirmed in 36 of the 42 (86%) resected patients, and 13 (31%) achieved a pathologic CR. Among the 28 tumors (67%) located <6 cm from the anal verge, SP was accomplished in 21 cases (75%). Although perioperative morbidity was higher, toxicity rates during CTX/XRT were comparable to that seen with conventional fractionation. Compared to our contemporary experience with conventional CTX/XRT (45Gy; 1.8 Gy per

A new interleaved double-input three-level boost converter

DEFF Research Database (Denmark)

Chen, Jianfei; Hou, Shiying; Sun, Tao

2016-01-01

This paper proposes a new interleaved double-input three-level Boost (DITLB) converter, which is composed of two boost converters indirectly in series. Thus, a high voltage gain, together with a low component stress and a small input current ripple due to the interleaved control scheme, is achieved....... The operating principle of the DITLB converter under the individual supplying power (ISP) and simultaneous supplying power (SSP) mode is analyzed. In addition, closed-loop control strategies composed of a voltage-current loop and a voltage-balance loop, have been researched to make the converter operate...... steadily and to alleviate the neutral-point imbalance issue. Experimental results verify correctness and feasibility of the proposed topology and control strategies....

The use of stereotactic radiosurgical boost in the treatment of medulloblastomas

International Nuclear Information System (INIS)

Woo, Charles; Stea, Baldassarre; Lulu, Bruce; Hamilton, Allan; Cassady, J. Robert

1997-01-01

Purpose: Starting in 1992, we began using a stereotactic radiosurgical (SRS) boost for the treatment of medulloblastomas. Four patients ranging in age from 7 to 42 years old have since been treated and are the subject of this retrospective study. Methods and Materials: All patients were initially treated with a maximally debulking surgery and external beam radiotherapy, which were then followed by a stereotactic radiosurgical boost using a modified 6 MeV linear accelerator. Radiosurgical boost doses ranged from 4.50 to 10.0 Gy. Target volumes ranged from 1.1 to 8.1 cc. The procedure was well tolerated with minimal acute toxicities. Results: All four patients are alive without evidence of recurrence (at 8 to 35 months). Acute nausea and vomiting was elicited during the radiosurgical procedure in the first patient treated. We have since begun premedicating patients with antiemetics or treating under general anesthesia. Late complications consisted of panhypopituitarism in one patient, which was thought to be attributable to the previous course of whole-brain radiotherapy. We have not observed any incidence of radionecrosis in this small cohort of patients. Conclusions: Our preliminary results with the use of radiosurgery for medulloblastomas are optimistic, and we would like to suggest the inclusion of a radiosurgery boost in future clinical trials for treatment of this disease

Concurrent Boost with Adjuvant Breast Hypofractionated Radiotherapy and Toxicity Assessment

Directory of Open Access Journals (Sweden)

Mona M. Sayed

2015-01-01

Full Text Available Background: The use of shorter radiotherapy schedules has an economic and logistic advantage for radiotherapy departments, as well as a high degree of patient convenience. The aim of this study is to assess the acute and short-term late toxicities of a hypofractionated radiotherapy schedule with a concomitant boost. Methods: We enrolled 57 eligible patients as group A. These patients received 42.5 Gy in 16 fractions of 2.66 Gy each to the whole breast over 3.2 weeks. A concomitant electron boost of 12 Gy in 16 fractions was also administered which gave an additional 0.75 Gy daily to the lumpectomy area for a total radiation dose of 54.5 Gy. Toxicity was recorded at three weeks and at three months for this group as well as for a control group (group B. The control group comprised 76 eligible patients treated conventionally with 50 Gy to the whole breast over five weeks followed by a sequential electron boost of 12 Gy in 2 Gy per fraction. Results: There were no statistically significant differences observed in the incidence of acute skin toxicity, breast pain, and edema recorded at three weeks or pigmentation and fibrosis recorded at three months between the two groups (P0.05. Conclusion: The results of this study suggest there are no increased acute and shortterm late toxicities affiliated with the hypofractionated schedule plus a concomitant boost as prescribed compared to the conventional fractionation of adjuvant breast radiotherapy. Large randomized trials and long-term follow-up are needed to confirm these favorable findings.

Boosting youth employment in agri-business | IDRC - International ...